Supporting Community Mental Health Teams’ to work in a more Trauma Informed Way

A factual description of your example (as free from judgement as possible):

We ran a 4-module training for members of a local CMHT (CPNs, OTs, Psychiatrists, Support Workers). Areas covered by the training included: 1) Understanding of the Impact of Trauma, 2) Window of Tolerance and Stabilising Trauma Reactions, 3) Rupture and Repair. Keeping the Therapeutic Relationship Safe when Working with Trauma. 4) Understanding and Managing Risk and Addiction in Trauma.

The team were provided with a Trauma Stabilisation Pack to support them to have trauma informed interactions with people they were working with. Team subsequently requested team supervision to facilitate and support their practice. The team also began to recognise the emotional toll of their work and needing a space for this.

We evaluated training through team reporting and service user feedback on changes in practice. The trust has asked this training to be rolled out across all CMHTs and other acute and community-based services. We are in the process of training Psychology dept colleagues as part of roll out. We recently shared the outcome of this pilot at a local conference and colleagues in the Police, Social Work and Probation have requested provision of training.

 

Whose needs are met in the example that you outline:

MDT colleagues: access to trauma informed training, perspective, and ways of working and access to supervision.

Service users accessing local services with a trauma-related presentation.

 

What positive impact do you think this example had at the time:

Training had a positive impact on staff and the people who they were supporting.

Both staff and service users they were working with reported benefiting from 1) understanding symptoms as safety strategies (de-shaming/validating/normalising), 2) developing stronger therapeutic relationship, working with rather than against, ‘getting alongside’ the person more, 3) and improved access to trauma informed stabilisation/intervention strategies.

Organisationally it has helped in raising the profile of trauma-informed care and helped identify the issue of staff well-being (both in terms of vicarious trauma but also staff’s own trauma history).

 

What factors do you think may have contributed to this example (e.g., leadership, pathway, values etc):

High motivation/support to see implementation of TIC from some key individuals in Trust.

“Bottom Up” strategy required to implementation. Being able to implement small scale, local pilot project to demonstrate effectiveness and value and then using this as an example of good practice to lead to wider roll out/winning of ‘hearts and minds’ in Trust. 

 

How do you feel when you bring this story to mind?

Pleased/proud to be able to implement a change in a system and to see others place value on this, has left me motivated but also impatient for more change!

 

What motivated you to bring this example in particular:

It was an example of the power of having a trauma-informed approach and how what seems like a little (in terms of resource commitment) can go a long way in terms of outcome and qualitative changes in interactions occurring. Led to very different conversations both within the team but also between team members and service-users they were supporting. For example, support workers described being able to de-shame flashbacks by talking about how trauma is stored in brain, CPNs were able to normalise and make sense of dissociation, led to shifts in how risk-behaviours were understood, talked about, and managed.