Healing Environments For Children Who Have Experienced Trauma

This evidence summary attempts to answer the question, "What are some of the elements of a healing environment for children who have experienced trauma?".

  • Author Annelies Allcock
  • Publisher IRISS (2019)

The summary includes evidence from a range of literature, including mental health and architecture. This review pulls together the relatively sparse evidence about children's home design, and combines it with selected articles from health and architecture, in order to illustrate the potential components of a healing home.

Key findings

This evidence review found that there is very little evidence exploring how a healing environment may improve outcomes for children who have experienced trauma. Some promising case studies show that the design, colour and appearance of a residential child care space can help to create and sustain a warm, happy and nurturing environment (Rice et al. 2011). Others suggest that both the architecture and interior design of a children's space can have an impact on relationships and can help or hinder social interaction (Docherty et al. 2006), which may be vital for creating healthy attachments.

Five themes of healing environments are suggested in the literature:

  1. Nature. Access to green (nature) and blue (water) space are essential for children and young people in residential care (Department of Health 2017; Connellan et al. 2013; University of Exeter 2014; Britton et al. 2019; McCormick 2017). For example, images of nature, such as a picture of a nature scene beside a bed combined with audio of nature sounds, are also thought to reduce the experience of pain (University of Exeter 2014).
  2. Connectedness. This covers the creation of social opportunities and interactions, which can, in-turn increase inclusion and connection within a group of people. This can include ensuring continued contact with the outside community and creating spaces for group therapeutic activities (Department of Health 2017; Connellan et al. 2013; Ahlquist et al. 2017; Docherty et al. 2006). For example, findings from McLoughlin and Gonzalez (2014), suggest that it is crucial that the home environment is enriching, supportive and safe, while also promoting a sense of inclusion and connection that does not separate young people from the broader community.
  3. Comfort and safety. The need for physical and psychological safety is emphasised. A potential tension between balancing security and comfort or homeliness is acknowledged (Department of Health 2017; Docherty et al. 2006; McAllister and Sloan 2017; Johnson 2016; Rice et al. 2011). For example, when children were involved in the design of their unit building, the imagined result was a large, secure and castle-like building (Johnson 2016).
  4. Personalisation. Means the freedom for children to personalise a space, to provide feelings of control and ownership, which can support both wellbeing and respect of the environment (Connellan et al. 2013; Department of Health 2017; Docherty et al. 2006). For example, within a residential child care environment, personalising space is important in taking ownership and thus respecting the environment (Docherty et al. 2006).
  5. Stakeholder involvement in planning and design. Is a collaborative design process based on integrating evidence along with the views of children and staff (Department of Health 2017; Elf et al. 2015; Docherty et al. 2006; Csipke 2016; Rice et al. 2011). For example, Elf et al. (2015) suggest it is important to design with specific patient outcomes in mind, with that a focus on outcomes. This can direct attention toward the main goals of the new environment, and can put users at the centre of the planning and design.

Conclusion and limitations

A weakness of the review is the evidence available. Often this is obtained from healthcare and wider wellbeing research; and is not specifically from children who have experienced trauma. There needs to be more robust research, specifically about the elements of a healing environment for children who have experienced trauma.

Implications for practice

  • The review is brief and practical and designed to be accessible to many.
  • This review can provide a framework for the key design elements to consider when either adapting existing homes or spaces or designing from scratch spaces for children who have experienced trauma.
  • The review should also act as a call for researchers to look into this area more specifically and add some more robust evidence about the components of healing environments for children who have experienced trauma.


Related resources by SCIE

  • Therapeutic approaches to social work in residential child care settings, Social Care Institute for Excellence (2012)
  • www.sciesocialcareonline.org.uk
    Use Social Care Online to keep up to date and search for new research, policy and guidance related to trauma-informed practice

Other related reading

  • Addressing adversity: prioritising adversity and trauma-informed care for children and young people in England, YoungMinds (2018)
  • Developing And Leading Trauma-Informed Practice: Leaders' Briefing, Julie Wilkinson, Research in Practice (2018)
  • On The Value And Meaning Of Trauma-Informed Practice: Honoring Safety, Complexity, And Relationship, Pamela Szczygiel (2018)
  • Routine Enquiry About Adverse Childhood Experiences: Implementation Pack Pilot Evaluation (Final Report), Public Health Institute, John Moores University (2018)
  • Trauma-Informed Approaches With Young People: Frontline Briefing, Danny Taggart, Research in Practice (2018)