Can Do Healthcare - Thinking Differently Together About Trauma Informed Care

Making trauma informed practice training a whole system standard Jessica told us how she felt if there is one word that summarises trauma, it is fragmentation: Adversity, in the absence of those internal or external resources needed to cope, overwhelms and in that process is the potential for this fracturing of mind and of body, of staff and teams and services. We see that what is significant in terms of the individual manifestations of trauma is also relevant for thinking in terms of teams, staff and organisational culture. Trauma is like light refracting – it projects its own image on every available surface. We see this at play in our staff teams and organisational cultures. Sandra Bloom and others talk about the concept of parallel process – that we can trace the symptoms and manifestations of trauma in the individual, and we can see a counter-process in the staff or the team. Often services are trauma oriented – meaning they are working with trauma rather than trauma informed. The former an unconscious orientation, the latter a conscious one. 8. Moving this Forward Jessica Cotton, Survivors in Transition Trauma as an organising experience for the individual Dissociation, hyper arousal and hyper vigilance - 'fight or flight' Impaired ability to affect regulate - impulse control/ inhibited executive function (i.e. no reflection), unable to learn mistakes Inhibited development or affect array (stuck) and language Maladaptive safety seeking behaviour Survival attitude = punish/ reward, "what's in it for me?" Trauma as an organising principle for the service Disengagement, or being drawn into 'fire fighting' poor planning, organisational amnesia Less opportunity for reflective practice and self-care (staff 'burn out'/'compassion fatigue') Limited or rigid strategic direction/unclear aims The medical model as superior authority (excessive diagnosis) Incentives and sanctions as motivation tools for engagement 19 | Suffolk and North East Essex Integrated Care System

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