The Care Sector needs national standards for Trauma-Informed approaches

ACEs Recovery Toolkit


25th April 2022


Laura Harris


Sue Penna, Chief Executive Officer, Rock Pool C.I.C

Working as an Occupational Therapist in acute and community mental health settings I had felt like a lone wolf arguing that my clients’ distress should not just be seen through a diagnostic lens – that the early life experiences they described to me – child sexual abuse, neglect, violence, extreme poverty – has profoundly impacted on their ability to cope socially, emotionally and cognitively.

People struggle to manage when they have non-regulated stress responses, poor attachments and lack of trusting supportive relationships in their lives and as a result can be targeted by those wishing to exploit them sexually and criminally.

I was lucky enough to visit centres of excellence in America and Canada informed by the ACE study who were using a trauma-informed approach with their community. This experience inspired me to develop recovery programmes for adults and children and young people who have experienced multiple ACEs. We have now renamed these group programmes  PAACE to incorporate positive childhood experiences and move away from the deficit model that only considers ACEs. 

The programmes have been written to educate and inform individuals about the impact of PAACEs. They provide guidance on protective factors that help mitigate the impact of ACEs and practical methods to help develop resilience and cope with the adversity they have experienced and may do so in the future.

Since launching these programmes in November 2017, we have trained over 1300 front line practitioners from across the UK to become PAACE Recovery Toolkit Facilitators.

It really feels like the time had come to address psychological trauma and its impact on individuals and communities.

But over the last 2 years I have become concerned that ACEs and trauma-informed practice have become just more buzz words; the latest box to tick.

There has been discussion on social media and within the social care sector about using the original ACE checklist on children and as a screening tool for people to access services (or not); there is a lack of recognition of the added societal traumas, poverty and homelessness, inequality and now Covid-19 that contribute to childhood trauma and psychological distress.

Similarly, ‘trauma-informed approach’ is a term bandied around as though it’s something that can be done to people rather than something that requires a cultural shift in organisations.

In the devolved governments of Wales and Scotland their public health departments and NHS have collaborated to develop best practice evidence, research, standards for trauma training and service delivery. There is a sense in these countries that as the agenda to address adversity in childhood and trauma-informed approaches progresses it does so safely; and safety (a key element in a trauma informed approach) is vital because if services are not safe, we will not be providing the right care for our traumatised communities. 

Last year the UK government finally produced a

“Working definition of trauma-informed practice”



However, there are still no guidelines or practice standards and the ‘everyone’s an expert’ narrative continues. 


These are challenging and exciting times, but we need to get it right or the agenda will shift again and opportunity to transform people’s lives will be lost and ‘another new best thing’ will arrive.

As practitioners and caring professionals, we need to hold the hope for our communities, to help resilience flourish and enable recovery.

Sue Penna is co-founder of Rock Pool, a training and consultancy service for the care sector, and author of The Recovery Toolkit.

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