Trauma-informed Practice

The practice problem

Trauma is most commonly framed in psychiatry as an exposure to an extraordinary experience that presents a physical or psychological threat to oneself or to others, and that provokes helplessness and fear. Over the last few decades, our understanding of trauma has grown and expanded to account additionally for the myriad ways in which traumatic experiences such as childhood abuse and neglect can have an enduring impact on children and adults. Individuals (and families) who have lived through traumatic experiences can feel unsafe in their physical environments, relationships, and emotions; their attempts to cope with feeling unsafe can manifest in behaviours that are detrimental and even destructive. They may then encounter child welfare, criminal justice, and healthcare systems that aren’t designed to recognise the impact of trauma in their lives.

What is Trauma-informed Practice?

Drawing from their own experiences of working in mental health, Maxine Harris and Roger Fallot in 2001 recognised this as a problem, and proposed that services should utilise a ‘trauma-informed’ approach to improve outcomes across practice systems – for both traumatised people and the professionals tasked with helping them achieve safety and stability in their lives. As a framework, Trauma-informed Practice is relevant across a range of disciplines, helping professionals to avoid pathologising trauma and, instead, emphasising the resilience and recovery inherent in traumatised individuals’ best efforts to stay safe.

This is particularly relevant for young people who have experienced emotional, physical, sexual, and relational trauma as a result of exposure to extra-familial risks. In practice systems that are not trauma-informed, young people may be easily penalised for behaviours that result from prior trauma and their own best efforts to feel physically, emotionally, and relationally safe. Professionals utilising Trauma-informed Practice prioritise safety, trust, collaboration, choice, and empowerment in their interactions with traumatised young people. They work with young people, not on or for them, prioritising the building of relationships, and working to avoid re-traumatising whenever possible. They understand the ways in which trauma responses can manifest, and ensure that the young people they work with feel physically and emotionally safe before, during and after any interactions. A growing body of research indicates that working in a trauma-informed way does effectively reduce trauma symptoms and lead to positive behaviour change. This has led to significant, increasing interest in TiP in the UK from a range of sectors including health, social care and criminal justice.

The case studies

The Trauma-informed Practice strand of the Innovate Project will explore the process of how Trauma-informed Practice is being used as an innovative way of addressing the needs of young people encountering or experiencing extra-familial risks or harm. Two different local authorities, organisations or networks in the UK will be involved as case studies of Trauma-informed Practice. Each case study will look at how practice or service innovations based on a Trauma-informed Practice framework are developed for that specific context, and why Trauma-informed Practice was thought to be the most appropriate approach. We will explore the specific levers and barriers to innovation which are encountered in each site. Through this, we will learn more about the effectiveness of Trauma-informed Practice and how it might be scaled and spread elsewhere.

Resources

In this vodcast, Dr Kristine Hickle, from the University of Sussex, describes how a trauma-informed approach can be important for working with young people experiencing extra-familial risks.

Dr Hickle has made available a site presenting a range of resources useful for organisations, services and professionals interested in Trauma-Informed Practice.

A Brief Introduction to Trauma Informed Practice by Dr Kristine Hickle  

This is designed to help you understand the impact of trauma on the children, young people, families, and communities you encounter in your work and, through the framework of ‘Trauma-Informed Practice’, find ways of improving safety, resilience, and well-being for yourself, your colleagues, and the individuals and communities you encounter in your work.

Read full brief

Who is involved with this strand of the project?

  • Dr Carlene Firmin from the University of Bedfordshire is leading the case study research conducted within the Trauma-informed Practice Strand of the Innovate Project.
  • Dr Kristine Hickle from the University of Sussex provides expertise in researching Trauma-informed Practice in other organisations and local authorities.
  • Dr Carlie Goldsmith will conduct embedded ethnography in each case study site, and interview young people and families.
  • Dr Reima Ana Maglajlic will work primarily with the professionals in each setting.
  • Rebecca Godar from Research in Practice will work with each site to consider how administrative data management systems can be used to support service delivery and evaluation.
  • Dr Lisa Holmes from the University of Oxford will lead cost benefit analysis.

Get updates about the project

If you’d like to receive updates about The Innovate Project, including our latest findings, blog posts and events, please sign up to the mailing list: