By Pratyasha Baruah and Isabel Sutton.

Introduction

Following the publication of Inclusion’s Trauma Informed Practice Guidance, our services are committed to embed the principles. This article focuses on the experiences and practical steps being taken by our colleagues in prisons.

Very often, young adults in establishments such as HMP/YOI Swinfen Hall and HMP Brinsford have gone through significant adverse life events, specifically in their childhood. From what we know of responses to adverse life events, many may continue feeling unsafe or frequently in a state of fight/flight/freeze. Coming to a prison may make these feelings worse, because being housed with many other young adults may expose them to conflicts and violence, even without direct involvement. This may lead to feeling unstable or unsafe. Furthermore, being in a prison may also lead to a feeling of loss of control over their lives. This makes it crucial for us to incorporate trauma-informed principles in our care, to ensure good practice and avoid re-traumatisation.

Incorporating trauma-informed care

We try to incorporate trauma informed practice by ensuring the principles of transparency, safety, trust, collaboration and choice and empowerment are reflected on all interactions with service users. This includes being transparent about our role, limits to confidentiality, what we are providing and what we are not.

Transparency:

When signposted to us, most young adults have opted for the service, but may not necessarily understand what the service or the sessions entail. Consent is taken before undertaking any work and we ensure to empower service users by providing them with clear choices about how they wish to engage with our service.

For example, if a service user states that they do not feel comfortable in a group environment, we offer the choice of engaging in 1-1 work instead. Additionally, during any group work we also write up a contract at the start of the group which includes confidentiality, respect, honesty. We also let people know that there is no expectation for them to disclose anything they are uncomfortable with. Writing a contract also allows people accessing our service to add any expectations they have for the group. This also means that people have a voice in their own care and do not feel forced into an environment they do not feel comfortable or safe in.

Safety:

With regards to building safety, we aim to make every session predictable. We clarify early on what skills we will be focusing on and what the sessions will look like. We also try to choose a physical space for the sessions that is free from all distractions, noise or any unpredictable element.

Above all, we try to establish emotional safety by maintaining a calm and supportive demeanour at all times.

Trust:

In addition, we aim to build trust gradually by maintaining consistency in our interactions – such as continuing to follow session plans, maintaining boundaries, or informing service users in advance if there are any changes. Furthermore, we aim to ensure all interactions are affirming and validating.

Collaboration and choice:

Simultaneously, we try to foster collaboration and choice by keeping service users involved in all decision making. We tailor session plans to allow service users to choose:

• Which skills to focus on
• Which strategies to practice
• Which strengths or current coping skills to build on
• When they would like to have the sessions.

Empowerment

We take a strengths-based approach to empower service users, while attempting to de-pathologize their experiences/responses. The goal is to build on their existing coping strategies and validate their strengths.

Conclusion

Following the above principles helps in ensuring that the potential power dynamics that may exist in a prison setting, do not get reflected in our interactions.

We aim to not be seen as instructor figures, who decide what would be beneficial to them or tell them what needs to be done. Instead, we strive to collaborate while working together. For instance, we are currently in the process of updating our existing ADHD self-help resource, with an emphasis on gathering and considering the feedback of service users. We believe it is important to look at improving available resources and including service users in the development of these resources, as it is essential that their voices are heard.

Additionally, our team receives regular reflective practice sessions monthly, which ensures that we can work in a trauma-informed way and can discuss any concerns we have and how to combat these.