How do staff in residential care transform Trauma-Informed principles into practice? A qualitative study from a Norwegian child welfare context

Abstract

ABSTRACT Trauma-informed practices (TIP) in social welfare and mental health services have become widespread. TIP is considered to be a mindset rather than an operationalized methodology. TIP principles need to be transformed into practice in any given context. We interviewed staff at a Norwegian residential care institution on how they transformed TIP-principles into practice after receiving competence building based on Howard Bath’s ‘three-pillar’ approach. Informants emphasized the importance of self-awareness such as self-reflection, authenticity, and other-regulation, intended actions such as building strength, providing staff availability, setting safe limits, and collaborating with the youth, as well as organizational and cultural practices such as promoting a shared coherent mindset, stability, routines, and cultural safety. Using an adherence check model as a framework, we discuss if informants´ descriptions reflect a general humanist approach, rather than TIP as such. Most of their descriptions make sense in a TIP perspective, but few can be claimed to be unique to TIP, and their focus on authenticity may even conflict with theories of change embedded in TIP. Further, we reflect on the debate on whether TIP should be more standardized or not, and outline implications of findings for future implementations of TIP programmes.