Trauma-Informed Care Jo Prestidge Senior Personal Advisor – Mental Health and Wellbeing

1. Trauma-Informed CareJo PrestidgeSenior Personal Advisor – Mental Health and Wellbeing

2. How I got here • Role with entrenched rough sleepers • Limited mental health services • Relationships and conversations • Transatlantic practice exchange • New role at Providence Row

3. What is Trauma-Informed Care? ‘TIC is a strengths-based framework that is grounded in an understanding of and responsiveness to the impact of trauma, that emphasises physical, psychological and emotional safety for both providers and survivors, and that creates opportunities for survivors to rebuild a sense of control and empowerment’ (Shelter from the Storm: Hopper, Bassuk & Olivet, 2010)

4. Key themes of TIC Hopper et al (2010): Four key themes of a TIC in homelessness services: • Trauma awareness • Emphasis on Safety • Opportunities to rebuild control • Strengths-based approach

5. Trauma-Informed Care • A broad approach to working with survivors of psychological trauma • Preparing people for trauma-specific/mainstream therapy? • Holistic approach • Physical and emotional environment • Peer support

6. Center for Urban Community Services - CUCS • Columbia University’s school of social work (1970s) • Single homeless and families • Leaders in training and best practice • Use evidence based practices • Janian Medical Care – psychiatric support • www.cucs.org

7. TIC at CUCS Staff training • All staff with any significant client contact • Biopsychosocial core training session • Complex trauma • Easily learned and applied interventions

8. TIC at CUCS Staff support • Supervision – weekly (60-90 mins) • Clinical supervision – weekly (group) • Vicarious trauma

9. TIC at CUCS Increasing Safety and Control • Open, honest, non-judgemental services • Personalised, client lead • Making practices and procedures as trauma-informed as possible • Crisis planning in advance • Consistency in behaviour management • Mental illness – seeing the behaviour from trauma perspective not purely focussing on diagnosis

10. TIC at CUCS Strengths based • Survivors! • Goals: client lead, build on the positives • Recovery groups: education, skills, goals

11. CUCS staff response • Not trying to ‘fix’ the person • Take things less personally • Don’t see things in a black and white way • Less reliant on managers • Preparing people for mainstream

12. Back in the UK • Integrated learning into practice immediately • Reframe how I view and respond to behaviours • Clients: more open, challenging behaviour deescalated, longer interactions • Me: less frustrated! Recovery is possible!

13. TIC at Providence Row What we do already: • Personalised holistic support • Harm reduction and recovery approach • Clear processes for new clients accessing the service • Staff supervision and client case meetings • Learning Programme/Trainee Schemes: our clients have skills and are assets not just ‘people with multiple needs’ • Peer mentors and co-production • Mindfulness and Peer Recovery Support group

14. TIC at Providence Row What we are implementing: • Staff in-house training on trauma • Reflective practice sessions • Trauma learning network • Women’s group • Mental health psycho-education group • Signage/welcome area • Processes e.g. crisis management, assessment

15. Contact jprestidge@providencerow.org.uk (Please email me if you would like a copy of my journal article) blog from the exchange: http://joprestidge.wordpress.com Twitter: @joanneprestidge