Universal screening and trauma informed care: Current concerns and future directions.

Raja, Sheela; Rabinowitz, Emily P.; Gray, Matt J.

doi:10.1037/fsh0000585

Cited by 15 publications

(16 citation statements)

References 41 publications

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“…For example, an increasing body of literature elaborates on the idea of universal precautions—treating every patient with TIC rather than reserving it for those with PTSD diagnoses. 31,119,120 This idea is particularly important when considering that the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) ( DSM-5 ) and other diagnostic manuals are reflective of the culture in which they are created and rely on Western illness scripts. 121,122 For example, a previous study found that 19 of 20 Salvadoran women exposed to trauma did not meet PTSD criteria despite high symptom burden and pain.…”

Section: Discussionmentioning

confidence: 99%

Trauma-Informed Care Curricula for the Health Professions: A Scoping Review of Best Practices for Design, Implementation, and Evaluation

et al. 2022

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Purpose Trauma-exposed persons often experience difficulties accessing medical care, remaining engaged in treatment plans, and feeling psychologically safe when receiving care. Trauma-informed care (TIC) is an established framework for health care professionals, but best practices for TIC education remain unclear. To remedy this, the authors conducted a multidisciplinary scoping literature review to discern best practices for the design, implementation, and evaluation of TIC curricula for health care professionals. Method The research team searched Ovid MEDLINE, Cochrane Library, Elsevier’s Scopus, Elsevier’s Embase, Web of Science, and the PTSDpubs database from the database inception date until May 14, 2021. Worldwide English language studies on previously implemented TIC curricula for trainees or professionals in health care were included in this review. Results Fifty-five studies met the inclusion criteria, with medicine being the most common discipline represented. The most prevalent learning objectives were cultivating skills in screening for trauma and responding to subsequent disclosures (41 studies [74.5%]), defining trauma (34 studies [61.8%]), and understanding trauma’s impact on health (33 studies [60.0%]). Fifty-one of the studies included curricular evaluations, with the most common survey items being confidence in TIC skills (38 studies [74.5%]), training content knowledge assessment (25 studies [49.0%]), participant demographic characteristics (21 studies [41.2%]), and attitudes regarding the importance of TIC (19 studies [37.3%]). Conclusions Future curricula should be rooted in cultural humility and an understanding of the impacts of marginalization and oppression on individual and collective experiences of trauma. Moreover, curricula are needed for clinicians in more diverse specialties and across different cadres of care teams. Additional considerations include mandated reporting, medical record documentation, and vicarious trauma experienced by health care professionals.

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Section: Discussionmentioning

confidence: 99%

Trauma-Informed Care Curricula for the Health Professions: A Scoping Review of Best Practices for Design, Implementation, and Evaluation

et al. 2022

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“…Based on the results of the student reflections, we modified both the structure and content for subsequent student cohorts, into a series of interactive classroom activities. As our effort progressed, we also drew on theoretical frameworks from nursing 34,35 and other health fields 27,32,36,37 …”

Section: Discussionmentioning

confidence: 99%

“…As our effort progressed, we also drew on theoretical frameworks from nursing 34,35 and other health fields. 27,32,36,37 Based on suggestions from students, this content has since been moved earlier in their education and students are now receiving content on TIC and the social determinants of health throughout their coursework.…”

Section: Revised Curriculummentioning

confidence: 99%

An approach to trauma‐informed education in prelicensure nursing curricula

Pfeiffer

Grabbe

2022

Nursing Forum

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Background Trauma‐informed care (TIC) is an evolving concept that acknowledges the prevalence and impacts of trauma on health; however, knowledge related to implementation for nursing students remains limited. Purpose The purpose of this study is to understand the learning perspectives of nursing students and develop an innovative conceptual model to guide educators in implementing teaching and learning strategies related to TIC, consistent with the trauma and resiliency competencies for nurses. Methods Qualitative analysis of student responses after an online module to educate students on adverse childhood experiences (ACEs), trauma, and their impact on health through the lifespan. Results Three persistent themes emerged from the data: Growing in Self‐Awareness, Filling Learning Needs, and Envisioning Future Roles. From these themes, we developed a framework for TIC content for nursing and other healthcare curricula. Conclusions Our findings demonstrate a model to embed ACE education, TIC competencies, secondary traumatic stress awareness, and methods of self‐care, including resiliency skills, into undergraduate nursing education.

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“…Resources could include post screening support as routine practice to address elevated distress, alongside appropriate training to clinicians to be attuned to possibility of assessment related distress (Greene et al, 2020 ). From a wider perspective Raja et al ( 2021 ) states that following any development, adaptation or refining of screening tools, there is a need to consider service users preferences and privacy concerns, assessing the resource limitations, as well as integrating public health advocacy into screening programs. Further, treatment approaches should be trauma‐informed, which could include assessment, psychoeducation, and managing safety in early psychosis (Bendall et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

“They may be confronting but they are good questions to be asking” young people's experiences of completing a trauma and PTSD screening tool in an early psychosis program

2022

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Background There is a history of inadequate enquiry about, and assessment of, trauma in young people within Early Psychosis services and even when screening does occur there is little known about how young people experience this process. Aims This study aimed to explore young people's experiences of completing a trauma and PTSD screening tool when receiving a service in an Early Psychosis Program. Method Semi‐structured interviews were conducted with 10 young people, aged 18–24 years, to explore their subjective experience of this process. Transcripts were analysed via interpretative phenomenological analysis. Results Four super‐ordinate themes were identified: (i) an emotional experience, (ii) the importance of the relationship with the clinician, (iii) an opportunity to reflect on past experiences, and (iv) the ability to be able to provide honest responses. Results from this study indicated that young people expected to be asked about their trauma experiences, acknowledged that this was challenging for them but found that this was made easier due to the relationship they had built with the clinician, the timing of the screening and also, possibly, by the written style format of the questionnaires. Conclusions Young people in this study accepted the need for screening for traumatic histories, and expected to be asked about their traumatic experiences, despite the possibility of a short‐term increase in distress. The support offered by a trusted clinician, whom the young person had built a relationship with, appeared to be an important component to the willingness and the ability of the young person to complete the questionnaires. This reinforces the fact that screening for trauma in an early psychosis service can be conducted in a way that is safe and acceptable to young people.

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Universal screening and trauma informed care: Current concerns and future directions.

Cited by 15 publications

References 41 publications

Trauma-Informed Care Curricula for the Health Professions: A Scoping Review of Best Practices for Design, Implementation, and Evaluation

Trauma-Informed Care Curricula for the Health Professions: A Scoping Review of Best Practices for Design, Implementation, and Evaluation

An approach to trauma‐informed education in prelicensure nursing curricula

“They may be confronting but they are good questions to be asking” young people's experiences of completing a trauma and PTSD screening tool in an early psychosis program

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