Trauma-Informed Care

The idea of a psychologically informed environment, a PIE, first appeared in the context of the UK, as part of an overview of creative and constructive practice as found in homelessness resettlement work there. This approach however has many points in common with new approaches developed in the US and Canada, such as "Trauma Informed Care" - or TIC  (and also with "Pre-treatment", for which, see the pages on this site HERE).  

For the moment, to sum up briefly:- where the PIEs approach talks of reflective practice, a psychological model, staff training and support, etc, Trauma Informed Care stresses (Hopper etc el) the need to create

  • a safe and predictable environment
  • support personalised to the individual
  • a focus on strengths
  • gaining a sense of safety and control
The Creating Cultures of Trauma-Informed Care (CCTIC) approach to organisational change is built on five core values of safety, trustworthiness, choice, collaboration, and empowerment (See column right, by Fallot & Harris). "If a program can say that its culture reflects each of these values in each contact, physical setting, relationship, and activity and that this culture is evident in the experiences of staff as well as consumers, then the program’s culture is trauma-informed." In this formulation, then, looking at the organisational culture as a while, the parallel with the PIE concept is clearly very close.

Over the coming months, we will continue exploring these parallel approaches, and the discussion will doubtless evolve.  In particular, the Transatlantic Exchange programme between the US and the UK is creating many useful opportunities to compare understanding and practice.  Several workers from the US side of this exchange have come to see services in the UK, and two colleagues have recently launched their own training and consultancy services, to extend an understanding of what these approaches have to offer.   You will find more on these initiatives, as applied in the context of "domestic"/"intimate partner" violence, in 'Further reading' 

There is also a preview draft of an extended conceptual paper, "Principles and practice in the psychology of homelessness", comparing TIC and PIEs with Housing First, with Pretreatment, and with System Change Brokerage.  (This paper argues, in short, that despite differences of emphasis and wide differences in context, between the US and the UK we may be seeing a convergent evolution, in recognition of a range of underlying issues, and a range of constructive practice approaches.)


Further reading

'Creating Cultures of Trauma-Informed Care (CCTIC): A Self-Assessment and Planning Protocol'   by Roger Fallot & Maxine Harris

Shelter from the Storm:   Trauma-Informed Care in Homelessness Services Settings  by Elizabeth Hopper, Ellen Bassuk & Jeffrey Olivet

(See in particular the excerpt: 'How Common Trauma Reactions May Explain Some “Difficult” Behaviors or Reactions Within Homeless Service  Settings' [Table 3] - a useful tool. )


 Principles and practice in psychology and homelessness: Part One, Johnson (2016)  for an overview

Jo's account of an exchange visit to New York is based on a weblog from the Transatlantic Exchange programme, by Jo Prestidge, now at HomelessLink, then a worker from an outreach service in London, which describes in some vivid detail her impressions of TIC, and what might be learned from this approach, in her own work.  (There is also a short video interview with Jo now in the Voices collection in the Library.

Viewing and listening

"Psychologically Informed Environments and Trauma Informed Care" - webiinar is a discussion, with questions from the online listeners, with Jo Prestidge and Claire Ritchie of No One Left Out Solutions. 

For Trauma Informed Care and intimate partner violence, see the website of Susan Hess, another on the Transatlantic exchange programme 

See also Elizabeth Eastlund - Director of Programmes, Rainbow Services:  website


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