Trauma Inform

So what is being trauma informed?

Well Im looking over the near horizon and realising my main benefit of working in education is almost over for another year , the summer holidays . I won’t have as much time to sit in a coffee shop and post blogs , that will have to be a pastime for the weekends as groups of screaming kids beckon , I miss school really , so I will be glad in a way . But before we get there there are a few subjects that I still want to cover and one of those is being trauma informed. Let’s start with a quick but boring definition and then look at policies, both now and planned in America and the UK. This subject makes me happy , I feel that we are slowly moving in the right direction and finally trauma is being taken seriously in our societies.

A trauma-informed policy refers to a set of guidelines, practices, and approaches that take into consideration the potential impact of trauma on individuals and seeks to create a supportive and empathetic environment for them. This concept is often applied in various settings, such as healthcare, education, social services, criminal justice, and more. The goal of trauma-informed policies is to ensure that people who have experienced trauma are treated with understanding and sensitivity, while avoiding practices that could retraumatize them or exacerbate their distress.

Key principles of trauma-informed policies include:

1. Safety: Policies are designed to create physical and emotional safety for individuals who have experienced trauma.
2. Trustworthiness and Transparency: Policies prioritize building trust with individuals through clear communication and transparent practices.
3. Choice and Collaboration: Policies respect the autonomy of individuals and involve them in decision-making processes whenever possible.
4. Empowerment: Policies aim to empower individuals by recognizing their strengths and supporting their agency in their own healing process.
5. Cultural Sensitivity: Policies consider the cultural, social, and individual differences of those affected by trauma.
6. Resilience and Strengths-Based Approach: Policies focus on fostering resilience and building on individuals’ existing strengths.
7. Trauma Awareness: Policies ensure that staff and personnel are trained to recognize the signs of trauma and respond appropriately.
8. Avoidance of Re-traumatization: Policies avoid practices that could inadvertently trigger or retraumatize individuals.
9. Holistic Approach: Policies acknowledge the interconnectedness of physical, mental, and emotional well-being, and provide comprehensive support.
10. Continuous Learning and Improvement: Policies are adaptable and open to learning from the experiences of those they serve, with a commitment to ongoing improvement.

Examples of trauma-informed policies could include providing trauma training for staff, developing protocols for handling sensitive information, creating flexible and individualised service plans, and implementing practices that minimise triggers or distressing situations. Seems easy enough to talk about, but ,is there any sign of governments implementing such policies , Ive decided to concentrate on America and The UK .

The UK government released a paper in April of 2023 ” Trauma-informed approaches to supporting people experiencing multiple disadvantages”. This outlines a new initiative , being trialled in 15 areas across England from 2021- 2024 .The report was written as a rapid evidence assessment to summarise the benefits of taking a trauma-informed approach to address the different needs of trauma survivors. The report wanted to look into what factors enable or prevent a service working in a trauma-informed way.

The paper acknowledges that although it is known that trauma-informed approaches work and increase peoples experiences of services , there is little robust evidence to show specifically how it helps. The benefits can be seen in a wide set of areas such as housing stability , criminal risk factors , reoffending , mental health and well being. The paper admits that there has been mixed results when it comes to areas such as substance abuse . Chung et al 2009 also showed that in hard to reach populations, a trauma-informed approach improves engagement with treatment the paper shows. This it is suggested was due to greater empathy, better relationships and lived experiences of social workers.

Moreton et al 2018 , the paper goes on to say ,showed that greater training for staff in this area of trauma made staff feel more able to do their job and face the challenges also a feeling of greater job satisfaction. The paper quotes Becker-Blease 2017 who showed that the cost of a trauma-informed approach could be seen as cost effective when compared to the costs of doing nothing. There is however a lack of evidence as to the cost saving that might be gained from the approach.

I recently asked the UK government to cost out the total cost of childhood trauma under the freedom of information act. I received a reply after three weeks saying it was unable to, as it has no way of collecting such figures . It stated that the UK has devolved government and did not hold the information to calculate what I had asked , interesting that this important figure is unknown.

Factors surrounding the implementation of Trauma-informed approaches.

The Uk government paper lists the enablers and barriers to implementing this approach and these include . Firstly the barriers. Change Fatigue , Limited capacity ,staff turnover , resistance to the idea that there is trauma in society , funding cuts . Also fragmentation of services being provided ( different service providers). Not recognising secondary trauma amongst staff, short term funding contracts and a lack of agreement as to what a trauma-informed approach should include.

Now the Enablers , Leadership , effective use of screening and assessments ,supporting policies and procedures. Also a promotion of supporting physical environments ( safe spaces) , collaboration between staff of all grades, good training , monitoring and then evaluation. Perhaps one of the most important one, is to enable sufficient resources and funding.

To enable a trauma-informed approach SAMHSA 2014 ( Substance Abuse and Mental Health Services Administration ) Recommend ongoing assessment , tracking and monitoring . To achieve this Bassuk et al 2017 describes the TICOMETER , this can be used to briefly measure an organisations trauma approach levels. It does this by testing 35 different items in an organisations working practices. The paper from the UK government that we have been looking at concludes that trauma-informed approaches should be implemented and that data recorded as to their benefit as evidence based in practice is in short supply in England . I know that the Scottish and Welsh governments in the UK are developing their own trauma-informed policies as is the Main opposition party in the UK , The Labour Party .

What about the US ?

( sorry this is a long one ….can I get you a coffee and a cake ?)

The Campaign for Trauma-Informed Policy and Practice (CTIPP) published a paper ” Trauma-Informed policy development highlights (2022), they show that they have seen “the needle move and grow further momentum towards trauma-informed change”, both in Federal and State policy.

The Institute on Trauma and Trauma Informed Care ( ITTIC) published a report tracking public policy initiatives in 2022 across the country that aligned themselves with the goals , values and principals of the trauma-informed approach. This doesn’t capture all policy but gives a good idea of what is happening, it tracks words like Adverse Childhood Experiences , childhood abuse , trauma informed care and similar terminology . They found 350 notable policy proposals , even if these are not assigned to laws it shows policy interest in the area and awareness of trauma informed policies. Interestingly it highlighted a bipartisan as well as party lead effort.

In fact of the trauma informed bills 92 actually became law , 68% of these were targeted specifically at children. This will need to be wider spread the ITTIC states to be truly trauma informed and address problems through someones life, not just as children. They did note that prevention legislation is being emphasised and that this is a good sign of chances to break intergenerational trauma. The ITTIC shows the in the US there is a strong momentum behind ” Translating trauma-informed practices into public policy).

I know that this has been a long post , thanks for staying with it …… This is a snapshot of what is happening worldwide , we could be here until Christmas if we wanted to cover them all ( If you’re reading this and it is Christmas …..happy Holidays!)

It does give us the feeling that there is a movement happening right now , we are making progress and society is becoming more trauma aware and new policies are reflecting this . That can only be a good thing and creates a more compassionate, resilient and equitable world for trauma survivors.

Thanks for reading the above , I write as a childhood trauma survivor looking for answers and bringing you along for the ride . I hope I find you in a good place , if not please remember you are not alone , lots of us are out there . If you need help ,look for a trauma trained therapist or trauma trained medical professional , beware of internet experts , especially those who want to sell you something . See you soon ……..

Citations

ESOURCES

• ITTIC’s Trauma-Informed Legislative Proposals: 2022 in Review
• CTIPP’s 2022 Trauma-Informed Policy Review
• Reflections and Discussion Questions (Word.docx and PDF) (discussed on the March 2023 CTIPP CAN Call)

Uk Department for Levelling Up , Housing and Communities

Trauma informed approaches to supporting people experiencing multiple disavantages

www.assets.publishing.service.gov.uk