Trauma-Informed Practice: The Stories We Write About People and How They Shape Their Recovery
-Blog Series with our Restrictive Practice Lead, Georgina (George) Rickard-
About Georgina:
Restrictive Practice Lead and Specialist Clinical Practitioner.
Georgina's Expertise:
Managing and reducing high-risk behaviour of concern, working with vulnerable people and their support teams for over 25 years in a wide range of education, community, and in-patient settings using a range of evidence-based positive approaches.
Advocacy:
A published researcher focusing on Practice Leadership and implementing skilled staff support; leader, autism specialist, practice lead and trainer.
Each young person we support has their own history and ways of responding to the world around them. Many of the children and young people we support at Catalyst have previously experienced trauma. Children who have experienced trauma need supporters who understand the impact this can have on all aspects of the child’s life. This means that trauma-informed care is compassionate, adaptable, and respectful of a person’s lived experience. When we take the time to understand what has shaped a person’s reactions and behaviour, how they communicate distress and what helps them feel safe, we can provide support that truly meets their needs.
Using a trauma-informed approach when considering behaviour of concern helps us understand where someone is in the healing and recovery process, what level of support they require, and how to prevent causing further harm. When we view behaviour through the lens of trauma, everything changes. We stop asking, “What’s wrong with the person?” or ‘Why do they do that?’ and instead ask, “What happened to the person, and what do they need right now?”
We discussed this with George, who shared what these principles mean in practice:
‘’As PBS Practitioners, our job is to ensure our approach is trauma-informed, to align the Positive Behaviour Support (PBS) approach with the ‘Trauma Recovery Model’ being implemented. One example of how a trauma-informed approach can be seen in practice is in the way our support staff have changed the way they write their daily records. When care teams write records about a child, the child has the right to read those records. In a trauma-informed approach, there is feedback from young adults who were previously children in care that reading these records after leaving Care can be traumatising in itself. It is important, therefore, that staff are trained to write in a way that the child can understand, with the aim of avoiding them feeling re-traumatised when they later read it. We have already started implementing this. During their recent and successful first Ofsted inspection, the inspector gave very positive feedback, saying she had not seen another service doing this. This was encouraging and validated the approach.’’
So, how does trauma-informed practice change the way behaviour is understood?
‘’Another key aspect is how staff understand the behaviour of children who have experienced trauma, so they use the most appropriate approaches. For example, children who have experienced trauma are more likely to experience difficulties with self-regulation and impulse control. They may experience heightened arousal; they may not be fully in control of their behaviour. Therefore, traditional consequences or punishments are not appropriate. For a neurotypical child who has not been through trauma, you might use sanctions, e.g., “You haven’t done your homework or cleaned your room, so you cannot see your friends.” But in trauma-informed practice, you would not respond this way to trauma-related behaviour such as a meltdown. You would instead try to understand what is behind the behaviour and avoid any punitive responses. Expectations are adjusted because the child’s capacity and emotional state are different.’’
Trauma is widespread, and global surveys estimate that a large majority of people experience at least one traumatic event in their lifetime. Yet, we are all different and traumatic events do not affect everyone in the same way. For example, the interaction between trauma, environment, communication, and sensory experience can create very different experiences for some neurodivergent people. This means trauma can sometimes accumulate, be ongoing, and be intertwined with daily living and ongoing negative experiences, not just tied to one event. When implementing trauma-informed informed, this creates some differences in how support should be approached.
Georgina shares:
‘’A key example that made me think deeply about this was reading an article written by a young woman who, after leaving care and becoming an adult, went back to read the records written about her. She said the language was cold and clinical, showing no care or love. It reduced her to a set of behaviours: “She had a meltdown,” “She did not do what I asked,” and so on. She described the experience of reading those records as re-traumatising. This highlighted the need for a more compassionate, trauma-informed approach to record-keeping.
Our staff write records as though they are speaking directly to the child. For example, George, this morning you were having a difficult time because you had not slept much. I tried to help by doing X, and when that didn’t work, I tried Y. We will keep working on this together.” This is a much more trauma-informed way of recording, and it shows that we are putting the principles into practice.’’ – shares George.
The Trauma Pyramid and Positive Outcomes
The Trauma Pyramid is a framework from the Trauma Recovery Model that illustrates the stages of recovery following early trauma, abuse, neglect, or chronic stress. It shows that before any therapeutic or behavioural work can succeed, a person must first have their basic needs for safety, trust, and regulation met.
It helps care teams, and sometimes the person themselves understands:
- what a person needs right now
- why certain interventions might fail if done too early
- how behaviour connects to unmet developmental or emotional needs
- where to focus support without overwhelming or re-traumatising the person
Photo Credit: https://www.cordisbright.co.uk
‘’Another way we use the Trauma Recovery Model is through the trauma pyramid, which shows the different levels of intervention. You typically start at the bottom, the foundations, focusing on safety, consistency, trust, and relationship-building. Many children and adults coming into care will begin at this first level, where they first just need to feel safe and secure. For one young person we are currently supporting, he has gradually moved from level one to level two, and sometimes towards level three. Progress is not always linear, however, and people may move up and down the levels depending on their experiences and stressors.
Staff use this model to understand the person’s needs better and identify appropriate interventions.
The pyramid also outlines some of the practical interventions used in trauma-informed practice. At the earliest stages, the focus is on basics such as regular mealtimes, bedtimes, and predictable routines. Feeling safe and secure is key. Only when those foundations are in place can deeper therapeutic work take place, such as self-reflection or trauma-specific therapy. This can take different lengths of time for different people. The person we are currently working with has been with us for two years, and only now is he ready to engage in psychological trauma therapy.’’
The trauma pyramid reminds us that stability comes first.
‘’In terms of positive outcomes through the Trauma Recovery Model, one of the most important areas has been working on the young person’s health needs, especially sleep, physical health, and emotional wellbeing. At the same time, it was essential to focus on the positive aspects of the person’s life and the things that bring him joy and engagement. To structure this, we used the PERMA Wellbeing model developed by the well-known Psychologist Maurice Seligman. I worked one-to-one with him and his staff team, and together we explored examples of positive emotions, engagement, relationships, meaning, and accomplishments, which Seligman’s model tells us are the foundations of wellbeing
We chose to focus particularly on the young person’s accomplishments, strengths, and achievements because this builds confidence and emotional resilience. This reflects the “accomplishments” aspect of PERMA. Another of the person’s goals was to engage with psychological therapy. He had been offered therapy, but refused to see the psychotherapist for many months. However, because of the strong relationships this young man built with the team at levels one and two of the trauma model, developing security and safety, he is now able to participate in the therapy. This is another positive outcome directly linked to trauma-informed and PBS-aligned practice.’’
Autism-Informed Approaches Within Trauma Informed Practice and PBS
Autism-informed practice recognises that autistic people experience the world differently, and that support must be adapted to their sensory, cognitive, and communication needs. It prioritises understanding, co-regulation, predictability and strengths, and aligns with the values of Positive Behaviour Support (PBS) because it centres on reducing distress rather than controlling behaviour. Autism informed practice also works hand inhand with support that is trauma-informed, as it focuses on finding out the person’s viewpoint and perspective.
So, how do autism-informed principles fit into this work? George shares:
‘’With regard to autism, many of the most important aspects of the person’s experience as an autistic individual are invisible to others, which makes staff training essential. Understanding the individual’s perspective is fundamental, and whenever possible, the autistic person themselves should be involved in sharing their experiences. Key areas include sensory profiles, communication differences, and physiological responses. It is understood that Trauma significantly affects the body’s arousal system, and autistic people, who often have heightened sensory and emotional responses, may be more vulnerable to the impact of trauma on their physiology and behaviour. Working with the person to complete sensory assessments and sensory support plans can therefore be very important.
It is also important to recognise that some autistic people may need or prefer different forms of psychological therapy from non-autistic individuals. Neurotypical people are often directed towards talking therapies such as CBT. Still, some autistic people find these unhelpful, preferring non-speaking or creative therapies such as art therapy, music therapy, or animal-assisted therapy, as part of their overall support.
Georgina’s Publications:
- Contextual and individual barriers to providing practice leadership by frontline managers in community services for adults with intellectual disabilities: A qualitative study.
- Frontline managers’ experiences of practice leadership for when supporting autistic adults with complex support needs residing in community housing.
To get the full copy of both publications, send a direct email to Georgina at georgina@catalystgrp.co.uk
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