Trauma-Informed Practice

Trauma-informed practice develops from the understanding of how trauma exposure can affect our neurological, biological, psychological and social development.

Trauma-informed approaches are founded on the understanding and acceptance that symptoms and experiences related to trauma are coping strategies established by people to manage traumatic experiences.

Trauma-informed practice seeks to avoid re-traumatisation by using the principles of safety, trustworthiness, choice, collaboration, empowerment and cultural consideration.

There is a natural crossover with this approach from the principles of adult safeguarding, which are empowerment, prevention, proportionality, protection, partnership and accountability.

As well as more broadly, the approaches and practice outlined in Making Safeguarding Personal (ADASS, 2014).

To understand trauma-informed practice, practitioners must recognise that the effects of trauma affect individuals, groups and communities.

In November 2022, The Office of Health Improvement and Disparities created a working definition of trauma-informed practice. (external link)

Why is it important to be trauma-informed?

For trauma survivors, trauma-informed services can bring hope, empowerment and support that is not re-traumatising. Moreover, such services can help close the gap between the people who use services and the people who provide them (Filson & Mead, 2016).

Practitioners need to have an understanding that trauma exposure can impact an individual’s neurological, biological, psychological, and social development.

Trauma, particularly in early childhood, can have a severe impact throughout the life course.

For many children it can be expressed through behavioural issues, and often leads to having a severe effect on both mental and physical health.

During adulthood the person is more likely to be drawn into violence, criminal activity, and self-harm, as well as being more likely to engage in health-harming behaviours.

Evidence of this includes:

Half of the people in contact with mental health services had experienced physical abuse
More than one-third had experienced sexual abuse in childhood or adulthood, indicating rates that were significantly higher than the general population (Mauritz, Goossens, Draijer, & van Achterberg, 2015)
People using mental health services are substantially more likely to have experienced domestic and sexual violence in the previous year compared to the general population (Khalifeh, et al., 2015).

These issues can continue to have effect on the way adults interact with others throughout their life, including with their relationship with their own children.

They are more likely to become a victim of abuse or become a potential perpetrator in their own relationships.

We often refer to these traumatic events in childhood adverse childhood experiences (ACES).

Almost half of the adult population of England has had some form of adversity within their childhood or adolescence.

These can include:

bereavement
neglect
violence
witnessing domestic abuse
sexual assault
substance use by parents and carers.

Effect on adulthood

Trauma can also have lasting affects in adulthood.

Types of traumatic events that are known to cause long-lasting trauma include:

abuse
neglect
sexual violence
extreme poverty
homelessness
mental illness.

Key principles of trauma-informed practice in safeguarding

1. Safety

Efforts made by practitioners and organisations to ensure the physical and emotional safety of people in safeguarding and those supporting adults in safeguarding is of paramount importance.

This includes ensuring reasonable freedom from threat or harm and attempts to prevent further re-traumatisation.

As well as the Care Act 2014, Article 3 of the Human Rights Act provides a duty not to be tortured, suffer degrading treatment or punishment, and Article 2 of the Human Rights Act gives a positive obligation to prevent a death.

2. Choice

Adults and frontline staff have meaningful choice and a voice in the decision-making processes of safeguarding.

Making Safeguarding Personal embeds personal choice in safeguarding process.

Rights and responsibilities should be informed clearly and in away the adult understands.

3. Collaboration

Organisations should recognise the value of people using services and frontline staff and their role in improving knowledge of how to overcome challenges and improving the system as a whole.

Adults have a significant role in planning and overcoming challenges and developing services.

4. Trustworthiness

Transparency exists in an organisation's safeguarding policies and procedures, with the objective of building trust among staff, clients and the wider community.

Recent feedback from a transitions audit clearly showed the trust that young people had in their Leaving Care Workers had a positive effect on safeguarding and the adult’s safety.

5. Empowerment

Skills of adults in services and empowerment should be prioritised by those working with them.

Efforts should be made by organisations and practitioners to share power and give adults a strong voice in addressing needs around safety, developing resilience and improving their lives.

Organisations should use this voice in service development and improvement, recognising trauma and how to work with its affects in structural improvements (Filson & Mead, 2016).

6. Cultural consideration

Move past cultural stereotypes and biases based on, for example, gender, sexual orientation, age, religion, disability, geography, race or ethnicity by offering access to gender responsive services.

They understand the healing value of traditional cultural and incorporating policies, protocols and processes that are responsive to the needs of individuals served.

There are many models of trauma informed-practice, but this is a good starting point for practitioners to begin to understand principles that will help to improve trauma-informed practice.

Prevent re-traumatisation

Trauma-informed practice seeks to avoid re-traumatisation, which is the re-experiencing of thoughts, feelings or sensations experienced at the time of a traumatic event or circumstance in a person’s past.

Re-traumatisation is generally triggered by reminders of previous trauma, which may or may not be potentially traumatic in themselves.

The purpose of trauma-informed practice is not to treat trauma-related difficulties, which is the role of trauma-specialist services and practitioners; instead, it seeks to address the barriers that people affected by trauma can experience when accessing health and care services.

Trauma-informed support for frontline workers

It is important that frontline workers who work with adults in safeguarding understand trauma-informed practice and are prepared for working in a way that contemplates secondary traumatic stress from taking on their experiences.

Sharing emotional responses with colleagues can help you to feel like you are not alone and support accessing further support.

Take advantage of supervision or workplace counselling services that may be available in your workplace.

Taking time to develop a healthy work-life balance is important, as is ensuring that work does not occupy time that should be for family, and private life.

Good practice in this includes reflective practice sessions, and adequate supervision, team meetings, and to give them space to be addressed in a timely and non-judgemental way before the needs of staff escalate.

Promoting a culture of cohesion and group support is a key part of protecting staff mental health.