A practical approach to trauma informed care
Do you know your TIC from your PIE?
As a sector, we are continually improving our understanding, and our approach to addressing the needs, of the people we support. It’s no surprise that many services are exploring how past traumas can affect behaviours in our services and, most importantly, what we can do about it.
Two approaches in particular are being adopted widely - trauma informed Care (TIC) and psychologically informed environments (PIE). But perhaps because they have much in common the key differences aren’t obvious.
Many of you have asked us to help you get to grips with these two recent innovations, so here’s a very quick introduction (and a few signposts to find out more).
Simply put, both approaches aim to address the psychological wellbeing of people using services by implementing a framework in which their psychological needs are considered.
Psychologically informed environments (designed in the UK) and trauma informed care (a US innovation) also consider the psychological wellbeing of the staff providing the service. They focus on staff development and support, positive and empowering relationships, and improving wellbeing through the environment and support provided to both service users and providers.
However, neither approach expects support staff to be quasi-therapists or to start delving into someone’s trauma history with them. Instead they promote the creation of safe and empowering environments based on an understanding of repeated experiences of trauma, which often started in childhood.
They acknowledge that a high proportion of people using homelessness services have previously experienced neglect, abuse or other traumas. They also acknowledge that these experiences will affect how a person relates to the world and other people.
So what is the difference?
Service development and delivery of trauma informed care is underpinned specifically by theory and research of trauma. In contrast, the thinking behind psychologically informed environments is less prescriptive, recommending that any psychological framework can be used. You may have heard of some of the popular frameworks used in this and other sectors - for instance, cognitive behavioural, psychodynamic therapies or trauma theory.
The choice of framework depends on the type of service and the needs of the client group. The key is that there is a framework that recognises the significance of psychological and emotional trauma, and that it is understood.
In fact, in many respects, you could view trauma informed care as one flavour of a psychologically informed environment.
Where to learn more
There is plenty of information out there about both approaches and how they can be implemented.
Pielink has a wealth of information about psychologically informed environments and invites you to join a network of people interested in the approach.
A quick search online for resources on trauma informed care will throw up reams of information from North America, where the approach has been developed in different public sectors over many years.
You can find more information about both approaches in reports by both Elizabeth Eastlund and I on our experiences on the 2014 Transatlantic Practice Exchange.
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Innovation and good practice project manager
Jo is an innovation and good practice project manager, leading a range of projects and training including Housing First England and Trauma Informed Care.