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Article
Publication date: 7 June 2021

Nicola Gregson and Claire Delaney

The purpose of this paper is to present a case study using a systemic team formulation approach, in the context of supporting a women with intellectual disabilities with a…

Abstract

Purpose

The purpose of this paper is to present a case study using a systemic team formulation approach, in the context of supporting a women with intellectual disabilities with a history of trauma.

Design/methodology/approach

A reflective stance is used to describe the process of assessment, hypothesising, formulation and intervention in a single case study design.

Findings

Feedback from care staff suggests that they found a team formulation approach helpful to improve their understanding of the service user they support.

Practical implications

The paper discusses how systemic team formulation can draw on trauma-informed care principles in the context of supporting an individual with an intellectual disability. Future research should aim to replicate the approach for findings to be applied more broadly. COVID-19 has meant clinical working has had to be adapted, clinicians should carefully consider how collaborative and meaningful work can continue to be facilitated within the current parameters.

Originality/value

This case study contributes to the literature in the use of systemic team formulation interventions within an intellectual disability context, drawing on trauma-informed care principles and reflecting on adapted working within the COVID-19 pandemic.

Details

Advances in Mental Health and Intellectual Disabilities, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2044-1282

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Article
Publication date: 22 July 2021

Daryl Mahon

Practitioners, organisations and policy makers in health and social care settings are increasingly recognising the need for trauma-informed approaches in organisational…

Abstract

Purpose

Practitioners, organisations and policy makers in health and social care settings are increasingly recognising the need for trauma-informed approaches in organisational settings, with morbidity and financial burdens a growing concern over the past few years. Servant leadership has a unique focus on emotional healing, service to others as the first priority, in addition to the growth, well-being and personal and professional development of key stakeholders. This paper aims to discuss Trauma Informed Servant Leadership (TISL).

Design/methodology/approach

A targeted review of the servant leadership and trauma-informed care literature was conducted. Relevant studies, including systematic review and meta-analysis, were sourced, with the resulting interpretation informing the conceptual model.

Findings

Although there are general guidelines regarding how to go about instituting trauma-informed approaches, with calls for organisational leadership to adapt the often cited six trauma-informed principles, to date there has not been a leadership approach elucidated which takes as its starting point and core feature to be trauma informed. At the same time, there is a paucity of research elucidating trauma outcomes for service users or employees in the literature when a trauma-informed approach is used. However, there is a large body of evidence indicating that servant leadership has many of the outcomes at the employee level that trauma-informed approaches are attempting to attain. Thus, the author builds on a previous conceptual paper in which a model of servant leadership and servant leadership supervision are proposed to mitigate against compassion fatigue and secondary trauma in the health and social care sector. The author extends that research to this paper by recasting servant leadership as a trauma-informed model of leadership that naturally operationalises trauma-informed principles.

Research limitations/implications

A lack of primary data limits the extent to which conclusions can be drawn on the effectiveness of this conceptual model. However, the model is based on robust research across the differential components used; therefore, it can act as a framework for future empirical research designs to be studies at the organisational level. Both the servant leadership and trauma-informed literatures have been extended with the addition of this model.

Practical implications

TISL can complement the trauma-informed approach and may also be viable as an alternative to trauma-informed approaches. This paper offers guidelines to practitioners and organisations in health and social care on how to operationalise important trauma-informed principles through leadership.

Social implications

This conceptual model may help reduce the burden of trauma and re-traumatisation encountered by practitioners and service users in health and social care settings, impacting on morbidity.

Originality/value

To the best of the author’s knowledge, this is a novel approach, the first of its kind.

Details

Mental Health and Social Inclusion, vol. 25 no. 3
Type: Research Article
ISSN: 2042-8308

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Article
Publication date: 3 September 2021

Dalia Chowdhury

Workforce development in rural communities to address a surge in opioid addiction and overdose related hospitalizations has been an unaddressed issue in the USA. This…

Abstract

Purpose

Workforce development in rural communities to address a surge in opioid addiction and overdose related hospitalizations has been an unaddressed issue in the USA. This study aims to present an integrated, trauma-informed, behavioral workforce development initiative in a midwestern rural setting in the USA.

Design/methodology/approach

This is a mixed method, two-phased study: the first phase tracked and analyzed two focus group conferences involving experts (n = 6) and professionals (n = 8) to develop a training protocol; the second phase provided a training (n = 101), based on the protocol to future professionals and compared competencies before and after the implementation of the training.

Findings

There is a need of a trauma integrated approach in providing interprofessional training connecting health-care workers in rural communities to address the current opioid crisis to bring about cohesion among integrated and interdisciplinary teams. Workforce building will need to implement best practices not only among medical providers but among community mental health practitioners in rural areas.

Originality/value

This is a unique trauma-informed workforce development initiative in a rural community. Such studies are extremely limited and almost non-existent. Further initiatives need to be taken in this field to identify unique differences within communities that may hinder implementation.

Details

The Journal of Mental Health Training, Education and Practice, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1755-6228

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Article
Publication date: 7 May 2021

Sue Holttum

This paper aims to highlight emerging research relating to the need to recognise and address trauma in mental health service users.

Abstract

Purpose

This paper aims to highlight emerging research relating to the need to recognise and address trauma in mental health service users.

Design/methodology/approach

The author searched for papers on trauma-informed care, published in the past two years.

Findings

One paper reports ideas of service users and family members for trauma-informed mental health services. A second paper describes an online survey seeking agreement between staff and service users of early intervention services for psychosis about practices of trauma-informed care. Both papers feature themes about safety and staff having training and support for asking about and responding to trauma. A third paper reports on specific therapies for trauma with people who experience psychosis. It found some evidence for talking therapies but noted that people with a psychosis diagnosis are rarely offered such therapies.

Originality/value

These papers highlight an emerging consensus about essential components of trauma-informed care and the need for staff training and support to realise it. The exclusion of people with a psychosis diagnosis from specific trauma therapies might begin to be addressed if services were more able to recognise trauma. There is some evidence that talking therapies for childhood trauma can be helpful for people who have a psychosis diagnosis. However, evidence reviews should be broadened to include a range of distressing experiences recognised to follow childhood trauma irrespective of whether the person has a psychosis diagnosis.

Details

Mental Health and Social Inclusion, vol. 25 no. 2
Type: Research Article
ISSN: 2042-8308

Keywords

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Abstract

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 34 no. 2/3
Type: Research Article
ISSN: 0964-1866

Content available
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…

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

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Article
Publication date: 13 July 2021

Jana Hunsley, Erin Razuri, Darlene Ninziza Kamanzi, Halle Sullivan, Casey Call, Elizabeth Styffe and Celestin Hategekimana

Rwanda established a deinstitutionalization program to end institutional care and transition to family-based care for children. Part of their program involved training…

Abstract

Purpose

Rwanda established a deinstitutionalization program to end institutional care and transition to family-based care for children. Part of their program involved training local volunteers in an evidence-based, trauma-informed caregiving model, Trust-Based Relational Intervention (TBRI), to provide education, support and TBRI training to caregivers who reunited or adopted children from institutional care in Rwanda. This study aims to describe the process of disseminating a trauma-informed intervention, TBRI, as part of the national deinstitutionalization program in Rwanda.

Design/methodology/approach

Semi-structured interviews were conducted with ten lay social workers about Rwanda’s care reform and their experience using TBRI. A phenomenological approach was used to qualitatively analyze the interviews.

Findings

Analysis revealed five themes centered on the usefulness and universality of TBRI, the power of community in meeting the needs of children and youth and the importance of connection in supporting children who have experienced institutional care.

Originality/value

A global call to end institutional care and shift to family-based care for children has organizations, governments and experts seeking pathways to implement care reform. Although care reform is a complex process, Rwanda created and implemented a deinstitutionalization program focused on spreading the message of care reform and providing sustainable support for caregivers and families.

Details

Journal of Children's Services, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1746-6660

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Article
Publication date: 28 November 2020

Deborah J. Morris, Elanor Lucy Webb, Emma Parmar, Grace Trundle and Anne McLean

People with developmental disorders are significantly more likely to experience adverse childhood experiences (ACEs), although the impact of ACEs on this population is not…

Abstract

Purpose

People with developmental disorders are significantly more likely to experience adverse childhood experiences (ACEs), although the impact of ACEs on this population is not well understood. Furthermore, considerably less is known about the exposure to, and impact of, ACEs in detained adolescents with complex developmental disorder needs. This paper aims to explore the exposure to ACEs in an adolescent population detained in a secure specialist developmental disorder service.

Design/methodology/approach

A retrospective file review was used to explore ACEs and placement histories within a specialist developmental disorder inpatient service. Data was collated for a convenience sample of 36 adolescents, 9 of whom were female, aged 13–20 years (M = 17.28 years).

Findings

A total of 33 participants (91.7%) had experienced at least 1 ACE, with 58% experiencing 4 or more ACEs and 36% experiencing 6 or more ACEs. The most common ACEs reported were physical abuse (61.6%), parental separation (58.3%) and emotional abuse (55.6%). The majority of participants had also experienced high levels of disruption prior to admission, with an average of four placement breakdowns (range 1–13, standard deviation = 3.1). ACEs held a significant positive association with the total number of placement breakdowns and total number of mental health diagnoses.

Practical implications

Adolescents detained in specialist developmental disorder secure care had, at the point of admission, experienced high levels of adversities and had been exposed to high levels of experienced and observed abuse. The level of exposure to adversity and ongoing disruptions in care suggests that Child and Adolescent Mental Health Services’ developmental secure services should consider adopting dual treatment frameworks of developmental disorder and trauma-informed care.

Originality/value

This study explored the early-life and placement experiences of a marginalised and understudied population.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 14 no. 6
Type: Research Article
ISSN: 2044-1282

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Article
Publication date: 15 August 2016

Charlotte Gill, Denise Gottfredson and Kirsten Hutzell

The purpose of this paper is to describe Seattle’s School Emphasis Officer (SEO) program, a distinctive approach to school policing that aims to connect at-risk students…

Abstract

Purpose

The purpose of this paper is to describe Seattle’s School Emphasis Officer (SEO) program, a distinctive approach to school policing that aims to connect at-risk students with services and has potential to incorporate a trauma-informed approach.

Design/methodology/approach

Using qualitative data collected from a process evaluation of SEO, including interviews, observations, and analysis of activity logs and program documentation, the authors explore elements of the program that could be adapted for the development of a trauma-informed policing (TIP) model and highlight some potential pitfalls.

Findings

SEO activities align well with trauma-informed principles of safety, promoting collaboration, and impulse management and are delivered in a context of trust-building, transparency, and responsivity. However, the program is poorly defined and has limited reach, has not been rigorously evaluated, and faces serious threats to sustainability.

Research limitations/implications

This study does not assess the effectiveness or appropriateness of TIP. A rigorous evaluation is needed to improve upon and test the model to ensure that increased contact between police and youth is effective and does not contribute to the school-to-prison pipeline.

Originality/value

To the authors’ knowledge, this paper is the first to describe a potential framework for TIP and lay out an agenda for further research and policy development around this idea.

Details

Policing: An International Journal of Police Strategies & Management, vol. 39 no. 3
Type: Research Article
ISSN: 1363-951X

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Article
Publication date: 12 August 2021

Daryl Mahon

Organisations are increasingly understanding the need to be trauma informed. However, how trauma therapies in such organisations apply the principles of choice and…

Abstract

Purpose

Organisations are increasingly understanding the need to be trauma informed. However, how trauma therapies in such organisations apply the principles of choice and collaboration is less understood. The present paper applies two trans-theoretical methods for involving clients in their therapy through preference accommodation and feedback-informed treatment (FIT). A case vignette is provided demonstrating how to involve clients in trauma therapy by listening to their preferences, needs and by providing them with a voice on their experience of the process and outcome of care.

Design/methodology/approach

A focused review of the literature was conducted, with relevant randomised control trials, systematic reviews and meta-analyses sourced. The resulting information informed the design and this model for working with those in trauma therapy.

Findings

The research regarding trauma-specific therapies being more effective is far from conclusive. At the same time, early attrition and negative outcomes make up a large percentage of those seeking therapy. Using preference accommodation and FIT is one possibly way to mitigate against these experiences in therapy and to provide choice, preference and collaboration consisting with the principles of trauma-informed approaches.

Research limitations/implications

Methods to improve the experiences of those seeking trauma therapy have been identified and discussed. According to the author’s knowledge, this is the first known paper aligning trauma therapy and trauma-informed approaches with preference accommodation and FIT. Future empirical studies may wish to examine the relative effectiveness of this approach.

Practical implications

Methods to improve outcomes for those seeking trauma therapy are at the disposal of practitioners. Improving outcomes, while also providing choice, voice and collaboration is a clinical setting.

Originality/value

This is a novel paper adding to value and extending how practitioners can use principles of trauma-informed approaches within trauma therapy.

Details

Mental Health and Social Inclusion, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2042-8308

Keywords

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