Back in November last year there was a helpful discussion with our North East London community about what we needed to focus on going forward, kindness and compassion featured strongly and ensuring that we were all ‘trauma informed’ featured strongly as this would help us in empowering others, whether the public or staff.
As a result we’ve worked with the Wave Trust @WAVE_Trust and they are providing 2 hour online sessions across March for any staff in the NEL family, sessions can be booked here https://www.eventbrite.co.uk/e/trauma-informed-healthcare-training-wave-trust-tickets-518585582437
Having the time to understand the evidence base and think about the practical actions we can take has been really valuable. I had time to chat with a Paediatric registrar about how her approach to engaging with a young person, she shared that providing a route for the young person to chat (without their parent) made a huge difference to their diagnosis, care and management. The registrar highlighted the importance of investing in building trust and when we do this outcomes can be influenced positively. A speech and language therapist talked about the importance of ensuring patients have control over health and empowering them to have their voice heard.
These conversations brought to life the importance of ensuring that we’re all thinking about trauma and it’s impact. Trauma occurs when an incident/s leaves a person so overwhelmed or threatened that it leaves a long last impact.
It can occur at any stage in life, yet being exposed to Adverse childhood experiences (ACEs), potentially traumatic events that occur in childhood (0-17 years) can be particularly challenging. These can include experiencing violence, abuse, or neglect, violence in the home or community and the death of a close family member, or events that undermine a child’s feeling of safety, stability, and bonding, such as growing up in a household where there are substance use, mental health problems or instability due to parental separation or a parent being in prison along with wider adversities such as poverty, discrimination, lack of economic opportunity and social connectivity.
Adversity in childhood can disrupt cognitive, social, emotional and behavioural development with prolonged exposure resulting in toxic stress. This adversity can cause hyper arousal, adversely affecting a young person’s ability to regulate their emotions. It can also increase the risk of developing health-harming behaviours that can impact on physical and mental health in later life including cardiac disease, diabetes and depression.
Children of course adapt to their circumstances, finding ways to survive, seek control/safety, they find ways to mitigate or tolerate adversity in some way, along with making sense of their experiences. So the impact of trauma on individuals is hugely variable and the context and support available can play a huge part in building resilience and this is a dynamic process.
To be trauma informed is for us to understand that trauma can be at the root of behaviour and shifting our focus from ‘what happened to you’ rather than ‘what’s the matter with you’ can be helpful.
The 4 R’s can help
1. Realise the impact of trauma
2. Recognise the signs and symptoms
3. Respond integrating this knowledge about trauma
4. Resist re- traumatising people
1. investing time in relationship building is widely appreciated and has huge value
2. Breaking down ‘them and us’ barriers either with patients/families or team members can be really helpful
3. Animal human relationships can be calming – one of our dentists managed to get dogs into the dental hospital and everyone loves it!
4. Focusing on a ‘shared understanding’ with active participation is powerful
4. Reviewing how we respond collectively to challenging behaviour an be helpful, emphasising deescalation and avoidance of re-traumatising patients
5. Encouraging greater control over health and care, through real shared decision making is needed
6. We all need to be taking mental health concerns seriously
7. Understanding and utilising a trauma lens to recognise signs, symptoms and impact on lives, allows us all to understand better the root causes of behaviour, enabling us to provide appropriate care and support. It seems we all need to become trauma champions …
And a final key thought we can’t care for other unless we care for ourselves ….
Happy new week!