By Ivana Kesar (Assistant Psychologist) and Dr Charlotte Irving-Curran (Principal Clinical Psychologist)
Aim
The aim of this article is to offer staff and services some practical ways of applying trauma-informed principles to their care delivery.
Trauma and Trauma-Informed Care
Trauma refers to a wide range of experiences, which can include:
- Growing up with domestic abuse
- Living through war or natural disaster
- Being assaulted
- Being in an accident
People can be affected differently by trauma, and what one person feels traumatised by, may not lead to a particular response in another person. However, trauma has the potential to negatively affect a person’s quality of life, and can impact their psychological, physical, and social wellbeing.
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Research shows that people who have experienced trauma are more likely to access mental health services, alcohol and substance use services, and the criminal justice system. As a provider of these services, it is essential that Inclusion offers trauma-informed care to support patient and staff wellbeing.
Trauma-informed care understands the nature of trauma and acknowledges the need for healthcare services to promote healing and recovery, rather than practices that may inadvertently re-traumatise. Evidence shows that trauma-informed care can improve outcomes for those accessing our services and increase staff wellbeing.
Practical Application of Trauma-Informed Care
Managing disclosures of trauma:
It is often intensely challenging for someone to make a disclosure of trauma.
The following will help you work in a trauma-informed way when managing disclosures:
- Let the person share their experience in their own way
- Let the person know that they can share as much or as little as feels comfortable
- Respond sensitively and appropriately
- It is important not to overwhelm the person with questions
- It is important not to question the person if they don’t remember all the details
- Remember that you don’t need to know all the details to offer care
- Take care of your own wellbeing after someone has made a disclosure to you
Staff wellbeing:
Working with trauma can be challenging for staff members too, and can lead to empathy fatigue, stress, exhaustion, and vicarious trauma. Good support in the workplace is the best way to protect staff wellbeing and can include:
- Regular supervision sessions
- Reflective practice spaces
- Access to relevant trauma-informed training
- Peer support
- Having breaks during the working day
- Using annual leave at regular intervals throughout the year
- Signposting to staff support systems (e.g., SOOTHE, Occupational Health)
Having a good support structure outside of work is also protective and making time for self-care can help you manage the impact that this work can have.
Training:
All staff across the organisation should be provided with introductory training in trauma-informed practice. The training could cover definitions of trauma, the impact of trauma on the brain and nervous system, and support staff to work in a trauma-informed way. The training could also include advice on self-care.
Supervision:
Supervision can help staff to feel supported at work. Supervisors and supervisees can work together to create a safe space for staff to debrief about challenges and reflect on their experiences. This is an important part of providing trauma-informed care.
Supervision can provide opportunities for learning and development. You should feel encouraged to ask your supervisor for support with improving your knowledge and skills. For example, you may identify together that you would like to increase your confidence in working in a trauma-informed way.
Whole system approach:
For trauma-informed care to be truly effective, it must be part of the culture at all levels, of the whole system.
Every member of the organisation must understand the importance of, and take responsibility for, working in a trauma-informed way. This includes those working in non-clinical roles such as administrators, who are often the first contact someone may have with a service, and senior managers, who develop and review organisational policies.
A simple change that we can all adopt, could be moving away from thinking “what is wrong with you?” towards “what happened to you?”.
