Trauma-informed activities “rarely lead to evidence-based interventions”, study finds

A new study by the Early Intervention Foundation (EIF) and What Works for Children’s Social Care finds that despite ‘adding value’ to children’s social care, trauma-informed activities are rarely leading to evidence-based interventions.

The study used a survey to analyse the approaches of 58 local authority children’s social care teams, with representatives from ten teams taking part in a follow-up ‘in-depth interview’ and consider the extent to which the teams were engaging with ten principles of trauma-informed care (TIC).

Despite being prevalent in 89% of the teams participating in the study, TIC activities were “highly varied” across different services. Additionally, authors said that there was a “high degree of overlap” between trauma-informed care activities and standard children’s social care practice. Of the teams participating in the study, so-called strengths-based methods for engaging families was the primary TIC activity, followed by trauma-informed training.

Participants reported that TIC activities provided a wide range of benefits, with better treatment decisions and improved family engagement listed as positives. However, the study found that no two teams offered the same components or attended the same training. Additionally, the study found that TIC activities rarely led to evidence-based treatments but were more frequently offered alongside other social work practices that had also not yet been rigorously tested.

The study said that while a uniform model of TIC was not determined from its research, it was possible that the results could be used to form the basis for one.

“Although this study failed to identify a model of TIC delivered across multiple CSC teams, it is likely that one could be developed and tested through the components identified in this study,” the authors said.

“Examples of outcomes that might be tested in future evaluations include practitioners’ awareness of trauma, improved family engagement and retention, greater practitioner satisfaction, and improved child wellbeing.”

Trauma-informed care has its roots in the war experiences of Vietnam War veterans in the 1980s in the US. Since then, the understanding of trauma has been expanded to children and families who have had traumatic experiences such as abuse and neglect. Over the last 20 years, trauma-informed approaches have become increasingly popular as a means for reducing the negative impact of childhood adversities and supporting child and adult mental health outcomes.

The most recent study follows the EIF’s 2020 report, ‘Adverse Childhood Experiences: What we know, what we don’t know and what should happen next’ which urged that trauma-informed approaches be “robustly tested so that its benefits could be verified and strengthened”.

As a result of the new research, the EIF is encouraging collaboration between Government departments – including the Department for Education, the Home Office, the Department of Health and Social Care, and the Department for Levelling Up, Housing and Communities – to identify and agree a “core definition” of trauma-informed care. Authors added that these departments should prioritise a “robust evaluation” of TIC models and training and how these operates in different service contexts.

Authors added that trauma-informed care “should never be used as a replacement for evidence-based, trauma-specific treatments”.

“The availability of effective, trauma-specific interventions should be prioritised and linked to any future investment in trauma-informed care,” the report said.