An evaluation of a trauma‐informed educational intervention to enhance therapeutic engagement and reduce coercive practices in a child and adolescent inpatient mental health unit

Author:

Heffernan Sinéad1,O'Malley Maria1ORCID,Curtin Margaret1,Hawkins Andrew1,Murphy Rachel1,Goodwin John1,Barry Karen2,Taylor Alice2,Happell Brenda13ORCID,O’ Donovan Áine1ORCID

Affiliation:

1. School of Nursing and Midwifery Brookfield Health Sciences Complex, University College Cork Cork County Cork Ireland

2. Eist Linn, Child and Adolescent Mental Health Services Cork and Kerry Healthcare, Health Service Executive Cork Ireland

3. Faculty of Health Southern Cross University East Lismore New South Wales Australia

Abstract

AbstractHigh‐risk behaviours are sometimes encountered in Child and Adolescent inpatient mental health units and can prompt the use of coercive practices to maintain safety. Coercive practices may lead to re‐traumatisation of young people and deteriorating therapeutic relationships. Trauma‐informed practice (TIP) has successfully reduced coercive practices. While education is identified as foundational to implementation, evaluations of programmes remain minimal. The aim of this study was to explore mental health professionals' views and experiences of a trauma‐informed education programme and its likely impact on their approach to practice. Five mental health professionals agreed to participate, four contributed in a focus group and one in an individual interview. Data were analysed thematically using the Braun and Clarke Framework. Three main themes were identified. Firstly, shifting attitudes and perceptions of trauma‐informed practice. Participants believed they had developed more compassion towards clients and these attitudes were reflected in their clinical practice. Secondly, challenges associated with trauma‐informed practice educational intervention. Staffing issues and shift work made it difficult for participants to attend education sessions regularly. Participants identified barriers to practicing in a trauma‐informed manner in the current clinical environment. Finally, the need for interdisciplinary communication and support was identified. Participants saw the need for all professionals, not only nurses, to take responsibility for changing practice, and for stronger support at the organisational level. Trauma‐informed practice is crucial to recovery‐focused mental health nursing practice. These findings highlight the importance of TIP education and suggest areas for further improvement to enhance positive mental health outcomes for young people.

Publisher

Wiley

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4. Australian Government. (2013)National Framework for reducing and eliminating the use of restrictive practices in the Disability Service Sector Department of Social Services Australian Government. Available from:https://www.dss.gov.au/our‐responsibilities/disability‐and‐carers/publications‐articles/policy‐research/national‐framework‐for‐reducing‐and‐eliminating‐the‐use‐of‐restrictive‐practices‐in‐the‐disability‐service‐sector[Accessed 28th January 2024].

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