This article presents a few key pieces of advice from Community Care Inform Children’s guide on how to become trauma-informed in practice, which was published in January 2021. The full guide explores the trauma model, the principles that underpin the approach, how it links to attachment theory, and considerations for assessment. Inform Children subscribers can access the full guide here.
The guide is written by Sue Penna, co-founder, chief executive officer and programme expert at training body Rock Pool CIC. She has worked with individuals who have experienced psychological trauma as a result of adverse childhood experiences (ACEs) for over 30 years in her professional life as a clinician, trainer and supervisor, both within the NHS and independently.
There is increasing understanding that traumatic events can seriously impact individuals’ psychological and physical health and wellbeing. Being trauma-informed means understanding that those in most need of services may also be the hardest to reach and least likely to engage effectively with services.
A trauma-informed approach assumes that all of us have potentially experienced trauma and therefore key principles should be applied throughout our work with all children, young people and families.
Five principles of the trauma-informed approach
The following principles are central to trauma-informed work and should be embedded in individual practice as well as service delivery. Trauma-informed social workers apply these principles in initial meetings, direct work, assessments and interventions.
Safety
- Physical and emotional safety are key. Traumatised people may have developed an overactive stress-response system and often feel unsafe. To do meaningful work, it is essential to first make the child or adult feel safe.
- Be open and honest in explaining what is happening and why at every stage of engagement: for example, informing the family of the initial referral, making sure they understand what will happen next, the possible outcomes and practical information on when and how you will meet.
- Consider intersectionality and how to meet people’s needs for cultural safety – minority groups are often disproportionately affected by trauma, and discrimination can compound its impact.
Practice point
It is important to be aware that re-traumatisation can occur when talking about specific events. In general, we should make clear to children and adults that they are not required and are in fact discouraged from talking about the specific details of trauma. When gathering information for assessments, it is not necessary to know the full details – but rather the impact of trauma and any recovery.
Trust
- For individuals who have experienced trauma in the context of relationships, it can be difficult to establish trust.
- Practitioners can develop trust by implementing good personal and professional boundaries; be aware that you may need to re-establish trust each time you meet someone.
- Be reliable and honest about what you can and cannot do, while recognising and addressing the power imbalances between client and professional.
- Use a non-judgmental, compassionate approach and be responsive to the experiences of those you work with, remembering that everyone experiences trauma differently.
Choice
- Offering real choice may be challenging for both practitioners and clients.
- It’s useful to acknowledge the power differential at the initial stages of any interaction to support you in working relationally with people who may have experienced others misusing power.
- We may need to acknowledge the limits in choice around, for example, changes in staff or meeting set-up. But we should aim to constantly keep these issues in mind to establish trust.
- It is the practitioner’s responsibility to engage the individual and give them choice in how work continues. The initial meeting should consist of obtaining informed consent, explaining how information will be shared and the limits to confidentiality; giving the person options and discussing with them what they would like to happen.
Collaboration
- Collaboration means working towards a common goal or purpose. Individuals who have experienced trauma may have very little trust in their needs mattering to others or very little experience of being involved in decisions, so may need support and encouragement to do this.
- Interactions that contain a psychoeducational element – where practitioners invite people to collaborate in their recovery by sharing information – are particularly useful.
- Collaboration could involve asking someone what they need for a certain part of the meeting or visit, or identifying coping strategies that may be helpful or problematic in the longer term and discussing options for support.
Empowerment
- The principles described above all contribute to empowering people we work with. Showing someone that they can be safe, demonstrating you can be trusted and so can they, offering choice and collaboration to someone who has never had these options, are all empowering.
- Empowerment means treating the person as an equal. This may include offering challenge (constructively, rather than judgmentally), which can enable reflection and be very useful.
- Supporting and empowering individuals to recognise unhealthy coping strategies can be a life-changing opportunity.
If you have a Community Care Inform Children licence, log on to access the full guide and read more detailed information on trauma-informed practice and how to support children and young people.
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I thought this very informative – my one comment is can we empower people? or do people need to empower themselves? – your view on this dictates your approach
The sense of control is central to a person’s mental health. The above article is very good and the principles all go towards promoting and empowering the person. Good article.