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By older adulthood, the majority of individuals will have experienced at least one traumatic event. Trauma-informed care (TIC) is proposed to improve effectivity of health-care provision and to reduce likelihood of services causing retraumatisation. This study aims to assess the effectiveness of staff training in TIC in older adult services.

TIC training was delivered across eight Older Adult Community Mental Health Teams in the same UK organisation. Questionnaires were administered before and after training: a psychometrically robust measure, the Attitudes Related to Trauma-Informed Care, was used to assess TIC-related attitudes, and a service-developed scale was used to measure changes in TIC competence. Data was analysed using linear mixed effects modelling (LMM). Qualitative data regarding the impact of training was gathered one month after training through a free-text questionnaire.

There were 45 participants, all of whom were white British. LMM on pre- and post-data revealed that staff training significantly increased competencies across all measured TIC domains. Overall, staff attitudes were also significantly more trauma-informed after training. Qualitatively, staff identified time as the only additional resource required to deliver the skills and knowledge gained from training.

Training was found to be effective in increasing TIC-related skills and attitudes. Organisations aiming to become trauma-informed should consider staff training as one aspect of a wider development plan.

To the best of the authors’ knowledge, this paper is the first to examine TIC training for staff working in Older Adults Mental Health Services. Recommendations for services aiming to develop a trauma-informed culture have been provided.

The goal of this review is to conduct an exploratory literature review on trauma-informed approaches in libraries to understand how librarians are discussing trauma-informed approaches and their integration into professional practice.

The author reviewed materials indexed in selected EBSCOHost databases. Included materials from selected EBSCOHost databases were available to the author in full text, in the English language and about trauma-informed approaches in libraries. Items were excluded from this review if they were a review of another work, a thesis or dissertation, or letters to or from the editor.

Twenty-five publications were included in this analysis. Publications included described approaches in school libraries, academic libraries and public libraries. Key topics are racial trauma-informed practices, trauma-informed teaching, resisting re-traumatization, social work and the effects of workplace trauma on the library workforce.

Trauma-informed approaches are gaining popularity in a variety of disciplines as the world copes with the turbulent events of recent years. The practical implications of this review are to explore the emergence of trauma-informed approaches in libraries to understand the current publishing landscape on this topic.

While librarians are writing about this approach and some are incorporating it into their practice, an analysis in the form of an exploratory literature review to summarize this work has not been done. Understanding how libraries are incorporating this trauma-awareness and trauma-informed principles into the work is crucial for identifying the future approach to library services.

School violence can cause or exacerbate individual and collective trauma. Trauma-informed school approaches offer schools and educators guidance for how to respond. In this chapter, we provide an overview of trauma-informed school approaches and their contributions to healing individual and collective trauma. We begin this chapter by addressing the complex intersection of disability and trauma, and the unique implications of school-based violence for students with disabilities and their teachers. We then define trauma-informed care, describe current short- and long-term trauma-informed school approaches, and explain the aims of these approaches at individual and collective levels. Next, we locate trauma-informed responses to school violence in a context of systemic trauma and share considerations for disrupting the systemic conditions that perpetuate trauma and school violence. We discuss critiques of the trauma-informed care movement and conclude with recommendations for scholars pursuing research in this area.

People in prisons have a high prevalence of poly-traumatisation throughout their life span. The behavioural and emotional sequalae of trauma are likely to be managed across the whole organisation. However, there is still a lack of clarity about the key components of a trauma-informed approach within the custodial context. This study aimed to gather in-depth knowledge of staff views on the components of an optimal trauma pathway in a prison and the organisational factors that influence its implementation.

The authors’ research design is qualitative, involving in-depth, semi-structured interviews with eight members of staff from different professional backgrounds at a single prison in the UK that houses sentenced and remand prisoners. Data was analysed using reflexive thematic analysis.

Three super-ordinate themes were identified within the data. Firstly, components of a trauma-informed pathway included sub-themes of asking about what has happened and knowing how to respond; providing specialist approaches; enabling residents to cope; screening and detection; and a compassionate relational approach. Secondly, organisational factors were associated with sub-themes of culture and leadership, resources and systems and processes. Thirdly, staff factors were associated with sub-themes of skills development and training, staff well-being and support and staff attitudes.

Post-traumatic stress disorder (PTSD) and complex PTSD in prisons are under-detected, and there are complex psychosocial factors within prisons that mediate the effectiveness of psychological therapies.

To the best of the authors’ knowledge, this study represents the first exploration of staff perspectives on the components of a trauma-informed pathway within custodial settings. Future directions should involve the piloting and evaluation of the components of the trauma-informed pathway, with a focus on longer-term outcomes and exploration of the organisational factors that impact on effectiveness.

The refugee journey is fraught with challenges before, during and after resettlement. There is a critical need for mental health support upon arrival, and refugees face language, cultural and logistical barriers. Arts-based therapies are a promising approach to mitigating such barriers. The purpose of this study was to elicit professional stakeholder perspectives on mental health challenges among refugees, the value of arts-based programs and future directions.

The authors conducted three 90-min focus groups with 19 professional stakeholders in North Carolina, USA. This included mental health professionals, professors and community services/resettlement workers. Participants were identified from professional networks and snowball sampling. Each group was held by videoconference, audio recorded and transcribed. Data were analyzed through a team-based approach using applied thematic qualitative analysis.

Interviewees described a need for targeted, culturally compatible mental health services for refugee families, including trauma-informed, family-focused services with language interpretation. Arts-based therapies were viewed as highly acceptable and culturally responsive approaches for understanding distress and building resilience and less stigmatizing than traditional mental health services. Services in schools and community settings would further reduce stigma and minimize logistical barriers. Participants identified needing strong, culturally sensitive assessment tools to measure treatment progress as a key future direction.

The study offers novel insights into the value of arts-based approaches and considerations for program development. The next phase of the project will obtain the perspectives of refugee parents and children to understand client preferences for arts-based therapies.

Knowledge about the prevalence and impact of Adverse Childhood Experiences (ACEs) is pivotal to trauma-informed approaches, yet the impact of ACEs training is rarely investigated. This study reports a qualitative investigation of police perceptions of ACEs training in relation to conceptualisations of ACEs and trauma-informed working, practical applications of ACE knowledge and service-level support.

Four focus groups were conducted with 29 police officers, who had participated in an ACEs-awareness training. Based on the qualitative data, themes were generated using reflexive thematic analysis (Braun and Clarke, 2019).

Analysis generated seven themes, conceptualised into three domains of conceptual understanding, police culture and operationalising ACEs.

The sample is limited to Scottish police officers and is ethnically non-diverse. Further evaluation of higher quality interventions is warranted.

The study highlighted that a lack of conceptual framework, officer concerns and police culture may present barriers to officers incorporating ACEs knowledge into their day-to-day work. Future trainings should address these issues to achieve maximum benefits.

To the authors’ knowledge, this is the first in-depth qualitative study of police officers' perceptions of ACEs training. Focus groups facilitated the expression of cultural norms. The results provide insight into tailoring trauma-informed interventions in police in future, as well as raising broader service-level issues.

A region’s transforming care partnership identified that autistic adults without an intellectual disability (ID) may be falling through gaps in services when presenting with a significant emotional and/or behavioural need in the absence of a mental health diagnosis. The region’s intensive support teams (ISTs) for adults with ID therefore piloted a short-term “behavioural support service” for this population. The purpose of this paper is to evaluate this pilot.

This study represents a mixed-methods service evaluation over a four year pilot period. The quantitative component examined referral rates and demographic data of accepted and declined referrals; and length of referral episodes and Health of The Nation Outcomes Scores (HoNOS) for accepted referrals. The qualitative component used thematic analysis to identify key themes relating to reasons for referral, clinical/therapeutic needs, and the models of support that most informed assessments and interventions at individual and systems levels.

The ISTs accepted 30 referrals and declined 53. Most accepted referrals were male (83%), and under 24 years old (57%). Average HoNOS scores were above the thresholds generally associated with hospital admission. Key qualitative themes were: transitional support; sexual risks/vulnerabilities; physical aggression; domestic violence; and attachment, trauma and personality difficulties. Support mostly followed psychotherapeutic modalities couched in trauma, attachment and second- and third-wave cognitive behavioural therapies. Positive Behaviour Support (PBS) did not emerge as a model of preference for service users or professionals.

This project represents one of the first of this type for autistic adults without an ID in the UK. It provides recommendations for future service development and research, with implications for Transforming Care policy and guidance.

This integrative literature review aims to explore themes within higher education that may be applicable to leadership education including: descriptions of trauma, trauma-informed practices and trauma-informed practitioners.

Integrative, systematic literature review.

The results suggest that trauma and trauma-informed practices may have a place in leadership education pedagogy.

There is no work being done in trauma informed practice in leadership education. This study provides future direction for both research and practice.

Resilience is an increasingly important concept that contributes to sustainability and wellbeing of a community. Asset-based community development (ABCD) may offer promising approaches to boosting community resilience in Australia, especially within marginalised groups.

A scoping review was conducted to conceptualise existing literature on ABCD approaches to building resilience. Research databases were searched with relevant details.

Thirty-three sources were identified as meeting the inclusion criteria and were reviewed in terms of six themes: integration and identity, health, mental health, education, employment and community planning. Issues identified by the literature within these themes can be alleviated through asset-based approaches. Implications for planning of asset-based programs and policy change are discussed in light of the findings.

The results of this study provide several implications for practise, policy recommendations and future research into this area. Results suggest that increasing capacity around asset-based coping mechanisms, such as support networks through religious and cultural groups, would promote community development and foster resilience. Furthermore, policy on refugees in multiple areas, such as psychological service provision and employment, should be redesigned in a way that acknowledges their complex and diverse needs and facilitates their integration into the community. Though multiple ways to achieve this goal have been explored in literature, a sustained and broader approach is necessary to see widespread change. Further research and funding are required to explore and implement appropriate responses. Based on the findings and discussion above, the authors make the following policy recommendations. Service providers need to be aware of and incorporate culturally appropriate programs in the areas of mental health assessment and intervention, education and employment. The trauma-informed approach should be used when dealing with refugee groups and other groups who have faced hardships. Government policy should focus on improving community engagement to create and strengthen social networks, which are vital in boosting integration into the community and increasing health education and access to services. Government should focus on asset-based approaches in designing education and employment integration programs to promote social belonging and community engagement, and thus, community resilience, which will consequently have beneficial individual and group outcomes. The current governmental policy surrounding refugees should be overhauled with the goal of successful refugee integration in mind, such as incorporating the ability for refugees to access vital services such as employment and skills transferability programs. Due to current policy, these services are inaccessible to a large portion of refugees, hindering their integration. Government needs to create specific guidelines for the provision of psychological services to refugees to improve the quality of mental health services available to this group.

This paper comprises an original data analysis of the relevant existing literature by the project team. The process was rigorous, and no content of the analysis has been published previously except the material published by other authors. All previously published materials were duly acknowledged.

The purpose of this paper is to explore the historic policy context and social implications of the diagnosis of personality disorder and also consider formulation-based and trauma-informed understandings of distress.

Ongoing changes to (and splits between) medical understandings of what is being labelled as personality disorder have eroded the label’s cultural capital, adding weight to lived-experience-led calls to Drop the Disorder (Watson, 2019). This paper explores the impact and implications of the historic policy and practice context through a lived experience lens.

Such diversity of views in the lived experience and medical communities on personality disorder has allowed alternatives to diagnostically informed understandings of distress (such as formulation-based and trauma-informed approaches) to gain traction with practitioners (Bloom and Farragher, 2013; Johnstone and Boyle, 2020). The broader assimilation of these alternative perspectives into dominant medical ideology is evidenced by the fact that the Royal College of Psychiatrists (RCP) is now also exploring alternatives to diagnosis (2023). This suggests even more change ahead for how we understand people and their relationships with trauma and distress.

This paper discusses UK policy and does not include broader global policies.

This paper would be helpful for any student interested in where the ideas that underpin personality disorder diagnosis stemmed from and why so many lived experience practitioners and experts by profession question the diagnosis' legitimacy.

As the RCP is now considering alternatives to diagnosis, it is even more critical that practitioners are aware of the competing narratives surrounding this contested diagnosis – as the author believes this will promote more compassionate, trauma-informed working practices.

This is the author’s own work and includes not only the RCP position change but also directly quotes Professor Tyrer (who wrote the International Classification of Diseases 11), giving his views on the changed RCP position, as he recently presented at a conference here in Cornwall. The author is a part of Lighthouse peer support group and wrote this paper as preparation for a Participatory Action Research project they are planning, where they will evaluate the Sanctuary Approach with their membership to create a lived experience-designed trauma-informed charter. Before starting that work, the author wanted to better understand the historic policy context and created this paper to fill that need.