National Trauma Training Programme: workforce survey 2021

Main findings from an online survey of the Scottish workforce exploring awareness and attitudes to psychological trauma and trauma-informed practice. The survey was carried out by the Improvement Service as part of the National Trauma Training Programme.

5. Barriers and Support

5.1 Respondents were asked to identify any barriers to working in a trauma-informed way, with a follow-up question that asked what support could help organisations or individuals to overcome these. It should be noted that respondents were provided with a prompt to help identify barriers[2] and each of these were frequently cited in responses.

5.2 One of the most commonly cited barriers was "time to undertake training". In many cases, respondents said that they were actively encouraged to take part in training but were unable to do so due to time constraints. In addition, some respondents highlighted additional pressures on their time as a result of COVID -19 as a reason that they were unable to complete any training.

"Time is always the main barrier. Time to train staff then time to deliver. With so many other priorities particularly at this time it can be difficult to firstly recognise or pick up when trauma is being experienced and then to have the time to follow up with appropriate supervision."

"Capacity to undertake training and supervision requirements are potential barriers to fully adopting trauma-informed practice which has been exacerbated by competing priorities relating to the coronavirus pandemic."

"Time. Senior leaders want this and so do staff, but I would be less confident that frontline staff feel they have time to devote to learning or capacity to reflect and develop their practice to the necessary degree."

5.3 A similar theme that many respondents highlighted was a lack of time, resources and capacity to properly put learning into practice and to implement trauma-informed approaches.

"Time for training but more importantly time to implement."

"We struggle to put the theory into practice."

"Capacity issues are longstanding in our service, this means that staff can be working with high caseloads and, while trauma-informed approaches are embedded within service provision, it would be beneficial to have more time to plan interventions and develop resources supports to enable our practice to develop further."

5.4 A third theme emerging from this section was a lack of prioritisation among a range of competing demands and a sense that senior leaders either did not fully understand the principles of trauma-informed practice or did not provide sufficient resource and support to support their implementation.

"Policy V Practice: Policy and will is there; resource to support this, not necessarily so."

"I do not feel that the majority of senior leaders have an understanding of trauma-informed practices, so it is not considered as a priority area."

"Clash of priorities. Trauma is quite a specific field and can get crowded out amongst lots of other concerns. Particularly in current Covid situation."

5.5 Additional themes coming out of responses to this question were a feeling that staff are not aware of trauma-informed practice or felt that it was not relevant to their area of work. This included those who felt it was not relevant to them because they did not work in front line service delivery, but was cited across most service areas. In addition, some respondents said that they were not aware of any available training. Others highlighted resistance from colleagues to engaging with training in this area, with some pointing to stigma and a resistance to change.

5.6 Suggestions for additional support tended to follow similar themes. Additional training was felt to be something that could help organisations and individuals to embed trauma-informed practice. In some cases, it was suggested that this should be mandatory for all staff.

"More included in mandatory sessions rather than opt in. The latter brings those with interest and previous knowledge back to the table but does not bring in those who have no idea or feel no need to improve knowledge and understanding around trauma-informed practice. Without it being widespread it will never become embedded fully into organisation and community practice."

5.7 Other suggestions included additional efforts to raise awareness and improved communication around the trauma-informed ambition and National Trauma Training Programme. It was also suggested that focus could be made on supporting organisations to put policy into practice. Others suggested that more resource would be needed within their organisation and some respondents pointed to the need for a broader societal shift to challenge stigma.

"Advice on how it relates to my specific work - can understand how an organisation can take the approach but have a lack of understanding on how to do it in my role."

"Culture is a big factor in trying to embed any change to practice, some organisations and people continue to resist change in any form."



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