Can Do Healthcare - Thinking Differently Together About Trauma Informed Care

Jessica explained that she works in a team that complete specialist assessments of, and direct work with children and families, as well as bespoke parenting where families have most likely than not had trauma experiences. Many of the families, children and adults that the team at the Family Centre work with will disguise their traumatic experiences, generally as a defence mechanism and a way to keep themselves safe, which make it hard for practitioners, particularly those dealing with crisis response trying to manage the balance of immediate risk and being mindful of who is behind the person. Being trauma informed doesn’t mean stopping this work ethic, it means being more aware and curious about what is being managed and why it might be happening and as social workers, becoming more curious about who is the person behind the presenting behaviour. It’s not ‘what is wrong with you’ but ‘what has happened to you’ “Don’t take a fence down until you know why it was put up” - Dr Karen Treisman, (2017). One of the things being looked at and to be conscious of, are the thoughts, feelings and actions around the behaviour, and along with that comes the emotions: Emotions are really difficult for parents and for survivors to talk about. Jessica spoke about a piece of research she had looked at recently, regarding talking about the painful events and that it doesn’t necessarily establish community – often quite the contrary. Families and communities may reject members who ‘air dirty laundry’, friends and family can lose patience with the people who get stuck in their grief or their hurt, and this is one of the reasons why trauma survivors often withdraw, and why their stories become rote narratives, edited into a form least likely to provoke rejection or concern. Jessica reflected how one of the families she had worked with recently; a Mum who had a fear within the child protection arena that if she shared that her emotional protection as becoming too overwhelming, it would cause concern for the children to escalate, yet if she didn’t share it they would escalate for her inside her anyway, to the point where there would be need for a crisis response, such as calling for an ambulance or attempting to take her own life. Either way she was always in fear of her safety and the safety of the children. When working with children and families and becoming more trauma-informed, one of the things noticeable is that we can see beyond the initial presentation of behaviours. Jessica referenced further metaphors created within Karen Treisman’s work (2017) ‘sometimes it is better to attack than be attacked; sometime it’s better to be scary than be scared and sometimes it is better to be feared than to be fearful’ – and these are useful in recognising why someone may be presenting in a certain way. This awareness helps in recognising there is a need to look underneath that and understand what is going on for the person. Being trauma informed practitioners requires social workers and other professionals to be curious and creative within their approach. It requires them to look beyond the label or the behaviour and recognise the thoughts and the feelings of the individual, to determine what is contributing toward their action. Jessica explained how often with children and families she works with, when she is exploring with them their experiences, childhoods, where they have come from and what shapes who they are today, generally that in itself can be very triggering. It is therefore vital for social workers and all professionals to be confident in not just dealing with trauma, but also dealing with how to support children and families they are working with around regulating those emotions. Quite often what we are inevitably doing is asking families to provide the information we as practitioners need to be able to 3. Being trauma informed with families Jessica Tye, Social Worker, Clacton Family Centre, Essex County Council 7 | Suffolk and North East Essex Integrated Care System