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Trauma-organized Systems and Parallel Process
... This exposure can lead to symptoms similar to post-traumatic stress disorder (PTSD), including trouble sleeping, intrusive thoughts or images related to the client's trauma, or avoidance of triggers related to the client's trauma (Bride, 2007;Stamm, 2005). Service providers experiencing compassion fatigue may be less effective in their work roles, ultimately affecting the quality and efficacy of services (Bloom, 2010). In general, staff experiencing compassion fatigue report feeling less safe with their clients, less supported by their organizations, and less able to deal with the enormity of the problems they confront on a daily basis, leading to hyperarousal during, or withdrawal from, client engagement (Bloom, 2010). ...
... Service providers experiencing compassion fatigue may be less effective in their work roles, ultimately affecting the quality and efficacy of services (Bloom, 2010). In general, staff experiencing compassion fatigue report feeling less safe with their clients, less supported by their organizations, and less able to deal with the enormity of the problems they confront on a daily basis, leading to hyperarousal during, or withdrawal from, client engagement (Bloom, 2010). ...
... It helpfully synthesizes the potential roles of microaggressions, organizational practice, and individual worker factors in maximizing positive outcomes for clients and workers alike. Trauma-informed care represents an approach to work with clients and for organizational practices aimed at workers (Bloom, 2010;Levenson, 2017; Substance Abuse and Mental Health Services Administration [SAMHSA], 2014). Trauma-informed organizational practices emphasize physical, psychological, and emotional safety of clients and providers, with the aim of helping trauma survivors restore a sense of control and empowerment (Hopper et al., 2010). ...
Gaps in knowledge related to occupational stress among the intimate partner violence (IPV) and sexual assault (SA) workforce remain. This study examined associations between key risk factors for occupational stress and compassion fatigue among a sample of IPV/SA service providers in the Southwestern United States ( N = 520). Results of the hierarchical regression analysis identified microaggressions, age, recent life stress, direct practice, and workload as factors associated with compassion fatigue. The findings point to the importance of incorporating trauma-informed organizational approaches to address microaggressions, reduce workload, and support staff experiencing recent stress and providing direct services.
... 18 Although there have been significant improvements since the early 2000s, there remain concerns about 'punishing disadvantage' 19 and 'double discrimination', 20 with the potential of the custodial experience to reproduce the trauma associated with adversarial childhood experiences, exacerbating mental health difficulties. 21 Understanding care provision within the CYPSE through a trauma-informed lens, 22 suggests there may be a risk of exacerbating previous experience of trauma, with practices such as restraint 23 and seclusion 3 increasing young people's risk of re-traumatisation and mental health difficulties. 18 Past research has highlighted limited resources within the youth justice system leading to significant challenges in meeting the complex needs of this vulnerable group. ...
... While encouraging evidence exists regarding the implementation of innovative trauma-informed care in secure settings, such as the Sanctuary Model, 22 the Developmentally informed Attachment, Risk and Trauma approach 31 and Trauma Systems Therapy, 32 there is insufficient empirical evidence on effective ways to meet the needs of this complex cohort of young people in the CYPSE, leading to the improvement of their well-being and life trajectories. Recent policy in children and young people's mental health calls for more research involving young people with high risk of harm to self and/or others. ...
Introduction
Young people in contact with the youth justice system are more likely to present with complex ongoing needs than young people in the general population. To address this, the Framework for Integrated Care (SECURE STAIRS) is being implemented in the Children and Young People's Secure Estate: a ‘whole systems’ approach to support secure settings to develop trauma-informed and relationally based environments, supporting staff to provide consistent, therapeutic care. This paper aims to present the protocol for a national cohort study examining the impact and implementation of this cultural transformation programme.
Methods and analysis
A mixed-methods realist evaluation will be conducted. Data collection will take place between August 2018 and December 2020. Eighteen sites will collect routine service activity data and questionnaires completed by young people, parents/guardians and staff. Semi-structured interviews and non-participant observations will be conducted across five qualitative focus sites with young people and staff. An economic evaluation will examine value for money. The results will be triangulated at the analysis stage to gain an in-depth understanding of experiences.
Ethics and dissemination
Ethical approval was granted by the Health Research Authority, Her Majesty’s Prison and Probation Service and UCL Ethics Committee. Findings will be disseminated via project reports, site feedback, peer-reviewed journal publications and conference presentations.
... Sometimes the organizations dealing with traumatize clients can unintentionally get stuck in the constant repetition of patterns that negatively affected clients, quality of services as well as the members of the stuff. Yet it may be very difficult for them to acknowledge these issues which prevents their growth and progress (Bloom, 2005;Bloom 2011;Borjanić Bolić, 2016). If the effects of trauma within the organization are not addressed, it can lead to a toxic and ineffective service delivery system. ...
The number of children in child residential care that are affected by traumatic experience is not negligible so all the professionals involved in childcare face a very challenging and emotionally demanding job. Their engagement in meeting children's needs and providing all the necessary support, sometimes exceeds their professional boundaries. As a result, there is a substantial number of professionals suffering from these secondary exposures to child-traumatic materials thus there is a strong widespread urge to deal with these issues. This article focuses on what trauma informed care is and why it is important for all the sides involved in child residential care. The accumulated knowledge about trauma has risen in recent years leading to new concepts and strategies which trauma informed care model represents. Trauma informed care may not represent a new model,actually it is a holistic approach in practices with traumatized children. It suggests that knowledge of prevalence of trauma and understanding the impact of trauma issues makes a frame for planning and incorporating services which promotes safe environment and positive interaction with children. Trauma informed care model appears to be a standard which enables to respond to the needs of children in order to overcome the impact of traumatic experiences and reduces possibility of vicarious trauma among residential workers. On the other hand, it can also help reduce avoidable care and excess costs for both the health care and social service sectors.
... Trust and safety are fundamental concepts of TIC, yet participants described a pervasive lack of these. It is plausible that this will in turn perpetuate negative dynamics in all interactions between claimants and the broader benefits system (Bloom, 2011), and indeed that working in such a system could have a deleterious impact on DWP staff, who may experience conflict between their perceived professional duties and their personal values. This in turn could result in othering and reduced empathy, as a way of attempting to reduce this dissonance (Sweeney et al., 2016). ...
While a growing body of evidence has highlighted the psychological distress experienced by individuals dealing with the UK benefits system, there has been little research into that system from the perspective of Trauma Informed Care (TIC). This study explored to what extent people’s experiences of benefits assessment fitted with TIC principles, using a framework produced by NHS Education for Scotland. Secondary aims were to understand experiences that were not captured by the framework, and to explore the limitations of the framework in context. Participants were 12 people receiving NHS therapy for trauma-related difficulties, who had attended an assessment for the Personal Independence Payment (PIP), a UK financial benefit designed to help with long-term illness or disability. Semi-structured interviews were carried out, and a framework analysis conducted. Results suggested that PIP assessments were severely re-traumatising, with a prolonged adverse effect on mental health. Participants’ experiences contrasted so greatly with the principles of TIC that an alternative framework was constructed, comprising five key themes: harm, distrust, rigidity, intimidation, and powerlessness. Recommendations are made for further research, including an understanding of assessors’ perspectives, and how TIC principles might be introduced into the assessment process.
... Organizational contexts may contribute further to the development of post-traumatic stress among service providers. Occupational environments that are chaotic and stressful can produce a parallel process response in which service users' histories of trauma are embedded onto overwhelmed providers, resulting in psychological harm (Bloom, 2010). Homeless service organizations that are overwhelmed by the lack of affordable housing and inaccessibility of mental health supports can become unpredictable workplaces with frequent crises (Tiderington, 2019). ...
Background
Service providers working with people experiencing homelessness can be directly and indirectly exposed to trauma and other chronic stressors in their work. The types of individuals that are most at-risk of problematic outcomes from traumatic event exposure are unknown.
Aim
This study examined exposure to and effects of workplace traumas and stressors among service providers working with people experiencing homelessness in Canada.
Methods
A cross-sectional survey was completed by 701 direct service providers working in the homeless service, supportive housing, and harm reduction sectors. Descriptive statistics, hierarchical multiple regression, and double moderation models were used in the analysis.
Results
Employment in homeless service settings, service provision to single adults, and more time in direct contact with service users were each positively associated with the frequency of exposure to critical events and chronic stressors. Younger age, lived experience of behavioural health problems, more frequent exposure to chronic stressors, and less social support from coworkers were significantly correlated with post-traumatic stress and general psychological distress. Emotional support from supervision moderated the relationship between direct exposure to workplace critical events and post-traumatic stress.
Conclusions
More trauma-informed psychosocial supports tailored to the needs of direct service providers working with people experiencing homelessness are needed.
... When examining the wellbeing of the helping professions, the literature identifies multiple terms including "vicarious trauma", "compassion fatigue" and "burn-out". Vicarious trauma is linked to the body of trauma-informed literature (Killian, 2008) through the acquisition of trauma-like symptoms obtained vicariously through interacting with, and hearing the stories of, traumatised individuals (Bloom, 2010). Similar to what we know about trauma itself, working with trauma survivors can impact the cognitive schema of the professional (Long, 2020) and can be a contributing factor to social workers exiting the profession (Curtis et al., 2010). ...
Compassion fatigue and vicarious trauma can be a consequence of social work practice in all contexts, including the fast-paced, crisis driven hospital environment. Four metropolitan hospitals collaborated with an academic partner to explore the understanding and awareness that hospital-based social workers have in this area, and to investigate both individual and organisational responsibility. The research utilised a Participatory Action Research methodology with Stage One being a collaboratively developed survey. The results of the survey showed that social workers’ understanding is impacted by their knowledge of compassion fatigue and vicarious trauma, the nature of everyday hospital practice, and the identification, provision of, and engagement in personal self-care and workplace support strategies. The findings highlighted the dual responsibility that employing hospitals and individuals have to care for themselves and each other, including the capacity for social workers to use supervision and collegial relationships to support their coping and resilience.
... At this juncture, it needs to be highlighted that these processes can become mirrored in intra-institutional and team dynamics, resulting in what has been called in the literature a 'parallel process' [26]. Of particular interest here are the political and social histories that are carried by service providers and practitioners working in mental health services. ...
Cambridge Core - Psychiatry and Clinical Psychology - Working with Refugee Families - edited by Lucia De Haene
The global social, economic, and political landscape has shifted immeasurably since the mid-2000s. In the United Kingdom this has left leaders in health and social care working in a context of complexity and ongoing disruptive change. Therefore there have been calls for leaders to develop new ways of responding to ever evolving challenges and workplace environments. Contemporary notions of effective leadership advocate flexibility, collaboration, compassion, emotional awareness, dialogue and debate, and authenticity. However, these approaches are perhaps more radical than they outwardly seem, especially in workplace cultures where interpersonal risks can be ubiquitous and complexities overwhelming. Any attempt to offer newer forms of leadership can be bolstered through a framework which helps to understand complex system and relational dynamics and offers possible ways forward that are productive and ensure the wellbeing and psychological safety of leaders and others. The chapter outlines how the cognitive analytic therapy (CAT) model of trauma can be used as scaffolding to reconceptualize complex relational ideas in accessible ways applying this to contemporary approaches of effective leadership at an individual and system level.
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