Expert view: Implementing a trauma informed approach
Dr Asha Patel, clinical psychologist and founder of Innovating Minds CIC
(as seen in Children & Young People Now Magazine, August 2022)
Frontline practitioners such as educational staff, early help teams, victim support and youth workers often provide early intervention and support to children and families within the heart of the community. These practitioners are supporting our most vulnerable children that have been affected by domestic abuse, ‘honour’-based abuse, criminal and sexual exploitation, children at risk of school exclusion and gender-based violence. At this moment in time, it is important for us to reflect upon the sheer responsibility these practitioners are carrying and the significant impact they have on enabling children to access early help to prevent vulnerable children becoming a victim of the ‘system’.
Frontline practitioners are generally not clinically trained professionals however they are skilled at developing therapeutic relationships that foster safety and connection through empathy and compassion. These practitioners may be the only safe adult in a child’s life, and they can help the child to feel safe, seen, soothed and secure (Sigel and Bryson, 2020). In essence, a majority are already on their journey to implementing a trauma informed approach to support children and families however to further develop their practice a systemic approach is required. A systemic approach acknowledges that strategic organisational changes need to be implemented to foster a culture that is based upon relational and neuroscientific approaches.
Systemic approach
An organisation that has a culture centred around trauma informed practice provides wraparound support which includes access to ongoing training, resources to deliver trauma-based interventions and the support for practitioners to reflect upon their work and the impact it is having on their mental health. Trauma informed practice requires practitioners to be grounded, self-aware and come from a place of empathy. Consequence and reward-based systems are typically not implemented as these approaches are viewed as shaming, humiliating, and re-traumatising.
Trauma focused Interventions are focused upon body-based approaches as opposed to cognitive-based interventions (i.e., cognitive behaviour therapy). For decades it was believed that talking about trauma will help, however trauma informed practice acknowledges that children retelling their trauma stories can be re-traumatising.
The literature demonstrates that the brain is always listening to the body and therefore when the body is feeling unsafe the brain will flick into safety survival mode to keep us safe (Dr Daniel Siegel, hand-brain model). Body based interventions focus on children learning about how their body and brain work together when they are feeling safe and unsafe. Carefully children learn how to pay attention and acknowledge how the body is physically feeling so they can implement strategies (i.e. breathing and grounding techniques) to send signals of safety to the brain.
Healing Together
With the increased focus on the impact of childhood trauma, schools and community services are implementing trauma informed practices to ensure children’s emotional and neurological needs are met.
Innovating Minds are training frontline practitioners nationally and providing the wrap around support to equip them to deliver the Healing Togetherä programmes. These are trauma informed programmes that provide children access to early trauma informed help by the people they trust, and in a space they feel safe.
The effectives of the Healing Together programme has been measured by the Emotional Awareness Questionnaire, research methodologies and statistical calculations (paired t-tests and ANOVA). The data demonstrates that the Healing Together programme has a statically significant difference for children aged 5-16 years on the measures ‘differentiating emotions’, ‘not hiding emotions’ and ‘verbal sharing of emotions’.
The ANOVA analyses measures whether there has been any interaction on reason for referral, delivery method (groups or one-to-one), or age of the children to the overall effectiveness of the programme. It has found that there are some significant interaction effects of referral reason, age and delivery method on verbal sharing of emotions.
The paired t-test also demonstrated that there is a statistically significant difference in facilitator’s knowledge, understanding and confidence in implementing a trauma informed approach after completing the Healing Together facilitators training.
The wider impact
One of the first academies to take up the Healing Together training was Orchard Hill College & Academy Trust. The trust was successful in gaining funding from the Youth Endowment Fund to train 18 of their staff. The fund prioritised work supported vulnerable young people at risk of youth violence.
The outcomes demonstrated that children for the first time had started to engage with the pastoral team, engagement in learning had improved and children had started to communicate more openly with the educational staff.
The results demonstrated that access to trauma informed practice can impact a child’s emotional and mental health, but this experience can also have a positive impact on other aspects of their life.
Further Reading
The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma, Bessel A. van der Kolk, Penguin Books Ltd, 2019
The Power of Showing Up: how parental presence shapes who our kids become and how their brains get wired - Mindful Parenting, Sigel, D., and Bryson, T., Scribe: London, 2020