Trauma-informed practice in residential child care settings

We recognise that when a child experiences developmental trauma, or abuse, they learn that they cannot rely on others and that without trust, they lose the ability to develop healthy relationships and form attachments, reducing their ability to self-regulate and falling into a cycle of trauma.

Research in areas such as adverse childhood experiences (ACEs), has given us an even clearer understanding of the impact of trauma as children reach adulthood. But the research about trauma also clearly identifies the link between early childhood trauma and subsequent difficulties with children’s learning and development of relationships.

For many young children we work with their trauma becomes internalised, leading to regression, dissociation or withdrawal, yet much of the current trauma-informed narrative relates to children who externalise their trauma or struggle with self-regulation. These children are often unable to calm themselves and may lack impulse control, which often manifest in behavioural difficulties such as aggression, violence and sexualised behaviour. We have developed a culture of understanding children’s trauma as a behaviour which communicates an unmet need – whether the behaviour is internalised or externalised – but a big question for the Mulberry Bush in recent years is how to translate this into impact with children and young people?

Whilst the widening of discussion about trauma-informed practice provides many positives, all too often we come across organisations where the ideas of trauma-informed practice are held by a small number of staff, often a school special educational needs co-ordinator or psychologist.

What is needed is an organisational culture of understanding and an agreed model of how this understanding will directly inform practice. This needs to include a culture of wellbeing that recognises the impact of working with trauma upon staff.

Our training packages draw on our history and experience to develop cultures of working with trauma across a range of settings.

Our training programmes offer an experiential learning environment for all our learners who are required to bring themselves, and their work, to their learning – the model is about linking theory directly to real practice.

Learners have been supported to help children to recognise that self-regulation is a core process of healthy development, to recognise their own stress responses, to learn to read their body’s signals and act accordingly to regulate their level of stress. Importantly, our learners have to learn this about themselves. This has involved the development of core wellbeing cultures such as the adoption of reflective practice and supervision for staff.

The Mulberry Bush recognises reflective practice as a vital tool in working with the intense emotions faced each day by those working with traumatised children. It is essential that staff are able to develop the skill of speaking the unspeakable – to be able to recognise, express and work with the intense emotions that often arise, such as murderous feelings. Without this the impact of secondary trauma can lead to staff becoming overwhelmed, burnt out or suffering from compassion fatigue, as too often happens across education and social care.

Dr Dave Roberts is head of outreach and deputy chief executive at Mulberry Bush.

• Read more in CYP Now's trauma-informed care special report