Thank you for listening to this short podcast on behalf of the West Sussex Safeguarding Adults Board, about trauma-informed approaches. In this podcast I will explain what trauma and trauma-informed care is. I will also discuss working with trauma, in terms of the five R’s and five principles, and provide details on where you can access further information.
So, firstly, what is trauma?
Trauma can refer to a traumatic, abusive, or neglectful event or events, that are experienced as being emotionally or physically harmful or life-threatening. Whether an event or events are traumatic depends not only on the adult’s experience of the event, but also how it negatively impacts on emotional, social, spiritual, and physical wellbeing.
Trauma can be understood in terms of the three E's:
- Firstly, the event: what was the event?
- Secondly, the experience: what was the adult’s experience of the event?
- And finally, the effects: what were the effects of the event on the adult?
So now I have explained what trauma is, what is trauma-informed care?
This means being able to see beyond an adult’s presenting behaviours and to ask, ‘what has happened to you’ rather than ‘what is wrong with you?’. It involves recognising when someone may be affected by trauma, collaboratively adjusting how we work to take this into account, and responding in a way that supports recovery, does no harm, and recognises and supports people's resilience.
This approach allows adults to feel safe and develop trusting relationships with services and practitioners. Being “trauma-informed” is much more than a term. It is multi-layered and requires a whole system approach. It applies to all areas of an organisation and across the system. This includes integrating trauma-related aspects, knowledge, and concepts into things such as training, recruitment, policies, and procedures amongst many other things.
So, how do we work with those who have experienced trauma?
This can be summarised by using the five Rs.
- The first R stands for realising. In practice this means realising how common the experience of trauma and adversity is.
- The second R stands for recognising. This means understanding the different ways that trauma can affect people.
- The third R stands for responding. We do this by taking in to account of the ways that adults can be affected by trauma to support recovery.
- The fourth R stands for resisting re-traumatisation. We do this by providing opportunities to offer a greater sense of choice and control, empowerment, collaboration, and safety.
- and finally, the fifth R stands for being reflective. Trauma-informed services reflect on their practice, with a fundamental focus on relationships at the heart of our work.
So, now I have explained the five Rs are, I am now going to explain the five principals that can be used to support your practice.
The first principle is safety. Physical and emotional safety are key to do meaningful work. Traumatised adults may have developed an overactive stress-response and may often feel unsafe. To support adults to feel safe, you should:
- Be open and honest, explain what is happening and why at every stage, making sure the adult understands what will happen next, the possible outcomes, and practical information, such as when and how you will meet.
- Consider intersectionality and how to meet people’s needs for cultural safety. Minority groups are often disproportionately affected by trauma; discrimination can also worsen or increase the impact of trauma.
It is incredibly important to note that re-traumatisation can occur when talking about specific events. In general, it should be made clear that adults are not required to talk about the specific details of trauma. When gathering information, it is not always necessary to know the full details, but rather the impact of trauma and details of recovery.
The second principle is trust. For adults who have experienced trauma, it can be difficult to establish trust. To develop trust, you should:
- Implement good personal and practitioner boundaries; be aware that you may need to re-establish trust each time you meet with the adult.
- Be reliable and honest about what you can and cannot do, while recognising and addressing the power imbalances between you and the adult.
- Use a non-judgmental, compassionate approach and be responsive to the experiences of those you work with, remembering that everyone experiences trauma differently.
The third is choice. Offering realistic choices may be challenging for the adult and those working with them. To offer choice, you should:
- Acknowledge the power difference at the initial stages to support working with adults who may have experienced others misusing power.
- Acknowledge the limits in choice, for example changes in staff. However, practitioners should aim to constantly keep these issues in mind to establish trust.
- Engage the adult and give them choice in how work continues. Consent should be sought, explaining how information will be shared and the limits to confidentiality, giving the adult options and discussing with them what they would like to happen.
The fourth is collaboration. This means working towards a common goal or purpose. Adults who have experienced trauma may have very little trust in their needs mattering to others, or very little experience of being involved in decisions, so may need support and encouragement to do this. To work collaboratively, you should:
- Encourage interactions that contain a psychoeducational element, this means inviting people to collaborate in their recovery by sharing information.
- Ask the adult what they need for a certain part of the meeting or visit, or identifying coping strategies that may be helpful or problematic in the longer term and discussing options for support.
The fifth principle is empowerment. The principles described previously all contribute to empowering adults we work with. Showing someone that they can be safe, demonstrating you can be trusted and so can they, and offering choice and collaboration to someone who has never had these options, are all empowering. Empowerment means treating the person as an equal. This may include offering challenge constructively, rather than judgmentally, which can enable reflection and be very useful. Supporting and empowering adults to recognise unhealthy coping strategies can be a life-changing opportunity.
So, finally, what other resources can you access to support a trauma-informed approach?
On the learning briefings and podcasts page of our website we have a number of learning briefings and podcasts. In relation to this briefing, these include:
- Making Safeguarding Personal
- Person-Centred Approaches
- and Multi-Agency Working
In the learning briefing accompanying this podcast you will also find useful links to resources used to create this podcast.
This brings us to the end of our podcast. Thank you for your time to listen to it. We do appreciate you recognising the importance and value of working in a trauma-informed way to help deliver supportive and effective care to those who have experienced trauma.