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1 – 10 of over 5000
Article
Publication date: 7 June 2019

Paula Robinson, Emma Griffith and Chris Gillmore

Studies show that experiences of repeated or complex trauma are very common in patients with severe mental health problems. Unfortunately, many professionals do not…

Abstract

Purpose

Studies show that experiences of repeated or complex trauma are very common in patients with severe mental health problems. Unfortunately, many professionals do not routinely ask about abuse, due to concerns about how to ask and respond. There is also a need for frontline staff to be trained in trauma-informed care. The purpose of this paper is to identify the needs of inpatient staff and developed a tailor-made training package.

Design/methodology/approach

A training programme was developed from focus-group discussion and delivered to the team. Questionnaires were administered pre-, post-training and at three-month follow-up, to assess changes in knowledge, confidence and worries in the assessment and treatment of complex trauma.

Findings

There was an increase in self-reported staff confidence (p=0.001) and knowledge (p=0.028) about working with complex trauma and their worries decreased (p=0.026) between pre- and post-training.

Practical implications

In order to sustain the benefits of training for longer, recommendations were made to the service for on-going training, supervision and evaluation.

Originality/value

Given the recent interest in complex trauma within the literature (Diagnostic and Statistical Manual of Mental Disorders – Fifth Version (DSM-V); International Statistical Classification of Diseases – 11th Version (ICD-11)), the piloting and development of complex trauma training packages is timely. To the author’s knowledge, this is the first published account of complex trauma training for inpatient staff. This paper offers clinical and research implications to services who may want to develop as trauma-informed services within the NHS.

Details

Mental Health Review Journal, vol. 24 no. 2
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 12 October 2012

Policarpo C. deMattos, Daniel M. Miller and Eui H. Park

This paper aims to examine complex clinical decision‐making processes in trauma center units of hospitals in terms of the immediate impact of complexity on the medical…

Abstract

Purpose

This paper aims to examine complex clinical decision‐making processes in trauma center units of hospitals in terms of the immediate impact of complexity on the medical team involved in the trauma event.

Design/methodology/approach

It is proposed to develop a model of decision‐making processes in trauma events that uses a Bayesian classifier model with convolution and deconvolution operators to study real‐time observed trauma data for the decision‐making process under tremendous stress. The objective is to explore and explain physicians' decision‐making processes under stress and time constraints during actual trauma events from the perspective of complexity.

Findings

Because physicians have blurred information and cues that are tainted by random environmental noise during injury‐related events, they must de‐blur (de‐convolute) the collected data to find a best approximation of the real data for decision‐making processes.

Research limitations/implications

The data collection and analysis is innovative and the permission to access raw audio and video data from an active trauma center will differentiate this study from similar studies that rely on simulations, self report and case study approaches.

Practical implications

Clinical decision makers in trauma centers are placed in situations that are increasingly complex, making decision‐making and problem‐solving processes multifaceted.

Originality/value

The science of complex adaptive systems, together with human judgment theories, provide important concepts and tools for responding to the challenges of healthcare this century and beyond.

Details

Management Decision, vol. 50 no. 9
Type: Research Article
ISSN: 0025-1747

Keywords

Article
Publication date: 9 December 2014

Joanne Prestidge

– The purpose of this paper is to share knowledge and observations of the Trauma-Informed Care (TIC) approach being used to engage “chronically” homeless people in the USA.

Abstract

Purpose

The purpose of this paper is to share knowledge and observations of the Trauma-Informed Care (TIC) approach being used to engage “chronically” homeless people in the USA.

Design/methodology/approach

This paper describes a placement with an organisation in New York City observing how the TIC approach is being implemented across outreach, housing and support services. The author then reflects on the lessons, for the work in the UK context.

Findings

TIC empowers staff and clients to understand psychological trauma and its effects and to use this knowledge to create safe, supportive environments for all involved; improving relationships and nurturing recovery. It appears that clients use services more effectively, with staff stating that they behave more appropriately and move towards independence more quickly. Staff consider the emotional needs of the individuals they support and it was reported that they are less reliant on managers and have a higher tolerance to their clients.

Research limitations/implications

TIC is an easily replicable and seemingly cost-effective way of empowering frontline staff to deliver holistic services to survivors of trauma.

Practical implications

Psychologically informed practice is gaining momentum within the homelessness sector in the UK, and whilst TIC has many similarities to it, this approach specifically focuses on providing a pre-therapy approach for trauma survivors to prepare them to engage appropriately with mainstream services.

Originality/value

Although there is no quantifiable data, it seems that the approach improves the well-being of service users and may ultimately reduce the cost in public spending of ineffective service use.

Details

Housing, Care and Support, vol. 17 no. 4
Type: Research Article
ISSN: 1460-8790

Keywords

Article
Publication date: 3 May 2022

Noelle Blackman, Konstantinos Vlachakis, Anna Annes, Sally Griffin and Peter Baker

Research and anecdotal clinical work indicate that complex post-traumatic stress disorder (CPTSD) in families that have children and adults who have a learning disability…

Abstract

Purpose

Research and anecdotal clinical work indicate that complex post-traumatic stress disorder (CPTSD) in families that have children and adults who have a learning disability and/or are autistic may be prevalent. This paper aims to provide a preliminary formulation of complex trauma in families.

Design/methodology/approach

This report is based on a review of clinical psychotherapeutic work with six families. The themes are derived from the assessment period through examining the assessment reports and clinical supervision notes for thematic patterns.

Findings

This report suggests that the prevalence of CPTSD in families of people who have a learning disability and/or are autistic needs to be researched across the family lifecycle and that there are specific factors that mediate complex trauma symptomatology.

Originality/value

CPTSD symptomatology in these families is inadequately conceptualised and this is one of the first papers suggesting this as a potentially helpful framework to consider the experiences of families.

Details

Tizard Learning Disability Review, vol. 27 no. 2
Type: Research Article
ISSN: 1359-5474

Keywords

Article
Publication date: 27 April 2020

Heather Evans

Human sex trafficking is a global rights violation prevalent nationally and globally. This study aims to contribute to the limited research conducted directly with…

Abstract

Purpose

Human sex trafficking is a global rights violation prevalent nationally and globally. This study aims to contribute to the limited research conducted directly with survivors with the goal of building sustainable aftercare from their feedback.

Design/methodology/approach

For this qualitative, retrospective study, 15 adult female survivors completed open-ended interviews, took photos and participated in online focus groups to explore identity, sexuality, relationships and factors of community reintegration. Data analysis included multi-level conceptual and thematic coding.

Findings

Participants identified with all aspects of complex trauma and domains of post-traumatic growth. Participants highlighted relationship development as the primary source of healing and growth, emphasizing the value of peer-based support and survivor leadership.

Research limitations/implications

The findings affirm the need for ecological and relational perspectives in care of survivors and approaches using a trauma-informed, victim-centered lens. Findings affirm the value of understanding the nuances of complex trauma as well as celebrating the capacity for post-traumatic growth. Furthermore, while relationships are most significantly impacted from the trafficking experience, they are also considered the greatest instrument of healing, offering long-term commitment and belief in the individual. This research excluded males and international trafficking survivors. Participants were recruited through service organizations, and many participants are active in advocacy work, which may hinder generalizable data for all trafficking survivors. Finally, this study did not distinguish data between geographic location or range or length of time since exiting trafficking.

Originality/value

This study highlights the voices of survivors throughout research design and data findings. Their lived experiences provide key recommendations for interaction and intervention. Data include rich expression through photography.

Details

International Journal of Human Rights in Healthcare, vol. 13 no. 2
Type: Research Article
ISSN: 2056-4902

Keywords

Article
Publication date: 6 September 2021

Peter Baker, Vivien Cooper, Winnie Tsang, Isabelle Garnett and Noelle Blackman

There is an established literature supporting the idea that families who have children and adults who have a learning disability and/or autism have a greater vulnerability…

Abstract

Purpose

There is an established literature supporting the idea that families who have children and adults who have a learning disability and/or autism have a greater vulnerability to mental health problems or poor psychological health. There are shortcomings in this literature in that there is a little consideration of the impact the families interaction with services has on their well-being. It is argued that complex post-traumatic stress disorder (CPTSD), with its focus on prolonged chronic exposure to trauma experiences and the recognition that this can occur in adulthood, may well be an appropriate framework to enable a better understanding of the experiences of families.

Design/methodology/approach

A total of 214 family members completed a co-produced online survey in relation to potential traumatic events, impacts and support.

Findings

The experiences of family carers of children and adults with a learning disability and/or who are autistic would appear to be multi-layered and complex, with many experiencing a wide range of traumatic events with the associated emotional and personal sequela. The reported responses are consistent with CPTSD with 10% of having received a diagnosis of PTSD. Their experience was that the system failed not only to provide support but also created additional trauma.

Practical implications

A trauma-informed approach needs to be adopted by agencies and professionals that serve families to ensure they understand their potential contribution to the trauma families experience.

Originality/value

To the best of the authors’ knowledge, this is the first study that has attempted to examine the experience of families using the framework of CPTSD.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 15 no. 5
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 3 September 2012

Richard Cross

This paper aims to explore an integrated therapeutic care approach for a group of children and young people who have experienced chronic and enduring interpersonal trauma.

Abstract

Purpose

This paper aims to explore an integrated therapeutic care approach for a group of children and young people who have experienced chronic and enduring interpersonal trauma.

Design/methodology/approach

This paper aims to emphasise the need to routinely assess for that which could have been relationally traumatic, as this is the context in which many looked‐after children's and young people's developmental experiences occur. In particular, it explores the need to have trauma‐informed assessments, clinically effective interventions based on this knowledge, and the need to ensure that a therapeutically enabling environment and organisational functioning is maintained, in order to improve outcomes. It builds on existing work on trauma systems theory, both within an organisational context and within a holistic completely integrated (therapy/assessment, care, education) residential child care treatment process.

Findings

This research raises consideration of the manner in which interpersonally traumatic experiences with the child's primary attachment figures (accommodation complex) may create the context in which children employ dissociative coping. This also may have possible helpful connections for those working with adults diagnosed with borderline personality disorder.

Originality/value

The paper provides a systemic model based on three strands of understanding, namely trauma, attachment and dissociation, which can provide an underpinning assessment and interventions model for children in residential care.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 33 no. 1
Type: Research Article
ISSN: 0964-1866

Keywords

Open Access
Article
Publication date: 12 September 2016

Angela Sweeney, Sarah Clement, Beth Filson and Angela Kennedy

The purpose of this paper is to describe and explain trauma-informed approaches (TIAs) to mental health. It outlines evidence on the link between trauma and mental health…

53201

Abstract

Purpose

The purpose of this paper is to describe and explain trauma-informed approaches (TIAs) to mental health. It outlines evidence on the link between trauma and mental health, explains the principles of TIAs and their application in mental health and explores the extent to which TIAs are impacting in the UK.

Design/methodology/approach

The approach is a conceptual account of TIAs including a consideration of why they are important, what they are and how they can become more prevalent in the UK. This is supported by a narrative overview of literature on effectiveness and a scoping of the spread of TIAs in the UK.

Findings

There is strong and growing evidence of a link between trauma and mental health, as well as evidence that the current mental health system can retraumatise trauma survivors. There is also emerging evidence that trauma-informed systems are effective and can benefit staff and trauma survivors. Whilst TIAs are spreading beyond the USA where they developed, they have made little impact in the UK. The reasons for this are explored and ways of overcoming barriers to implementation discussed.

Originality/value

This paper – authored by trauma survivors and staff – describes an innovative approach to mental health service provision that, it is argued, could have immense benefits for staff and service users alike.

Details

Mental Health Review Journal, vol. 21 no. 3
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 5 September 2016

Biza Stenfert Kroese, Sara Willott, Frances Taylor, Philippa Smith, Ruth Graham, Tara Rutter, Andrew Stott and Paul Willner

Trauma-focussed cognitive-behaviour therapy (TF-CBT) is the most effective treatment for post-traumatic stress disorder (PTSD). Individuals who present with complex PTSD…

Abstract

Purpose

Trauma-focussed cognitive-behaviour therapy (TF-CBT) is the most effective treatment for post-traumatic stress disorder (PTSD). Individuals who present with complex PTSD are among the most complex and challenging patients seen by intellectual disability psychology and psychiatry services. The purpose of this paper is to study TF-CBT intervention for people with intellectual disabilities and complex PTSD.

Design/methodology/approach

Three groups of adults with intellectual disabilities (ID) presenting with complex PTSD (n=3, n=5 and n=4) were treated using a 12-week manualised intervention adapted from a procedure routinely used in adult mental health services. Participants completed the Impact of Event Scale as adapted for people with intellectual disabilities (IES-ID) before and after the intervention, and interviews conducted to ascertain their experiences of the group were analysed using interpretative phenomenological analysis (IPA).

Findings

The ten participants who completed the intervention showed a 27 per cent decrease in median Impact of Event Scale Intellectual Disabilities scores, equivalent to a medium effect size (d=0.50). Five themes were identified from the interviews: being listened to; it is nice to know you are not the only one; being in a group can be stressful; the importance of feeling safe; achieving and maintaining change. Participants also provided constructive feedback to promote improvements to the manual.

Research limitations/implications

A feasibility study followed by methodologically robust clinical trials is now needed to establish the effectiveness of the intervention and its utility in clinical practice.

Practical implications

This small study has confirmed the potential of TF-CBT as an intervention for extremely vulnerable individuals with ID who present with complex PTSD.

Social implications

The findings indicate that a group intervention is both feasible for and acceptable to adults with ID.

Originality/value

To date, no study has investigated the effectiveness and feasibility of a TF-CBT group intervention for adults with mild ID.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 10 no. 5
Type: Research Article
ISSN: 2044-1282

Keywords

Book part
Publication date: 28 April 2022

Daryl Mahon

In this chapter, an overview of the trauma-informed approach is described. The background and context to trauma, its impact on the person, and organisational responses are

Abstract

In this chapter, an overview of the trauma-informed approach is described. The background and context to trauma, its impact on the person, and organisational responses are considered. More specifically, I distinguish between trauma specific and non-specific organisations by defining the characteristic of each. This chapter sets the tone for the remainder of the book by introducing a conceptual model for both specific and non-specific trauma organisations. In order to do this, I outline the differential components that are deemed necessary for organisations to be trauma-responsive; in doing so, I introduce the Trauma Ecology Model to the literature, outlining its various components.

Details

Trauma-Responsive Organisations: The Trauma Ecology Model
Type: Book
ISBN: 978-1-80382-429-1

Keywords

1 – 10 of over 5000