Developing trauma-informed care: using psychodynamic concepts to help staff respond to the attachment needs of survivors of trauma

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Emma Rye ◽  
Joanna Anderson ◽  
Max Pickard
Keyword(s):  
Quantitative Research ◽  
Verbal Ability ◽  
Training Programme ◽  
Care Staff ◽  
Term Care ◽  
Content Type ◽  
Trauma Informed Care ◽  
Adults With Learning Disabilities ◽  
Trauma Informed ◽  
The Impact

Purpose Many referrals to our mental health of learning disability service focus on concerns about behaviours that present risks to the referred person and to those around them, including support workers. If the referred person has good verbal ability, psychological therapy may be requested and offered, but the person may find it too difficult to engage for a number of reasons. Even when they do engage in therapy, the authors recognise the importance of helping staff better understand their attachment needs. This paper aims to demonstrate an innovative approach to helping staff provide Trauma-Informed Care (TIC). Design/methodology/approach The authors developed a training programme for support workers using psychodynamic concepts, such as splitting, transference and counter-transference, to help them develop insight into the processes that get enacted during their work. In this paper the authors have generally used the term “care staff”, recognising that an important aspect of the role of those staff is to provide care within an attachment framework; as well as support to maximise independence. Findings The feedback from staff who have attended has been very positive, both at the time and later. Staff who have attended have talked to multidisciplinary colleagues about the impact their learning has had on their ability to work with service users who present great challenges, in the context of their trauma histories. Originality/value The importance of providing TIC is gaining traction across varied settings. The authors are in the process of developing both qualitative and quantitative research programmes to evaluate this approach to increasing TIC for adults with learning disabilities, reducing staff burn out and placement breakdown.

Drawing in not encouraging away: systemic team formulation to support the trauma-informed care of a lady with intellectual disabilities, in the context of COVID-19

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nicola Gregson ◽  
Claire Delaney
Keyword(s):  
Intellectual Disability ◽  
Intellectual Disabilities ◽  
Single Case ◽  
Meaningful Work ◽  
Care Staff ◽  
Future Research ◽  
Content Type ◽  
Trauma Informed Care ◽  
Trauma Informed

Purpose The purpose of this paper is to present a case study using a systemic team formulation approach, in the context of supporting a women with intellectual disabilities with a history of trauma. Design/methodology/approach A reflective stance is used to describe the process of assessment, hypothesising, formulation and intervention in a single case study design. Findings Feedback from care staff suggests that they found a team formulation approach helpful to improve their understanding of the service user they support. Practical implications The paper discusses how systemic team formulation can draw on trauma-informed care principles in the context of supporting an individual with an intellectual disability. Future research should aim to replicate the approach for findings to be applied more broadly. COVID-19 has meant clinical working has had to be adapted, clinicians should carefully consider how collaborative and meaningful work can continue to be facilitated within the current parameters. Originality/value This case study contributes to the literature in the use of systemic team formulation interventions within an intellectual disability context, drawing on trauma-informed care principles and reflecting on adapted working within the COVID-19 pandemic.

Does training change practice? A survey of clinicians and managers one year after training in trauma-informed care

2017 ◽  
Vol 12 (3) ◽  
pp. 188-198 ◽  
Author(s):  
Theresa Maureen Williams ◽  
Geoffrey Paul Smith
Keyword(s):  
Mental Health ◽  
Behaviour Change ◽  
System Level ◽  
Content Type ◽  
Trauma Informed Care ◽  
Trauma Informed ◽  
One Year ◽  
The Individual ◽  
The Impact ◽  
Drug And Alcohol

Purpose The purpose of this paper is to describe the impact of a trauma-informed care (TIC) training programme on practice at the individual and workplace level in mental health and drug and alcohol services and to examine the implications of using training alone as a strategy for achieving system-level practice change. Design/methodology/approach A total of 271 clinicians and managers from public mental health and drug and alcohol services in Western Australia who had undertaken TIC training were invited to complete an on-line survey 12 months after training. Individual survey items were based on a five-point Likert scale with opportunity being provided for additional comments from respondents. Findings One year post-training, both clinicians and managers reported that training had increased their awareness and knowledge and had a positive impact on their attitudes towards TIC. Clinicians reported a moderate impact on their individual practice and both groups reported very limited success in bringing about change in their workplaces. Workforce development and organisational factors were identified by both clinicians and managers as being barriers to implementation. Research limitations/implications Only 30 per cent of the training participants responded to the survey and it is not possible to determine whether they differed from non-respondents. Findings were based on a self-report survey with no objective measure of behaviour change. Originality/value This “naturalistic” study examines the longer-term impact of training, from the perspective of clinicians and managers, on changing practice at the individual clinician and workplace level. It highlights the critical importance of understanding and addressing contextual factors where collective, coordinated behaviour change is needed in order to effect organisational change.

Leadership expectation gap and LMX quality: ethnic and nationality dissimilarities as moderator

2018 ◽  
Vol 50 (7/8) ◽  
pp. 409-419
Author(s):  
Anusuiya Subramaniam ◽  
Murali Sambasivan
Keyword(s):  
Quantitative Research ◽  
Conflicts Of Interest ◽  
Training Programme ◽  
Middle Level ◽  
Content Type ◽  
Moderation Effect ◽  
Expectation Gap ◽  
Negative Effect ◽  
The Impact ◽  
The Relationship

Purpose Demographically similar individuals often believe they are similar, in spite of the differences in values, beliefs and expectations. However, dissimilar dyads experience will encounter more interpersonal difficulties due to misunderstandings, misperceptions and conflicts of interest. The purpose of this paper is to investigate the impact of leadership expectation gap on LMX quality and the moderating role of ethnic and nationality dissimilarity between manager and their superior on the relationship between leadership expectation gap and LMX quality. Design/methodology/approach This study adopted a quantitative research design. A purposive sampling survey of 137 lower-to middle-level managers working under the supervision of Malaysian and Japanese superiors in Japanese multi-national corporations was conducted to test the hypotheses of this study. Findings The study found the following: leadership expectation gap has a significant and negative effect on LMX quality; and ethnic dissimilarity and nationality dissimilarity moderates the relationship between leadership expectation gap and LMX quality. Practical implications There is a need for a comprehensive training programme for both leaders and followers, towards developing their interpersonal skills on how to work better and more effectively in the workplace. Furthermore, prior to the start of the expatriate assignment, organisations can help expatriate superiors to adapt themselves by providing pre-departure and cross-cultural training. Originality/value This paper addresses an important and not so well researched issue. It analyses the moderation effect of ethnic and nationality dissimilarity between manager and their superior on the relationship between leadership expectation gap on LMX quality in the Malaysian context.

scholarly journals A Cross-Sectional Study on the Impacts of Perceived Job Value, Job Maintenance, and Social Support on Burnout among Long-Term Care Staff in Hawaii

2021 ◽  
Vol 18 (2) ◽  
pp. 476
Author(s):  
Bum Jung Kim ◽  
Sun-young Lee
Keyword(s):  
Social Support ◽  
Long Term Care ◽  
Cross Sectional Study ◽  
Care Staff ◽  
Hierarchical Regression ◽  
Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
The Impact

Extensive research has demonstrated the factors that influence burnout among social service employees, yet few studies have explored burnout among long-term care staff in Hawaii. This study aimed to examine the impact of job value, job maintenance, and social support on burnout of staff in long-term care settings in Hawaii, USA. This cross-sectional study included 170 long-term care staff, aged 20 to 75 years, in Hawaii. Hierarchical regression was employed to explore the relationships between the key independent variables and burnout. The results indicate that staff with a higher level of perceived job value, those who expressed a willingness to continue working in the same job, and those with strong social support from supervisors or peers are less likely to experience burnout. Interventions aimed at decreasing the level of burnout among long-term care staff in Hawaii may be more effective through culturally tailored programs aimed to increase the levels of job value, job maintenance, and social support.

scholarly journals Understanding contributors to quality of care in long-term care and changes under COVID-19

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Sara Luck ◽  
Katie Aubrecht
Keyword(s):  
Quality Of Care ◽  
Long Term Care ◽  
The United States ◽  
Control Measures ◽  
Qualitative Description ◽  
Care Staff ◽  
Term Care ◽  
The Impact

Abstract Nursing home facilities are responsible for providing care for some of the most vulnerable groups in society, including the elderly and those with chronic medical conditions. In times of crisis, such as COVID-19 or other pandemics, the delivery of ‘regular’ care can be significantly impacted. In relation to COVID-19, there is an insufficient supply of personal protective equipment (PPE) to care for residents, as PPE not only protects care staff but also residents. Nursing homes across the United States and Canada have also taken protective measures to maximize the safety of residents by banning visitors, stopping all group activities, and increasing infection control measures. This presentation shares a research protocol and early findings from a study investigating the impact of COVID-19 on quality of care in residential long-term care (LTC) in the Canadian province of New Brunswick. This study used a qualitative description design to explore what contributes to quality of care for residents living in long-term care, and how this could change in times of crisis from the perspective of long-term care staff. Interviews were conducted with a broad range of staff at one LTC home. A semi-structured interview guide and approach to thematic analysis was framed by a social ecological perspective, making it possible to include the individual and proximal social influences as well as community, organizations, and policy influencers. Insights gained will improve the understanding of quality of care, as well as potential barriers and facilitators to care during times of crisis.

Evolution of top management’s understanding of product quality in Eastern Europe since the end of communism

2017 ◽  
Vol 29 (1) ◽  
pp. 82-100
Author(s):  
Svetoslav Georgiev ◽  
Emil Georgiev
Keyword(s):  
Eastern Europe ◽  
Product Quality ◽  
Quantitative Research ◽  
Business Performance ◽  
Research Approach ◽  
Senior Managers ◽  
Content Type ◽  
Doing Business ◽  
Using Data ◽  
The Impact

Purpose The purpose of this paper is to analyse the evolution of top management’s understanding of product quality in Bulgaria since the end of communism. The study examines three specific areas: top management’s understanding of the term “quality”; top management’s understanding of the relationship between quality and business performance; and top management’s understanding of the impact of job position on quality. Design/methodology/approach The paper relies on a quantitative research approach by using data from a survey of 186 companies in Bulgaria. Findings The paper suggests that senior managers in Bulgaria continue to base their understanding of “quality” on a single approach (*a characteristic of the communist era), with the product-based and the user-based approaches currently being the two most common ones. At the same time, surprisingly enough, this study claims that senior management in Bulgaria is currently well aware of the importance of quality as a dimension of firm’s competitiveness, and is also highly conscious of its roles’ impact on product quality. Research limitations/implications The results of this study are exclusively based on the case of Bulgaria and must be treated with caution in the case of other former communist states from the Central and Eastern Europe (CEE) region. Practical implications This paper has relevance for both managers and companies doing business in Eastern Europe. Originality/value This is the first paper to provide detailed analysis of the evolution of the understanding of “product quality” in CEE since the end of communism. Moreover, this paper applies, for the first time, Garvin’s five approaches to defining quality within a practical context.

Supporting creative ageing through the arts: the impacts and implementation of a creative arts programme for older people

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Simon Chester Evans ◽  
Jennifer Bray ◽  
Claire Garabedian
Keyword(s):  
Social Interaction ◽  
Older People ◽  
Well Being ◽  
Care Staff ◽  
Successful Implementation ◽  
Creative Arts ◽  
Standard Format ◽  
Content Type ◽  
The Impact

Purpose The purpose of this paper is to report on an independent evaluation of a three-year “Creative Ageing” programme, focussing on the impacts for participants and factors promoting successful delivery of sessions. Design/methodology/approach Artists provided feedback through reflective journals and questionnaires, while the views of care staff and participants were also captured in a standard format at the end of each arts session. Thematic analysis of the qualitative data identified common themes. Findings Twenty-three arts projects were delivered across a range of settings and through diverse art forms including dance, drama, music, visual arts and poetry. They reached nearly 2,200 participants who recorded over 8,100 session attendances in total. Participation in high quality creative experiences improved well-being for older people, as well as increasing social interaction and reducing isolation. Several factors facilitated successful implementation and delivery of the activities, particularly the need to hold planning meetings with staff to provide guidance around participant numbers and suitability, minimising disruption of the sessions and the supportive role of staff during the sessions. Opportunities for reflection enabled artists to address potential challenges and adapt their practice to meet the needs and preferences of participants and to the complexities of diverse settings. Originality/value Previous research has largely focussed on the impact of activities in a single setting. This study supports the role of creative arts in increasing social interaction as an attempt to tackle isolation and loneliness, both for older people living in the community and for those living in a communal setting such as care homes and supported living schemes.

scholarly journals Outcomes-based commissioning for social care in extra care housing: is there a future?

2017 ◽  
Vol 20 (2) ◽  
pp. 60-70 ◽  
Author(s):  
Randall Smith ◽  
Robin Darton ◽  
Ailsa Cameron ◽  
Eleanor K. Johnson ◽  
Liz Lloyd ◽  
...  
Keyword(s):  
Design Methodology ◽  
Social Care ◽  
Resistance To Change ◽  
Care Staff ◽  
Central Importance ◽  
Content Type ◽  
Care Services ◽  
The Impact ◽  
Critical Consideration ◽  
Extra Care Housing

Purpose The purpose of this paper is to provide an overview of the process of commissioning adult social care services in England. It reflects the literature on commissioning at the strategic level followed by a section on operational or micro-commissioning. The rest of the paper focusses on the emergence of ideas about outcomes-based commissioning (OBC) in the field of adult social care and ends with critical consideration of the effectiveness of OBC in adult social care as applied to support and care provided in extra care housing. Design/methodology/approach The review of strategic and operational commissioning in adult social care in England (and Scotland in brief) is based on both policy documents and a review of the literature, as are the sources addressing OBC in adult social care particularly in extra care housing settings. Findings The core of this paper focusses on the challenges to the implementation of OBC in adult social care in the context of provision for residents in extra care housing. Of central importance are the impact of the squeeze on funding, increasing costs as a result of demographic change and the introduction of a national living wage plus the focus on the needs of service users through the idea of person-centred care and resistance to change on the part of adult social care staff and workers in other relevant settings. Originality/value Addressing the implementation of OBC in adult social care in England in the context of extra care housing.

The rate and impact of substance misuse in psychiatric intensive care units (PICUs) in the UK

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hattie Catherine Ann Moyes ◽  
Lana MacNaboe ◽  
Kate Townsend
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Substance Misuse ◽  
Well Being ◽  
Training Programme ◽  
Content Type ◽  
National Quality ◽  
Improvement Programme ◽  
The Uk ◽  
The Impact

Purpose This paper aims to understand the current scale of substance misuse in psychiatric intensive care units (PICUs), identify how substance misuse affects members of staff, patients and the running of wards and explore with staff what resources would be most useful to more effectively manage substance misuse and dual diagnosis on PICUs. Design/methodology/approach The paper used a mixed-methods approach, using a quantitative survey to determine the extent of substance use in PICUs and a co-design workshop to understand the impact of substance misuse on PICU wards, staff and patients. Findings The estimated rate of substance misuse in PICUs over a 12-month period is 67%, with cannabis the most frequently used substance. Despite the range of problems experienced on PICUs because of substance misuse, the availability of training and resources for staff was mixed. Research limitations/implications The findings may not be fully generalisable as research participants were members of a national quality improvement programme, and therefore, may not be representative of all PICUs. Data was collected from clinicians only; if patients were included, they might have provided another perspective on substance misuse on PICUs. Practical implications This paper emphasises the importance of substance misuse training for PICU staff to adequately respond to patients who misuse substances, improve the ward environment, staff well-being and patient outcomes. Originality/value This paper provides an updated estimation of rates of substance misuse in PICUs over a 12-month period and make suggestions for a training programme that can better support staff to address substance misuse on PICUs.

Sign in / Sign up

Export Citation Format

Share Document