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Trauma-informed care seeks to: (1) realize the widespread impact of trauma and understand paths for recovery; (2) recognize the signs and symptoms of trauma in patients, families, and staff; (3) integrate knowledge about trauma into policies, procedures, and practices; and (4) actively avoid re-traumatization.
Apr 13, 2019 · This chapter presents the foundational principles and mission of trauma-informed care and a practical framework called the 4 Cs (Calm, Contain, Care, and Cope) to transform theory into...
Apr 6, 2023 · Trauma-informed care (TIC) offers a framework to address and mitigate these consequences and promote safety and health.
- Policy Documents
- Qualitative Interviews
- How Ti Approaches Are Represented in UK Health Policies
- How Ti Approaches Are Understood
- How Ti Approaches Are Implemented
We identified 50 documents and selected 24 policy documents at national, local, and organizational levels. The remaining 26 documents provided context and a background on TI approaches. The documents included were published over nine years (2012–2021) and considered all UK nations, multiple sectors, government policy and service-user voices. The do...
In total, 21 professionals expressed interest, 2 did not have direct experience of TI approach at the system level, 8 did not respond by the deadline, 11 provided consent and were interviewed. Interviews lasted between 32 and 68 min (mean 52 min). We achieved a maximum variation sample representing diversity of gender (4 men, 7 women), organization...
We found that the TI approach is referenced in government initiatives and included in policies at a national level, as well as in NHS and non-NHS organizations, local authorities, and devolved nations; however, there was no dedicated strategy or a position statement, nor was there an agreed terminology and framework, or a robust evidence base in th...
TI care as different from other practices
We found divergent interpretations of a TI approach versus other concepts related to trauma, such as ACEs, psychologically informed environments and standard good clinical practice. One participant unified concepts such as TI care, ACEs and psychologically informed environments in recognising past traumatic experiences. Another participant detached the terms ACEs and TI care, reflecting that ACEs have become well known in research whereas a TI approach is a pragmatic way of supporting those w...
TI care as a contextually tailored organizational approach
In line with the SAMHSA guidance , document and interview data showed that the framework of a TI approach needs to be tailored to the organizational and wider context. Policy documents advised organizations to clarify what TI care means for them, and that application of the framework should depend on the needs of service users and organisations [25, 28, 52, 54, 59, 60]. Several documents suggested that this organizational tailoring should be informed by service-users through co-production...
TI care as a remedy to challenges
In all policy documents and in nine interviews, TI approaches were presented as a remedy to a variety of problems within health systems. Sixteen of twenty-five documents justified a TI approach as a way for addressing the high prevalence and negative impact of violence and trauma on patients, with eleven documents considering its impact on staff. The growing international evidence base for the impact of psychological trauma and the need for service response was used in documents and interview...
Piecemeal implementation and a need for a shared vision
Interviewees confirmed the piecemeal implementation of TI approaches in the UK and felt that a shared national vision would be beneficial. Participants agreed that the implementation of TI approaches varied across the UK, with Scotland having more strategic coordinated implementation (additional file 2, quote 1). We found that different regions and organizations reinvented the TI approach wheel, with interviewees expressing a need for national coordination. Participants expressed the need for...
Factors that facilitated or hindered implementation
At the organization level, some participants felt high level leadership support was needed, and if lacking is a barrier to implementing a TI approach. To achieve effective implementation leaders with power and those with passion were felt to be important. The concept of organizational champions garnered support when “champions act as influencers and their credibility within services adds to the potential for buy-in from other staff”, fostering sustainable change . One participant warned a...
The evidence-policy gap
UK policies on implementation of TI approaches were not supported by UK-specific, methodologically robust, evidence for effectiveness, cost effectiveness and acceptability. Participants explained the policy-evidence gap by citing methodological challenges of evaluating system-level transformation and a need for commitment from commissioners and funders (additional file 2, quote 11). In addition, participants who developed and implemented TI approaches in their organizations and regions did no...
Sep 14, 2022 · Background Trauma-informed (TI) approach is a framework for a system change intervention that transforms the organizational culture and practices to address the high prevalence and impact of...
A Trauma Informed Approach (TIA) is a wide-ranging term and can apply to services, organisations, strategies, and policies that seek to acknowledge and mitigate the impacts of trauma on...
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• What do we mean by a trauma-informed approach? • What are the key principles of a trauma-informed approach? • What is the suggested guidance for . implementing a trauma-informed . approach? • How do we understand trauma in the context of community? SAMHSA’s approach to this task has been an attempt
