Showing we care about Trauma-Informed practice

Lauren Wolfenden, Development Manager at Blackpool Better Start, considers the development of Trauma Informed Maternity and Perinatal Mental Health Services (TIMPS) Training

Trauma-informed Care is an approach which assumes that those accessing services are more likely to have a history of trauma. This also applies to staff working in these services and is built on creating a physically and emotionally safe environment.

It establishes trust and boundaries and supports autonomy and choice to create collaborative relationships and participation. It uses a strengths and empowerment-focused perspective to promote resilience and it requires a cultural shift to really understand what has happened for that individual and what the lasting effects are.

This helps us to understand behaviours and reactions better, and choice and personalisation can be optimised.

It’s important that when women and partners are accessing services, and when staff are working in services, the care provided promotes feelings of psychological safety, choice, and control for all.

To address this, we developed the “Trauma Informed Maternity and Perinatal Mental Health Services” (TIMPS for short) training. The TIMPS training is aligned with the Integrated Care Networks ambition to become trauma informed. Lancashire and South Cumbria Maternity and Newborn Alliance have a commitment to becoming trauma-informed and TIMPS is the first step in mobilising the service delivery improvement within maternity and perinatal mental health services.

To develop the training, we looked at the strengths and barriers to healthcare that is informed in the latest evidence, and began building the training package using the work and learning from the national good practice guide that Blackpool Better Start produced for NHS England and Improvement the year previously.

The training aims to ensure that staff can understand trauma and how this applies to their practice within the different roles they undertake. When we were commissioned to develop the national good practice guide, we travelled the country to speak with hundreds of individuals with lived experience of different types of traumas (e.g. birth trauma; childhood trauma; physical disabilities in services; long term mental health conditions etc.), as well as staff in a wide variety of roles. They each shared their experiences in services, gave recommendations for change, and looked at areas to build on.

The training is offered to Maternity and Perinatal Mental Health services staff across Lancashire & South Cumbria, including Continuity of Carers, professional midwifery advocates, Specialist Community teams, Infant Feeding Leads, Maternity Voices Partnership Chairs, Bereavement, Physiotherapy, Mother and Baby Unit Services and the Reproductive Trauma Service.

The TIMPS training is split across two days and five ‘modules’. Within module 1, staff learn about the basics of what trauma is and how it is associated with adversity and ACEs and the impact this can have on the developing brain and across the lifespan. It also includes how coping strategies can be used as coping mechanisms for self-soothing.

Within module 2 staff learn about the impact of different types of traumas on pregnancy, childbirth and throughout the perinatal period and looks at the ongoing challenges trauma can have in pregnancy and beyond.

Module 3 thinks more practically in terms of understanding what trauma informed care is and what it means for their roles, what the principles of trauma informed care in the perinatal period are and how they can be used. We have many group-based activities throughout the session including break-out rooms and jam boards which keeps the sessions interactive.

For day 2, the session is face-to-face, and staff take part in the ‘brain game’ and module 4 and 5. Within these modules the core focus is on thinking about the application of trauma informed care in practice with consideration given to the positives and the negatives of their work, the danger of vicarious trauma and burnout, as well as opportunities for well-being and self-care. Again, group discussions and activities form a large part of this session to ensure it is as interactive as possible.

To date, approximately 250 staff have undertaken or registered for the training and an essential element of the work has been ensuring we’re contributing to the evidence base about the difference being more trauma-informed can make. We have a robust evaluation strategy attached to the TIMPS project, where we get pre, immediately after training and post feedback. We’re really excited about the potential for this work to provide insight not only into the training itself, but the challenges staff may currently face in being able to implement their new knowledge. We hope this will enable more conversations to take place about the cultural shifts and systems change required to make trauma-informed care truly meaningful.

About A Better Start

A Better Start is a ten-year (2015-2025), £215 million programme set-up by The National Lottery Community Fund, the largest funder of community activity in the UK.

Five A Better Start partnerships based in Blackpool, Bradford, Lambeth, Nottingham and Southend are supporting families to give their babies and very young children the best possible start in life. Working with local parents, the A Better Start partnerships are developing and testing ways to improve their children’s diet and nutrition, social and emotional development, and speech, language and communication.

The work of the programme is grounded in scientific evidence and research. A Better Start is place-based and enabling systems change. It aims to improve the way that organisations work together and with families to shift attitudes and spending towards preventing problems that can start in early life. It is one of five major programmes set up by The National Lottery Community Fund to test and learn from new approaches to designing services which aim to make people’s lives healthier and happier

The National Children’s Bureau is coordinating an ambitious programme of shared learning for A Better Start, disseminating the partnerships’ experiences in creating innovative services far and wide, so that others working in early childhood development or place-based systems change can benefit.

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