TIC Changing attitudes and cultural bias

Please describe a relationship, service intervention, program implementation, policy, or other that you initiated or know about that would be considered trauma-informed:

Roll out of trauma informed care on 4 female secure wards where there was a heavy focus on risk, behaviour, diagnosis, medication, problem, and symptoms.

Training for ward staffs that was based on challenging ideology, attitudes, recognising trauma in staff and service users, challenging practice that is punitive or coercive& disempowering.

Co- produced design and implementation of stabilising core sessions aimed at regulating emotions of service users and staff and developing routine, structure and cohesion on the wards.

Introduction of Trauma informed processes such as routine enquiry, screening, assessment, and formulations, all with a trauma focus. Development of trauma narratives so this information may be readily available for staff as Paris doesn’t support quick identification of such information.

Co-produced trauma focussed nursing intervention plans that look at risk and advanced decisions around safety and interventions at critical or crisis periods.

Introduction of staff supervision to identify trauma related issues along with introduction of alternative to debrief in line with new nice guidelines for staff who do not wish to proceed via usual processes post incident

Service user’s supervision – to offer service users opportunity to talk through any trauma related incidents on the ward that may have been adversely impacting on their own mental wellbeing or re-traumatising

Identification and development of key trauma staff who are leading the TIC changes on the wards and in the clinical areas.

DATA completed on staff and service users’ wellbeing to ensure impact is positive.

 

What was the outcome?  

Variable – initially motivated and then some resistance when changes evoked some initial increase in harmful behaviours. Improved again with sustaining methods, - supervision ongoing training staff support.

Positive outcomes overall, reduction in incidents – controversially some staff came forward with increased anxiety and trauma symptoms, this has been viewed differently from service, some think it is a negative TIC team think this is good as staff are being more open about their struggles.

Stabilisation and core sessions has been amazing and really improved ward structure

Supervision has identified key issues in implementation of tic especially re processes and culture.

 

What supported the positive outcome? (Systemic supports? Organizational supports? Interpersonal supports?):

Senior leads investment and support

Staff willingness to try something different

Service users’ compassion, support, and belief that this is a positive change and their willingness to try new things

 

In what way has your example changed you, your practice, or your goals:

My practice hasn’t necessarily changed other than it has given me a lot more understanding of impact of Trauma especially on culture and attitudes

 

Tell us more about what motivated you to bring this example to discuss:

It has been my full-time role for the last 18 months and it has been a massive roller coaster ride of emotions

 

Whose needs are met in the example that you outline:

Staff and service users

service

 

Was there any one person or factor that was central to the success of your example and why:

Service users

All staff who embraced this new way of working and were brave enough to share their thoughts in an open and honest way, this allowed us to see the real issue and be able to challenge them using the TIC underpinning framework and compassion focussed approaches

 

What can you or others do to spread this good practice to colleagues and services:

Share our experiences