Evaluating trauma informed care training for services supporting individuals experiencing homelessness and multiple disadvantage

Purpose Implementing trauma informed care (TIC) for individuals facing homelessness and multiple disadvantage is proposed to help both service users and staff work effectively and therapeutically together. However, the effectiveness of implementing TIC via training is debatable. This study aims to explore the effects of a four-day TIC and psychologically informed environments training package in such services. Design/methodology/approach The analysis explores the effect of this training on the degree of TIC as measured by the TICOMETER, a psychometrically robust organisational measure of TIC. The study examines group and individual level changes from before training and again at six-month and one-year follow-up time-points. Findings At the group level analysis, three of the five TICOMETER domains (knowledge and skills, relationships, and policies and procedures) were higher when compared to pre-training scores. The remaining two domains (service delivery and respect) did not improve. Individual-level analysis showed some participants’ scores decreased following training. Overall, the training appeared to modestly improve the degree of TIC as measured by the TICOMETER and these effects were sustained at one-year follow-up. Research limitations/implications Findings are limited by the design and low response rates at follow-up. Practical implications Training is necessary but not sufficient for the implementation of TIC and needs to be complemented with wider organisational and system-level changes. Originality/value This paper is the first UK study to use the TICOMETER.

Download Full-text

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

The Journal of Mental Health Training Education and Practice ◽

10.1108/jmhtep-02-2016-0016 ◽

2017 ◽

Vol 12 (3) ◽

pp. 188-198 ◽

Cited By ~ 4

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.

Download Full-text

Archival Big Data and the Spanish Flu in Copenhagen

Information Discovery and Delivery ◽

10.1108/idd-11-2020-0142 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Kim Abildgren

Keyword(s):

Big Data ◽

Birth Cohort ◽

Mortality Risk ◽

Early Life ◽

Birth Cohorts ◽

Content Type ◽

Individual Level ◽

Early Life Exposure ◽

Spanish Flu ◽

One Year

Purpose The Spanish Flu 1918–1920 saw a high degree of excess mortality among young and healthy adults. The purpose of this paper is a further exploration of the hypothesis that high mortality risk during The Spanish Flu in Copenhagen was associated with early life exposure to The Russian Flu 1889–1892. Design/methodology/approach Based on 37,000 individual-level death records in a new unique database from The Copenhagen City Archives combined with approximate cohort-specific population totals interpolated from official censuses of population, the author compiles monthly time series on all-cause mortality rates 1916–1922 in Copenhagen by gender and one-year birth cohorts. The author then analyses birth cohort effects on mortality risk during The Spanish Flu using regression analysis. Findings The author finds support for hypotheses relating early life exposure to The Russian Flu to mortality risk during The Spanish Flu. Some indications of possible gender heterogeneity during the first wave of The Spanish Flu – not found in previous studies – should be a topic for future research based on data from other countries. Originality/value Due to lack of individual-level death records with exact dates of birth and death, previous studies on The Spanish Flu in Denmark and many other countries have relied on data with lower birth cohort resolutions than the one-year birth cohorts used in this study. The analysis in this paper illustrates how archival Big Data can be used to gain new insights in studies on historical pandemics.

Download Full-text

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

Advances in Mental Health and Intellectual Disabilities ◽

10.1108/amhid-12-2020-0033 ◽

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.

Download Full-text

SEC adopts regulation systems compliance and integrity

Journal of Investment Compliance ◽

10.1108/joic-06-2015-0041 ◽

2015 ◽

Vol 16 (3) ◽

pp. 4-14 ◽

Cited By ~ 1

Author(s):

James Burns ◽

Georgia Bullitt ◽

Howard Kramer ◽

Jack Habert ◽

James Doench

Keyword(s):

Cyber Security ◽

Financial Services ◽

Periodic Review ◽

Content Type ◽

Security Issues ◽

Market Participants ◽

Investment Companies ◽

Policies And Procedures ◽

Investment Advisers

Purpose – To explain the requirements of Regulation Systems Compliance and Integrity (“Regulation SCI”) and the new responsibilities of organizations defined as “SCI entities.” Design/methodology/approach – Explains the purpose of Regulation SCI, the responsibilities of SCI entities, systems covered by the rules (“SCI systems”), and specific obligations of SCI entities, including the establishment and periodic review of policies and procedures, compliance with the Exchange Act, designation of “responsible SCI personnel,” appropriate corrective action in response to “SCI events,” notification of systems changes, annual “SCI reviews,” business continuity and disaster recovery testing, and recordkeeping and filing. Discusses future implications for SCI Entities and other market participants. Findings – Regulation SCI launches a broad and extensive overlay of rules and guidance to address systems capacity and integrity issues that have increasingly affected the securities markets. The adoption of this regulation suggests that there will continue to be increased scrutiny by the SEC, FINRA and other regulators of the automated systems and related policies and procedures of all market participants. Practical implications – SCI entities will need to devote considerable attention and resources not just to prevent incidents where possible, but also to establish systems for ensuring thorough compliance and well-documented and reasonable follow-up actions where necessary. All market professionals – including broker-dealers, investment advisers, pension funds and investment companies – should study the new regulation and consider adopting appropriate policies and procedures to address operating as well as cyber security issues with respect to their own critical operating technology. Originality/value – Practical guidance from experienced financial services lawyers.

Download Full-text

Supplemental Material for Understanding Staff- and System-Level Contextual Factors Relevant to Trauma-Informed Care Implementation

Psychological Trauma Theory Research Practice and Policy ◽

10.1037/tra0000948.supp ◽

2020 ◽

Keyword(s):

Contextual Factors ◽

System Level ◽

Trauma Informed Care ◽

Trauma Informed

Download Full-text

Rethinking mental health provision in the secure estate for children and young people: a framework for integrated care (SECURE STAIRS)

Safer Communities ◽

10.1108/sc-07-2018-0019 ◽

2018 ◽

Vol 17 (4) ◽

pp. 193-201 ◽

Cited By ~ 2

Author(s):

Jenny Taylor ◽

Lisa Shostak ◽

Andrew Rogers ◽

Paul Mitchell

Keyword(s):

Mental Health ◽

Young People ◽

Evidence Base ◽

Content Type ◽

Theoretical Concepts ◽

Record Keeping ◽

Care Plans ◽

Trauma Informed Care ◽

Assessment And Treatment ◽

Trauma Informed

Purpose The purpose of this paper is to outline the challenges to achieving positive outcomes for young people within the secure estate in England, and introduces a psychologically informed framework, SECURE STAIRS (SS), aimed at improving outcomes. Design/methodology/approach The paper argues that there is a need for a fundamental shift in the way care and intervention for young people within the secure estate is delivered. It gives an overview of current challenges and needs and summarises the theoretical concepts and evidence base which can guide practice and form the foundations of the SS framework. Findings The framework recommends that intervention shift from focussing primarily on individual assessment and treatment to a greater emphasis on supporting the work of the wider system of care. Recommendations include promoting trauma-informed care, a focus on the system dynamics within institutions and how these impact on the care young people receive, and on the collaborative development with residential staff and young people of formulation-led care plans that include a focus on issues of sustainability after leaving the secure estate. Practical implications These include the establishment of discrete residential groupings with truly integrated and trauma-informed work across residential, mental health, education and criminal justice agencies. This involves addressing governance issues around shared record keeping, and challenges to sustainability and the accompanying need for local implementation plans for each establishment alongside central support at a strategic level. Originality/value This paper describes a new and innovative way of working within secure settings to ensure children and young people’s needs are better met.

Download Full-text

The HPWS and AMO: a dynamic study of system- and individual-level effects

International Journal of Manpower ◽

10.1108/ijm-12-2019-0541 ◽

2020 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Fiona Edgar ◽

Jing A. Zhang ◽

Nancy M. Blaker

Keyword(s):

Task Performance ◽

Service Sector ◽

Contextual Performance ◽

System Level ◽

Human Resource Research ◽

Organizational System ◽

Content Type ◽

Individual Level ◽

The Relationship ◽

And Task

PurposeDrawing on the dynamic model of ability, motivation, opportunity (AMO) for human resource research, this study aims to examine how organizational system-level (i.e. the high-performance work system (HPWS)) and individual-level AMO affect employees' performance. Specifically, this paper proposes that employee task performance is resultant from the integration of system- and individual-level AMO factors with employee contextual performance.Design/methodology/approachA survey design is employed with data collected from 250 employees working in New Zealand's service sector.FindingsThis study finds both organizational system (HPWS) and individual AMO dimensions have positive associations with employees' performance. At the system level, the supportive role played by contextual performance is highlighted with pro-social behaviors fully mediating the relationship between the HPWS and task performance. At the individual level, contextual performance is found to partially mediate the relationship between ability and task performance and fully mediate the relationship between motivation and task performance. Opportunity, on the other hand, is significantly associated with task but not contextual performance.Originality/valueIn acknowledging there are a plurality of factors that impact performance, this study enriches our understanding of AMO's influence in the context of people management.

Download Full-text

A Systematic Review and Synthesis of Trauma-Informed Care Within Outpatient and Counseling Health Settings for Young People

Child Maltreatment ◽

10.1177/1077559520927468 ◽

2020 ◽

pp. 107755952092746

Author(s):

Sarah Bendall ◽

Oliver Eastwood ◽

Georgina Cox ◽

Anna Farrelly-Rosch ◽

Helen Nicoll ◽

...

Keyword(s):

Young People ◽

Therapeutic Interventions ◽

System Level ◽

Family Carer ◽

Clinical Practices ◽

Provider Training ◽

Trauma Informed Care ◽

Trauma Informed ◽

And Gender ◽

Definition Of

There is growing consensus that outpatient health services for young people (aged 12–25 years) need to deliver trauma-informed care to ameliorate the effects of trauma, offer safe treatments, and avoid retraumatization. Trauma-informed care has become a familiar term for many professionals; however, its operating definition lacks clarity. MEDLINE, Embase, and PsycINFO were systematically searched to clarify what trauma-informed care is, and what it should achieve in these settings. We reviewed 3,381 unique records, of which 13 met criteria for inclusion. Content analysis identified 10 components of trauma-informed care as it has been operationalized in practice: seven of these occurred at the system-level (interagency collaboration; service provider training; safety; leadership, governance and agency processes; youth and family/carer choice in care; cultural and gender sensitivity; youth and family/carer participation), and three involved trauma-specific clinical practices (screening and assessment; psychoeducation; therapeutic interventions). There is a need for greater consensus regarding an operating definition of trauma-informed care and further research into outcomes for young people and their families/carers.

Download Full-text