Applying trauma research to service design and delivery

Trauma is pervasive across different populations that engage with the criminal justice system. Sharon Lambert from the School of Applied Psychology at University College Cork and Aoife Dermody from Quality Matters1 outline how trauma-informed practice can enhance service design and delivery.

In 2018, eolas published an article titled ‘Psychological trauma as a contagion’, where research regarding the high levels of childhood trauma within homeless populations was presented and we discussed the impact this has on workers and the potential for organisational trauma, including the criminal justice system.

Since that time, more data has been gathered from a range of sources that further highlights the pervasiveness of trauma within different populations that engage with the criminal justice system, and agencies within the criminal justice system are now exploring the implications of this learning for their practice.

Research with women in the probation services indicated that these women had experienced significant issues during childhood that had a direct impact on later life wellbeing and functioning. The findings profiled a group of women with considerable resilience and capacity for survival, despite very challenging life experiences; 21 per cent had spent time in either foster care or a group home during childhood. An Adverse Childhood Experiences (ACEs) analysis showed that the women in this research cohort were more frequently affected by almost all forms of childhood adversity than people in the general population.

In addition, 91 per cent of the women had experienced intimate partner violence in adulthood and 67 per cent were homeless at the time of the research, an indication that traumatic experiences were still part of their lives. The women proffered some practical advice that could help services to be designed and delivered in a trauma- and gender-informed manner.

The women who participated were generally positive in their overall perception of drug and alcohol service providers, in relation to feeling cared for, valued, and respected. Housing-related services scored in the average range and the least well-regarded services were offending-related/criminal justice services. It is worth noting that many of the addiction services and homelessness services in the region had already started to consider trauma awareness as a feature of their service delivery.

Thematic analysis of the research findings indicated that there is variance between the women’s experience of the service they received and some service providers’ perceptions of themselves in relation to key factors underpinning trauma-informed care, including feeling valued, respected, safe, cared for, understood and trusted. This points to the potential value of services turning the lens of scrutiny away from the women and towards themselves, so that they might better understand their capacity to provide effective, trauma-informed services to this cohort.

In 2020, a collaboration with An Garda Síochána, Youth Rise and Quality Matters looked at young people in the Garda Youth Diversion (GYDP) schemes. An alarming level of adverse childhood experiences within this cohort of young people was revealed. The ACE scores of the young people revealed that 63 per cent had four or more ACEs (only 12 per cent of people in the general population have four or more) and more than one-third of the total had six or more ACEs.

The most frequent ACEs reported were the loss of a parent, emotional abuse and household substance use. The items where youth workers were least likely to know whether the young person experienced it, or knew they had not, were sexual abuse and domestic violence against the mother. This is not uncommon as childhood sexual abuse is more frequently disclosed during adulthood.

The ACE profile of young people in this study mirrors more closely that of populations accessing adult homeless, probation and addiction services. These findings underline high rates of trauma in this population, and the importance of effective intervention, engagement, and diversion strategies. Young people engaged with Garda Youth Diversion Programmes.

Higher levels of trauma increase the likelihood of engagement with the criminal justice system. Traumatic experiences impact on behaviours in a range of ways that can negatively affect a young person’s engagement with a programme such as the GYDP. This can include difficulties with emotional regulation, self-soothing, learning, and social engagement, all of which can negatively impact on how the young person works with figures in authority, with community programmes, with workers and with their peers. When practices and policies are not aligned with the needs of traumatised populations, trauma symptoms displayed by young people can go unrecognised or be misunderstood.

It has been well established that exposure to trauma has implications for brain structure, decision making, ability to engage effectively with services, and emotional regulation. Experiences of trauma frequently result in behaviours that can be considered aggressive, challenging, evasive and non-engaging.

Where services such as social, criminal justice and health fail to recognise the symptoms of traumatic experience in a young person’s behaviour, this can be mislabelled as ‘challenging’ behaviour. This mistaken labelling of such behaviours can impact on how workers treat young people and can compromise the continued engagement of a young person in a service, possibly resulting in the young person’s needs going unmet and objectives of the programme not being achieved.

Understanding trauma, its effects on behaviour and its impact on the service provider-user interaction could help criminal justice professionals to avoid triggering traumatic reactions or re-traumatisation, potentially aid in the recovery and healing process and, at the same time, promote a greater sense of safety among staff.

Services that incorporate knowledge about the impact of trauma on the brain and behaviour facilitate a better understanding of presenting behaviour; the client is no longer regarded as unwilling and difficult, but instead is perceived as unable and trying. Reinterpreting these behaviours as entirely understandable adaptive responses to unresolved trauma depersonalises the behaviour and improves staff responses, and ultimately increases the service’s capacity to support traumatised clients.

The increase in research output in this area has highlighted the breadth and depth of trauma in the lives of those involved in the criminal justice system. Trauma-informed and trauma-aware approaches are being engaged with, both by the Courts Service, which has committed to a training and implementation programme for all staff over the coming three years, and An Garda Síochána, which is exploring trauma-informed practice pilots within the GYDP as a recommendation arising from the GYDP research project.

1. Quality Matters is a registered charity and not-for-profit social enterprise involved in a range of community initiatives including the development of Trauma Informed Practice training and supports to non-profit bodies and organisations.

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