Trauma-Informed Care

The first accounts of a psychologically informed environment, a PIE, were contemporary 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). They have very many points in common.

To sum up briefly: where the PIEs approach talks of encouraging 'psychological awareness', developing reflective practice, creating and using 'space  of opportunity', staff training and support etc, Trauma Informed Care stresses (see: Hopper et al) the need to promote, in services:

  • a safe and predictable environment
  • support personalised to the individual
  • a focus on strengths
  • gaining a sense of safety and control

In a slightly different formulation - but clearly compatible - the 'Creating Cultures of Trauma-Informed Care' approach to organisational change (see column right, by Fallot & Harris) is built on five core values of:

  • safety
  • trustworthiness
  • choice
  • collaboration, and
  • empowerment

As they say:

"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 whole, the parallel with the PIE concept is clearly very close.


Being 'informed'

A very useful distinction made in some of the earlier descriptions of TIC was that between trauma-focussed services, and trauma-informed work.  Trauma-focussed services, it was suggested, need a full professional training, competent supervision etc.  But trauma informed work is something we can all be engaged in.

This distinction reflects the comparable distinction between being 'psychologically informed' in the narrow sense of having psychologists in the team; and being 'psychologically aware', which is - and needs to be - pervasive, and supported, throughout a services. See, for example, "Does it take a psychologist to make a PIE?"


Other psychology, and systems awareness

One possible difference between PIEs and TIC is that the PIEs framework is explicitly open to being informed by any branch of psychology, including schools of thought that pre-date by many years more recent understandings of trauma. Yet in practice, we do see a much broader 'awareness' both encouraged and used, in TIC.

There is also more scope, in the PIE framework, for organisational psychology, the understanding of social systems and the impact on services of ways of thinking about excluded people, as a societal problem as much as an individual one. Yet all these additional sources of insights can be incorporated into the TIC framework.

Another difference - one that has emerged more clearly in recent years, with the PIEs 2 framework - is the attempt with PIEs 2 to consider and pro-actively engage the wider networks, the pathways in and through a service. This difference too may be simply temporary, reflecting the current more advanced state and greater coherence of homelessness policy in the UK and Europe.

Further background reading/listening/viewing


PIElink pages

Working with trauma : HERE

Trauma-informed design (Q&A) : HERE


Library items

Does it take a psychologist to make a PIE? : HERE

An introduction to Psychologically Informed Environments and Trauma Informed Care: a briefing for homelessness services from HomelessLink : HERE

Core skills of engagement - pre-treatment, trauma-informed care and psychologically informed environments :   HERE

Rainbow services: Trauma Informed Care and Psychologically Informed Environments with Intimate Partner Violence services in Los Angeles : HERE

Person-centred, holistic, psychologically informed : the Young Women’s Housing Project approach HERE

'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 Prestidge's account of an exchange visit to New York is based on a weblog from the Transatlantic Exchange programme, by Jo, now at HomelessLink, but then a worker from an outreach service in London. She 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.

Connecting paradigms: Talking trauma across the Atlantic with Jay Levy and Robin Johnson  (Episode 55) :  HERE

"Psychologically Informed Environments and Trauma Informed Care" - webinar records an on-line discussion, with questions from the online listeners, with Jo Prestidge and Claire Ritchie of No One Left Out Solutions.


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

Also more from Elizabeth Eastlund - Director of Programmes, Rainbow Services (website) - on the tensions between domestic violence programs and the current application of Housing First in the US context. Intersections between the Domestic Violence and Homelessness Programs

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