Research conducted over the past few decades has led to a greater awareness of the prevalence of trauma in society, and a deeper understanding of the profound and long-term effects that trauma can have on individuals, families and communities.
A key area of interest has been the growing body of evidence which highlights how, when systems are not adequately informed, those affected by trauma can often experience difficulties accessing and engaging with services and may even be retraumatised by the very organisations that are intended to care for and support them.
In order to be accessible and to avoid re-traumatisation, services such as health, education, children’s social care, and criminal justice organisations all have a responsibility to ensure that their policies and practices are grounded in an understanding of how trauma exposure impacts an individual’s psychological, emotional, social, neurological and biological development. This is known as trauma-informed practice.
Jump Straight In
- Understanding Trauma Informed Practice
- Key Principles of Trauma Informed Practice
- Benefits of Trauma Informed Practice
- How to Implement a Trauma Informed Practice
Understanding Trauma Informed Practice
Despite the ever-growing knowledge and awareness of trauma and its impact, practices which blame, shame or belittle service users are still common practice in many health and justice settings across the UK. Individuals are often subjected to physical restraint, restriction of movement, forced treatment, and the use of language and behaviours which inadvertently re-traumatise.
Trauma-informed practice provides a framework for organisational change that promotes environments of healing and recovery, rather than practices which may inadvertently re-traumatise.
In the process of becoming trauma-informed, services must integrate knowledge and awareness of trauma into all aspects of their functioning, to provide environments which emphasise emotional, psychological and physical safety, and which avoid further harm and the dangers of vicarious trauma for staff.
Being trauma-informed requires us to understand people, their behaviour, and their strengths and difficulties within the context of their personal experiences. It challenges us to shift from focusing on “what is wrong with you?” or “why are you behaving in that way?” to “what has happened to you”, “how has this affected you?” and, importantly, “what do you need?”. This shift in perspective reduces blame and shame on the individual and improves the accessibility and quality of services by empowering and supporting individuals to make choices about their health, wellbeing, and service use.
The Key Principles of Trauma Informed Practice
- Safety: Efforts should ensure that the physical, psychological and emotional safety of service users and staff is prioritised through the physical environment, and through the relationships and interactions taking place within it.
At Meadows Psychology Service, we understand that in order to create environments that feel safe, we need to understand what safety (or feeling unsafe) means to the people we support and the staff we employ and work alongside.
In this way, we challenge our own worldviews and assumptions regarding what safety means, and encourage other staff teams to do the same, in order to ensure we are continuously striving to achieve a sense of safety for all. - Trustworthiness and Transparency: To build and maintain trust, decisions and operations need to be clear, consistent and transparent, and everyone needs to be given the opportunity to have their voice heard in the process.
- Collaboration and Mutuality: Organisations should adopt a collaborative approach, which breaks down power differentials and which supports the individuals they work alongside to reflect on and attend to their own well-being.
At Meadows Psychology Service, we recognise that healing happens in relationships and in the meaningful sharing of power and decision-making. We understand that the teams and carers we support take on difficult roles that can often be extremely emotionally demanding. That is why we prioritise working collaboratively with carers to create spaces where they feel safe to reflect on this work and empowered to meet shared goals. - Peer Support: Organisations should facilitate connections and relationships among people who have shared experiences. This helps to foster a sense of hope and empowerment.
- Cultural Considerations: It is essential to recognise that trauma does not occur in a vacuum. Rather, it occurs within the context of one’s gender, cultural, historical or generational experiences.
Without this principle, others such as safety, or collaboration, cannot be fully understood.
At Meadows Psychology Service, we believe that in order to be truly trauma informed, we must be curious and reflective about or own and others experiences and how these shape our assumptions, interpretations and beliefs. Only then can we champion an environment where people feel safe to bring their authentic selves to the work that we do together. - Empowerment, Voice and Choice: Individuals should be empowered to voice their thoughts, opinions and concerns, and services must recognise and value the strengths and capabilities of their staff and those they support.
At Meadows Psychology Service, we recognise that those who have experienced trauma also have strengths, capabilities and talents than should be nurtured and harnessed to promote healing. We adopt a strengths-based approach to working with young people and their caregivers, which ensures that we notice and celebrate individual and team’s skills, strengths and positive qualities.
Learn more about our approach and values here.
Benefits of a Trauma Informed Practice
Trauma informed care has a number of benefits for individuals, professionals, and organisations as whole. For example:
- A trauma informed approach helps services to achieve a shared understanding about the impact of trauma and adversity.
- It helps to prevents re-traumatisation, which can often discourage individuals from attending the service, and from seeking further professional support.
- It reduces staff burnout: a trauma informed approach can ensure that staff feel valued and listened to. It can improve staff wellbeing, which can positively impact staff turnover rates.
- It can lead to staff and carers experiencing greater satisfaction, as they feel better equipped to understand trauma and its impact on those they support and care for.
- It supports staff and those seeking support from services to feel safe. This increases engagement with support, reduces challenging behaviours in young people, and has a positive effect on service outcomes.
- It helps individuals to feel empowered and in control, which supports the development of healthy coping and promotes resilience.
- It leads to improved client-provider relationships.
- In schools, a trauma informed culture where children feel safe in the classroom can help to reduce suspension and expulsion rates and improve academic achievement.
Implementing Trauma Informed Practices
“Everyone has a role to play in a trauma-informed approach” (SAMHSA, 2014, p.15).
Becoming trauma-informed is a fluid process which requires ongoing commitment and reassessment at every level of an organisation. To be truly trauma informed, practices at both organisational and clinical level must recognise the impact that trauma has on providers and those who utilise their services.
As Sandra Bloom eloquently stated, “trying to implement trauma-specific clinical practices without first implementing trauma-informed organisation culture change is like throwing seeds on dry land” (Sandra Bloom MD, Creator of the Sanctuary Model).
Trauma-informed systems should adhere to the ‘4 R’s, whereby service providers seek to (1) Realise the widespread impact of trauma on the individuals and communities they serve; (2) Recognise the signs of trauma in those they care for or support; (3) Respond to trauma in an effectively and informed way; and (4) Resist re-traumatisation (SAMHSA, 2014).
There are various different frameworks that organisations may adopt in their journey to becoming trauma informed. However, all share common components which are helpfully reflected in Trauma Informed Oregon’s 2018 roadmap to trauma-informed care (see figure 1):
Implementing trauma-informed practice across an organisation requires attention and commitment across various levels and areas of a service, including governance and leadership. workforce development, progress monitoring, quality assurance, and the physical environment.
Below are some key steps organisations can take to implement trauma informed practices:
Organisational commitment:
- Secure buy-in and commitment from leadership to adopt a trauma-informed approach.
- Develop a shared vision and values that prioritise trauma-informed principles.
- Allocate resources and ensure adequate training and staffing.
Assessment:
- Conduct organisation assessments (and re assessments) to evaluate current policies, procedures, and practices.
- Identify strengths, gaps, and areas for improvement.
- Assess the physical environment.
Staff training and education:
- Provide comprehensive training for all staff on the impact of trauma and trauma informed principles.
- Ensure access to ongoing education, training and reflective practice to ensure that staff at every level of an organisation has a good understanding of trauma, how this might present and how to respond.
Trauma-informed service delivery:
- Empower clients to be active participants in their own care.
- Offer referrals to appropriate services.
- Incorporate trauma informed practices into all aspects of service delivery.
- Share knowledge with appropriate services to ensure holistic, integrated support.
Trauma sensitive policies and procedures:
- Review and revise existing policies and procedures to align with trauma-informed principles.
- Implement policies and procedures that promote safety, choice, empowerment and collaboration.
- Establish clear protocols for responding to disclosures.
Evaluation and continuous improvement:
- Regularly evaluate the effectiveness of trauma informed practices.
- Gather feedback from staff and clients to identify areas of improvement.
- Remain up to date with the evidence base to ensure best practice.
Trauma Informed Services We Offer
- Therapeutic Support for Residential Children’s Homes
- Adoption Support
- Trauma Informed Practices for Schools
- Supported Accommodation Providers
- Fostering Settings
How Can We Help
Meadows Psychology Service, we provide support to a range of organisations across multiple different sectors to develop trauma-informed practice. We work with children’s homes, schools, local authorities, supported accommodation providers, foster carers and adoptive parents to help carers and professionals to develop therapeutic practice and skills, and to deliver trauma-informed care through training, consultation, reflective practice and evidence based psychological assessments.
Our staff team have extensive experience in supporting services to implement trauma informed practices, for the benefit of children, young people, and the carers and professionals who support them. To learn more about how Meadows Psychology Service can support you to implement trauma informed principles in your service, please get in touch via our online contact form.
