Trauma Responsive

Trauma Responsive

Trauma responsive practice is an approach to health and care interventions, which recognises the impact of trauma on a person’s neurological, biological and/or social development. 

What is Trauma?

Trauma is a response to an overwhelming stressful event or series of events that exceeds the capacity to cope.  The effects of trauma can be long-lasting. 

Traumatic events can happen at any age and can cause long-lasting harm.  They can be a single incident where a person experiences a sudden loss, or they are directly harmed or witnessing harm.  It can also be a series of incidents / events and can also happen such as experiencing domestic, physical, emotional, sexual abuse or neglect. 

Everyone is different and how they react to trauma, or a traumatic event will be individual to them and how the event(s) made them feel at the time; how frightened, under threat, abandoned or humiliated they felt. 

Experiencing trauma may lead to flashbacks, intrusive thoughts, being jumpy, avoidance or having relationship difficulties.

Adverse Childhood Experiences (ACEs)

According to Young Minds, 2018, these are, “highly stressful, and potentially traumatic, events or situations that occur during childhood or adolescence. They can be a single event, or prolonged treats to, and breaches of, the young person’s safety, security, trust or bodily integrity.”

Research identified a set of 10 traumatic events or circumstances occurring before the age of 18 that have been shown to increase the risk of adult mental health problems and debilitating diseases.  These are:

• Physical abuse
• Sexual abuse
• Psychological abuse
• Physical neglect
• Psychological neglect
• Witnessing domestic abuse
• Having a close family member who misused drugs or alcohol
• Having a close family member with mental health problems
• Having a close family member who served time in prison
• Parental separation or divorce on account of relationship breakdown.

As well as ACE’s, being trauma responsive also involves recognising the need to focus on other wider social determinants of adult outcomes that are comparable to a history of 4/more ACEs. Other aspects of an individual’s personal and social identity can afford people different levels of power, privilege and bias. These include but not limited to; low family income, poor housing, neighbourhood deprivation, high levels of parental stress & negative parental beliefs about child. Therefore being trauma responsive involves reducing issues of trauma, discrimination and oppression that may arise from wider aspects of someone’s identity. Trauma responsive practice must therefore be aware, considerate and responsive to an individuals; gender, geography, race, religion, age, ability, appearance, class, culture, ethnicity, education, employment sexuality, sexual orientation and spirituality.

Being trauma informed and trauma-responsive practice

Being trauma informed means understanding that those in need of services may also be the hardest to reach and least likely to engage with services.  Experiencing trauma can negatively impact on a person’s ability to feel safe or develop trusting relationships. 

Trauma responsive practice aims to create culturally safe services that respond sensitively to individual needs.  It encourages practitioners to build trusting relationships and work in partnership with people to empower them. 

It also aims to prevent re-traumatisation, which can occur when people keep having to repeat the story of what happened in their past.  Re-traumatisation is where people experience thoughts, feelings or sensations experienced at the time of the trauma, which can be triggered by talking about the events or other things that might remind them of the trauma.

Key principles of trauma informed practice

There are 6 principles of trauma informed practice:

• Safety,
• Trust,
• Choice,
• collaboration
• empowerment; and
• cultural consideration.

Vicarious Trauma

This is where a professional can experience the effects of trauma because of their exposure to someone else’s trauma. It is important that professionals supporting people experiencing or who have experienced trauma are aware of this and the potential signs so they can exercise self-care and mitigate the risk of vicarious trauma.  Workplace support systems should always be in place to support professionals who are exposed to trauma through their work. 

More information and useful links

Trauma Responsive Greater Manchester

Office for Health Improvement and Disparities (UK Government)

Community Care – A trauma informed approach to social work

Early Intervention Foundation – Adverse Childhood Experiences

Article about the window of tolerance

Free online training on ACES

Beacon House has produced lots of resources which are free to use

Trauma Awareness Webinar and other mental health and wellbeing training

British Medical Association: Vicarious trauma: signs and strategies for coping

Trauma informed care e-learning programme

NHS England’s e-learning for healthcare and Mental Health team have worked together to develop a new e-learning programme about trauma informed care.

The COVID-19 pandemic has highlighted a growing need for health and care professionals to understand the dynamics and impact of trauma on the lives of individuals, families and communities.

Whilst embedding trauma informed care requires a systematic multi-faceted approach, the aim of this programme is to support the learner in deepening their understanding on the importance of becoming more trauma sensitive in the way care is delivered, both as an individual and within a team or service.

The programme, which is aimed at frontline health and care professionals, emergency services colleagues, violence reduction units and education staff, consists of 5 modules:

• Human Development and Responses to Threat
• What Do We Mean by Trauma?
• Basic Awareness, Concepts and Challenges
• Public Health and Prevention, Personal Capacity
• Making Trauma Informed Approaches Part of Healthcare

On completion of the programme learners will have a greater understanding of trauma and its impact on the lives of everyone who encounters services, including

those who work within it. It will help learners to recognise and sensitively respond to people who have experienced trauma.

For more information and to access the resource, please visit the Trauma Informed Care programme page.