Knowledge, principal support, self-efficacy, and beliefs predict commitment to trauma-informed care.

Abstract

Objective: Organizations are identifying trauma-informed care (TIC) as a priority yet implementation is slow. Research suggests commitment to a change effort is an important predictor for change behavior; however, there is little theoretical or empirical evidence exploring commitment to TIC. This study examines the variables that predict affective commitment to TIC including foundational knowledge, principal support, self-efficacy, and beliefs about trauma. Does foundational knowledge independently predict affective commitment to TIC or is this relationship mediated by other variables? Method: Data were collected from 118 participants working in human services, using cross-sectional survey design. Participants completed selfreport measures of affective commitment to TIC, foundational knowledge, principal support, self-efficacy, and beliefs about trauma. It was hypothesized that the relationship between foundational knowledge and affective commitment to TIC would be mediated through selfefficacy and beliefs about trauma, but not through principal support. Structural equation modeling was used to test the direct and indirect effects. Results: The findings support a partially mediated model with a direct effect between foundational knowledge and affective commitment to TIC (explaining 5% of the variance in affective commitment) and indirect effects between foundational knowledge and affective commitment through principal support, TIC self-efficacy, and beliefs about trauma. Altogether, the model explained 65% of the variance in affective commitment to TIC. Conclusion: This study contributes to both the organizational change literature and the growing TIC literature. As individuals and organizations work to implement TIC, these findings provide theoretical and practical implications for the field, addressing an important gap in research.

Measuring Trauma- (and Violence-) Informed Care: A Scoping Review

“…(Richardson et al, 2010(Richardson et al, , 2012) "I understand how historical and structural oppression may create traumatic conditions and psychological trauma." (Sundborg, 2019) Principle 2: Create emotionally and physically safe environments for all clients and providers Addresses safety (physical, emotional, cultural, and spiritual), or aspects of place/space that contribute to perceptions of safety. Focuses on interactions that may influence perceived safety such being nonjudgmental, avoiding "triggering," fostering connection/ trust, providing clear information or ensuring confidentiality/privacy.…”

Nationwide efforts for trauma-informed care implementation and workforce development in healthcare and related fields: a systematic review

“…65,66 Organizations and communities that have most successfully implemented TIC have reviewed and amended TIC procedures and policies, provided training to all staff and aligning staff hires with TIC training, followed recommended guidelines, and adopted refinements in TIC, such as service user involvement and ongoing staff training using system-level approaches. [67][68][69][70][71][72] Healthcare systems remain an important setting for identifying children and families who have been exposed to trauma. Pediatricians and other childcare providers are integral to the process of implementing TIC, especially if they work in a trauma-informed system and are properly trained.…”

Experiences of Becoming Emotionally Dysregulated. A Qualitative Study of Staff in Youth Residential Care

“…If not, they may lead to frustration and demands for interventions that promise increased predictability and order (Van Beurden et al, 2013), beyond setting safe boundaries and having consistent routines. To avoid these processes, efforts must be focused toward ensuring that staff are in agreement about the theoretical model being used, and that all stakeholders, including the management and supervisors, commit to the same model (Sundborg, 2019).…”