Monitoring the Implementation of Trauma-informed Care

Thirkle, Steven (2021) Monitoring the Implementation of Trauma-informed Care. Doctoral thesis, Northumbria University.

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Abstract

This work, which unites the fields of occupational psychology, cultural anthropology, and complexity science, examines the novel and nebulous domain of trauma-informed care. Mere definitions of concepts like trauma-informed care, organisational culture, and culture change ignite discord between researchers, writers, and practitioners alike. Trauma-informed care is a system model which encourages system-wide adoption by all involved within the organisation. An organisational shift towards adopting this model requires fundamental change. Change not necessarily within practice and policy but within the individuals who occupy the organisation themselves. Introducing a system-wide model is practicable, but ensuring that adoption and adherence is challenging when faced with the dynamic nature of the human psyche.

When attending to organisational change, organisations must prioritise the sensitivities of individuals. Involving individuals and respecting the dynamics of change can smooth over the rough edges that make transitions difficult. Perceptions, attitudes, and behaviours change alongside correlating events, environments, and system stimuli. To be one step ahead of organisational fate, the organisation must adapt to the individual rather than the contrary. A whole-system approach is needed. The reflection on implementation requires a practical self-assessment. A whole-system approach utilises a network of interrelated systems that permits timely self-reflection and enables immediate action.

This research utilises both qualitative and quantitative data by means of primary and secondary sources through a pragmatic design: staff and service-user participants from the NHS and relevant references within the broader context. The research congregates opinions from both parties and co-produces an implementation framework for application in dynamic contexts. The Roots framework is adapted into a learning and growth training package that stakeholders at the NHS and broader audiences can adapt and redefine at will.

This work advances the fields of trauma-informed care and organisational culture change by coproducing a framework and drafting recommendations on how to co-produce a self-assessment that can monitor the implementation of trauma-informed care.

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