Evaluation of the Lewisham Trauma Informed Group Work Programme

Abstract

This study is an evaluation of the Trauma Informed Group Work Programme developed by the Lewisham Youth Offending Service. It was commissioned by the London Borough of Lewisham with funding from the Youth Justice Board.

Full text

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Andrew Whittaker, Denise Harvey and Becky Sheppard
Evaluation of the
Lewisham Trauma
Informed Group Work
Programme
Andrew Whittaker, Denise Harvey and Becky Shepherd

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Executive Summary
1.
Introduction
This study is an evaluation of the Trauma Informed Group Work Programme developed by
the Lewisham Youth Offending Service. It was commissioned by the London Borough of
Lewisham with funding from the Youth Justice Board.
2.
Aims of the intervention
The Lewisham Trauma Informed Group Work Programme is an intervention that aims to
reduce morbidity and mortality in under-18s due to violent assaults by seeking to:
• Increase participants’ knowledge about stress and its impacts on the brain.
• Develop stress-relieving breathing techniques and mindfulness skills to enable young people
to manage stress and anxiety levels more effectively.
• Increase resilience against anti-social interpersonal relationships and digital environments.
• Develop a more positive self-image and prosocial interpersonal relationships with others.
• Gain deeper understanding of identity and culture particularly how bias affects perceptions
and decision making.
• Increase positive perceptions and respect for their peers.
• Improve communication and negotiation skills
• Reduce perceived susceptibility of being a victim of violence in Lewisham.
3.
Study design
The study had a mixed method design in two stages. The first stage consisted of a workshop
with key staff to develop a logic model, i.e., a model that explain how the intervention,
followed by a focus group with the same staff to explore their experiences of developing
and running the programme. The second stage consists of individual interviews with former
group participants to explore their experiences of the programme and examine any changes
that resulted from group involvement.
4.
Findings
4.1.
Background of young people:
• Twenty-two young people went through the group work programme in four cohorts.
• All participants were male, and the average age was 15.8 years (range 12-18 years).
• The young people had relatively high levels of involvement with children’s social care
(55%) and child and adolescent mental health services (23% rated as A+).
• Each participant had committed an average of 1.95 offences (range = 1-3 offences),
mostly related to weapon possession in a public place (18 offences), drug possession
(10 offences) and theft-related offences (9 offences). There were four serious violent

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offences, including wounding, inflicting grievous bodily harm without intent and
assault by beating.
4.2.
Quantitative reoffending outcomes:
• During the 12-week intervention, there was only one offence across all cohorts of
possession of a firework under the age of 18 years.
• In two cohorts (cohorts 1 and 4), there were no instances of reoffending in the
following 12 months. In one cohort, four young people reoffended.
• In the following 12 months, the total reoffending rate was 21% (n=4) and the
reoffending rate for violence-related offences (possession of knife blade, affray) was
15.5% (N=3).
• This compared favourably to the national reoffending rate of 38.4% (Youth Justice
Statistics 2018/19).
4.3.
Qualitative findings
The qualitative data analysis across the data from young people and staff members
identified three main themes:
Theme 1: ‘Young people often feel very unsafe’
A common theme from both young people and practitioners is that young people feel very
unsafe in their everyday lives. Young people described multiple experiences of trauma and
the young people referred to the programme had relatively high levels of involvement with
children’s social care (55%) and child and adolescent mental health services (23%).
The young people’s feelings of being ‘unsafe’ related to physical and emotional safety and
linked with both their previous experiences of trauma and their perceptions of current
threats in their lives. These were inter-related as early experiences of trauma can influence
young peoples’ thinking and perceptions of risk, e.g., some young people described how
they sought to protect themselves from perceived risk through carrying weapons. The
concept of unconscious bias was very helpful in understanding how young people could
misperceive the nature and extent of risks posed by other young people.
Theme 2: ‘Helping young people to feel safer in their lives’
The feelings of being unsafe can present significant challenges to young people engaging in
particular interventions and staff members described a number of measures that they
introduced to address this. These included:
• An initial pre-group engagement phase with four individual sessions.
• Creating a nurturing environment, e.g., set up and layout of the room, essential oils,
making healthy smoothies.

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• Clear structure in the group sessions to increase feelings of predictability and safety,
e.g., having set rituals for the beginning and end of sessions.
• Ground rules to promote emotional safety. For example, group members must greet
each other with a physical greeting, staff avoid shaming young people who are late.
• Gradually encouraging young people to talk about themselves and their feelings,
once they felt safe.
• Breathing exercises to reduce anxiety and increase emotional control.
• Introduce the concept of unconscious bias to help young people to recognise when
they misperceive threats from others.
Theme 3: Helping young people to have more pro-social and healthier lives.
Once young people felt safe in the group, this enabled them to engage with other goals:
• More positive perceptions of peers and prosocial personal relationships.
• Improved relationship to authority
• Healthier social media use
• Greater sense of personal responsibility.
5.
Benefits from the programme
Young people identified the followings benefits from the group:
• Greater self-control and stress management skills gained through breathing and
mindfulness exercises. This included in response to specific situations or more
generalised feelings of anger or anxiety.
• Greater ability to discuss their emotions with others and more positive relationships.
• More aware of unconscious bias that leads them to react to others in unhelpful
ways.
• Less likely to assume other people are a threat and more aware of how they are
perceived by others.
• An improved relationship with authority, moving away from feeling all authority
figures were ‘out to get them’ to according them a legitimate role. This did not mean
feeling positively towards the police but recognising that their role in providing
justice rather than young people having to seek revenge after violent incidents.
• Some participants also described rethinking their friendship networks to avoid
negative influences.
• The use of credible role models, e.g., a high profile and successful musician from the
local area, was valued by participants.
• Some aspects, e.g., healthy social media use, proved more difficult for participants to
change, although they described being more informed and aware about their
importance.

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6.
Lessons for the service and for other Youth Offending Services nationally
1. The training and skills of core staff are central
Group facilitators need to have a good understanding of the emotional issues faced by
young people based upon the trauma informed principles. Their skills are vital as they are
likely to be working with young people with considerable fear and mistrust.
2. The importance of a pre-group engagement phase
Preparation for the group and building a relationship with one of the facilitators beforehand
is very important in order to promote the conditions for effective engagement. Inconsistent
or inadequate preparation is likely to lead to high drop-out rates.
3. Pay attention to creating a physical environment that helps young people to feel
safe
The physical environment is important and activities such as using essential oils and
preparing drinks together can make a significant contribution towards building trust.
4. Structure and rule for the group create a sense of predictability for young people.
Another important aspect is that the sessions are well structured and predictable so that
participants feel that they know what is going to happen. Group rules should include group
members greeting each other in a physical way and group facilitators avoiding sanctions
that create feelings of shame.
7.
Conclusions
The Lewisham trauma informed group work programme has shown positive results in both
qualitative and quantitative terms. While the present results relative to a small-scale pilot
study so cannot be regarded as definitive, they point in an encouraging direction. In
particular, the relatively low rates of reoffending in relation to violent offences (15.5%) and
total offences (21%) is promising compared to the national average of 38.4% (Youth Justice
Statistics 2018/19).
In addition, the qualitative data helps move beyond simple reoffending rates to
understanding how the intervention works. Staff members were able to articulate a clear
and coherent theoretical framework that fitted well with the experiences of young people
that we interviewed. As well as direct benefits to participants, the group work intervention
had wider benefits within the YOS service by influencing other activities, such as individual
work and targeted work around social media and unconscious bias.
The intervention has good potential for transferability to other geographical areas and
would benefit from replicating with a larger cohort. Key issues for implementation are likely
to be the availability and retention of suitably trained practitioners and fidelity to the model.

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Table of Contents
1. Introduction ...................................................................................................................... 2
1. Introduction and study design .......................................................................................... 7
1.1. Aims of the study ............................................................................................................................. 7
1.2. Study design ..................................................................................................................................... 7
1.3. Sample ............................................................................................................................................. 8
1.4. Data analysis and ethics .................................................................................................................. 8
1.5. Consultation ..................................................................................................................................... 8
1.6. Acknowledgements .......................................................................................................................... 9
2. Literature review of trauma informed approaches in youth justice ............................... 10
2.1. Why is a trauma-informed approach needed? .......................................................................... 10
2.2. Definitions of trauma and trauma-informed approaches .......................................................... 11
2.3. Examples of trauma-informed approaches ............................................................................... 15
2.4. Trauma-informed approaches: Key components ....................................................................... 17
3. The Lewisham Trauma Informed Group Work Programme ........................................... 20
3.1. Background and development of the programme ..................................................................... 20
3.2. Comparison with previous programmes ................................................................................... 20
3.3. The structure of the programme .............................................................................................. 20
3.4. Background of young people who went through the group work programme ............................ 21
3.5. Developing the logic model ...................................................................................................... 22
4. Findings .......................................................................................................................... 24
4.1. Outcomes for young people who went through the group work programme ............................. 24
4.2. Qualitative findings ................................................................................................................. 26
5. Benefits of the group ...................................................................................................... 40
6. Lessons for the service and for other Youth Offending Services nationally .................... 41
7. Conclusions ..................................................................................................................... 42
Appendix 1 - Project team ...................................................................................................... 43
References .............................................................................................................................. 45

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1.
Introduction and study design
This study was commissioned by the London Borough of Lewisham in order to evaluate its
Trauma Informed Group Work Programme. Since 2016, Lewisham Youth Offending Service
(YOS) redesigned its service to incorporate a trauma-informed approach, which included
rethinking all aspects of the service. A trauma-informed group work programme was
developed after staff undertook in-depth training and further research on how adverse
childhood experiences affect people in later life.
1.1.
Aims of the study
• To develop a logic model with the developers of the programme, i.e., a model that
explain how the intervention works and identifies the processes by which change is
achieved for young people (YJB, 2014).
• To interview former participants to examine their experiences of undertaking the
programme.
• To capture the learning gained from adapting a trauma informed approach to a
group work programme, addressing both positive achievements and challenges and
identify lessons for future implementation.
1.2.
Study design
Our research design had a mixed method design in two stages combined the following
components:
Stage
Data collection
Stage One: Practitioner
perspectives
This stage had two
components:
a) A workshop to develop a logic model for the intervention with the key
staff who were involved in the development and implementation of
the programme (n=6).
b) A focus group with the same group to explore their experiences and
perceptions of the intervention (n=6).
Stage Two: Young
peoples’ perspectives
The second stage consisted of individual semi-structured interviews
with young people (n=5).

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1.3.
Sample
At stage one, the logic model workshop and focus group consisted of 6 practitioners from
the Lewisham Youth Offending Service. This included the two practitioners who led the
development of the programme, a senior manager and three group facilitators who were
YOS practitioners.
At stage two, there were a total of 5 young people who had been through the group work
programme who were interviewed. This was a lower number that envisaged but the
challenges of engaging young people in research is well known in the youth justice field
(Haines et al., 2012). Although five participants is not a large sample, it does represent
almost a quarter (23%) of the young people who went through the programme.
1.4.
Data analysis and ethics
The study received ethical approval from the London South Bank University ethics
committee. Participants were provided with a participant information sheet and a consent
form before and at the interview. Transcripts were carefully anonymized to protect the
identity of the young people. Afterwards, participants were debriefed by the interviewer
and had the opportunity to ask questions.
The focus group and interview data were analysed using NVivo 12 qualitative data analysis
software within a thematic analysis (Braun and Clarke, 2006) approach. This provided a
rigorous and robust analysis that is compatible with interview and focus group data.
1.5.
Consultation
The analysis was also tested through consultation with the following experts in the field:
• Professor James Densley, Metropolitan State University, Saint Paul, Minnesota, USA
• Professor Ross Deuchar, University of the West of Scotland
• Professor Simon Harding, University of West London, UK

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1.6.
Acknowledgements
The following provided support in the development and evaluation of the intervention:
• Mayor's Office for Policing and Crime (MOPAC) for providing funding and supporting
the initiative.
• Dr Fiona Bailey - Clinical Psychologist - trainer and clinical advisor/supervisor.
• Mpume Mpofu - ICoN Program Manager for designing the training.
• Youth Justice Board for providing funding for the evaluation.
The following staff were central in the development of the intervention:
• Lawrence Russell, Programmes and Interventions Lead, The Liminality Group -
former Lewisham YOS Operational Manager and Vanessa Reid YOS Officer and
Therapist for designing, innovating, researching and applying the program in
practice.
• All the staff of Lewisham Youth Offending Service who supported the program
particularly Ryan Robotham, Phillip Lelitte and Rupert Salawu, expert group workers
and trauma-informed practitioners.
• Keith Cohen, Head of Service, Lewisham YOS for vision and leadership.

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2.
Literature review of trauma informed approaches in youth justice
The concept of a trauma-informed approach has been developed relatively recently in youth
justice discourses within the UK (Liddle et al, 2016). Initially led by increased psychological
understandings of trauma within mental health treatment fields (for example, Harris &
Fallot, 2001; Reeves, 2015), crossover and dissemination between academic and practice
fields has meant that the trauma-informed approach has now gained a foothold within
youth justice (Ford & Blaustein, 2013). However, trauma-informed approaches are still in
their relative infancy (Becker-Blease, 2017) and have not been integrated coherently into
the youth justice system at this time. Therefore, the developments within Lewisham YOT to
integrate a trauma-informed approach across the board should be considered as being in
the vanguard of this integrated approach.
This review will consider definitions being used in practice and will conclude that there is a
lack of consensus on a widely accepted definition of ‘trauma’, and that there is a lack of
conformity on what a trauma-informed approach should ‘look like’ in the field. This
discussion of the literature will focus primarily on youth justice rather than the wider
criminal justice system, and consider the aims of a trauma-informed approach in this
context – what will be improved by adopting a trauma-informed approach in youth justice?
One important corollary of providing effective trauma-informed interventions for young
people is a requirement that staff are adequately supported to undertake the work, as this
is an area of practice in which the risk of vicarious trauma is high. A US literature review on
trauma-informed approaches with young offenders indicates that consideration of this
aspect of trauma work is required for robust and sustainable interventions to be put in place
(Branson et al, 2017).
Of the current YJB-sponsored pathfinder schemes, funded under the Serious Violence
Strategy (Ministry of Justice, 2018), five relate to trauma-informed approaches, but only one
(Nottingham) specifically mentions trauma-informed staff support. However, it is positive
that the YJB briefing document on trauma-informed approaches (YJB, 2017) does emphasise
that staff support is necessary to do this work properly and recommends that clinical
supervision be made available. This necessity is also discussed by Branson et al (2017).
2.1.
Why is a trauma-informed approach needed?
Young people who enter the justice system have been exposed to a variety of traumatic
experiences (Liddle et al, 2016), and differing approaches to responding to youth crime have
been attempted over the decades (Stephenson, Giller & Brown, 2010). Despite reductions
in convictions in recent years (YJB/MoJ, 2018; Pitts, 2015), youth offending inevitably

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continues, including serious youth violence (Walsh, 2018; Home Office, 2018). There is a
well-established body of evidence that young people who end up in the youth justice
system frequently demonstrate significant psychological, emotional and social problems
including evidence of trauma (Jacobson et al, 2010).
This means that youth justice professionals are frequently working with vulnerable young
people who have experienced multiple social and personal problems (MoJ/DfE, 2016; YJB,
2017) against a backdrop of now-escalating violent crime rates (ONS, 2018), ongoing
concerns about gang activity among young people (Longfield, 2019) and criminal and sexual
exploitation by adults (Berelowitz et al, 2013). This makes the work very challenging, and a
simplistic focus on offending behaviour is not sufficient. Hence, this evaluation’s indicators
that the young people benefited in ways that related to other areas of their life as well as
their offending are welcome.
Furthermore, socially and economically excluded young people and BAME young people,
who already suffer discrimination and structural disadvantage, are more likely to come
under state scrutiny (Lammy, 2017; Holley & VanVleet, 2006) as compared to all young
people who offend, which is a far wider group (Gottfriedson & Hirschi, 1983; Loeber et al,
2012). This is of particular concern given the ample evidence that contact with formal youth
justice systems can function as a criminogenic factor (Pritchard, 2010; Bowman, 2018),
thereby entrenching and formalising social exclusion. Youth justice interventions need to be
designed to assist young people and not disadvantage them further. A trauma-informed
approach such as the one adopted by Lewisham is arguably the best way to achieve this due
to the holistic focus applied, rather than merely responsibilizing vulnerable young people,
many of whose circumstances are largely outside their control.
2.2.
Definitions of trauma and trauma-informed approaches
One of the barriers to trauma-informed work being disseminated and implemented more
consistently may be due to a lack of universal definitions, both on trauma itself and on what
constitutes a valid trauma-informed approach.
The concept of a ‘trauma-informed approach’ has entered the lexicon of youth justice but
there remains a lack of widely agreed definition of what such an approach must entail
(Branson et al, 2017) as well as something of a lack of an accepted definition of trauma
itself, in part due to the multitude of disciplines which discuss the issue (Liddle et al, 2016).
There is no widespread consensus across disciplines (outside the field of medicine in which a
specific physical meaning is applied) as to what constitutes trauma, although there are
many similarities. The DSM-5 (the American Psychiatric Association’s Diagnostic and

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Statistical Manual of Mental Disorders) applies a narrower definition than that adopted by
many non-psychiatric service providers, for example. More elastic interpretations have been
critiqued (e.g., Brandell, 2012) as trivialising trauma, and it is important to ensure the term
does not become so broad its usefulness is diluted. However, it can also be argued that the
comparatively rigid DSM-5 definition may restrict access to mental health services for those
who have experienced severe adverse experiences but do not neatly fit the diagnostic
criteria. There seems to be a particular debate in the psychological and psychiatric literature
in relation to post-traumatic stress disorder (e.g., Spitzer, First & Wakefield, 2007;
Wakefield, 2013).
The Youth Justice Board wisely does not seek to provide a definitive description of trauma,
and actively promotes an inclusive interpretation. The YJB briefing paper on trauma states
‘Trauma can result from experiences that cause intense fear or pain, overwhelming the
ability to cope’ (YJB, 2017:1). It advises that in its consideration of trauma-informed work, ‘a
broad view is taken of traumatic stress and of the experiences that can lead to it for children
and young people’ (YJB, 2017:4).
The US National Centre for Child Traumatic Stress Network (NCTSN)’s definition similarly
provides a helpful frame for understanding trauma in the context of young offenders, whilst
remaining quite open: ‘Trauma is an emotional wound, resulting from a shocking event or
multiple and repeated life-threatening and/or extremely frightening experiences that may
cause lasting negative effects on a person, disrupting the path of healthy physical,
emotional, spiritual and intellectual development.’ (NCTSN, 2004). This allows for wide
interpretation relating to the behaviour which may result from trauma, including capacity to
relate healthily to others.
This inclusive perception of trauma enables service providers to think creatively about how
to meet the needs of this vulnerable client group without being overly prescriptive.
However, given this lack of consensus on defining trauma, unsurprisingly there is a
corresponding lack of a standardised trauma-informed approach in the field of statutory
interventions (Liddle et al, 2016). This lack of a universal definition has been identified as
problematic (Branson et al, 2017 as without one there can arguably be no consistency in
trauma-informed interventions. This means that each agency designs its own trauma-
informed approach, and these can differ widely. This is perhaps inevitable given the
number of different fields from which the research on trauma is generated.
One useful definition of a trauma-informed approach is as follows:
‘In the simplest terms, the concept of trauma-informed care is straightforward. If
professionals were to pause and consider the role trauma and lingering traumatic
stress plays in the lives of the specific client population served by an individual,

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professional, organization, or an entire system, how would they behave differently?
What steps would they take to avoid, or at least minimize, adding new stress or
inadvertently reminding their clients of their past traumas? How can they better help
their traumatized clients heal? In effect, by looking at how the entire system is
organized, and services are delivered through a ‘trauma lens’, what should be done
differently?’ (Wilson, Pence & Conradi, 2013:1)
Based on the available data, there appear to be some broad parameters to trauma-
informed work, which bear in mind the challenge posed by Wilson, Pence and Conradi
(2013) above, namely: interventions, systems and professional relationships must be
designed and delivered with an awareness of the likely impact of traumatic experiences on
the client population and their corresponding problematic behaviour.
A shorthand phrase which encapsulates this approach is sometimes used by practitioners –
in essence a trauma-informed approach involves changing the central question from ‘what
is wrong with you?’ to ‘what has happened to you?’, thereby locating the offending
behaviour or mental distress in a continuum of life experiences and potential traumatic
damage rather than ‘responsibilizing’ the individual and denuding their behaviour of its
context (the latter approach within the CJS having been repeatedly criticised as a neoliberal
response which ignores social factors which impact upon offending (e.g. Kemshall, 2002;
Barry & McNeill, 2009)).
In a youth justice context therefore, trauma-informed approaches must be underpinned by
an understanding that youth offending is very frequently linked to adverse childhood
experiences (Baglivio & Epps, 2016) of varying severity, and that a restorative approach by
the youth justice system, which aims to enable the young person to recover meaningfully
from harm, is required for an effective and supportive journey towards desistance (Harden
et al, 2015; Hammersley, 2011; Anderson, 2019). This is precisely the approach which this
Lewisham YOT groupwork programme encapsulates.
This approach arguably has its roots in a number of pre-existing schools of thought, such as
(among others) relationship-based social work (Trevithick, 2003) and restorative justice
practices (Haines & O’Mahony, 2006) but has developed theoretically in recent years due to
engaging with the emerging evidence from neuroscience, which indicates that childhood
and adolescent trauma can impact the development of the brain in key locations which
regulate empathy, emotional self-regulation and communication with others (see Evans-
Chase, 2014). This neurodevelopmental understanding, combined with the evidence that
large numbers of young people in the youth justice system may have suffered significant
problems with attachment due to trauma, has led to a widening understanding of the need
for a trauma informed approach to youth justice which can actively enable young people to
work through their trauma as part of a desistance process, in which reduction of

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reoffending remains key, but is by no means the sole objective of intervention. This is why a
wider evaluation lens is necessary, which captures qualitative improvements in young
people’s lives as well as actuarial data on offending behaviour.
The Youth Justice Board’s approach has been to issue guidance rather than laying down a
specific required set of interventions (as yet), and to fund a series of pathfinder
programmes, some of which seek to implement a trauma-informed approach (YJB, 2017).
Consequently, local youth offending services and the youth secure estate have been able to
take a variety of approaches in devising and implementing trauma-informed approaches,
and much of the emerging evidence from these initiatives is still very new. Subject to
evaluation it seems likely that a more coherent commitment to trauma informed
approaches from the political centre in the UK will emerge in the fullness of time, but this
will be dependent on political will.
Trauma-informed approaches in youth justice should therefore be considered as a still
emerging field of practice and has the potential to demonstrate a paradigm shift in how
organs of the state engage with young people who offend.
It is also helpful to locate weapon-related interventions work within an evolving field of
study. ‘Knife crime’ initiatives have developed over time and often reflect
contemporaneous dominant discourses in offending behaviour work. For example, previous
iterations of knife-related offending interventions have included ‘shock’ tactics such as the
showing of graphic photographs, or visits to hospital casualty departments (Davis, 2011),
which was consistent with a perspective of developing young people’s consequential
thinking skills, and also with a government agenda which promoted responsibilisation of
young people involved in offending (Muncie, 2004).
First person testimony, in which young people would meet and hear from those bereaved
by knife crime, has also been widely used in youth justice interventions, including as part of
the Youth Justice Board-developed Knife Crime Prevention Programme in 2013, which fits
into a framework in which developing empathy and strengthening pro-social thinking in
young people is understood as central to desistance (YJB, 2019).
The new development of trauma-informed interventions for young people at risk of
weapons-related offending and serious harm draws on increasingly sophisticated
knowledge about trauma and its impact on young people’s development and behaviour,
and suitable interventions (Hickle, 2020).

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2.3.
Examples of trauma-informed approaches
The Enhanced Case Management pilot scheme in Wales
Wales in particular appears to have taken an interest in trauma-informed practice with
young people. Although justice is not fully devolved in Wales, a distinctive field of Welsh
justice is developing, and even within the current partial autonomy available, has enabled a
human-rights based focus to be developed within youth justice (Drakeford, 2010), and a
trauma-informed approach fits within this (see Ministry of Justice/Welsh Government, 2019
for a further discussion).
Between 2013 and 2016 the YJB, the Welsh Government and the All Wales Forensic
Adolescent Consultation and Treatment Service (FACTS), in conjunction with three Welsh
YOTs, developed the pilot Enhanced Case Management (ECM) approach.
The theoretical underpinning for ECM is the Trauma Recovery Model (TRM), developed by
Skuse & Matthew (2015), which is informed by theories on child development; attachment;
neurological impairment; impact of maltreatment and behavioural conditions; the mental
health of young people in the youth justice system; and interventions, effective practice and
treatment attrition (Mylona, 2017:11). Among other key aspects, staff were given training
in trauma, a case formulation model for understanding young people was introduced, led by
a clinical psychologist, and clinical supervision was made available for YOT staff. The aim
was to enable YOT staff to tailor and sequence interventions more effectively according to
the young people’s developmental and mental health needs (Mylona, 2017; Ministry of
Justice, 2018).
An evaluation found that staff already felt they were trauma-aware, but that organisational
changes which prioritised child wellbeing over timescales and procedures was beneficial, i.e.
the workplace organisation and ethos needed to change more than the practitioners.
Practitioners reported feeling more confident with sequencing interventions appropriately
using the ECM, and that they had more autonomy to develop bespoke interventions and
approaches with the young people. The pilot was well-supported with a unanimous
commitment to further roll-out (Mylona, 2017). This clearly indicates that the ECM, which is
a flagship trauma-informed approach, has the potential to change the youth justice
landscape if it is rolled out across England and Wales in future.
TARGET (Trauma Affect Regulation: Guide for Education and Therapy)
Target is a strengths-based approach to education and therapy for trauma survivors and
aims to provide a practical approach to recovery. Target is a widespread intervention in the

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US and is suitable for adults and young people. (There is also an adapted programme for
parents of traumatised young people.) One evaluation of Target’s use in juvenile justice
secure settings completed a study of 74 young people incarcerated in a juvenile justice
setting (with only 7 of them being girls). 38 young people were provided with Treatment as
Usual (TAU) plus a one-day trauma training for staff, while 36 young people were provided
with the intervention, which included TAU combined with environmental modifications,
additional trauma training for staff, and Target group therapy.
Results showed significant reductions in depression, threats to staff, use of physical
restraint, and seclusion rates for young people on the Target programme as compared with
young people on Treatment as Usual. The young people who received the Target
intervention also reported greater hope and optimism. Whilst this evaluation does not
provide longitudinal follow-up data regarding reoffending rates, the evaluation gives a clear
indication that the young people benefited from the trauma-informed intervention to the
extent that their problematic behaviour in custody was minimised and they also showed
signs of emotional improvement.
In brief, the Target approach involves providing training on psychological trauma for all staff
at the residential unit, followed by a 10-session programme teaching a 7-step sequence of
skills for processing and managing trauma-related reactions to current stressful experiences
such as PTSD symptoms, traumatic grief, survivor guilt, shame and alienation. The steps
include education about what happens to people when they experience trauma, resilience
strategies, behaviour modification techniques and life story work (for a full discussion of this
evaluation see Marrow et al, 2012).
Healing Trauma groupwork programme
Although there are significant differences between (primarily male) young people who
offend and adult women offenders, there is also some crossover in traumatic experiences
and behaviours, despite the differently gendered responses to trauma discussed in the
literature (Ministry of Justice, 2018; Mallett, 2018). In light of the apparent lack of attention
to gender in much of the trauma-informed literature, it is helpful to consider one project
which runs in the adult female estate in England & Wales and consider its potential
relevance for girls in the youth justice system.
Healing Trauma is a trauma-informed programme for criminal justice-involved women
designed for delivery when a short-term intervention is needed. It comprises 6 sessions
delivered in small groups. The programme is peer-facilitated: specially trained prison staff
train serving inmates to deliver the intervention. The programme is strengths-based aimed
at empowering women: “In contrast to deficit-based interventions that start from the

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question ‘what’s wrong with her?’ trauma-informed treatment asks, ‘what happened to
her?’” (Petrillo, Thomas & Hanspal, 2019:3). The programme is gender-responsive and is
informed by the evidence on the interaction between women’s offending and their
experiences of violence, substance misuse, mental health problems and poverty, with a
particular focus on intimate partner violence. This programme was rolled out under the
auspices of a National Offender Management Service (NOMS) initiative to work in a trauma-
informed way with women prisoners called Becoming Trauma Informed (BTI), of which
Healing Trauma is one aspect (see Covington, 2016). Initially trialled in HMP Send, Healing
Trauma has now been rolled out across the adult female estate.
At the time of the evaluation by Portsmouth University, it was being delivered in eight
women’s prisons. The programme had previously been rolled out in America to positive
outcomes: the intervention was shown to significantly improve depression, anxiety, PTSD,
emotional regulation, and aggression (Messina and Calhoun, 2018). The programme uses a
psycho-educational approach. Treatment methods are taken from research on effective
responses to trauma and an understanding of women’s psycho-social development.
Cognitive behavioural approaches are enriched by guided imagery, expressive arts,
mindfulness, emotional freedom technique, and relational therapy.” (Petrillo, Thomas &
Hanspal, 2019:12) The programme has a particular focus on domestic abuse, sexual assault,
childhood sexual abuse and other forms of gender-related victimisation. Given the
prevalence of these experiences in the histories of many girls in the youth justice system
(Kerig & Ford, 2014), this particular programme may be of interest to practitioners
developing trauma-informed approaches for use with girls who offend.
2.4.
Trauma-informed approaches: Key components
As the case examples discussed above demonstrate, approaches to trauma-informed work
are not standardised. However, given the wealth of research into how trauma manifests, it
is perhaps unsurprising that trauma-informed interventions tend to coalesce around certain
key approaches.
The Youth Justice Board appendix of trauma-informed interventions and assessment tools
(YJB, 2020) and the Beyond Youth Custody project’s review of trauma-related research and
practice literature (Liddle et al, 2016) combine to provide a helpful round-up of current
practice and academic debate and are recommended reading on this topic. This report does
not aim to be a systemic review, but rather a reflection on the dominant approaches which
emerge from the available data (see Branson et al (2017) for their extensive typology,
involving 10 ‘domains’ of trauma-informed care for a more sophisticated analysis).

18
The available literature falls into two camps: empirical data on trauma-informed work
currently being done, and theoretical discussion of what trauma-informed interventions
should look like. There is necessarily overlap and repetition between these two types.
There is a third dataset comprising existing interventions which are not described or
conceptualised as trauma-informed but cover similar ground, for example relationship-
based social work interventions and restorative justice initiatives which recognise that
young offenders are likely themselves to have been victimised.
Based on the available literature, therefore, it appears that trauma-informed interventions
in youth justice either do or should incorporate the following:
Key components
1) enhanced training and knowledge on trauma, complex trauma, PTSD and adverse
childhood experiences (ACEs) for staff, including attachment theory and mental
health awareness.
2) establishing trusting working relationships and being reliable – modelling a healthy
relationship.
3) cognitive behavioural intervention from a trauma informed perspective – addressing
the links between trauma and violence to re-learn ways of relating to others and
responding to stress or perceived threat from others.
4) risk of vicarious trauma to staff and the need for robust mechanisms, support and
supervision, ideally clinical supervision – to counterbalance this and aim to prevent
burnout.
5) multi-agency working/wraparound support/family involvement – a whole system
approach is needed to address trauma coherently. There is a recognition in the
literature that too much of the formal architecture of youth justice systems
(particularly custody) is not currently designed in a way which assists healing from
trauma.
This indicates that despite the lack of a widespread accepted definition, individual service
providers and programme designers are drawing upon the existing data to design
interventions with similar underlying principles. The literature indicates that training staff
to work in a trauma-informed way with young people provides a new set of professional
skills and empowers staff to work with sometimes very challenging behaviour in an
emotionally literate and psychologically safe way. The need for staff to be protected from
the risk of vicarious trauma is central to this model of working and should not be
downplayed.
Therefore, it appears that the trauma-informed groupwork programme developed by
Lewisham YOT fits neatly into this emerging framework, with several key components of

19
trauma-informed approaches included. The intersection with wraparound services such as
children’s social care or drug treatment falls outside the scope of this evaluation, however,
as does the additional support required by practitioners to work in a fully trauma-informed
way.

20
3.
The Lewisham Trauma Informed Group Work Programme
3.1.
Background and development of the programme
In 2014, MOPAC commissioned the South London Resettlement Consortium to deliver
trauma informed training for six South London boroughs; Lewisham, Southwark, Croydon,
Wandsworth, Lambeth and Greenwich. This was led by Lewisham, who commissioned the
initial eight-day training. The initial training focused upon how the brain works and the
impact of adverse childhood experiences on young people in the short and long term.
In 2015, another round of funding enabled further training in the six boroughs and two staff
members from Lewisham completed an additional eight days of training. Following an
inspection in 2016, Lewisham Youth Offending Service underwent a service redesign in
order to work in a trauma informed way. This was involved every aspect of the service, from
organisational policies to how practitioners work and communicate with young people.
3.2.
Comparison with previous programmes
As part of the redesign, it was decided to develop a trauma informed group work
programme. The group work programme at that time was a weapons awareness
programme called Double Edge which had been running between 2009 and 2018. This was a
generic five-session programme and included victim statements and images of knives.
The review of the programme highlighted that showing images of knives and having victims
talk about the impact of a violent offence could possibly retraumatise young people who
themselves have been victims. It also diverts attention away from the central issues, as one
staff member explained:
‘The knife is not the issue, it’s the behaviour that we are trying to address’ (Participant
1, staff member).
3.3.
The structure of the programme
The programme had two stages – a one-to-one engagement phase followed by 8 groupwork
sessions.
The one-to-one engagement phase normally last 4 weeks and the young person is seen at
least once per week.

21
During this phase, caseworkers engage with families to explain the programme to them,
including the activities and techniques that they will learn.
This enables them to introduce specific activities, such as
This is followed by an 8-session group work progress that included the following topics:
• Understanding stress and how it affects our brain and behaviour.
• Unconscious bias and how it influences behaviour.
• Breathing techniques based upon a form of Tai Chi.
• Mindfulness activities, including guided imagery.
• Healthy relationship to social media
• Final session around building a legacy
After each group session, the facilitators provided an update to individual case workers
about how the group had gone to enable them to follow up.
3.4.
Background of young people who went through the group work
programme
A total of 22 young people went through the programme in 4 cohorts:
Characteristics
Percentage
N =
Age at time of group:
12 years
13 years
14 years
15 years
16 years
17 years
18 years
Average age
5%
0%
9%
27%
18%
36%
5%
15.8 years
1
0
2
6
4
8
1
Race/ethnicity
Black
White
Mixed
Other
55%
9%
23%
14%
12
3
5
2

22
Gender
Male
Female
100%
0%
22
0
Intervention at
time of group
RO
RO/YRO
YRO
YRO with ISS (Band 1 High)
YCC
Section 90/91
DTO Post Custody
55%
9%
14%
5%
9%
5%
5%
12
2
3
1
2
1
1
Known to children’s social care?
Never
Known previously
55%
45%
12
10
Known to CAMHS?
Not in A+
Yes
73%
23%
16
5
3.5.
Developing the logic model
A workshop was held with the key staff who were involved in the development and
implementation of the programme to develop a logic model for the intervention. A logic
model (YJB, 2015; HM Treasury, 2011) explains how and why an intervention has achieved
change in young people’s lives.

23
Fig. 1. The logic model:
Lewisham Youth Offending Service
Trauma Informed Violence Reduction Logic Model
GOAL: Eliminate Violence among Under 18’s in Lewisham
OUTCOMES
Background Inputs Activities Short-Term Intermediate Long-Term
\
Age
Gender
SES
Household
Makeup
Education
Attainment
Ethnicity &
Immigration
status
Court History
of Violence
Offending
Space
Paid Staff
Parents
Partnership with
Courts
Case Workers in
Lewisham Youth
Offending
Service
Youth Justice
Board
Computers
Group
Discussion
Worksheets
Interactive
Games
Knowledge about
unconscious bias
Knowledge about
stress and its
impacts on the
brain and the
decision-making
process
Resilience against
anti-social
interpersonal
relationships
Resilience against
anti-social digital
environments
Prosocial
interpersonal
relationships
Stress
Anxiety
Morbidity &
Mortality due to
weapon assaults
Morbidity &
Mortality due to
physical assaults
(fighting)
Affirmation
Libation
Handshakes/
physical
greeting
Videos – for
discussion
Poem –
reading of and
discussion
Aroma
Therapy
Breathing
Techniques
Music
Positive
perceptions
about
their peers
Positive
self-image
Self-respect and
respect for their
peers
Perceived
susceptibility of
being a victim of
violence in
Lewisham
Communication
skills
Negotiation skills
Stress-relieving
breathing
technique skills
Mindfulness skills
Jobs/Careers
offering
livable wages
Law-Abiding
Citizenship
Recidivism into the
criminal justice
system
EVALUATION

24
4.
Findings
4.1.
Outcomes for young people who went through the group work
programme
There was a total of 22 people who went through the group work programme in four
cohorts. The third cohort was terminated early because of insufficient numbers so their data
has not been included for reoffending purposes.
Nature of offending before the intervention
Nature of offence
Number of offences
Violent offences:
Wound / inflict grievous bodily harm without intent (Violence against
the person)
Assault by beating (Violence against the person)
Section 18 – wounding with intent (violence against the person)
1
1
2
Weapon-related offences, including:
Possess knife blade / sharp pointed article in a public place - Criminal
Justice Act 1988 (Violence against the person)
Possess an offensive weapon in a public place (Violence against the
person)
Possess article with blade / sharply pointed article on school premises
(Violence against the person)
18
Drug-related offences:
Possession of Class B Cannabis
Possession of Class A Cocaine
9
1
Theft-related offences, including
Robbery or attempted robbery
Theft from a shop (Theft and handling Stolen Goods)
Theft of motor vehicle (Theft / Unauthorised Taking)
9
Breach of Statutory order
2
Total number of offences
43 offences
Average offences per group participant
1.95 offences
The group participants had a range of previous offences prior to attending the group and,
on average, each participant had committed 1.95 offences (range = 1-3 offences). The most
common related to weapon possession in a public place (18 offences), drug possession (10
offences) and theft-related offences (9 offences). There were four serious violent offences,
including wounding, inflicting grievous bodily harm without intent and assault by beating.

25
Reoffending outcomes
Cohort
Total
number
in cohort
Number who
reoffended
during the 3-
month
intervention
Number who
reoffended in
following 12
months
Reoffending with
violence-related
offences
Extent and nature of
reoffending within the
following 12 months
Cohort 1
7
0
0
0
None
Cohort 2
7
1
4
3
• Possession of a firework
under 18 years.
• Motoring offences.
• Possession of knife blade,
motoring offences.
• Possession of imitation
firearm on school
premises, affray, motoring
offence.
• Affray, cannabis,
possession of knife blade,
robbery
Cohort 3
N/A
N/A
N/A
N/A
This cohort did not complete so
has been excluded for
reoffending data.
Cohort 4
5
0
0
0
None.
Total for
reoffending
data
19
1
4
3
Percentage
100%
21.0%
15.5%
During the 12-week intervention, there was only one offence of possession of a firework
under the age of 18 years. In two cohorts (cohorts 1 and 4), there were no instances of
reoffending. In one cohort, four young people reoffended. In the following 12 months, the
total reoffending rate was 21% (n=4) and the reoffending rate for violence-related offences
(possession of knife blade, affray) was 15.5% (N=3). This compared favourably with the
national picture with a national reoffending rate of 38.4% (Youth Justice Statistics 2018/19).

26
4.2.
Qualitative findings
The data from the focus group with professionals and the individual interviews with the
young people who had gone through the programme were both analysed. Since there were
a strong agreement between both datasets, the findings have been integrated to avoid
fracturing the findings artificially.
Theme 1: ‘Young people often feel very unsafe’
A common theme from both young people and practitioners is that young people feel very
unsafe in their lives and this has an impact on them engaging in the group. This related both
to their previous experiences of trauma and their perceptions of current threats in their
lives. These seemed to be inter-related as early experiences of trauma can influence young
peoples’ thinking and perceptions of risk. One practitioner explained it in the following way:
Anyone who’s had adverse childhood experiences and constantly in a state of hyper-
vigilance or anxiety, their cortisone levels are quite high. The amygdala, the part of the
brain that stores stress and anxiety, gets enlarged every time there’s more anxiety
added onto it’ (Staff participant 1).
He went on to explain about how this could affect young people’s behaviour and ability to
engage with interventions:
If they’ve gone through adverse childhood experiences, their brains aren’t working as
effectively as someone who hasn’t gone through trauma, so they’re in a constant state
of hyper-vigilance, fight and flight, all the time. So, when they come into this office or
meeting with us, they’re not really thinking about the intervention that we’re doing,
they’re thinking about ‘When I’m leaving here, am I going to be safe?” (Staff
participant 1).
He explained that, at the initial stages of designing the programme, he had interviewed
young people who had previously been engaged with the Youth Offending Service in order
to explore their experiences of growing up in Lewisham and what led them to commit
violent offences. He found that they were experiencing high levels of stress and anxiety
related to their heightened perceptions of risk:
‘The summary of what they told me was they were really under stress and they had
lots of anxiety. A lot of the fears that they had weren’t even real, so they thought that
people was after them and actually there probably wasn’t. Not that there wasn’t any
animosity between parties, but the people who they thought were willing to harm

27
them actually didn’t, you know, just had a bit of issues with them’ (Staff participant 1,
staff member).
He stated that this led them to rethink about the young people that they were working with
and recognise how the high levels of stress that they experience leads to continually raised
cortisone levels. The concept of unconscious bias was very helpful in understanding how
young people could misperceive the nature and extent of risks posed by other young
people.
Unconscious bias has been defined as ‘when we make judgments or decisions on the basis of
our prior experience, our own personal deep-seated thought patterns, assumptions or
interpretations, and we are not aware that we are doing it’ (Frith, 2019). Our unconscious
biases are influenced by our personal experiences, background and context and frequently
influence our everyday decision making and awareness outside our conscious awareness
(Atewologun et al., 2018).
This is not to minimise the very real risks that young people faced in their everyday lives, but
to recognise how those risks may be increased by unconscious bias that can lead to
misperceptions of threats from other young people.
In the study, a conscious decision was taken not to directly ask participants about their
personal experiences of trauma in order to avoid increasing distress and many participants
were understandably reluctant to talk about trauma. However, several participants
voluntarily disclosed personal experiences of trauma during general discussions, including:
• Having a close friend stabbed to death.
• Being the victim of an attempted acid attack.
• Witnessed multiple stabbing in the local area since the age of 11 years
• Having a machete pulled on them.
• Watching another person being stabbed.
These experiences of violent trauma appear to have contributed towards the young people
having a heightened sense of vulnerability. Another contributing factor to a sense of
vulnerability identified by some young people was that they felt that growing up in certain
neighbourhoods where violence was prevalent meant that it had become normalised and
they had to keep themselves safe. For example, two young people described how they
carried a knife in order to feel safe:
‘I lived in New Cross at the time, which was a known area for gangs and violence.
When I first moved there, someone got stabbed outside my block on the road, and he
was shouting ‘Oh I’m bleeding out’. It’s just like when I was travelling through New

28
Cross, Lewisham, to like where I needed to go, at night-time as well, I personally
carried [a knife] out of fear’ (Participant 2, young person, 16 years).
‘I brought a knife into school… I felt I had to protect myself’ (Participant 3).
In the interviews with young people, anxieties around personal safety manifested itself in a
preoccupation with potential attacks by other group participants. For example, two young
people talked about their experience of attending the first session:
‘Hypothetically speaking, if I was in a gang… and I had to go onto this course for
carrying a knife, and someone else that might be my enemy also went to that
course, you know, so very paranoid during that course… You don’t get searched,
you don’t get searched, you come in here, you don’t get searched’ (Participant
Young person, 16 years).
“I sat one chair away from everyone…That’s just how I am’ (Participant 3).
This supported the previous comment by the programme lead that young people are
frightened of each other, which relates both to personal trauma and unconscious bias linked
to wider media perceptions of young men as violent and threatening.
Theme 2: ‘Helping young people to feel safer in their lives’
In order to help young people to feel safe in the group as well as to help them recognise
how stress influences them physically and emotionally and can lead violence, the
programme designers included the following:
a)
Pre-group engagement phase
Staff members had identified the tendency for young people to disengage with groups after
a few sessions if they do not have a relationship with anyone in the group. One staff
member described how they addressed this:
‘… due to a lot of young people now being hyper-vigilant, they don’t know what’s
happening, they’re coming into a situation, they don’t know who’s on the group so
they’re stressful of that as well, so it’s about preparing them. So, because this group
has a lot of new elements as well, like breathing techniques, like mindfulness,
affirmations, it’s a bit unfair to just drop someone straight in when they don’t know. So
the engagement phase was set up to work with the facilitators and broach those topics

29
at a pace that the young person could feel comfortable with’ (Participant 2, staff
member).
Staff felt that building a relationship with one of the facilitators beforehand enabled young
people to feel more comfortable to come into a session and more comfortable in trying out
some of the new techniques.
In the third cohort, the engagement phase was not as consistent as previously and this
resulted in lower numbers attending. Those that attended had experienced the full
engagement phases, but others were less committed. Consequently, the group did not have
all of the eight group sessions.
b)
Creating a nurturing environment
Staff members highlighted the importance of the physical environment in helping young
people to feel safe:
‘I do think that creating the safe spaces is really key to the trauma recovery model…
this room gets transformed… you feel the difference when you walk in, it’s tangible,
you know, and that’s creating a space which is different and works on the senses to
enable the mind to work more effectively’ (Participant 3, staff member).
The group was originally allocated a large room, but this had felt that it was too large, so
they moved to a smaller room and this worked much better. In order to create a welcoming
physical environment, essential oils were used in the room to create a relaxing atmosphere.
As well as the physical setting, the making of healthy smoothies contributed towards a
welcoming environment that participants found nurturing. For example, one participant
described how he felt anxious for the first session, but the smoothies contributed to a more
relaxed atmosphere:
‘We went around, said who we was, introduction, had a little fruit juice… That was,
like, the little thing that kept everyone coming back... the juices were good (Participant
1, young person).
This included the young people making smoothies themselves and one person described
how he was normally ‘more of a fizzy drinks kind of person’, but he felt that ‘the smoothie
session was the best session’ (Participant 3, young person).
c)
Structure and rules of the group sessions

30
Staff members were aware that one of the most anxiety-provoking aspects for young people
was coming to a group where they did not know what was going to happen. In order to
reduce a sense of vulnerability, the sessions were designed so that they would begin and
finish with predictable rituals. This would enable the middle section to be used to explore
different topics each week. As one member explained:
‘At the beginning it’s the same, at the end it’s the same… and then in the middle, we’ll
explore the topics at hand, but the start and the beginning, the start and the end is
always the same. So, in that way, when young people walk in, they already know
what’s happening, that reduces the risk and that opens them up to getting used to the
new concepts that we’re developing and the topics’ (Participant 2, staff member).
d)
Ground rules to promote emotional safety
In addition, there were a number of ground rules that were designed to reduce participants
wariness of each other:
• Physical greeting and acknowledgement. Group members shall greet each other
and as how they have been doing along with some form of physical greeting, e.g.,
handshake, fist bump or pound. This has two aims. Firstly, it reduces tensions and
brings down barriers. Secondly, it prepares the young people for an adult world
where they will be expected to greet people that they do not know.
• A ‘no shaming’ rule. If group members were late, the facilitators would discuss with
them afterwards individually rather than responding in ways that may provoke
feelings of shame in front of the group.
e)
Gradually encouraging young people to talk about themselves and their feelings, once
they felt safe
An important aspect was recognising this early anxiety and wariness and not forcing group
participants to talk about themselves too soon. One young person described the first
session, saying that everyone was being ‘a little bit antisocial: just a little bit because, I
mean, it’s the first time’. He said that ‘the first conversations were on topics that they knew
you would feel comfortable talking about. The result was that:
‘…halfway through it, everyone’s, like, kind of opening up a bit because they just eased
into the programme, isn't it? They didn't just shit at us straight on and say, ‘Right, start
talking about yourselves’ (Participant 1, young person, 15 years).

31
The same participant talked about how he was able to open up more in the group, which he
linked to also received a diagnosis of post-traumatic stress disorder:
‘Even before I was diagnosed as a posttraumatic stress disorder, I never would really
talk. I never talked. From that day on – from when they diagnosed me with it – that’s
when I started to open up more because people understood. They had a bit more of an
insight. So I found the session easier because I knew they knew what I was already
dealing with. So it’s like they don’t know because you can’t help someone you don’t
know what’s wrong with them, isn't it? (Participant 1, young person, 15 years).
As well as physical safety, another challenge was emotional safety within the group. For
example, one young person was able to be open about this:
‘I was not looking forward to it at all because I’m not a person to just outright
express my feelings on an emotional or personal thing’ (Participant 1, Young
person, 15 years).
However, he later said:
‘I’ve seen an improvement… I know how to be a bit more open’ (Participant 1,
young person, 15 years).
f)
Breathing exercises and guided imagery to reduce anxiety and promoting feeling safe:
One of the core methods in which the group helped young people to feel safe was the use
of breathing exercises to reduce anxiety and strengthen emotional control. One practitioner
explained the rationale:
‘The reason why we brought in the breathing exercises was young people said to us
when we was preparing the group or starting to develop the group that coming into a
group work setting they feel very anxious about it; one, because they don't know who’s
going to be there, they feel stressed leaving, so we thought of that, and some of the
topics that we discuss as well could raise a bit of anxiety as well, so we thought that
starting a session doing some breathing techniques brings the heart rate down, starts
making young people feel very relaxed’ (Participant 1, staff member).
The breathing exercises were based upon a martial art that was a form of Tai Chi. One
practitioner commented that this was more likely to be seen as ‘cool’ than terms such as
mindfulness. However, mindfulness exercises included guided imagery were also
incorporated towards the end of the programme. This included a visualisation exercise in

32
which group members were invited to imagine a safe space where they felt protected and
secure:
‘I use a lot of imagery, a lot of language where they take themselves... I ask them to
take themselves to the safest place they can think of, but they’ve got to build it from
the scratch up, so what does the door look like, what does the window. Are there
windows, are you outside, and asking them to describe how the grass, if there is grass,
how it feels on their feet. So they’re creating this image in their minds and they
actually get really zoned out… They describe it as they feel so relaxed when they leave
here, you know, that’s the aim that we want to do, we want them to feel at ease,
relaxed, we want the YOS to be a place where they feel safe, it’s a place of safety’
(Participant 2, staff member).
One of the most common benefits of the group that the young people reported was greater
self-control gained through breathing and mindfulness exercises. Several young people
were able to describe how they used the breathing techniques after the group had finished,
either in specific stressful situation or because they felt ‘angry all the time’ (Participant 4,
young person). For example, one young person stated:
“You don’t realise that those little things, like these, they stay in your subconscious. It
sticks in your brain… when I’m getting inpatient, I can just take my time and just shut
my eyes and breathe. … you’re taking time out from the stress. When you space out
from everything else and just breathe, it brings you back to earth…. So that helps a lot”
(Participant 1, young person, 15 years).
One staff member described feedback from a parent about how the breathing exercises had
helped her son:
‘One of my parents on a home visit, she said that, with the breathing techniques, she’s
noticed that he’s been doing that, and just how that helps him to kind of remain calm,
but not only that, it just helped him to think about stress, because before the group it’s
not something he’d really thought about” (Participant 2, staff member).
The practitioner went on to say:
“He was actually talking, was actually able to articulate how he was feeling, how it
was affecting him, and practically doing stuff to try and decrease that stress, and
preparing for stress, ‘Mum, I’ve got exams next week, it’s going to be stressful, can we
do this, can we do that, can I not do this just so that I can have time to rest and relax?’’
(Participant 2, staff member).
Interestingly, one young person described using the breathing techniques when he was
outside the home but, when asked about using it at home said: ‘I don’t get angry at home. I

33
don’t need to get angry at home’ (Participant 4, young person). One way to interpret this
was that his anger was strategic rather than expressive, i.e., he used anger in situations
outside the home as a way of presenting a public persona that he felt was necessary to kept
him safe.
g)
Introduce the concept of unconscious bias to help young people to recognise when
they misperceive threats from others
The concept of unconscious bias was used as a means of talking about what young people
found threatening, specifically how they may misperceive other young people as
threatening. One group leader described how this was discussed in the sessions:
‘A lot of the people who they were fearful of and who they were willing to attack
looked like themselves, were black, and I asked them a question, ‘Why is there no-one
else of any other race that you’re afraid of or that you’re willing to actually harm?’,
and they said ‘Well what we see on TV is black people that are doing this type of
violence, so when I see another black person who looks like me or a group of black
boys I immediately start feeling anxious’ (Staff participant 1, staff member).
The group facilitators used the session to explore how it possible to misread the behaviour
of other young people as a threat, which can become a self-fulfilling prophecy. One staff
member described how they would talk about this to young people in the group:
‘… you see a group of five boys who look similar to you, that you think may look
menacing, but are they a risk to you? The reality is, probably not, they probably are
not a risk to you, but they need to pause for a second and think, ‘I’m looking at their
behaviour, which is causing my behaviour to change, I’m approaching them now and
I’m starting to walk a bit different or I may start to put my hand in my trousers like I’ve
got something’. Now they’re thinking ‘What’s this boy want now, is he a threat to
me?’, and then you’re both thinking about threats now, then that can cause an issue’
(Staff participant 1).
Consequently, the focus is to encourage young people to challenge their own deep-seated
beliefs when they are judging risk in their everyday lives:
‘How their brain works when they’re making decisions within milliseconds, sometimes
pause for a second, think about ‘Is what I’m seeing or what I’m thinking, is it real, is it
a real threat or not?’ So we do a discussion on threat and risk management, so an
example that I use with the young people is, when they’re crossing the road, where
they’re not using a traffic light, they will look left and right, they’re doing risk
management there, they step out into the road, still doing risk management, but then

34
they might have misjudged and there’s a car very, very close to them right now, that is
now threat management, so they have a decision there to stand still, run forward, run
back, or try and fight the car if they think that they’re superman. So that’s what I show
them, when they’re leaving their house, they’re doing risk management…They
probably don’t realise that they’re doing this, but we explain it to them, ‘This is exactly
what you’re doing, it’s not written down but in your mind you’re risk assessing,
“Should I go here, what time should I leave, shall I get on this bus?’ (Staff participant 1,
staff member).
She went on to explain how this mirrored wider changes within the service:
‘… it’s a place where they can talk about how they’re feeling, not just about their
offending behaviour, which is what we have started to do as a service anyway, not just
in the group, as a service as a whole (Participant 2, staff member).
Another staff member discussed how the group had opened up the possibility of dialogue
that was continued in subsequent individual sessions:
‘It definitely opens up a lot of dialogue. So, with one young person we had a whole
hour just talking about unconscious bias, which was really nice because I didn’t expect
him... and he brought up the topic as well. (Participant 5, staff member).
This was echoed by another staff member, who explained how the group had influenced
other aspects of the ways that their service had become more trauma-informed:
I think this has been the pilot to influence other things, so one-to-one work and social
media work and unconscious bias work. I think this was the first opportunity to test
something out’ (Participant 3, staff member).
Theme 3: ‘Helping young people to have more pro-social and
healthier lives’
Once young people felt safe in the group, this freed up energy and attention to other goals:
a)
More positive perceptions of peers and prosocial personal relationships:
One of the main barriers to young people forming prosocial peer relationships was that
unconscious bias was leading young people to regard their peers as threatening. The work
on unconscious appears to have enable young people to challenge their initial fear and
suspicion of other young people. For example, one young person said that he had become

35
more aware of his tendency to react to people and went to describe how he felt less likely
to jump to negative conclusions and more open with others:
‘It’s made me think bigger. Obviously, I was thinking my faults already before,
obviously how I’m going to react to people or how to present myself to people and
stuff like that, but obviously they show you different sides. So, it’s like you can’t really
just judge them without giving them a little chance, you know what I mean, like
sometimes you need to give them a little chance to actually see the person for who
they are’ (Participant 5, young person).
This was echoed by the following feedback received by a staff member:
‘One of my young people said while they’re looking at every person that looks like him
as a threat, they now look at them more like a brother. They wait for them to show
them something threatening before they see them as a threat, initially now it’s more
like their brother, they’re just like me’ (Participant 2, staff member).
The discussion of unconscious bias appeared to not only made participants more conscious
of how they perceive other young people, but also how they were perceived by others. For
example, one participant stated:
One of the main sessions that I thought was very good was when they was talking
about our unconscious biases and stuff like that, like how people judge you and stuff
like that, and it was like how people will look at us because of the way we dress and
that and judge, and it’s not a good thing but obviously everybody has it, so it’s like you
have to kind of counteract it… that’s what I feel like was one of the best sessions that
we’ve had…. I didn’t know about the word ‘unconscious bias’ stuff, but I use it a lot
now... made me like mature even a bit more, if you understand, obviously think about
the bigger picture for life and that sort of thing, yes’ (Participant 5).
Another young person described how he had changed his behaviour after he realised how
he might be perceived by the police:
“… when me and my friend go out, we look quite dodgy. One time we went out and the
police stopped us… I think [they stopped us] because of what we were wearing and
how we acted” (Participant 3).
Another young person said that it was helpful to know about unconscious bias, adding ‘I
haven’t been stopped by the police since I’ve been on this [programme]’ (Participant 4,
young person).

36
As well as being aware of how they might be perceived with their friends, several stated
that they had changed their friends since they went on the programme. For example, one
young person said:
‘…there are certain people that obviously I avoid that used to be friends, because
obviously I don’t really want to attract them and get myself involved in that same
situation’ (Participant 5, young person).
Staff members emphasized the importance of the role in modelling pro-social behaviour and
to help young people think about how they present themselves in different situations, e.g.,
how they present themselves to a judge is different to how they present themselves to their
peers.
b)
Improved relationship to authority:
An additional benefit that young people reported was an improved relationship with
authority. This was often linked to an understanding of unconscious bias, which enabled
some young people to question their own immediate responses to authority figures. This
was most articulately expressed by one young person, who described how he previously
regarded anyone in authority with suspicion and added, ‘my unconscious bias was…‘All of
these lot are just out to get me.’ He went on to say that the group ‘helped a lot’ to challenge
this belief:
‘It did change a lot because I can now see that these people don’t just have malicious
intentions… I didn't know what unconscious bias was before that… So I think they kind
of educated us and armed us with the right kind of weapons: the knowledge that we
needed to actually navigate our way through this kind of system. And that’s why I
appreciated it. I appreciated it a lot more. I appreciated the YOP a lot more than I did
before’ (Participant 1, young person, 15 years).
Another example took place in response to the death of a local young person, which had a
considerable impact on young people in the area. At that time, a group was running, and the
group facilitators thought that the young people may not come to the session. In fact, there
was high attendance, and this became the focus of the session. In the aftermath, group
facilitators were pleasantly surprised to see that group members had moved away from the
idea that personal revenge was the only way to respond. Instead, the discussion focused
upon the responsibility of the police to catch those responsible:
“…where their only option before may have been one option of revenge, they now
know actually there are various different ways that this situation can be dealt with and
if I choose this way it’s not only better for me but it’s better for those around me, and it
means that I won’t get into trouble dealing with it this way” (Participant 2).

37
One interpretation is that the young people felt safe enough in the group to move beyond a
posture of invincibility in which they were going to avenge the death of their friend to being
able to express their loss and vulnerability.
One staff member talked about young people from the group talking to the Chair of the
Youth Justice Management Board at an engagement session:
‘I interpreted that they felt safe, and safety is at the heart of this, they felt safe in the
environment that we were asking them the question, and therefore they took a
different perspective on the police. It doesn’t mean to say they’d got massive positivity
towards the police, but they described safety in terms of authority supporting them
and they felt supported’ (Staff member 3).
Some participants also described greater openness and cooperativeness in their
relationships with their parents:
‘[My Mum would say] He’s good… He’s not naughty, he’s more co-operating and he
listens more ‘(Participant 3, young person, 12 years).
c)
Healthier social media use:
‘It’s the identity thing that’s massive, you know, your self-esteem and your reputation
can live and die on social media’ (Participant 2, staff member).
The penultimate session was focused upon social media, which is held as a discussion. The
facilitators have some information but seek to foster a discussion on a topic, e.g., whether
drill music is an influence for violence. The facilitators explained that it is a constantly
changing field, so they have to substantially update it every time that it is run.
This session is delivered in a trauma-informed way because it encourages young people to
think about how their social media use may impact upon their stress levels and how it could
lead to retraumatization. As one practitioner stated:
‘That is really about young people recognising… is it increasing your stress levels, what
you’re looking at there? Because social media uses algorithms, so if you’re looking at
only drill and violent videos, that’s all you’re going to see. So again, it’s going to impact
your stress levels if all you’re looking at is violence and you’re re-traumatising yourself
if you’ve gone through a traumatic experience’ (Participant 1, staff member).
The ways in which social media can influence violence was highlighted by one young person,
who described the difference between school fights before and after social media:

38
‘Okay, me and John have a fight, round Catford, for it to spread all around Catford, I’d
have to tell my cousin... And then it goes around. And then, maybe, someone tells their
older brother and then that’s how it starts to spread. And it’s spreading, isn't it? But,
now, I would still go and punch John in the face, someone could … ‘Oh, my God!’ And
it’s everywhere and it’s got thousands of views and it ends up on some blog page and
half of London knows about it already’ (Participant 1, young person, 15 years).
He went on to explain how the speed of social media means that violence become more
visible quickly, which can intensify the conflict:
‘Social media itself just creates a lot of tension because people use it to call each other
out... And all that does is intensifies issues that are already there. Like that thing I said
earlier with me and the random guy, John. I punch him in the face or whatever: we
have our little scrap and then it goes around our school… everyone finds out. I’ve got
my friends: he’s got his friends. In this day and age, my friends are probably already
going to know about it beforehand. So, if I decided to step back, they might not: they
might take it further’ (Participant 1, young person, 15 years).
Consequently, what began as a conflict between two individuals quickly ripples out to a
conflict between two groups. If these groups are not equally matched, this can lead to the
more vulnerable group resorting to weapons:
And that’s how it starts to just escalate and escalate until all of our friends are on this
guy and this guy hasn’t got that many friends, so he feels that he needs to level out the
playing field. And that’s when he might go, pick up something. So that’s how it all
starts, kind of thing, like. And, with social media, that makes that whole process
happen like that. Because all it takes is for me to send one message into a group chat
and then ten, twenty people.… Everyone’s like, ‘Bro’, you did this and that?’ ‘Oh, have
you seen that?’ ‘Oh, you go to this school?’ ‘Cool. Cool. Cool.’ Like, that’s all it takes.
That’s all it takes’ (Participant 1, young person, 15 years).
The session also encourages young people to challenge their assumptions based upon
unconscious bias. For example, there had been a spate of stabbings and this was a focus of
the discussion:
‘We were saying to the young people ‘What do you think? Do you think it’s been more
young people have been stabbed or more like older people?’ And then we actually
showed them stats which showed that it was older people, and they refused to believe
us. ‘But no, YouTube says this’. Yes, that’s exactly it, and even then, we were saying

39
‘But no, look, here are the stats’, ‘No, those stats are fake’, ‘No, they’re real’
(Participant 4, staff member).
As well as raising awareness around legal issues, e.g., sharing inappropriate images, the
session also sought to encourage young people to critically question information that they
see on social media:
We talk about fake news as well, there’s a lot of fake information and we encourage
young people to do additional research outside of social media, so you see, I don't
know, a stat or a so-called fact which might not be a fact on the internet, they should
look elsewhere to see what they can find out about it, don’t just rely on a meme or
image that says... 99% of people that take vaccines get cancer, you know. I see things
like that, but is that true? Go and have a look, go and look outside… Don’t just read
online, get a book as well, books still exist, libraries are still free, you know, so we do
encourage young people to try and go outside of the online world (Participant 1, staff
member).
During the interviews, young people tended to initially downplay their involvement with
social media. When this was explored further, most indicated that they were active on social
media on apps such as Snapchat, Instagram and FaceBook, although it was difficult to gain a
sense of the extent of their social media use. In general, participants did not feel that their
use of social media had changed significantly as a result of the course, but they described
being more informed and aware about the issues.
d)
Greater sense of personal responsibility
The programme encouraged young people to be actively involved in shaping the
programme and taking responsibility, rather than being passive:
‘I thought ‘Oh yes, it’s just going to be one of them programmes where you’re just
going to chat a load of rubbish, saying the same thing they say to a lot of kids’… Went
there and it was different, it was basically our programme, if you get what I mean, like
they made it into us, so we basically controlled the programme in a way’ (Participant
5, young person).
An activity that was focused upon increasing a sense of personal responsibility was each
participant having a plant that they took care of. One staff member described the wider
benefits of the group on later individual work following:
The other thing is this sense of responsibility, especially with the plants, I found with all
my young people they felt that they had to water it every week and some had named it

40
as well, and that sense of responsibility I started using in my one-to-one sessions, not
buying them all plants, obviously, but looking at the element which they wanted to take
control of, and I would be the supporter. Obviously with a court order I would support
them in that as well but let them lead the way. So that definitely helped, so the sense of
responsibility definitely surfaced out of the programme… the obvious things about future
goals, so education, whether they’re doing GCSEs now and they want to go college or
whether it’s driving, it’s about... it’s bespoke to each young person, so it’s where they
want to go and the direction they want to go into. If there’s something I can identify as
a professional, where I can see a skill, I will try to encourage them for that’ (Participant 5,
staff member).
One young person described it in the following way:
‘..from having that cactus, that was a plant that I was looking after, like it was my own
little thing… so if it was a thing, like I’m feeling a bit low or down or need some positivity,
I feel like that would be a good thing for me to go and grab a plant and do the same
thing’ (Participant 5, young person).
One young person who went through the group talked about the experience at an
involvement event with the Chairman of the Youth Justice Board, in which he described it as
involving a ‘shift in identity’ and ‘the importance of the relationships in the group, feeling
safe… and talked about the changes he’d made in his self-perception… his relationships at
home, and also a lot of ambition for the future which he was able to articulate very, very well”
(Participant 3, staff member).
The final session is about having a positive ending and is about building a personal legacy:
And the last session is around building legacies, we have an external person come in and
they talk about ‘How do you create a legacy?’, and this person talks about names that
young people will recognise, so people like Versace, how did Versace come from being a
regular guy to being this multi-billionaire, like the timeframe that it took to get there. I
know young people think about this get-rich-quick schemes, but unless you’re going to
win the lottery there’s no such thing as a get-rich-quick scheme, there’s this sort of long
journey to do this, and does that legacy... do you link your legacy with making money or
are there other purposes to it? Does it mean, because you are poor now, that you can’t
have a positive legacy or put influence on people? (Participant 1, staff member).
5.
Benefits of the group
Young people identified the followings benefits from the group:

41
• Greater self-control and stress management skills gained through breathing and
mindfulness exercises. This included in response to specific situations or more
generalised feelings of anger or anxiety.
• Greater ability to discuss their emotions with others and more positive relationships.
• More aware of unconscious bias that leads them to react to others in unhelpful
ways.
• Less likely to assume other people are a threat and more aware of how they are
perceived by others.
• An improved relationship with authority, moving away from feeling all authority
figures were ‘out to get them’ to recognising their roles. This did not mean feeling
positive towards the police but recognising that their role in providing justice rather
than young people having to have revenge after violent incidents.
• Some participants also described rethinking their friendship networks to avoid
negative influences.
• The use of credible role models, e.g., a high profile and successful musician from the
local area, was valued by participants.
• Some aspects, e.g., healthy social media use, proved more difficult for participants to
change, although they described being more informed and aware about their
importance.
6.
Lessons for the service and for other Youth Offending Services
nationally
The following key lessons were identified:
1. The training and skills of core staff are central:
Group facilitators need to have a good understanding of the emotional issues faced by
young people based upon the trauma informed principles. Their skills are vital as they are
likely to be working with young people with considerable fear and mistrust.
2. Importance of engagement phase.
Preparation for the group and building a relationship with one of the facilitators beforehand
is very important in order to promote the conditions for effective engagement. Inconsistent
or inadequate preparation is likely to lead to high drop-out rates.
3. Pay attention to creating a physical environment that helps young people to feel
safe.

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The physical environment is important and activities such as using essential oils and
preparing drinks together can make a significant contribution towards building trust.
4. Structure and rule for the group create a sense of predictability for young people.
Another important aspect is that the sessions are well structured and predictable so that
participants feel that they know what is going to happen. Group rules should include group
members greeting each other in a physical way and group facilitators avoiding sanctions
that create feelings of shame.
7.
Conclusions
In conclusion, the trauma informed group work programme is a pilot study that has shown
promising quantitative and qualitative results. Quantitative reoffending data provides a
useful indicator but only ever gives a partial picture of the benefits of an intervention. The
reported qualitative benefits should be considered equally valid from a trauma-informed
perspective, which is about a holistic approach to the young person’s wellbeing.
Staff members had a clear and credible rationale for the intervention and were able to
article a coherent theoretical framework that fitted well with the experiences of young
people who attended.
It should be noted that the group work programme only included young male participants.
The gendering of violent behaviour and young people’s routes into violent offending is
complex and the programme might need to be amended for young females in light of the
evidence base on female violent offending.
While it is a small sample size, the indications are positive that the programme should
continue and has good potential for replication in other geographical areas. This would
enable a large evaluation that would benefit from replicating with a larger cohort.
The final word should go to one young person who offered a hopeful but cautionary note on
expecting any form of intervention to immediately address the consequence of significant
trauma that has often accumulated over a considerable period of time:
It’s a process. You’re not going to go on the programme on a Monday and then, on the
Tuesday, ‘Well, everything’s rosy.’ You’ve been through a lot’ (Participant 1, young
person).

43
Appendix 1 - Project team
Professor Andrew Whittaker FRSA, Co-Principal Investigator
Andrew Whittaker is Professor of Social Work Research and Co-Lead for the Serious
Violence research cluster at London South Bank University. He is lead author of the
Postcodes to Profit study of gangs in Waltham Forest, which won the Research in Action
2018 Award. He is author or editor of six books, including a textbook on child and
adolescent development that explores the effects of trauma and life events, two edited
books on risk and decision making in social work and several research textbooks. He was
previously the operational lead for the Centre of Social Work Research at the Tavistock
Clinic and is Editor of the Journal of Social Work Practice. Andrew previously worked as a
Senior Social Worker in a local authority child protection team, a Child and Adolescent
Mental Health (CAMHS) clinic and as the Director of a mental health organisation.
Denise Harvey MA, Co-Principal Investigator
Denise started her professional career working within Public Health leading on the Healthy
Schools Agenda in Havering, Barking and Dagenham in 2001. Denise pursued a qualification
in social work and qualified in 2005. With over 21 years’ experience working within various
children and families services Denise has spent the last 13 years in various senior
management posts. She has extensive experience of working with high-risk offenders as
well as managing high profile government projects. Her area of interest is risk and decision
making within youth/criminal justice systems and is currently undertaking her PhD in this
field. Denise has been a key member of the research team on a British Academy funded
study of professional decision-making in child protection, the Seeing Through the Eyes of
Experienced Practitioners (STEEP) project. Denise is also currently involved in a GSTT funded
research project looking at the court liaison and diversion scheme for people with Mental
Health/Neuro-disability Disorder.
Becky Shepherd MSc, Co-investigator
Becky is a criminology lecturer at LSBU and a former probation officer. She has an MSc in
criminology which focused on violent women and trauma-informed practice. She has direct
experience of supervising those at risk of serious youth violence and specialised in working
with girls and women in probation and youth justice. Becky has published a book chapter on
youth justice practice with girls and is a regular contributor to the Probation Journal.
Tajae Tyrell MSc, Senior Researcher
Tajae is a co-author of the ‘Postcodes to Profit’ study of gangs in Waltham Forest. She
completed a BA in Criminology at London South Bank University and an MSc at Greenwich
University. She has ten years’ experience as an employment advisor, including focusing on
assisting ex-offenders and care leavers into employment, training and education. She is the
Company Director of 2 Become 1 Solutions that delivers specialist workshops and training

44
sessions to multi agencies who work with young people, who have become involved in
crime.
Dr Tirion Havard MA, Co-Investigator
Tirion is an Associate Professor in the Social Work department and the co-lead of the
Serious Violence Research Group at LSBU. She is currently PI evaluating the Serious
Violence Intervention and Prevention project at Kent County Council and the use of
Independent Domestic Violence Advocates (IDVAs) in Surrey hospitals. Her PhD considered
the role of mobile phones in the coercive control of heterosexual women. This coupled with
her practice experiences as a probation officer working with perpetrators of domestic abuse
and gang members informs her research into Violence Against Women and Girls (VAWG).
She is also working in partnership with Southwark Council and the St Giles Trust developing
a training programme designed to understand children and young people’s experiences of
gang life through the lens of coercive control. Tirion is currently an Academic Fellow in The
Home Affairs Section of the House of Commons Library advising them on the topic of
coercive control (including tech abuse) and how it relates to domestic abuse and gangs.

45
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