Transitioning to a Trauma Informed Forensic Unit: Staff Perceptions of a Shift in Organisational Culture

Abstract

Background: Trauma-informed care can be defined as “a system development model that is grounded in and directed by a complete understanding of how trauma exposure affects service user’s neurological, biological, psychological, and social development” (Patterson, 2014). It is widely acknowledged that trauma informed approaches are designed to have a positive influence on both staff and service users. However, there is limited evidence that exists on implementing trauma-informed approaches in service provision. This limited evidence has also focused mainly on the influence of trauma-informed care on service users rather than staff members (Hales et al. 2017). Given the high prevalence of trauma in forensic populations and the fact that staff members are participants in an organisation’s culture and the processes through which services are delivered, it would be important to gain an understanding of how staff members are impacted by the process of moving towards trauma informed care within the NHS context in the UK.

Aims: The aim of this study is to provide an in -depth description of the impact of transitioning to a trauma-informed service model on staff working in an inpatient forensic unit in the North of England and the factors that influence the progress of this transition.

Method: The study employs a qualitative design and the data were collected via four focus groups comprising of staff members working in the four wards of a female forensic unit. All participants in this study were female. Thematic analysis (Braun and Clarke, 2006) was used to analyse the data through a social constructionist epistemology (Burr, 1995).

Findings: Four themes were identified: Reconstructing your professional identity; Redefining group dynamics; Navigating new clinical practices; Managing longer term challenges of trauma-informed change.

Implications: Implications for policy, practice and research are discussed.