A Call for the Integration of Trauma‐Informed Care Among Intellectual and Developmental Disability Organizations

Abstract

Research exploring the occurrence of trauma among adults with intellectual and developmental disabilities (I/DD) has grown over the past decade. Yet there is a dearth of literature investigating the impact of organizational factors on the trauma experience despite this population's need for organizational supports. Trauma-informed care (TIC), a systems-focused model for service delivery, is a fast-developing interest among the broader field of trauma in the general population. It recognizes the prevalence and impact of trauma, and creates a culture of safety, trustworthiness, choice, collaboration, and empowerment. The author synthesized relevant literature from both the intellectual and developmental disabilities areas and integrated this with TIC and trauma literature drawn from the general population. Explored are the implications of organizations for service delivery and the potential assimilation of TIC within I/DD organizations. The effectiveness of TIC applications and their potential barriers are discussed and related to the philosophy of quality of life and organizational culture. The author notes that some individuals with I/DD comprise a vulnerable subgroup of the population that in large part relies upon the support of organizational services to foster quality of life. Given the implications of the focus on quality of life, he posits that TIC presents as a viable response for organizations, complimenting and augmenting current efforts.

Literature review of trauma‐informed care: Implications for mental health nurses working in acute inpatient settings in Australia

“…TIC is essentially a systems‐focussed approach that recognizes the pervasiveness and impact of trauma (Bateman et al . ; Kessler ; Reeves ). The TIC approach acknowledges that consumers have a high prevalence of historical trauma, and argues that service providers are in a powerful position to recognize and respond to their trauma (Bateman et al .…”

Trauma and Life Events in Adults with Intellectual Disability

“…The approach requires training and the creation of a particular organisational culture and service delivery which has implications for resources and care of staff [67,69]. This may be difficult in environments where there is a lack of opportunity to develop independence, low staff to service user ratio, high staff turnover and limited opportunities for training [67].…”

“…The model proposes creating environments which promote trust, a sense of safety, boundaries, empowerment and choice, and introduction of the model to intellectual disability services has recently been described [67]. The approach requires training and the creation of a particular organisational culture and service delivery which has implications for resources and care of staff [67,69].…”

“…The approach requires training and the creation of a particular organisational culture and service delivery which has implications for resources and care of staff [67,69]. This may be difficult in environments where there is a lack of opportunity to develop independence, low staff to service user ratio, high staff turnover and limited opportunities for training [67]. Thorough information gathering for biographical timelines and identification of trauma triggers is very promising for the development of appropriate interventions for people with moderate to severe intellectual disabilities but is time intensive, and working at this level day to day has implications for resources and education of carers [26].…”

“…Given that reactions to trauma develop as an interaction with variables in the social landscape and are not just a process located within the individual, it is important to consider environment factors [66]. Trauma-informed care (TIC) considers the impact of organisational structure and procedures and staff on traumatised individuals [67]. The aim of trauma-informed care services is that organisations be more attuned to the possibility of trauma in a person's past and its role in the aetiology of current presentation.…”