The Care Sector needs national standards for Trauma-Informed approaches
Sue Penna, Joint Chief Executive Officer, Rock Pool
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 and that 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.
The programmes have been written to educate and inform individuals about the impact of ACEs. 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 September 2018, we have trained over 1154 front line practitioners from across the UK to become ACE 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 banded around as though it’s something that can be done to people rather than something that requires a cultural shift in organisations.
Suddenly there are experts everywhere and while this may be the case, in England, we have no benchmarks to assess the quality of trauma informed service delivery.
Contrast this to 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. This is even more vital as we continue to live in a world dominated by a pandemic.
There is no such national strategy in England, no standards for practitioners/trainers or clients to benchmark against. No vision and now no Public Health England to even lead on this. Where work is being done nationally it is hard to access and is not inclusive.
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.