What is known about the application of trauma-informed care within services for people with intellectual and/or development disabilities?

Abstract

Trauma-informed care (TIC) is gaining momentum in various health, social, and educational settings globally in response to the widespread pervasiveness of adverse experiences and resultant psychological trauma. Given that people with intellectual and/or developmental disabilities (IDD) are more likely to experience traumatic life events than the general population, it makes sense that TIC should be in place within services supporting individuals with IDD. Yet there is a dearth of empirical research exploring the integration of TIC in such organisations and the spread of limited available literature is diverse. Thus, this paper aimed to scope and synthesise the emerging literature to elucidate what is known -regarding TIC in the context of IDD. A scoping review was conducted using the Arksey & O’Malley (2005) guidelines. Three databases, PsycINFO, Web of Science, and PubMed, were searched using relevant search terms to retrieve 69 papers published since 2000, which were systematically screened for eligibility. Twenty-three papers comprising a range of source types met inclusion criteria and were reviewed rigorously, with included empirical studies appraised using the mixed methods appraisal tool (MMAT; Hong et al., 2018). The PAGER framework (Bradbury-Jones et al., 2022) was followed to generate four patterns from the findings: (1) Opportunities for Embedding TIC within IDD Contexts, (2) Incorporating TIC Principles into Specific IDD Service Models, (3) Implementing TIC across Micro, Meso, and Macro Levels, and (4) Challenges and Barriers to Implementing TIC in IDD Organisations. There is a growing body of literature exploring the implementation of TIC within IDD organisations, including newly emerging TIC training programmes for staff. Yet there remains a lack of empirical implementation research examining outcomes for service providers and recipients. Tentative evidence for clinical practice and research recommendations from each pattern of findings are discussed, along with strengths and limitations of this review.