Trauma-informed practice: toolkit

Methodology

Phase One

A literature review was conducted to establish the theoretical underpinnings of trauma-informed practice and identify the sector areas where an evidence base existed for best practice. The scoping consisted of literature searches, web searches and a Rapid Evidence Assessment (REA), The REA included searches of the following databases:

PsycINFO, Medline, CINAHL+ with full text, ERIC (Education Resources Information Centre), Criminology Collection, Education Collection, Social Sciences Database, Sociology Collection, Cochrane Library, and the Campbell Collaboration. A literature review was conducted to establish the theoretical underpinnings of trauma-informed practice and identify the sector areas where an evidence base existed for best practice. The scoping consisted of literature searches, web searches and a Rapid Evidence Assessment (REA), The REA included searches of the following databases: PsycINFO, Medline, CINAHL+ with full text, ERIC (Education Resources Information Centre), Criminology Collection, Education Collection, Social Sciences Database, Sociology Collection, Cochrane Library, and the Campbell Collaboration. Final results from the literature searching are included in Appendix 11. All findings from the literature review were recorded in excel spreadsheets, including key themes, Trauma-informed model adopted, barriers to implementing TIP and adopted outcome measures. Useful general, and sector specific toolkits and reading from the literature review are included in Appendix 8.

Phase Two

The following sources were used to identify potential areas of best practice in Scotland:

• findings from two focus groups with survivors on their experiences of services (recruited through Resilience Learning Partnership);
• information gathered at attendance of conferences and seminars on Trauma-informed Practice in Scotland; and
• findings from a WebQuest survey of members of the National Steering Group on Trauma Training.

Attempts were made to contact each potential case study identified. Data was gathered by telephone interview, based on a paper identifying key ingredients necessary for successful trauma-informed care implementation (Menschner & Maul, 2016a).

The following sector areas and associated case studies were selected:

Overall ethical approval was assessed using the Scottish Government Social Research Ethics Checklist. Ethical approval was also gathered from two case study areas through their own internal systems (We Are With You and Kibble). Council access was granted for Criminal Justice Social Work and Education services. The remaining sites were approved through Quality Improvement (QI) Systems.

Phase Three

In total, 50 depth interviews (primarily paired depth and triad interviews) were conducted as part of the qualitative fieldwork. Semi- structured interviews were completed either by telephone or virtually (due to Coronavirus restrictions) with staff (including management) and service users on the implementation of TIP and their experiences of 'touch-points' of direct interaction with services. Information on perceived barriers to implementation were also collected.

Phase Four

The qualitative data gathered from the case study areas during the course of the fieldwork were transcribed and analysed using a coding framework based on the SAMHSA principles and implementation domains (SAMHSA, 2014). The data was then triangulated with findings from the literature review.