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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).

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.

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.

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.

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.

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.

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

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.

This paper aims to explore how peer support can support a combined Child First, trauma-informed and restorative approach for youth justice. While other scholars have identified clashes between these approaches, particularly between Child First and restorative approaches, a focus on reparative practice with peers has been under-explored as a more child-centred model for reparation-focused work.

We draw on qualitative data from interviews and surveys undertaken with young people and parents/caregivers in a London youth offending service (YOS). The data was part of a broader mixed-methods study in the YOS that used observational methods alongside surveys and interviews to evaluate the effectiveness of its model of practice. Peer support emerged as a theme.

Participants expressed the desire to see young people working and volunteering in the YOS and felt this would help make it a safe and non-threatening space. Young people who had completed their time with the YOS saw themselves as role models with the insight and skills to support others. These young people expressed a strong desire to work in the YOS and, in some cases, to develop long-term careers supporting young people.

Our research challenges the notion that young people who have been involved in crime struggle to empathise, providing rich examples of their empathic understanding for peers. Peer support opportunities could offer a reconceptualisation of restorative practice that is Child First and trauma-informed. Such opportunities would benefit both the young people being supported and those offering support, building a co-produced approach that is directly informed by the expressed needs and desires of the young people.

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.

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.

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.

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

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.

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.

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.

In the previous chapter, I introduced trauma-informed care as an approach to organisational change and a shift in culture to recognise that many employees and people attending services have past trauma experiences. In this chapter, I recast servant leadership (SL) as a trauma-informed leadership model that naturally operationalises some of the principles discussed in the TIA literature. The first section of this chapter addresses the societal need for a more ethical and moral leadership approach, before briefly outlining the prevalence of trauma experienced by service users and employees. The next section provides an overview and definition of SL in a general sense, before articulating a trauma-informed model of SL and its characteristics. Finally, some of the outcomes associated with SL are discussed with a key focus on how this approach operationalises the principle of psychological safety, trust and empowerment found in trauma-informed approaches, as they relate to employees.

This study aims to introduce context-specific intersectionality and trauma-informed perspectives for transformative services theory and practice. While transformative service research concerning vulnerable people has focused on well-being and alleviating suffering, there has been less attention paid to how the intersection of scales of social categorisation such as class, gender and cultural norms shapes experiences and outcomes. Likewise, there is a paucity of attention to how lived experiences of trauma among people, such as human trafficking survivors, can and should influence service interactions, delivery and outcomes.

The authors draw upon insights from a focused ethnographic study featuring narrative interviews with ten human trafficking survivors and seven rescue service industry stakeholders, as well as field observations, in Nigeria. Thus, this work enriches the limited scholarship on transformative services across Africa, where local cultural contexts have a significant influence on shaping service environments.

The authors identify how the intersections of socio-economic class, gender dynamics, cultural norms and trauma shape the service experience for survivors.

The authors argue for the criticality of intersectionality and trauma-informed perspectives to transformative services to improve the mental and economic well-being of survivors of human trafficking in the long term.

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.

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.

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.

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.

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.

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.

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