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.

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

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rupert Burge ◽  
Anna Tickle ◽  
Nima Moghaddam
Keyword(s):  
System Level ◽  
Content Type ◽  
Individual Level ◽  
Trauma Informed Care ◽  
Policies And Procedures ◽  
Trauma Informed ◽  
Care Training ◽  
One Year ◽  
Level Analysis

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.

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.

Creating a culture of employability in mental health

2014 ◽  
Vol 18 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Naomi Boycott ◽  
Justine Schneider ◽  
Michael Osborne
Keyword(s):  
Mental Health ◽  
Supported Employment ◽  
Implementation Process ◽  
Lessons Learned ◽  
Service Development ◽  
Content Type ◽  
The Individual ◽  
The Uk ◽  
Early Intervention In Psychosis ◽  
The Impact

Purpose – The purpose of this paper is to draw out the lessons learned from the implementation of the Individual Placement and Support (IPS) approach to supported employment in two contrasting adult mental health teams; one “standard” CMHT, and one early intervention in psychosis (EIP) team. Design/methodology/approach – These inferences are based on the evidence from a four-year study of IPS in one mental health care provider in the UK, which began by setting up a new service, and went on to run a RCT looking at the impact of psychological input as an adjunct to IPS alone. Findings – In attempting to introduce IPS to mental health teams in Nottingham the authors came across numerous barriers, including service reorganisation, funding cuts and the wider context of recession. Differences were observed between mental health teams in the willingness to embrace IPS. The authors argue that this variability is due to differences in caseload size, recovery priorities and client profiles. The authors have learnt that perseverance, strenuous efforts to engage clinical staff and the use of IPS fidelity reviews can make a positive difference to the implementation process. Practical implications – The experience suggests that setting up an IPS service is possible even in the most challenging of times, and that EIP services may be a particularly fertile ground for this approach. The authors also discuss potential barriers to implementing new services in mental health teams. Originality/value – This paper will be of value to service development and the science of implementation in mental health.

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

2018 ◽  
Vol 17 (4) ◽  
pp. 193-201 ◽  
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.

The impact of employees’ well-being on performance in the workplace

2018 ◽  
Vol 17 (2) ◽  
pp. 72-75 ◽  
Author(s):  
Janice Haddon
Keyword(s):  
Mental Health ◽  
Personal Experience ◽  
Well Being ◽  
Content Type ◽  
Different Types ◽  
The Individual ◽  
Hr Managers ◽  
The Impact ◽  
Mental Well Being ◽  
Made In

Purpose The purpose of this paper is to look at the link between employee well-being in the workplace and its effect on productivity. Specifically, it looks at the different types of well-being (physical, nutritional and mental) and how organisations should be putting the welfare of staff at the heart of their workplace culture, to ensure their well-being and productivity. Design/methodology/approach Written as a viewpoint, the paper outlines the ways in which organisations traditionally offer employees incentives to look after their physical and nutritional well-being, such as gym memberships and healthy food options. It goes on to look at the impact of mental health on productivity and the symptoms employees may display if they are suffering with mental illness. Findings Mental health is one of the key contributors to productivity, and employers should do more to ensure the mental well-being of their staff. In addition, it outlines the impact a person’s mental well-being can have not only on themselves, but also on those around them, affecting, therefore, the productivity of a team/organisation as a whole, not just the individual. Originality/value The findings in the paper are based on personal experience, as well as recent statistics which are used to highlight the importance of the arguments made in the paper about the effect of mental health on and individual’s well-being and productivity. It is designed to advise HR managers and employers of the steps they can take to ensure the well-being of their employees and the benefits to themselves in doing so.

Adverse childhood experiences and trauma informed care: treating the whole patient with a more complete osteopathic approach

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
T. Brian Marcoux
Keyword(s):  
Adverse Childhood Experiences ◽  
Medical Training ◽  
System Level ◽  
Traumatic Experiences ◽  
Childhood Experiences ◽  
Health Crisis ◽  
Trauma Informed Care ◽  
Adverse Childhood ◽  
Trauma Informed ◽  
The Impact

Abstract In 1998, a seminal study identified a strong connection between participants’ exposures to adverse childhood experiences (ACEs) and the development of risk factors for serious health conditions later in life. More than two decades later, leaders in both policy and health care professions now appreciate the impact of social determinants of health, including the enormous societal costs incurred by deleterious experiences, and recognize that treating illness begins with prevention in early childhood. The trauma informed care (TIC) model offers a treatment approach that lends consideration to the traumatic experiences that impact a given patient and allows for more complete treatment by their physician. Delivering care under the TIC model encourages trauma identification, early intervention, system level awareness and policy change, and avoiding retraumatization in the therapeutic setting. Various programs across the country seek to employ these methods at the community, state, and federal level. Several programs aimed at introducing medical students to these principles have contributed to an incorporation of TIC within the physician pipeline. In this Commentary, the author proposes an expansion of the Tenets of Osteopathic Medicine with a fifth principle—considering the implications of a patient’s past formative experiences, their present life circumstances, and their future prospects—as a vehicle for instilling TIC principles ubiquitously throughout osteopathic medical training to develop physicians who treat the whole person more completely and are better equipped to manage this public health crisis.

scholarly journals Effects of Trauma-informed Care Training on Healthcare Providers Caring for Victims of Human Trafficking

2020 ◽  
Author(s):  
Sandrine Gaillard-Kenney ◽  
Brianna Kent ◽  
Jenna Lewis ◽  
Chennel Williams
Keyword(s):  
Mental Health ◽  
Human Trafficking ◽  
Mental Health Professionals ◽  
Group Discussion ◽  
Mental Health Provider ◽  
Health Providers ◽  
Trauma Informed Care ◽  
Trauma Informed ◽  
Care Training ◽  
The Impact

Objective: The purpose of this study is to analyze the impact of trauma-informed care training on the practice of dental, optometry, and mental health providers caring for victims of human trafficking. Methods: A mixed method approach was used, including pre-post surveys and one focus group discussion. Results: The dental, optometry, and mental health provider participants reported a greater awareness of human trafficking and greater knowledge of how to approach and care for the victims in a trauma- informed way. Conclusion: Continued training on the provision of trauma-informed care for victims of human trafficking is necessary for dentists, optometrists, and mental health professionals serving in health clinics in a university located in the southeast United States.

Creative practice as a mutual route to well-being

2020 ◽  
Vol 24 (4) ◽  
pp. 235-239
Author(s):  
Elaine Argyle
Keyword(s):  
Mental Health ◽  
Design Methodology ◽  
Mental Health Problems ◽  
Well Being ◽  
Group Leaders ◽  
Content Type ◽  
Group Members ◽  
Recovery Models ◽  
The Individual ◽  
The Impact

Purpose Drawing on the evaluation of a series of workshops in painting and drawing, this paper will assess the impact of attendance on the well-being of participants who had been identified as being at risk of developing mental health problems. Design/methodology/approach The evaluation was conducted by an independent researcher and consisted of interviews with group members at the beginning and the end of the project about their expectations and experiences. To complement this data, interviews were also carried out with group leaders and artists. Findings Workshop attendance helped to promote the mutual recovery and inclusion of participants while also enhancing the supportive capacities and social capital of their respective groups. These impacts were broad, sustained and mutually reinforcing, transcending the individual and the group to incorporate wider settings. Originality/value The importance of the these wider factors are often overlooked by traditional recovery models with their person-centred focus tending to neglect the context in which this recovery is located.

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