Trauma Informed Practice

This Sexual Health Week we want to amplify the voices of those who face barriers as well as those who are working tirelessly to break barriers. We have collaborated with The Survivors Trust as part of the #CheckWithMeFirst campaign, to help raise awareness of the barriers that may be faced by young people who are survivors of sexual abuse, assault and trauma when accessing sexual health and wellbeing services. Here, Ella Craddock and Simone Taylor explain what trauma-informed practice is and what it means for Brook.

What is trauma-informed practice? 

Trauma-informed practice gives practitioners tools to create a safe environment for those they are working with and themselves. The key goal is to raise awareness about the wide impact of trauma and to prevent the re-traumatisation of clients accessing services which are meant to support them. The practice itself aims to minimise distress through prior planning and recognising content, procedures or activities that could trigger or mirror past trauma. 

With a trauma-informed approach we move from thinking about ‘what is wrong with you?’ to ‘what has happened to you?’ 

We try to take in the full context and complexity of a person’s experience, rather than only reacting to their presenting behaviour. Sometime we hear young people or groups called ‘challenging’, ‘risk taking’ or ‘hard to reach’. With a trauma-informed approach we try not to negatively label people but think about the reason for this behaviour, the feelings and experiences which are causing this response.  

Why is it important that services are trauma-informed? 

Research from Young Minds shows that close to half of adults (48%) in the UK have experienced at least one Adverse Childhood Experience (ACE) in their childhood or adolescence, with 9% experiencing four or more. Adverse Childhood Experiences (ACEs) are defined as highly stressful events or situations that occur during childhood and/or adolescence, which can be a single event or incident, or prolonged threats to someone’s safety, security or bodily integrity. These experiences require significant adaptations by the child or young person to not only survive in their immediate environment, but also establish a sense of control and to make sense of what has happened. These adaptions are often the safest response when faced with danger, but the issues come when these adaptations or coping strategies continue away from the dangerous environment or person. Experiencing adversity can have a lasting impact on someone’s life.

They may see the world through ‘trauma tinted glasses’, applying the lessons they learnt through their trauma to the wider world.

Evidence suggests that experiencing ACE’s can impact your health outcomes throughout your life, with more ACE’s meaning a greater potential impact. People may be more likely to smoke, more likely to have low levels of mental wellbeing, more likely to use illicit drugs, be involved in violence and more likely to be incarcerated.  

However, we want to stress this is a causation not a correlation. People are unique and everyone will respond differently. We all have protective factors which support us to manage adversity. These might be a supportive family, friend or peer group, having therapeutic interventions or our own self resilience. Another protective factor would be accessing safe and trauma-informed services for support.  Nevertheless, we can see the importance of being aware of the impact of trauma as it will affect so many of the people who use our services and those working in them too.  

What does being trauma-informed look like in practice for sexual health services like Brook? 

Those who have experienced childhood adversity and trauma may have additional barriers in accessing services, like Brook. For many anything that reminds them of that traumatic experience will set off their own unique trauma response to protect themselves, meaning they may avoid the situations, places and people that are actually meant to help.

Trauma often happens in relationships with others, meaning trusting professionals and services to be safe can be really difficult. 

As sexual health professionals at Brook we often have short interventions with service users and can wonder what impact we can make. However, a trauma-informed practice emphasises the value of showing a different and safe relationship with those who have experienced trauma, even if only once and only briefly. If this message is repeated again and again in people’s interactions, learning taken on through their traumatic experience can be relearnt. People can then feel safe to take advantage of the help the service is offering and so improve their health and wellbeing outcomes.   

There isn’t one definitive definition of how to be trauma-informed but at Brook we advocate for applying NAPAC’s (National Association for People Abused in Childhood) key principals.  

They state that an organisation should be and show: Safety, Trustworthiness, Collaboration, Empowerment and Choice. We hope to live these principals in our work with clients but also throughout our organisation in policies, procedure and the culture we create at work. In practice this means lots of small and large steps to build a safe environment; from offering clients choice about their health options in a non-judgemental space to implementing robust anti-discriminatory procedures within our HR policies.  

What steps is Brook taking to ensure that its services are trauma-informed? 

Importantly trauma doesn’t just impact those who use our services but those who work in them too. We have implemented a large number of mental health and wellbeing initiatives in recent years, offering support for any staff who may need additional help.

Brook strives to create an empathetic space which listens to our teams, working with them to achieve.

We offer mandatory internal training on trauma-informed practice for all staff at Brook, within our suite of internal safeguarding and mental health awareness training. Building on this we are working on a programme of best practice sharing sessions and action planning initiatives to support implementation of learning around trauma. But there is always more to do. At Brook we aim to develop our individual practice and our services informed by a recognition and understanding of the lived experience of trauma, with a commitment to promote recovery and enhance protective factors at every contact with Brook. 

People should feel empowered and safe at Brook, with agency in a trusting and collaborative relationship. We should assume complexity, approaching with empathy, working from the assumption that everyone we interactive with may have experienced trauma or adversity. 

Find out more about Brook’s Sexual Health Week 2022: Breaking Barriers