National Trauma Transformation Programme: Trauma-Informed Substance Use Pathfinders – Learning Report

Annex A: Familiarisation Discussion Guide

Context setting includes:

• The aims of the Pathfinders and an overview of the National Trauma Transformation Programme; purpose of today’s session and interview format; informed consent for interview and permission to record.

Question Areas

1. Respondent’s role

• What is their current role (i.e. job title, what do they do)?
• How long have you been in a) your current post and b) working in substance use

2. Current service

• Tell us about your service?
  • Outline key service user groups (approx split alcohol/drug use)
  • Outline Services offered
  • How many staff, type of staff, length of service (latter important as TI Practice likely to be taught on more recent professional courses?), where based
    • How do they all come together as a team? Team meetings? How often? When?
  • Referral pathways into the service and through the service (including to therapeutic input; psychiatry; Occupational Therapy (OT))
  • Outline key partners/stakeholders/ referral routes (other services work alongside, any third sector provision in the team, referral routes in place to third sector services)
  • What is the discharge process? Who is involved? How is this managed?
  • Any lived experience in team as a paid role?
  • How do they currently identify if a service user has experienced trauma? Any trauma pathway?

• Specific information about Counselling and Trauma Therapy provision?
  • Types of interventions provided
  • When offered, take up?
  • Screening /assessment for service users
  • Safety and risk management processes

• Other types of specialist input into team – probe for OT, specialist pharmaceutical

(Ask same questions as above)

• Key contextual issues challenges/strengths for their service
  • Geographical issues
  • Partner issues
  • Resources/staffing
  • Others

Understanding of TI Practice/NTTP

• Understanding If Any of TI Practice and the NTTP?
• Has anyone seen any NTTP resources? Which ones?

TI Practice in their service

• Current levels of knowledge/experience [personal/across service]
• Has anyone had existing Trauma training?
  • What level of training
  • Other relevent training e.g. Mental Health or MI?
• Have there been challenges for staff being released to attend training?
• What is the supervision structure in the service? Is this separate to line management? Is trauma raised in supervision and/or team meetings much?
• Are underpinning service values [e.g. choice, trust etc.] made explicit to staff and service users
• Any TNA been done that they are aware of?
• Current policies and activities for wellbeing, supervision, vicarious trauma [more below]
• Any processes for assessing TI Practice current/planned
• Any current priorities [aims/activities /settings/sub geographies] for the pathfinders re TI Practice
• What are people’s views and attitudes towards TI Practice? Any concerns?
• What staff feel the aims and objectives of the project should be in relation to implementing trauma-informed practice? How can this project support the local agenda?
• What is already being done well in reation to TI Practice that the pathfinder can build on?

Are there staff from any other connected services that should be included in this pathfinder or should access the training on offer? (depending on what is feasible)?

4. Current staff health and wellbeing support

• What is the existing provision for supervision – is this enough? Does it need to be improved?
• Is there any existing Reflective Practice Groups? Peer Support groups?
• What are the existing staff health and wellbeing policies? Is there one for vicarious trauma?
• How much emphasis is given on having manageable workloads and/or the importance of self care
• What are the existing Risk Management and safety processes/policies
• What is the current environment like for safety and wellbeing? Are most people in the office/ working from home? Has this impacted on the level of perceived support by a) management and b) your team?
• How emotionally safe do you feel doing the work you do? In your workplace? What could be done to maximise this?

5. Lived Experience

• How is existing feedback gathered from service users? Service user panel?
• If not currently, has this been done before?
• How, if at all, do they include peer support as part of their delivery model?
• Have any of you worked for services before that do use peer support models?
• What do you think of including peer support in service delivery models?
• How could this be done? Do you have any other ideas as to how to get lived experience input into the development of this project and to improve TI Practice in your service?

6. Leaders and management

• How much contact do you have with a) immediate management and b) senior management?
• How supportive do you feel senior management will be of developing Trauma-informed Practice?
• How do you feel they should be involved in the process?

7. Documentation and documentary review

• Likely documentations needed – Annual reports/ strategies
• Is it worth speaking to HR re policies (staff wellbeing especially)?
• Contacts and methods of contact, timescales

8. Issues /concerns

• Any further questions/concerns
• Pathfinder generally
• Their role

9. Next steps

• Documentary review
• Support for establishing project and planning
• Theory of change drafts
• Second visits
• ToC refinement workshop