A Comprehensive Guide for Trauma-Informed Work with Children and Young People
Working with children and young people who have experienced trauma can be both deeply meaningful and incredibly complex. Their behaviours often communicate what they struggle to articulate or don’t yet have words for; e.g., distress, unmet needs, and survival strategies developed in unsafe environments. In this context, a structured and compassionate approach to understanding these young people is not just helpful – it is essential.
One of the most widely used tools in trauma-informed psychological work is the 5 Ps formulation, also known as the 5 P formulation model. This approach offers a holistic, non-pathologising way to make sense of a child or young person’s experiences, behaviours, and strengths; all within the context of their unique life story.
What Is the 5 P Formulation?
The 5 Ps of psychological formulation is a framework used to collaboratively build a shared understanding of a young person’s current difficulties. The model explores five key areas:
- Presenting Needs, Difficulties or Concerns
- Predisposing Factors
- Precipitating Factors
- Perpetuating Factors
- Protective Factors
This model helps those around the child – including carers, educators, and practitioners – understand not just what is going on, but why. It’s especially valuable in trauma-informed care because it emphasises understanding the roots of behaviour; recognising that many behaviours are adaptive responses to past experiences.
By exploring what has shaped a child or young person’s responses, rather than focusing solely on managing outward behaviours, we can provide support that is compassionate, meaningful, and more likely to promote long-term healing and relational safety.
Breaking Down the 5 Ps
1. Presenting Problem(s), Needs, Difficulties or Concerns
This refers to the current concerns or difficulties that have led a child or young person to be referred for support. This might include behaviours, emotional responses, or relationship challenges that are causing distress or disruption in daily life (both for the young person themselves and/or those around them).
In trauma-informed practice, the presenting problem is not viewed as something “wrong” with the child, but rather as a form of communication; a way of expressing unmet needs, emotional pain, or the impact of past experiences.
Recognising and naming the presenting problem is the first step toward understanding what the child might need in order to feel safe, supported, and connected.
2. Predisposing Factors
These are the earlier life experiences or background circumstances that made the young person more vulnerable to developing current challenges. These might include experiences of neglect, disrupted attachment, exposure to violence, or loss. Understanding these helps us see behaviour in the context of survival, rather than defiance.
3. Precipitating Factors
These are recent events or changes that may have triggered or intensified the current difficulties. For a young person, this might be a change in caregiver, an anniversary of a significant event, or an experience that reminds them of a past trauma. Triggers can be internal or external, and can re-activate feelings of fear, loss, or shame.
4. Perpetuating Factors
These are the ongoing patterns in the environment or within the young person themselves that keep the cycle going. These might include responses from adults that unintentionally reinforce distress or increase feelings of shame (such as punitive approaches), internalised beliefs like “I’m not safe” or “I’m unlovable,” or ongoing instability.
5. Protective Factors
This final area identifies what is going well, i.e., the young person’s strengths, coping strategies, supportive relationships, and other positive influences in their life. Trauma-informed work places a strong emphasis on these strengths to help young people rebuild trust, safety, and a sense of hope.
How Is the 5 P Formulation Used in Practice?
Carers and professionals working in education, social care, residential settings, supported accommodation or mental health services can all benefit from using the 5 P formulation as a shared thinking tool. It can be developed in multidisciplinary meetings, used to inform care or support plans, or introduced in supervision as a way of making sense of complex presentations.
A trauma-informed approach to using the 5 Ps includes:
- Listening without judgement to the young person’s story, even when it’s told through behaviour.
- Collaborating with caregivers to build a compassionate understanding of what the child needs.
- Looking for meaning beneath the behaviour, not just managing it at the surface.
- Using the formulation to guide how adults respond to the child with consistency, curiosity, and care.
This approach isn’t static. As relationships develop and the young person’s needs shift, the formulation can be revisited and updated to reflect new insights and evolving support needs.
Why Use the 5 P Model in Trauma-Informed Care?
The 5 Ps of psychological formulation supports a whole-child approach. Instead of asking “What’s wrong with them?” we begin to ask “What happened to them?” and “What do they need now?”
Benefits of using the 5 P model in work with children and young people include:
- Fostering understanding among all adults involved, reducing blame and frustration.
- Helping carers and professionals respond more effectively, with greater empathy and consistency.
- Identifying underlying needs, rather than focusing only on challenging behaviours.
- Highlighting resilience and existing strengths, which can be built upon in everyday life.
- Encouraging collaborative care, ensuring all adults around the child are aligned in their approach.
Trauma-Informed Formulation with Meadows
The 5 Ps of psychological formulation offer a structured yet compassionate way to understand children and young people who have experienced trauma. It encourages us to move beyond the surface, to see behaviour as communication, and to respond in ways that foster safety, trust, and healing.
At Meadows Psychology Service, we are committed to supporting carers and professionals in applying trauma-informed practices and models like the 5 P formulation. Whether you’re a teacher, social worker, foster carer, or support worker, this model can help you build more attuned, thoughtful responses to the young people in your care.
Need support developing a trauma-informed formulation for a child or young person you’re working with? Get in touch with Meadows Psychology Service. We are here to help.
