Article: Trauma Informed Practice: A solution to some of the problems of targeted youth work

Author: Emma Bainborough and Jon Ord | Tags: , , , ,

Emma Bainborough and Jon Ord explore the relationship between youth work and trauma informed approaches and suggest that an overlap in values may help promote relational practice, particularly in targeted services.

It is often claimed that youth work is difficult to define and remains misunderstood (Smith, 2013). This may in part be due to the multifaceted and complex nature of youth work (Council of Europe Youth Partnership, 2020), the many different settings in which youth work is practiced, as well as the absence of a legally protected professional identity (Banks, 1999). However, whilst youth work can be described as a family of practices, it can also be articulated with clarity, as it is underpinned by four core values – ‘Treat young people with respect’, ‘Respect and promote young people’s rights to make their own decisions and choices’, ‘Promote and ensure the welfare and safety of young people’, and ‘Contribute towards the promotion of social justice for young people and in society generally’ (NYA, 2001, p.6). This ethical foundation informs its professional principles and practices. As a result, this places the young person at the centre of youth work practice (Ord, 2016) in order to empower young people to gain control over their own lives and find their own solutions to problems (Sapin, 2013). The key purpose of youth work therefore follows from this and is:

To enable young people to develop holistically, working with them to facilitate their personal, social and educational development, to enable them to develop their voice, influence and place in society and to reach their full potential (Banks, 2010, p.10).

Translating these values into youth work practice, Davies’ (2015) argues that youth work’s distinctive identity can be articulated through the following characteristics:

  • Voluntary participation
  • Proactively seeking to tip the balance of power in young people’s favour
  • Perceiving and receiving young people as young people, rather than through the filter of adult-imposed lenses and labels
  • Starting where young people are at
  • Focus on the young person as an individual
  • Respectful and actively responsive to young people’s peer networks
  • Respectful and actively responsive to young people’s wider community and cultural identities
  • Seeking to go beyond where young people start by encouraging them to develop their personal potential and to be critical and creative in their responses to the world around them
  • Being concerned with how young people feel, as well as with what they know and what they can do (Davies, 2015, p.100)

Despite this clarity, and perhaps partly as a result of the multiplicity of its approaches, youth work is often buffeted by a variety of policy demands and increasingly becomes focused on meeting governments’ agendas (Davies, 2010). This was particularly prevalent in the New Labour era which saw a reorganisation of children and young people’s services aimed at prioritising the needs of ‘at risk’ or ‘disadvantaged’ young people; and addressing various issues such as anti-social behaviour, youth offending, substance misuse and teenage pregnancy or those identified as NEET, (ibid). Importantly this period saw the rise of ‘targeted youth work’ at the expense of open access centre-based youth work (Davies 2019). For example, by 2014 targeted support services accounted for 52% of youth spending (McGhee, 2015) and a 2014 cabinet survey publicised that 75% of 97 respondents predicted that within three years, 75 to 100% of their budgets would be allocated to targeted youth work (Davies, 2015, p.114).

Davies, Taylor and Thompson (2015) rightly point out that structured and targeted approaches based on prescribed outcomes and behavioural modification schemes cannot be described as youth work. Youth work practitioners are however increasingly finding themselves working within targeted and specialist frameworks with an emphasis on effective early interventions (McGhee, 2015). These are often in rigid statutory or quasi-medical settings alongside multiagency partners with an emphasis on ‘sharing information’ for the purpose of multiagency safeguarding and managing risks, thresholds and caseloads. These systems may have been established to attempt to combat social exclusion. However, its authoritarian control, containment and surveillance (Jeffs and Smith, 2014) can and does exacerbate and perpetuate social exclusion and power imbalances. There is therefore a real danger that the fundamental role and purpose of youth work within these targeted structures is being lost. This paper seeks to address this problem by assessing the usefulness of trauma informed practice to targeted youth work practice and related services.

Within the context of targeted services, it would be easy to see the emergence of Trauma Informed Practice (TIP) as yet another nail in the coffin of youth work’s distinctive approach, but perhaps surprisingly as will be demonstrated, youth work and trauma informed practice have distinctive yet similar embedded values, principles, and practice. So, TIP has the potential to provide a buffer to the mechanistic and instrumental targeted youth work approaches.

Trauma Informed Practice

Both trauma informed approaches and trauma informed practice are – similarly – according to Hopper et al (2010) beset with multiple meanings and its associated methods and frameworks are also often poorly defined and misunderstood. Again, some clarity is required.

Firstly, it is important to understand what is meant by trauma. The Substance Abuse and Mental Health Services Administration (SAMHSA) usefully defines trauma as:

Experiences causing intense physical and psychological stress reactions. It can refer to a single event, multiple events, or a set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being (SAMHSA, 2014b, p.xix).

Importantly, whilst the adverse effects of trauma may occur immediately after the event(s), they may also be delayed and be long lasting. Such long-term effects may include the inability to cope with day-to-day life, the inability to form trusting relationships, the impairment of cognitive processes and self-regulation, hyper-vigilance and avoidance (SAMHSA, 2014a). Crucially, Van der Kolk (2014) suggests those who have experienced trauma can continually re-experience overwhelmingly distressing emotions and behaviours, and these may not be consciously associated with past experiences of trauma.

The concept of trauma covers an extensive range of experiences including interpersonal violence, complex childhood and developmental traumas, and social and economic trauma (Sweeney, et al 2016). Trauma may be viewed through a wide contextual lens, taking into account bio-psychosocial, interpersonal, community, environmental and societal factors (SAMHSA, 2014a).

 Trauma informed approaches are underpinned by an understanding and awareness of trauma; and the recognition of the impact of trauma on individuals and across settings, services, and communities (SAMHSA, 2014b). SAMHSA identify four key fundamentals of trauma informed approaches: realising the prevalence of trauma, understanding potential pathways to recovery, and understanding potential barriers to positive outcomes; recognising how trauma directly or indirectly impacts on and affects individuals, families, communities, services, systems and employees; responding by incorporating knowledge into practice, policies and procedures; and resisting re-traumatisation of service users and staff through organisational systems and cultures (SAMHSA, 2014a).

Trauma Informed Practice (TIP) is defined as a strengths-based service:

Grounded in an understanding of and responsiveness to the impact of trauma; that emphasizes physical, psychological, and emotional safety for both providers and survivors; that creates opportunities for survivors to rebuild a sense of control and empowerment (Hopper, Bassuk, and Olivet, 2010, p.82).

 To understand TIP, it must firstly be recognised that it is NOT a form of therapeutic intervention to resolve or treat trauma. TIP is an essential requirement for engaging effectively with service users who have experienced trauma (such as the homeless, those accessing emergency accommodation, young offenders, those experiencing substance misuse, as well as those accessing targeted youth support services).Trauma informed practice involves an awareness of potential trauma and encourages the avoidance of individual practices and organisational processes that are liable to re-traumatise individuals and exacerbate individual problems rather than lay the foundations for successful interventions. These foundations include the significance of service user participation in the development, delivery, and evaluation of services as well as the sharing of trauma informed approaches such as shame sensitive practice (Dolezal & Lyons, 2017). Trauma informed practitioners recognise how behaviours may be understood within the context and lenses of trauma, and therefore practice from a strength-based, collaborative approach. Collectively they attempt to create a trauma informed organisation. Trauma informed practice therefore seeks to proactively address the needs of traumatised individuals and communities (SAMHSA, 2014b; Wilkinson, 2019).

Trauma Informed Practice and Youth Work

Whilst originally coined in the US, the UK is increasingly adopting trauma informed approaches in educational services, children and young people’s welfare agencies, criminal justice and youth offending services (Asmussen et al., 2020). It would be wrong to assume however that this is yet another approach to instrumentalised problem based targeted solutions to working with young people. It should have begun to become apparent that many of the values of TIP are consistent with youth work values.

TIP, like youth work, has been referred to as a values-based approach (Fallot, 2011, p.99). The core values of which are: Safety, where interpersonal relationships promote a sense of safety and where safety is defined by those using the services. Trustworthiness and Transparency: where organisational operations and decisions are conducted with transparency with the aim of building and maintaining trust with service users. Peer Support: which helps build trust and hope and safely utilises lived experience to promote resilience, recovery and healing, as a collaborative space from which to inform practice. Collaboration and Mutuality: with an emphasis on the levelling of power differences between service users and practitioners, demonstrating that healing happens in relationships and in the meaningful sharing of power and decision making. Empowerment, Voice and Choice: where organisations foster empowerment; understanding power imbalances; and an awareness of how mandatory or coercive services can diminish the voice and choice of service users. Lastly, Cultural, Historical and Gender Issues: where organisations move past cultural discrimination and oppression; and incorporate policies, procedures and practices that are responsive to the cultural needs of service users; and recognise and address historic trauma (SAMHSA, 2014a, p.11).

Analysis of the Trauma Informed Plymouth Network (2019) which has youth workers at the heart of it, reveals a set of values which are also consistent with youth work. They are intended to apply at an individual level (for people accessing a service or responding to a need), at a team or organisational level, as well as at a community level. The values are:

  • Safety: Recovery from trauma occurs within the context of relationships, within families and communities, but also with supportive professionals. The role of those relationships is to provide physical and emotional safety and to bolster the courage to tolerate, face and process the reality of what has happened. Safe relationships build confidence, resilience, and trust in those affected by trauma. Each interaction is an opportunity to show someone that they are valued and to help build self-esteem.
  • Person Centred: When building trusting relationships people need to be given choices in how services will be delivered and focus is placed on the outcomes that best meet their needs, rather than those that enable an agency or service outcome to be delivered. To be person centred means working with individuals and communities on their priorities, starting where they are at.
  • Kind: The relationships we seek to establish can provide physical and emotional safety for those who have experienced trauma. A critical aspect of a trauma informed approach is about avoiding judgment, having and understanding empathy, or simply being kind. These are crucial factors in creating connections and enhancing creating wellbeing.
  • Collaborative: Working together and collaborating to achieve the best possible actions for those who use our services. Being trauma informed recognises that our own agencies and our multi-agency systems can also traumatise, particularly when multiple professionals are involved with a person or a family. Seeking the most proportionate and least intrusive interventions; avoiding where possible a narrow focus on single-agency outcomes; and focusing instead upon a fully coordinated, integrated and compassionate response in order to help people feel safe and supported.
  • Empowering: In creating a sense of safety, being person centred, creating connection through empathy, and collaborating with people to achieve the best outcomes, we seek to be empowering, helping people to build resilience to support healing and move forward. In working with others, we become empowered to make a difference. (Hardwick, Moss & Shaw, 2019, p.14-19)

Trauma informed practice places an emphasis on an understanding of how the past influences the present and attempts to empower service users to discover their own resilience (Knight, 2014). In relation to young people, TIP offers an opportunity for practitioners to work alongside young people as active partners in creating personal, organisational and cultural change, and bringing about systemic change and social justice (Taggart, 2018).

It is evident that both youth work and trauma informed approaches share core values, principles and practices which demand an awareness of and commitment to the levelling of power and control (SAMHSA, 2014a, Davies, 2010). This involves the concept of ‘power to’ (Thompson, 2007) and relates to an individual’s potential to realise and achieve their own aims. This is closely linked to empowerment, defined by Thompson as ‘helping people gain greater control over their lives and circumstances’ (2007, p.21). Empowerment cannot be imposed or done ‘to’ or done ‘for’ other people. As Bounds and Hepburn (1996, p.15) point out “individuals cannot be empowered by others but can be enabled to power themselves”.

Ord (2012) suggests if there is to be resistance to the dominant neoliberal hegemonic order, youth workers, youth work managers and educators will need to think more deeply and politically about the wider context of youth work and how it is managed in the current economic climate (Ord, 2012, p.27). Although austerity and a lack of resources makes it harder to engage with new initiatives (Sweeney et al., 2016), trauma informed approaches strive to implement frameworks which help practitioners and services talk to each other in a collaborative way, in order to understand links between trauma, behaviour and bio-medical issues (SAMHSA, 2014a). Trauma informed approaches do not seek to treat trauma, this requires effective pathways to specialist services. Rather trauma informed approaches seek to be sensitive in their response to trauma by understanding its effects and prioritising safety, choice, and emotional connection (Hardwick et al, 2019). Without TIP, many young people accessing complex needs services may well view professionals as a perceived threat to their safety, exacerbating their problems and potentially re-traumatising them. Viewing distress through a trauma lens develops awareness and understanding of how trauma impacts on well-being and emphasises the importance of safety, trusting relationships and empowerment at the heart of the response.

To conclude, there are fundamental connections between youth work and trauma informed approaches and rather than seeing trauma informed practice as yet another threat to youth work in targeted settings, TIP has the potential to bolster the person centred, relationship-based, empathetic, and empowering approach that ought to be integral to all youth work interventions. Therefore, explicitly adopting a trauma informed approach in targeted services can only be beneficial and ensure continuing commitment to youth work principles and practices in targeted services.

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Last Updated: 23 November 2021

References:

Asmussen, K., Fischer, F., Drayton, E. & McBride, T. (2020). Adverse childhood experiences: What we know, what we don’t know, and what shouldhappen next.London: Early Intervention Foundation

Banks, S. (1999). Ethical Issues in Youth Work. London: Routledge

Banks, S. (2010). Ethical Issues in Youth Work. (2nd Ed.). London: Routledge

Bounds, J. & Hepburn, H. (1996). Empowerment and Older People. Birmingham:            Pepar

C of E (Council of Europe Youth Partnership) (2020). Youth Work, a very diverse field of practice. https://pjp-eu.coe.int/en/web/youth-partnership/youth-work1

Davies, B. (2010). What do we mean by youth work? In Batsleer, J. & Davies, B. (Eds.) What is Youth Work? (pp. 1-6). Exeter: Learning Matters Ltd

Davies, B. (2015). Youth Work: A Manifesto For Our Times – Revisited. Youth &   Policy, (114) 96-117

Davies, B. (2019).Austerity, Youth Policy and the Deconstruction of the Youth Service in England, Basingstoke: Palgrave.

Davies, B., Taylor, T. & Thompson, N. (2015). Informal Education, Youth Work and Youth Development: Responding to the Brathay Trust Case Study. Youth & Policy, (115), 85-86. https://www.youthandpolicy.org/wp-content/uploads/2017/06/davies-115.pdf

Dolezal, L. & Lyons, B. (2017). Health-related shame: an affective determinant of health? Med Humanit, (43) 257-263. doi: 10.1136/medhum-2017-011186

Fallot, R. D (2011). Trauma-Informed Care: A Values-Based Context forPsychosocial Empowerment. In Deepali, P. (Ed.) (2011) Preventing Violence Against Women and Children Workshop Summary. Washington, DC: The National Academies.             https://www.ncbi.nlm.nih.gov/books/NBK189835/pdf/Bookshelf_NBK189835.pdf#page=112

Hardwick, S., Moss, A. & Shaw, S. (2019). Envisioning Plymouth as a Trauma Informed City. Plymouth: The Trauma Informed Plymouth Network.https://democracy.plymouth.gov.uk/documents/s96832/Trauma%20Informed%20Plymouth%20Approach.pdf

Hopper, E. K., Bassuk, E. L., & Olivet, J. (2010). Shelter from the storm: Trauma-informed care in homeless service settings. The Open Health Services and Policy Journal, 3, 80-100.https://www.researchgate.net/publication/239323916_Shelter_from_the_Storm_Trauma-Informed_Care_in_Homelessness_Services_Settings2009-08-        202009-09-282010-03-22

Jeffs, T. & Smith, M. (2014). Social exclusion, joined-up thinking and individualization – new Labour’s Connexions strategy. Infed. https://infed.org/mobi/social-exclusion-joined-up-thinking-and-            individualization-new-labours-connexions-strategy/

Knight, C. (2019). Trauma Informed Practice and Care: Implications for Filed Instruction. Clinical Social Work Journal, 47, 79-89.

McGhee, P. (2015). Youth work: ‘Open access youth work principles must be instilled into all services’. Children & Young People Now. https://www.cypnow.co.uk/Other/article/youth-work-open-access-            youth-work-principles-must-be-instilled-into-all-services

National Youth Agency. (2001). Ethical Conduct in Youth Work a statement of values and principles from The National Youth Agency. Leicester: The National Youth Agency

Ord, J. (2012). Critical Issues in Youth Work Management. Oxon: Routledge

Ord, J. (2016). Youth Work Process, Product and Practice. Oxon: Routledge

Sapin, K. (2013). Essential Skills for Youth Work Practice. (2nd ed.) London: Sage Publications Limited

Smith, M. K. (2013). What is youth work? Exploring the history, theory and practice of work with young people. The Encyclopaedia of Informal Education (infed).       https://infed.org/mobi/what-is-youth-work-exploring-the-history-theory-and-practice-of-work-with-young-people/

Substance Abuse and Mental Health Services Administration Trauma and Justice Strategic Initiative. (2014a). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication Number 14-4884.

Substance Abuse and Mental Health Services Administration. (2014b). Trauma-Informed Care in Behavioural Health Services, A Treatment Improvement Protocol. Rockville, MD: Substance Abuse and Mental Health Services Administration.      https://www.integration.samhsa.gov/clinical-practice/SAMSA_TIP_Trauma.pdf

Sweeney, A., Clement, S., Filson, B. & Kennedy, A. (2016). Trauma-informed mental healthcare in the UK: what is it and how can we further its development? Mental Health Review Journal, 21(3), 174-192.    https://www.researchgate.net/publication/308003715_Trauma-            informed_mental_healthcare_in_the_UK_what_is_it_and_how_can_we_furth            er_its_development

Taggart, D. (2018). Trauma-informed approaches with young people. Research in Practice. https://www.researchinpractice.org.uk/children/publications/2018/august/trau       ma-informed-approaches-with-young-people-frontline-briefing-2018/

Thompson, N. (2007). Power and empowerment. Dorset: Russell House Publishing

van Kolk, B. (2014). The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma. England: Penguin Books.

Wilkinson, J. (2018). Developing and leading trauma-informed practice. Research in Practice.             https://tce.researchinpractice.org.uk/developing-and-leading-trauma-informed-    practice/

Biography:

Emma Bainborough is a qualified youth & community work practitioner who leads the implementation of Trauma Informed Practice and co-leads the Plymouth Trauma informed Network. She also delivers training nationally to a range of services including the Police & Crime Commissioners, Criminal Justice Boards and the NSPCC.

Jon Ord was a youth worker for many years and is currently an Associate Professor at Plymouth Marjon University where he teaches on U/G and P/G youth & community work programmes. He is the author of a number of books and articles on youth work theory and practice.