3. Supporting trauma-informed working
Source: gov.uk (2025-12-11)

The Changing Futures evaluation has produced a rapid evidence review, Trauma-informed approaches to supporting people experiencing multiple disadvantage. This report discusses the evidence that taking a trauma-informed approach benefits individuals and services.

Why is trauma-informed support important?

See footnote on trauma-informed support. 4 (#footnote4)

Research suggests (https://lankellychase.org.uk/publication/hard-edges/) that 85% of people experiencing multiple disadvantage as adults experienced trauma earlier in their lives. As the Changing Futures baseline evaluation report (https://assets.publishing.service.gov.uk/media/642af3b9fbe620000f17db99/Changing_Futures_Evaluation_-_Baseline_report.pdf) (PDF, 1980 KB) highlights, a lack of understanding of trauma’s effects on people’s behaviour and engagement with services can result in services stigmatising, excluding or re-traumatising people. This can be a substantial barrier to people getting support.

The Changing Futures programme aimed to improve local services’ understanding and application of trauma-informed approaches in their work with people experiencing multiple disadvantage. Increasing trauma-informed working and reducing stigma can help to:

1. Ensure that service delivery models, processes, cultures and practices in local systems are responsive to the trauma people have experienced. This includes recognising the impact of trauma on people’s thoughts, feelings and behaviour. It also involves delivering support that helps people to feel safe, gives them a sense of trust, control and empowerment, and does not re-traumatise them.

2. Increase sensitivity and responsiveness to cultural, historical and gendered contexts. This may include highlighting and addressing power imbalances between staff and people who use services. Trauma-informed approaches can help address these by building collaborative relationships, such as peer support and co-production.

3. Enhance engagement with services, build trust, and improve people’s experiences of support. Better engagement can result in positive outcomes for people experiencing multiple disadvantage, including housing stability, improved mental health and wellbeing, and reduced use of crisis services.

4. Improve the wellbeing, confidence, morale and resilience of frontline staff, so that they are better supported and more able to have a positive impact on those that they support.

The Changing Futures evaluation has produced a rapid evidence review, Trauma-informed approaches to supporting people experiencing multiple disadvantage (https://assets.publishing.service.gov.uk/media/642af3507de82b000c31350c/Changing_Futures_Evaluation_-_Frontline_support_models_REA.pdf) (PDF, 640KB). This report discusses the evidence that taking a trauma-informed approach benefits individuals and services.

Most Changing Futures areas introduced or expanded their provision of specialist caseworker roles to support people experiencing multiple disadvantage. Trauma-informed approaches and the conditions needed to work in this way were built into these roles from the outset. The caseworker role is explored in the report The role of Changing Futures caseworkers: A deep dive (https://assets.publishing.service.gov.uk/media/67a228f97da1f1ac64e5fe83/The_role_of_Changing_Futures_caseworkers_-_a_deep_dive.pdf) (PDF, 435KB), and in the rapid evidence assessment Frontline support models for people experiencing multiple disadvantage (https://assets.publishing.service.gov.uk/media/642af3507de82b000c31350c/Changing_Futures_Evaluation_-_Frontline_support_models_REA.pdf) (PDF, 640KB); therefore, it is not covered here. Instead, this chapter focuses on the changes the programme sought to create in the wider system – namely, increasing local services’ capabilities, motivation and capacity to provide trauma-informed support.

Things to consider

What changes could you make?
- How trauma-informed are your systems and services already? There are self-assessment tools available for use with services. At the systems level, the learning and reflective activities described in the chapter on Creating a learning culture (https://www.gov.uk/guidance/systems-change-learning/6-creating-a-learning-culture) may be a useful starting point.
- Where in the system is the need greatest? Is a system-wide or a targeted approach more appropriate? Are the understanding and application of trauma-informed approaches less advanced in some services or sectors than in others? Are there some services and sectors where change would be most impactful?
- Do staff have the resources and capacity to implement trauma-informed approaches? If not, training people is unlikely to bring about positive change.
- What else do people working in services need in order to improve their skills and confidence in trauma-informed practice? Workforce development approaches beyond initial training may be needed to help people to sustain and build on their initial learning, and to apply learning in their day-to-day work.
What is available to build on?
- Can you draw on frameworks for implementing trauma-informed approaches? There are several well-recognised frameworks which could form the basis for promoting trauma-informed approaches locally.
- Is there local momentum and expertise on which you can capitalise? There may already be initiatives seeking to expand trauma-informed approaches in your area. There may also be lived experience groups working to tackle the stigma attached to multiple disadvantage, or who have expertise in workforce development.
- Are there services and roles which are already implementing trauma-informed approaches effectively? These services may be able to model the approach to others and demonstrate its benefits, or provide practical advice to other services.
Who needs to be involved?
- It is vital to involve strategic-level staff in training and other workforce development activities. Strategic-level buy-in is crucial for creating the working conditions needed for sustainable frontline change.
- Who are the most credible voices to promote a greater understanding and application of trauma-informed approaches? People may respond more positively to people from the same service or sector. Involving people with lived experience can be a powerful way to promote understanding of the impact of trauma-informed support.
- Where is specialist input needed? Some activities require specialist, clinical input. Examples include support with case formulation, reflective practice, or clinical supervision.
What were the barriers?

In recent years, there has been a growing interest in and awareness of the importance of trauma-informed working with people experiencing multiple disadvantage, in part thanks to promotion by Changing Futures. Nevertheless, at the start of the programme, areas faced several barriers to trauma-informed working and reducing stigma.

Inconsistent understanding and application of trauma-informed approaches

Across Changing Futures areas, there was inconsistent adoption and application of trauma-informed practice within services that support people experiencing multiple disadvantage. This was partly driven by varying levels of prior exposure to trauma-informed principles, and therefore differences in the degree to which staff understood trauma-informed working. The inconsistency was also linked to the staffing and capacity challenges outlined below, which sometimes prevented the uptake of trauma-informed working.

A lack of understanding of trauma and multiple disadvantage more widely also contributed to the stigmatisation of people experiencing multiple disadvantage, within some service cultures or by individual staff members. This sometimes led service users experiencing multiple disadvantage to be perceived as ‘undeserving’ or ‘difficult’, and staff to be rude or dismissive towards them. This then reduced the likelihood of service users’ positive engagement.

Staffing and capacity challenges

Many of the services required by people experiencing multiple disadvantage have limited capacity. The need to manage demand and make delivery as time-efficient as possible can result in inflexible policies and processes. These include waiting lists, fixed appointment times, and closing cases after missed appointments. Within this context, it can be challenging for service users and professionals to build meaningful relationships, and for professionals to provide a tailored support offer. It can also be difficult to empower service users and give them control over their care.

Staff had limited capacity to engage in activities that would help them to implement trauma-informed practice, such as training, supervision, and attendance at multi-disciplinary meetings to discuss cases and coordinate support.

Further, there was often high staff turnover in services that supported people experiencing multiple disadvantage. This meant that understanding and skills were frequently lost. Service users also lost relationships they had built up with staff over time and needed to start afresh with new staff.

What worked well?

Changing Futures areas used a range of strategies to develop and embed trauma-informed practice in their local systems. Most have employed a combination of the strategies described below, as each on its own would be insufficient to catalyse systems change.

Creating or adapting accessible frameworks for implementing and evaluating trauma-informed working

Some Changing Futures areas used frameworks or tools to support their work on trauma-informed practice. For example, the 6 key principles of a trauma-informed approach (https://library.samhsa.gov/product/samhsas-concept-trauma-and-guidance-trauma-informed-approach/sma14-4884) developed by the United States Substance Abuse and Mental Health Services Administration (SAMHSA) are commonly recognised as informing good practice. These are:

1. Safety 2. Trustworthiness and transparency 3. Peer support 4. Collaboration and mutuality 5. Empowerment, voice and choice 6. Cultural, historical, gender issues

Evidence-based frameworks can make the idea of using trauma-informed approaches in practice more tangible, help stakeholders to identify where the ethos is lacking, and devise ways to better embed it. Changing Futures areas used such trauma-informed principles to spread understanding of what it means to be trauma-informed. Some developed and disseminated easy-to-use resources such as posters, informed by the principles, to further increase their accessibility. Some areas combined the principles with other good practice and local knowledge to produce frameworks tailored to the local context; this included highlighting the relevance of trauma-informed working to local policies (such as strategies belonging to the Integrated Care System and Police and Crime Commissioner). Some areas developed tools to help organisations assess the extent to which they are trauma-informed, and to identify areas for improvement:

The trauma-informed principles have empowered me to be curious, enquire about the multitude of factors and levers which are required to be trauma-informed. Having that framework will be really useful if you’re starting off.

People with lived experience co-produced some of the trauma-informed frameworks and self-assessment tools. In one area, people with lived experience designed an online magazine, which reflected on their understanding of trauma and made recommendations for services to shape their responses accordingly. This was used as the basis for a co-produced self-assessment tool.

Offering multi-agency and multi-role workforce development opportunities

Many Changing Futures areas offered training in trauma-informed working to local services. Training sessions were often delivered to multiple agencies; this created cross-sector learning opportunities, and increased the likelihood of consistency in understanding trauma-informed approaches. Bringing different agencies together to participate in training also enabled them to identify opportunities to collaboratively drive forward trauma-informed approaches across the local system.

Where strong training was already present locally, Changing Futures enhanced this by providing additional funding and resources to strengthen rather than duplicate training. This avoided variation in the understanding and application of trauma-informed approaches, which could arise from uncoordinated training programmes.

Spotlight on Stoke-on-Trent: Co-producing trauma-informed training People with lived experience shaped trauma-informed training offers through co-producing training plans and content. They also contributed to the delivery of training, including through sharing their experiences of receiving trauma-informed support – as well as support that was not trauma-informed – and the impact this had on them. In Stoke, The INSIGHT training academy (https://expertcitizens.org.uk/insight-academy/) is an important vehicle for delivering trauma-informed training, including mandatory training for adult social care staff. The academy is a collaboration between Expert Citizens C.I.C. (an organisation led by and for people with lived experience of multiple disadvantage) and the local authority.

Generating and enabling opportunities for reflective practice

Reflective practice is the ability to reflect on one’s actions to engage in a process of continuous learning. 5 (#footnote5) Ensuring that staff members have spaces, tools and skills for reflective practice is an important aspect of trauma-informed working. This topic is also covered in the chapter on creating a learning culture (https://www.gov.uk/guidance/systems-change-learning/6-creating-a-learning-culture).

Changing Futures areas have created and enabled a range of spaces for professionals who support people experiencing multiple disadvantage, which encourage them to reflect on and learn from their practice. These have included in-person and online group sessions, sometimes focused on a specific theme. Sometimes these spaces are facilitated by specialists, such as clinical psychologists. In some areas, reflective practice sessions and communities of practice have been introduced, to sustain and reinforce learning generated through system-wide activities such as journey mapping. Other areas have introduced or built on trauma-informed networks in their local area. Some have developed websites or other online content linked to these networks and reflective spaces, which act as a focal point for promoting trauma-informed approaches and as a repository for supporting materials.

Reflective practice spaces for staff who work with people experiencing multiple disadvantage help to embed trauma-informed principles, in three ways:

1. Improving the working environment for professionals. In reflecting on their practice together, staff are able to better understand one another, thereby increasing empathy and opportunities for mutual support, and reducing blame cultures.

2. Encouraging collaborative action. Reflective practice spaces should feel psychologically safe, as this empowers staff to raise challenges that they are experiencing in their roles, and to identify opportunities to overcome these challenges by working together. This can prevent people from working in siloes, stuck with problems they cannot overcome alone, and instead encourages people to commit to and invest in collaborative action. Setting up open spaces for different peer groups to come together, as well as spaces for individual peer groups, can provide opportunities for escalating problems to higher levels, and for solutions to be worked on throughout the system.

3. Better support for people experiencing multiple disadvantage. These learning and collaboration opportunities allow greater reflection and understanding of trauma-informed approaches, and improve staff’s ability to implement them.

People getting to voice their experience is trauma-informed. Creating conditions for people to have those conversations in an honest and open way is a facilitator for the change we’re trying to achieve.

One area offered training for people to become reflective practice facilitators, to encourage the spread of reflective practice across the local system. This was intended to create more spaces for staff support and supervision, thereby improving their wellbeing, as well as their ability to implement trauma-informed practice.

Reflective practice can really enable people to identify when things are getting tough, recognise the impact of the work on them, use colleagues to debrief and talk through that impact, maintain their wellbeing, and improve their practice.

Recognising the need for specialist trauma-informed input

Although anyone can work to embed trauma-informed principles, Changing Futures teams found that there are certain activities which require specialist input. For example, in one area, an occupational therapist was employed to pilot a ‘three-lens model’ of support – diagnostic, trauma-informed, and strengths-based – with a person-centred approach overarching all three. The therapist provided support, supervision and advice to upskill practitioners in the model, thus helping them to adopt a holistic, person-centred approach with their clients. In addition, they worked with peer researchers and local partners to co-produce a trauma-informed supervision and reflective practice offer for practitioners. Staff reported improving their practice, and feeling better informed and more confident in advocating for people experiencing multiple disadvantage.

Targeting specific services

Targeted activity can focus resources on a part of the system where increased use of trauma-informed approaches would be particularly impactful. For example, one area set up a housing pathway for young adults, which sought to improve local hostels’ work with young people who had experienced trauma. They did this by helping hostel staff to create and maintain psychologically informed spaces 6 (#footnote6) in selected hostels. The pathway was informed by co-production sessions with young people, who shared their experiences of navigating the system, and presented potential improvements and solutions to issues they had encountered. These co-production sessions were held with hostel staff, to promote the kind of collaboration expected within trauma-informed practice. For targeted work to be effective, strategies and resources need to be tailored – for instance, by highlighting the ways in which working in more trauma-informed ways will benefit the staff and organisations being targeted.

At the same time, there is also a role for universal workforce development on trauma-informed working, as this can increase the reach of trauma-informed principles across the system.

Demonstrating trauma-informed approaches to other services

Changing Futures areas have helped to disseminate an understanding of trauma-informed approaches, how to implement them, and the benefits of doing so, in three key ways:

1. Funding and embedding workers who are using trauma-informed approaches within services. This has increased services’ exposure to trauma-informed approaches, and the impact this can have on both clients and the staff.

Because of [the embedded worker’s] severe multiple disadvantage experience, she’s able to contribute massively to those organisations, in terms of upskilling other workers around what severe multiple disadvantage is and how to do those referrals.

2. Employing workers with lived experience to deliver support using trauma-informed approaches, and supporting their work with wider services (for example, through multi-disciplinary team meetings). Again, this has increased services’ exposure to the implementation and impact of trauma-informed approaches. People with lived experience were also employed as peer researchers in some areas. Enabling other services to work with people with lived experience helped to reduce the stigma that is still present in some services.

As part of employing people with lived experience, projects took trauma-informed approaches to recruiting and inducting staff with lived experience. For example, one area created an informal application process and advertised opportunities for peer researchers through trusted networks, such as their trauma-informed network – instead of advertising online, which might digitally exclude people. They also encouraged people to apply in a way they felt comfortable with, including creative mechanisms such as blogs, poems and artwork. Once people were recruited, they undertook a relaxed induction process which focused on how they could be supported in their role, rather than how they were expected to act. They were placed in host organisations, which were selected for their readiness for co-production and taking trauma-informed approaches to supporting people. Peer researchers also had individual development plans, development days with other peers for support, and personalised budgets to obtain the support they might need in their role, including therapy.

In some instances, hosting peer researchers led to improvements in the host organisation’s working environment:

And one of the peer researchers in their placement had identified they don’t have a break-out space for staff, and because of the nature of service delivery, they can’t take lunches together because it’s very reactive, and everyone’s kind of on red alert from 10 o’clock to half-past 3… And they’re exploring a one-hour lunch where people can lunch together if they want to, and they’re looking at creating a space where, if people want a breakout space, just somewhere to relax, they can.

3. Generating and sharing research and evidence of the value of trauma-informed approaches. For example, one area commissioned ‘deep listening’ research, in which a researcher conducted in-depth qualitative interviews with Changing Futures clients, to showcase the value of the trauma-informed approaches that practitioners were using.

Case study - Bristol: Providing ongoing support to help organisations change practice

Restorative practice is an approach to working with conflict, which focuses on repairing harm that has been done, promoting accountability, and fostering empathy. There has been increasing interest in and use of restorative practice over the last decade, particularly in youth justice and school settings. The Changing Futures team recognised the potential for using restorative practice in supported accommodation. Their experience demonstrates that successfully introducing trauma-informed approaches requires ongoing support, but that when new practices can be introduced, they benefit both staff and service users.

The aim of building-in restorative practice was to improve the quality of people’s experience in supported accommodation, through improved communication and conflict resolution. In these settings, conflicts related to issues such as theft, noise and mess are common, and approaches to conflict resolution can be inconsistent and often punitive.

Restorative practice was also felt to have the potential to reduce the number of evictions from supported accommodation. Evictions can cause significant personal damage, increase the risk of homelessness, and also have a negative impact on the system – such as through the potential for increased demand on other services, and higher costs associated with repeated housing assessments.

Bristol Changing Futures commissioned a specialist in restorative practice to deliver training to sixty people locally. It then employed the specialist to deliver a pilot in restorative practice approaches with a small group of supported accommodation providers, to help them to embed these approaches into their services. Staff attended a 2-day training course and monthly coaching sessions. This helped them to create environments conducive to restorative practice, such as regular house meetings and activities for residents, to encourage a sense of community. Staff felt the pilot had been effective in enabling them to implement restorative conversations within supported accommodation; also, in encouraging residents and staff to communicate their feelings and needs, incorporating activities to restore fractured relationships, and empowering staff to have challenging conversations with residents when necessary.

Bristol Changing Futures is now in conversation with housing commissioners to consider how restorative practice can be embedded more systemically. They are considering whether key performance indicators (KPIs) for supported housing could be adjusted to encourage the adoption of restorative approaches in future contracts.

Lessons learned

There may already be local activity promoting trauma-informed working

Some areas highlighted that there can be considerable uncoordinated activity happening locally, resulting in crossover and duplication. Taking time at the start of any trauma-informed initiative to review the local landscape can help to align it with other efforts, avoid duplication and confusion, and bring other system partners on board.

Tailoring workforce development to roles and contexts is more effective

Training was most impactful when content was tailored to people’s roles (frontline staff, operational managers, and strategic leaders or commissioners) and used scenarios that participants might face. Areas gathered input from local data sources such as safeguarding reviews and potential participants, to inform training and ensure the content targeted development needs. Trainers with their own experience of working with people experiencing multiple disadvantage helped bring scenarios to life. It was also felt that when training was facilitated by people with experience of using trauma-informed practice in the same service or sector, this improved credibility.

Include strategic roles in workforce development activity

Workforce development should not be restricted to staff in frontline roles. People in senior management and leadership positions have the power, through commissioning and service planning, to create the working conditions necessary for trauma-informed approaches. Some strategic staff may need to be convinced of the need to attend training, as some may feel trauma-informed approaches are only relevant to those who directly work with people experiencing multiple disadvantage.

Delivering one-off training is unlikely to result in systems change

The sustainable changes to culture and practice required for trauma-informed working to become the norm are unlikely to be achieved through one-off events. A suite of ongoing activities that help to sustain and reinforce learning, and promote the conditions needed to implement trauma-informed approaches, is likely to be most effective.

Devising approaches that help people to apply learning can shift practices, processes and structures in favour of trauma-informed working. In Changing Futures, training participants were sometimes asked to identify opportunities to implement their learning (for example, adapting policies to make them more trauma-informed, or reviewing staff wellbeing).

Case study – South Tees: Using ‘insiders’ to support culture change

South Tees employed a Trauma-Informed Project Lead to promote a culture of trauma-informed working. An early task for the Lead was to visit services to introduce herself, gain trust and engage services, with the goal of making the system more trauma-informed. The Trauma-Informed Project Lead’s experience of drawing on her own background, and of recruiting internal Champions, demonstrates the value of having ‘insiders’ promote different ways of working.

The lead delivered trauma-informed training extensively in the area – ultimately to around 700 staff in South Tees. The training focused on helping participants understand the relevance, importance and benefits of trauma-informed approaches in their work settings. The Lead emphasised how it could improve people’s engagement with and experience of services, as well as making staff’s work easier and safer, and highlighted results from within the sectors that participants were working in. She also offered strategies for implementing trauma-informed approaches, to move beyond increasing understanding and towards practical ways to support their introduction and use.

She was particularly effective in engaging prison staff and the police. As her previous career was in the criminal justice system, she was a credible source of expertise. She had a strong understanding of the situations staff may experience, and their sometimes traumatic nature. Also, she could describe first-hand how using trauma-informed approaches in this sector had resulted in positive outcomes for staff and people experiencing multiple disadvantage.

In addition to this introductory-level training, the Lead delivered more intensive training to a sub-set of participants, co-facilitated by a specialist in trauma-informed therapeutic techniques. These people became ‘Trauma-Informed Champions’ within their organisations.

The Champions’ role was to bring the learning from the training to colleagues within their own organisations, and to work towards changes in organisational culture and practice. Multiple champions provided greater reach into different organisations and parts of the system than could have been achieved by a single Lead role for the area.

There’s only one of me … I need a team of people who work within services who can be inside there every day, changing the culture.

The Lead developed a person specification for the Champions; this highlighted a need for people who were interested in changing systems for their staff and people accessing services. The specification also requested strong communicators who were confident enough to advocate for trauma-informed working, and able to challenge poor practice. The person specification was shared with organisations working with people experiencing multiple disadvantage; these organisations selected staff members to attend the training.

Those who were most passionate about the topic and keen to take on the role have been most engaged in the ensuing work. In some cases, organisations put forward people based on their managerial roles, although they did not express a high level of interest or enthusiasm for the process; they were less engaged after the training. The Lead held regular meetings with the Champions to discuss their work, and there is a WhatsApp group to enable ongoing communication and mutual support.

There are now 55 Trauma-Informed Champions in South Tees, including representatives from Cleveland Police, local authorities, drug and alcohol services, and voluntary and community organisations. As well as modelling trauma-informed approaches, the Champions are encouraging their organisations to view their work through a trauma-informed lens, identifying specific changes to ensure that services are more trauma-informed. The knowledge that Champions have acquired through the specialist training – coupled with a detailed understanding of their own organisation, a day-to-day presence, and relationships and credibility with their colleagues – mean they are in a strong position to identify improvement areas and influence change.

Changes the Champions have made include incorporating client assessment processes later in the support, so they do not overwhelm clients, and offering specialist therapeutic techniques, such as Integral Eye Movement Therapy.

Getting started: Thinking about behaviour change

Trauma-informed working is shorthand for how services and organisations should do a wide range of things. These include how people communicate and work with other staff and service users; how physical environments are designed and used; how staff are supported and how they treat each other; which policies and procedures people choose to put in place and how these are used; and how senior people lead and manage others. In summary, moving towards trauma-informed working involves changes in how people behave.

When planning to promote trauma-informed working, it can help to reflect on what changes in behaviour you seek, and what is needed for people to adopt the new behaviours. As discussed in this chapter, training alone is not always enough to change behaviour in services. Why might that be?

There are many theories of how to change people’s behaviour, but a useful model developed in the UK is the COM-B behaviour model, which is based on a systematic review of theories of behaviour. 7 (#footnote7) It identifies that to achieve a change in behaviour, a person will need to have the capability, the opportunity, and the motivation to carry out the new behaviour. To support people in planning how to achieve behaviour change, researchers developed the behaviour change wheel (https://www.behaviourchangewheel.com/about-wheel), a tool that can help you think about what you need to do to make sure each of these conditions is in place.

For example, the case study of South Tees: Using ‘insiders’ to support culture change (#SouthTees) shows that the training focused both on reasons why staff would want to adopt trauma-informed approaches, such as making work easier and safer, and information on how to implement trauma-informed approaches. The aim here was to increase both motivation and capabilities.

The behaviour change wheel also highlights that in addition to increasing people’s knowledge and understanding (education and training), there are many other types of interventions that can support changing behaviours. In South Tees, they also used another type of intervention on the wheel: modelling. Specifically, Champions used trauma-informed approaches in their own work, so that others might be encouraged to do this. They found that those who were most passionate about the topic and role were the most engaged and successful at modelling trauma-informed practice, and persuading their organisations to change their thinking and practices.

Whether or not you use the behaviour change wheel to aid your thinking, you may find it useful to discuss the following with colleagues:

1. What is the specific behaviour we are trying to change? Which workers, including senior people, are we targeting? What do we want them to do that they don’t do now?

2. What is helping or hindering people from behaving in the desired way? For example, what is helping or hindering their motivation or intentions to to so? What factors, such as staffing levels or other organisational restrictions, might limit their opportunity to act in this way?

3. What different strategies are open to you, which respond to the barriers and enablers you have identified?

Resources and further reading

See a working definition of trauma-informed practice (https://www.gov.uk/government/publications/working-definition-of-trauma-informed-practice/working-definition-of-trauma-informed-practice)

Balanced Minds (2023), Compassion Focused Therapy Worksheets (https://balancedminds.com/compassion-focused-therapy-worksheets/) (free via subscription).

Changing Futures Plymouth (2024), Building Trauma Sensitive Assessment Practices with ‘Your Story’ Approach (https://www.youtube.com/watch?v=jaHEjiHWFuk&t=31s). This webinar shares learning from the Your Story project, in which a tool was co-produced with people with lived experience, to support more relational, trauma-informed and person-centred assessment approaches.

Changing Futures Plymouth (2023), A Trauma Informed Approach to Recruitment (https://vimeo.com/888812402). This video provides an account of Plymouth’s trauma-informed approach to recruiting peer researchers.

Michie, S., van Stralen, M. M. and West, R. (2011), The behaviour change wheel: A new method for characterising and designing behaviour change interventions (https://implementationscience.biomedcentral.com/articles/10.1186/xx-xxxx-xxxx). This article introduces the behaviour change wheel, a method for thinking about ways to create behaviour change.

Policy Lab (2024), Lived experience in policy making guide (https://openpolicy.blog.gov.uk/wp-content/uploads/sites/35/2024/03/PL_Livedexperienceguide_v6-1.pdf). This short guide sets out the principles, behaviours and mindsets that underpin lived experience work. It was developed as part of Policy Lab’s work for Changing Futures.

University of Oxford (2020), Oxford Brain Stor (https://www.oxfordbrainstory.org/)y. The website provides a wealth of accessible resources on how early experiences can affect long-term mental and physical health.

Local frameworks can help organisations to self-assess the extent to which they are operating in a trauma-informed way, and to make improvements to their approaches:

Back on Track Manchester (2025), Trauma Self Assessment tool (https://www.backontrackmanchester.org.uk/trauma-self-assessment-tool/). This tool supports organisations to assess the extent to which they are operating in a trauma-informed way.

Surrey and Borders Partnership NHS Foundation Trust (no date), Trauma-Informed Framework (https://www.sabp.nhs.uk/our-services/professionals/trauma-informed-surrey-and-north-east-hampshire/trauma-informed-framework). This is freely available, but you need to complete a registration form (via the link) to access it.

Trauma Informed Hull (https://www.traumainformedhull.org.uk/) is an example of a website supporting trauma-informed practice, funded by Changing Futures.

(4) Trauma-informed practice or working refers to an approach to health and care interventions that is grounded in the understanding that trauma exposure can impact an individual’s neurological, biological, psychological and social development. It can encompass not only how workers interact with people, but also elements such as service environments, policies and processes. ↩ (#note4)

(5) Schön, D.A. (1992). The Reflective Practitioner: How Professionals Think in Action (https://doi.org/10.4324/9781315237473) (1st edition). Routledge. ↩ (#note5)

(6) Psychologically informed environments are designed to consider the emotions, trauma and past experiences of people entering that environment. See further information (https://homeless.org.uk/knowledge-hub/trauma-informed-care-and-psychologically-informed-environments/) ↩ (#note6)

(7) Michie, S. van Stralen, M. M. and West, R. (2011). The behaviour change wheel: a new method for characterising and designing behaviour change interventions (https://doi.org/10.1186/xx-xxxx-xxxx). Implementation Science 6:42 ↩ (#note7)