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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.

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.

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.

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.

Based on an extensive literature review, this chapter outlines key developments in global health and research during the last century with focus on the emergence of violence and child maltreatment as international public health priorities. Violence has been known to humans for millennia, but only in the late 1990s was it recognised as a global public health issue. Every year, an estimated 1 billion children are exposed to trauma, loss, abuse and neglect. Child maltreatment takes a social and economic toll on countries. Research initiated in 1985 found child maltreatment to be associated with increased disease, disability and premature death in adult survivors. The global availability of data on child maltreatment is, however, sporadic with low validity and reliability. Few global experts have consulted and involved the survivors of child maltreatment, as the experts by experience, in their attempts to provide a more comprehensive picture of reality. Youth and adult survivors of child maltreatment are often traumatised by the experience, and it is important to use trauma-informed approaches to prevent re-traumatisation. Participatory and inclusive research on child maltreatment is only in its infancy. There is a need for more inclusive research, designed by survivors for survivors, hereby strengthening local capacity building and informing policymakers from the bottom up. This chapter reviews lessons learnt and provides recommendations for how to enhance the participation and inclusion of the experts by experience in research on child maltreatment.

An emerging evidence base, and increased awareness of the effects of trauma on the body, advocates a sensory-based approach to treatment with posttraumatic stress and complex trauma survivors. This paper aims to identify, analyse and summarise the empirical evidence for the sensory-based interventions, which occupational therapists are using in the treatment of adult and adolescent trauma survivors.

An integrative review of the literature was undertaken. Both empirical and conceptual papers were included. An inductive approach and constant comparative method were used to understand and synthesise the research.

The literature search yielded 18 papers describing the types of sensory-based interventions used, sensory processing (SP) patterns and the context and evidence for sensory-based occupational therapy practice with trauma survivors. Nine of the studies were empirical and nine were conceptual and review papers. Themes identified included: atypical SP patterns; type of sensory-based intervention used with trauma survivors; and transdisciplinary treatment programmes can reduce the symptoms of trauma.

Sensory-based interventions with adult and adolescent trauma survivors are emerging as promising areas of practice and research in the literature. Although empirical data is limited, the sensory needs of the body in processing trauma experiences is becoming more recognised and are supported by the atypical SP patterns identified in survivors. A sensory-based, transdisciplinary approach to treatment has the potential to be effective in treating the trauma survivor.

With a skill base in sensory integration and occupational analysis, occupational therapists have much to offer the field of trauma studies. This review begins to address the gap in the literature, recommending more rigorous controlled outcome research with larger sample sizes, person-centred studies focussing on the trauma survivor’s perspective and continuing professional development and mentorship for occupational therapists working with this population.

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.

Polyvictimization means looking at multiple victimizations of different kinds that one person has experienced. Virtually, all of the work in this field focuses on the effects of childhood trauma and victimization on currently distressed children, and empirical and theoretical work on the intertwining of adult female offline and online abuse experiences is in short supply. Recently, however, some scholars are starting to fill these research gaps by generating data showing that technology-facilitated violence and abuse are part and parcel of women's polyvictimization experiences at institutions of higher education. This chapter provides an in-depth review of the extant social scientific literature on the role technology-facilitated violence and abuse plays in the polyvictimization of female college/university students. In addition to proposing new ways of knowing, we suggest progressive policies and practices aimed at preventing polyvictimization on the college campus.

How does the human brain absorb information and turn it into skills of its own in psychotherapy? In an attempt to answer this question, the authors will review the intricacies of processing channels in psychotherapy and propose the term transprocessing (as in transduction and processing combined) for the underlying mechanisms. Through transprocessing the brain processes multimodal memories and creates reparative solutions in the course of psychotherapy. Transprocessing is proposed as a stage-sequenced mechanism of deconstruction of engrained patterns of response. Through psychotherapy, emotional-cognitive reintegration and its consolidation is accomplished. This process is mediated by cellular and neural plasticity changes.

Through research on child sexual abuse (CSA) and adult survivors, knowledge is gained. This knowledge might support decisions – whether political, professional or otherwise – that affect the lives of children who are victims of CSA and adult survivors. Additionally, this knowledge influences what the public knows about CSA and adult survivors and as a consequence, how child victims of CSA and adult survivors are treated in everyday life. Given the huge impact research can have on survivors' lives, this chapter raises the question of what aspects of CSA and survivorship are relevant for survivors from survivors' perspective and whether these aspects can be addressed by Participatory Action Research (PAR) as a research paradigm. To identify relevant aspects, survivors' artwork is analysed because art is a way to contribute to public discourses with very little regulation. For analysis, the Sociology of Knowledge Approach to Discourse is used. In this chapter, we introduce basic theories of knowledge from a constructivist perspective in a short background section and explain the aim and method of analysis. Afterwards, we present some key aspects of survivors' art on CSA and survivorship: The invasiveness of CSA, speech, the symbolic violence behind physical abuse and issues of injustice and responsibility are discussed. Additionally, the discursive relation between artists and audience is of interest to finally answer whether – and, if so, why – PAR is an appropriate research paradigm to address these aspects.

This study aims to examine the emotional and cognitive responses of frontline homelessness service support staff to the highly insecure attachment styles (AS) exhibited by people experiencing multiple exclusion homelessness (MEH), that is, a combination of homelessness and other forms of deep social exclusion.

Focus groups were conducted with frontline staff (N = 19) in four homelessness support services in Scotland. Hypothetical case vignettes depicting four insecure AS (enmeshed, fearful, withdrawn and angry-dismissive) were used to facilitate discussions. Data is analysed thematically.

Service users with AS characterised by high anxiety (enmeshed or fearful) often evoked feelings of compassion in staff. Their openness to accepting help led to more effective interactions between staff and service users. However, the high ambivalence and at times overdependence associated with these AS placed staff at risk of study-related stress and exhaustion. Avoidant service users (withdrawn or angry-dismissive) evoked feelings of frustration in staff. Their high need for self-reliance and defensive attitudes were experienced as hostile and dismissing. This often led to job dissatisfaction and acted as a barrier to staff engagement, leaving this group more likely to “fall through the net” of support.

Existing literature describes challenges that support staff encounter when attempting to engage with people experiencing MEH, but provides little insight into the causes or consequences of “difficult” interactions. This study suggests that an attachment-informed approach to care can promote more constructive engagement between staff and service users in the homelessness sector.

Global evidence indicates that multiple structural, biological, and behavioural mechanisms link gender-based violence (GBV), HIV/HCV, and substance misuse among women and adolescent girls. The aim of this chapter is to briefly summarise and synthesise recent literature that examines the complex and bi-directional relationships among these epidemics in different populations of adolescent girls and women around the world. To inform this chapter, a selective search strategy was conducted, prioritising use of meta-analytic epidemiological studies and research on interventions and policies that address different aspects of the syndemic among women and girls who use drugs worldwide. The search targeted publications from 2015 to 2019 using PubMed, MEDLINE, and Google Scholar. The chapter highlights methodological and geographic gaps in existing policy, intervention, and implementation research and makes recommendations for strategies to tackle these gaps. It also identifies a continuum of multilevel evidence-based interventions that target the risk environments and key syndemic mechanisms linking these intersecting epidemics that have been found to be effective in reducing intimate partner violence and other forms of GBV, substance use, and HIV/HCV risks. This chapter also assesses inclusiveness of existing research and interventions for underserved and disproportionately affected populations, affecting adolescent girls, sexual minority women, and racial/ethnic minority women and identifies strategies to target gaps or disparities for these key affected populations. Finally, this chapter describes the gaps and opportunities that harm reduction programmes, medical settings, and other community organisations experience in implementing gender-responsive programmes and policies to redress these intersecting epidemics.

Women who use drugs are one of the most maligned, misunderstood and maltreated groups in contemporary culture and society. Despite this, little public outcry nor empathy is given. As a woman who uses drugs, the author examines what lies behind this neglect. A post-structuralist approach is taken in order to examine the categories of meaning assigned to bodies under the twin ruling structures of prohibition and patriarchy. This is done with the intent to better understand and challenge the process of (masculinist) knowledge-making and practices surrounding women who use drugs that treats us as mere objects of knowledge. Furthermore, this chapter draws from feminist auto-ethnography, as the author uses own personal experiences as a woman who uses drugs, a feminist and a drug user advocate as a lens through which to give form to this analysis. Ultimately, the author argue that it is time to let go of outdated, unjust and prejudicial images by challenging established norms and practices, test and apply new theories and negotiate different identities outside of those currently available to women who use drugs. In undertaking this piece, the author hopes that the critical reflections contained within this chapter can ‘cause some trouble’, by being politically useful for the growing movement surrounding women who use drugs.