Understanding the Conceptualization and Operationalization of Trauma‐Informed Care Within and Across Systems: A Critical Interpretive Synthesis

Abstract

In order to achieve successful operationalization of trauma-informed care (TIC), TIC policies must include conceptual clarity regarding the definition of both trauma and TIC. Furthermore, TIC requires clear and cohesive policies that address operational factors such as clearly delineated roles of service providers, protocol for positive trauma screens, necessary financial infrastructure, and mechanisms of intersectoral collaboration.r Additionally, policy procedures need to be considered for how TIC is provided at the program and service level as well as what TIC means at the organizational, system, and intersectoral level.Context: Increased recognition of the epidemiology of trauma and its impact on individuals within and across human service delivery systems has contributed to the development of trauma-informed care (TIC). How TIC can be conceptualized and implemented, however, remains unclear. This study seeks to review

How the police conceptualise and view the relevance of adverse childhood experiences (ACEs) for policing: a qualitative investigation

“…In particular, examples endorsed by senior staff would have the potential to allay concerns about reprisal. More broadly, the operationalisation of trauma-informed approaches has been poorly defined across services (Bargeman et al, 2022). Given the inherent risks associated with policing, clear operationalisation of trauma-informed policing is urgently required.…”

“…This was further identified in the officers' appeals for more practical guidance on how trauma-informed practice could be adopted within current guidance and policies. Institutional policy has been identified as significant barrier to trauma-informed practice across several systems (Bargeman et al. , 2022), and Brough et al.…”

“…In particular, examples endorsed by senior staff would have the potential to allay concerns about reprisal. More broadly, the operationalisation of trauma-informed approaches has been poorly defined across services (Bargeman et al. , 2022).…”

“…This was further identified in the officers' appeals for more practical guidance on how trauma-informed practice could be adopted within current guidance and policies. Institutional policy has been identified as significant barrier to traumainformed practice across several systems (Bargeman et al, 2022), andBrough et al (2016) noted that police culture is particularly characterised by "formality, enforcement of rules and compliance with procedures" (p. 34, 2016). Furthermore, individuals expressed concerns about reprisals if they were to work in more trauma-informed ways.…”

Barriers to trauma-informed care include unsafe environments and mental health nurses’ lack of emotional intelligence

“…TIC is an approach that has emerged from recognition of the prevalence of psychological trauma 1. There is also increasing awareness of the avoidable harms that coercive practices such as detention and restraint cause to people using mental health services, particularly people who have experienced trauma 2.…”