Trauma Informed Practice

This webpage provides health and social care professionals with a comprehensive overview of trauma-informed practice in the context of adult safeguarding. This webpage highlights the importance of understanding trauma, its impact on individuals, and how professionals can adopt trauma-informed approaches to improve care and support.

Definition of Trauma

Trauma is described as the result of events or circumstances perceived as harmful or life-threatening, leading to long-term adverse effects on an individual’s well-being and functioning.

Trauma-Informed Practice

Trauma-informed practice is an approach that:

• Recognises the widespread impact of trauma on individuals, groups, and communities.
• Understands how trauma affects neurological, biological, psychological, and social development.
• Seeks to avoid re-traumatisation and improve access to safe, culturally sensitive services.
• Encourages practitioners to ask “What does this person need?” rather than “What is wrong with this person?”

It is not a treatment for trauma but a framework to reduce barriers to care for those affected by trauma.

Key Principles of Trauma-Informed Practice

Trauma-informed practice is guided by six key principles that help health and social care professionals create safe, supportive, and empowering environments for individuals who have experienced trauma. These principles are derived from evidence-based frameworks and are reflected across the three source documents.

Safety

Ensure physical and emotional safety for individuals by creating environments that are predictable, respectful, and free from harm.

Trustworthiness

Maintain transparency in decision-making and professional boundaries to build trust with individuals receiving care.

Choice

Empower individuals by offering meaningful choices and respecting their autonomy in care decisions.

Collaboration

Foster shared decision-making and partnership between professionals and individuals to promote mutual respect and understanding.

Empowerment

Support individuals in recognising their strengths and building resilience through affirming and validating interactions.

Cultural Consideration

Recognise and respect cultural, historical, and gender contexts that influence individuals' experiences and responses to trauma.

All Our Health framework

The All Our Health framework, designed to help health and social care professionals address vulnerabilities and promote wellbeing through trauma-informed practice. It supports frontline staff, managers, and strategic leaders in understanding and responding to vulnerability across the life course.

Key Concepts

Vulnerability: Defined as needing special care, support, or protection due to age, disability, or risk of abuse/neglect. It can be influenced by individual, relational, community, and societal factors.

Trauma: Results from harmful or life-threatening events with lasting adverse effects on wellbeing. Trauma-informed practice acknowledges these impacts and aims to create safe, supportive environments.

Re-traumatisation: Occurs when individuals re-experience trauma due to triggers, often unintentionally caused by service interactions.

Risk and Protective Factors

Risk Factors:

• Individual: Early malnutrition, substance misuse, learning difficulties.
• Relationship: Abuse, neglect, poor parenting, household dysfunction.
• Community: Unsafe environments, low social mobility.
• Society: Poverty, discrimination, lack of services.

Protective Factors:

• Individual: Emotional regulation, communication skills.
• Relationship: Stable, nurturing homes.
• Community: Safe, cohesive environments.
• Society: Good housing, economic opportunities.

Professional Actions

Frontline Staff: Understand trauma impacts, apply principles in care, and use local resources.

Managers: Promote inclusive cultures, provide training and supervision, and model trauma-informed approaches.

Strategic Leaders: Use data to shape services, invest in workforce development, and embed trauma-informed systems.

Trauma-Informed Practice in General Practice

GPs are encouraged to:

• Recognise the prevalence of trauma among patients
• Be sensitive to how trauma may affect patient interactions
• Understand that medical procedures may be triggering

Use approaches like the Survivors Trust’s #CheckWithMeFirst campaign, which promotes:

Explain: Describe each step of an examination.

Reassure: Remind patients they can stop at any time.

Practical Applications

• Ask about trauma sensitively
• Provide opportunities for disclosure
• Listen actively
• Empower patients by offering choices and control
• Avoid attributing all issues solely to trauma

Becoming Trauma-Informed

Ongoing Journey: It’s not a one-time achievement but a continuous process of learning, reflection, and adaptation.

Two Key Actions:

1. Learn about trauma responses.
2. Reflect on how these responses may manifest in others’ behaviours.

Further Information

1. Royal College of General Practitioners (RCGP). Safeguarding Toolkit Trauma-Informed Practice.
2. Public Health England. Vulnerabilities: Applying All Our Health.
3. Working definition of trauma-informed practice.
4. Mind Mate Trauma-Informed Practice Information Hub. 

Further Learning Opportunities

Health and social care professionals are encouraged to explore the following resources for further learning:

• Online courses on trauma-informed care.
• Workshops and webinars hosted by professional bodies such as RCGP and NHS.
• Reading materials and case studies available through Public Health England and NHS websites.