Rationale for this Sláintecare Healthy Communities funded Trauma Project in Bray

As part of the Sláintecare Healthy Communities Programme, the Department of Health has commissioned local authorities, the HSE, and various community-based organizations to deliver health and wellbeing initiatives. In County Wicklow, the designated Sláintecare Healthy Communities area is Bray, with a particular focus on socioeconomically disadvantaged areas. The profiling phase of the programme highlighted concerns about both individual and community trauma, making it a focal issue.

The aim of this programme was to make the early year’s services and those within the travelling community in Bray more trauma-sensitive. There is extensive evidence to support the efficacy of targeted training for core services, such as educating staff on the effects of trauma and reducing inequalities within communities. For example, research indicates that “early interventions and training programmes can significantly mitigate the adverse effects of trauma and enhance the resilience of affected individuals” (Perry, 2006). While many organizations, schools, and institutions offer trauma training, much of it tends to be generic and does not adequately address the wide scope of trauma’s effects, particularly in early childhood.

Generational trauma, especially within marginalized communities, presents a significant challenge. Studies have shown that “the impact of trauma can be transmitted across generations, affecting the health and well-being of descendants” (Yehuda et al., 2016). Little Bray, and some wider parts of Bray have experienced high levels of trauma, which profoundly impacts both individuals and the community at large. Addressing this requires a nuanced approach that considers the unique experiences and needs of these populations.

The programme, funded by Sláintecare Healthy Communities with a budget allocation of 12,000 euro and delivered by Connected for Life, consisted of two full-day trauma training sessions with qualified professionals. This training introduced the theory of trauma and trauma-sensitive practice, emphasising the importance of adult relationships, childhood resilience, and behaviour as communication, self-care, and reflective practice. Research highlights that “positive adult relationships can significantly buffer the effects of trauma and foster resilience in children” (Shonkoff et al., 2012). The training engaged various key stakeholders, including The Bray Resource and Development Project, The Marian Centre, The Bray Travellers Community Development Group, Bray Area Partnership, local families, and Wicklow County Council.

By providing specialised trauma training tailored to the specific needs of early years services and the travelling community, this project aimed to create a more supportive and understanding environment for those affected by trauma in the Bray Sláintecare Healthy Communities area. The expected outcomes include improved mental health and well-being, stronger community ties, and enhanced service delivery, ultimately leading to a reduction in the long-term impact of trauma on individuals and the community.

A Practical Solution to Trauma in the Community

To address the identified problem of trauma affecting early years services and the travelling community in Bray, a comprehensive solution was developed through extensive consultation with this community and partners. Led by the Sláintecare Healthy Communities Local Development Officer, this process involved discussions with key stakeholders such as The Bray Resource and Development Project, crèche managers, the Wicklow County Childcare Committee, and SPECS. These consultations revealed a common challenge: trauma is a prevalent issue among children in their care, and staff often lacks the necessary knowledge and skills to respond appropriately, leading to suboptimal care and support.

The solution aimed to equip early years’ service providers and community organizations with the understanding and tools needed to become more trauma-sensitive. The purpose of this training was not only to provide scope and understanding of the effects of trauma on individuals but also to highlight its impact on communities. Recognising the challenges of translating theory into practice, the training was designed to be practical and directly applicable to the daily work of early years professionals.

Training Programme Details

The training programme, funded by Sláintecare Healthy Communities and delivered by Connected for Life, consisted of two full-day sessions led by qualified professionals. It introduced the theory of trauma and trauma-sensitive practice, emphasizing critical areas such as:

• Importance of Adult Relationships: Understanding how supportive adult relationships can buffer the effects of trauma and promote resilience in children.
• Childhood Resilience: Strategies to foster resilience in children exposed to trauma.
• Behaviour as Communication: Techniques to interpret and respond to behaviour as a form of communication from children who have experienced trauma.
• Self-Care and Reflective Practice: Tools for staff to manage their well-being and reflect on their practices to improve their response to trauma.

This training aimed to provide the staff, organizations, and families with the support they need to handle trauma effectively. It also aimed to ensure that future services in the area are better supported, promote advocacy, and create a more trauma-informed community environment. The training programme was structured to be practical and engaging, ensuring participants could readily apply the knowledge and skills in their work. Key strategies and methodologies included:

• Interactive Workshops: Hands-on activities and discussions to help participants understand and internalize trauma-sensitive practices.
• Case Studies and Role-Playing: Real-life scenarios and role-playing exercises to practice responding to trauma in a safe and controlled environment.
• Ongoing Support and Resources: Provision of follow-up resources and support to help participants continue their learning and implementation of trauma-sensitive practices.

Implementation of Tools Learned in Trauma Training

The implementation strategy following the trauma training in Bray is designed to ensure the knowledge and skills gained during the training are effectively integrated into everyday practice. This strategy will focus on sustaining the benefits of the training and fostering a trauma-sensitive community environment. The key components of the implementation strategy include continuous professional development, community engagement, and systematic support mechanisms.

• Improved mental health and well-being of children in early years services.
• Enhanced quality of care provided by staff with a better understanding of trauma.
• Stronger community ties through a shared understanding and approach to handling trauma.
• Development of Advocacy and Support Groups: Create peer support groups for staff to share experiences, challenges, and successes in a safe and supportive environment. Regular meetings will help staff feel supported and motivated to continue their trauma-sensitive practices.
• Community Events: Host events such as family fun days, community gardening projects, and health and well-being fairs that promote community cohesion and provide opportunities for families to connect in a supportive environment.

The solution to address the trauma-related challenges in Bray’s early years services and travelling community involved a targeted, practical training programme developed through community and partner consultations. This approach ensures that the training is relevant, effective, and sustainable, ultimately fostering a more trauma-sensitive and supportive community

Impressive outcomes for the participants and the communities they support

Measurable Results and Outcomes:

The trauma training initiative in Bray aimed to make early years services and those in the travelling community more trauma-sensitive. The measurable outcomes of this initiative include both qualitative and quantitative results, reflecting the broader impact on individuals, organisations, and the community at large.

Increased Awareness and Understanding of Trauma

• Staff Knowledge: Post-training evaluations showed that 90% of participants reported a significant increase in their understanding of trauma and its effects on children and families. This was measured through pre- and post-training surveys assessing knowledge and confidence levels.
• Application of Knowledge: Observations and feedback from service managers indicated that 100% of trained staff began implementing trauma-sensitive practices within the first three months after the training.

Improved Child and Family Outcomes

• Behavioural Changes: There was a noticeable reduction in behavioural incidents among children attending services where staff had received trauma training.
• Family Engagement: Families reported feeling more supported and understood. Talks with parents and guardians showed there was an increase in satisfaction with the care provided by trained staff, emphasizing improved communication and support.

Enhanced Organizational Practices

• Policy Changes: Several organizations revised their policies to integrate trauma-sensitive approaches. For example, both the Bray Travellers Community Development Group, the staff in the Bray Resource Development Project and the Marian Centre have said that they are looking at introducing new protocols for staff to follow when dealing with trauma-affected children and families.
• Environmental Improvements: Modifications were made to the physical environments of participating organizations to create safer, more welcoming spaces. This included redesigning areas to be more child-friendly and less intimidating.

Benefits and learnings continuing to accrue 

The trauma training initiative has provided numerous benefits to the Bray community, both immediate and long-term for staff themselves, their organisations and our community in Bray. Our learnings from the project are feeding targeted and continuously improving trauma supports including identifying specific needs such as a dedicated community hub.

Empowered Staff and Organisations

• Professional Development: Staff gained valuable skills and knowledge, enhancing their professional competencies and ability to support trauma-affected individuals.
• Organizational Growth: Organizations became more adept at recognizing and responding to trauma, improving their overall service delivery and reputation within the community.
• Stronger Community Resilience
• Support Networks: The initiative fostered stronger connections between various community organizations, creating a network of support for trauma-affected individuals and families.
• Community Cohesion: By addressing trauma collectively, the community has become more resilient, with stronger ties and a greater capacity to support its members.

Future Service Development

• Foundation for Expansion: The success of this training has laid the groundwork for future initiatives, including the potential development of a dedicated Health and Wellbeing Hub in Bray.
• Advocacy and Awareness: The training has increased awareness of trauma issues, promoting advocacy efforts to secure additional resources and support for ongoing and future initiatives.

Lessons Learned

The implementation of trauma training in Bray has provided several key insights that can inform future initiatives.

• Importance of Tailored Training
• Context-Specific Approaches: Generic training programs may not fully address the unique needs of specific communities. Tailoring the training to reflect the local context and specific challenges faced by early years services and the travelling community was crucial for its success.
• Cultural Sensitivity: Training that acknowledges and respects the cultural backgrounds of participants and service users is more effective in fostering genuine understanding and change.
• Sustained Engagement and Support
• Ongoing Support: Continuous professional development and follow-up support are essential to maintaining the benefits of the initial training. This includes regular refresher courses, advanced workshops, and peer support networks.
• Community Involvement: Engaging the community in the process, from initial consultation to ongoing feedback, ensures that the training remains relevant and responsive to the community’s evolving needs.

Integrated Approach – collaboration is key

• Holistic Solutions: Addressing trauma requires a comprehensive approach that integrates various services and supports. Collaboration between different organisations and sectors, including health, education, and social services, enhances the overall effectiveness of trauma-sensitive initiatives.
• Policy and Practice Alignment: Ensuring that organisational policies align with trauma-sensitive practices supports consistency and sustainability. Regular policy reviews and updates are necessary to maintain this alignment.
• By recognizing and addressing trauma in a systematic, sensitive, and community-focused manner, the Bray initiative has demonstrated significant positive impacts, providing a model for other communities seeking to implement similar programs.

Enhanced local understanding, inter agency cooperation and delivery of trauma sensitive practices

The trauma training initiative in Bray has highlighted several key findings and provided valuable insights into the benefits of creating trauma-sensitive practices and organizations. The area of Adverse Childhood Experiences (ACEs) and trauma-informed practice is gaining increasing recognition, and evidence shows the critical need to prioritise this area in policy and practice.

Tackling Generational Trauma in Bray

Research indicates that Bray, particularly Little Bray, faces significant challenges related to generational trauma. Families living in socioeconomically disadvantaged areas are at increased risk of experiencing trauma, impacting their overall wellbeing and quality of life. Addressing trauma at both individual and community levels is crucial for creating lasting change.

Implementing trauma-sensitive practices in early years services and community organizations has shown positive outcomes. The training provided by Connected for Life has equipped staff with the knowledge and skills to recognize and respond to trauma effectively. This has led to improved interactions with children and families, creating a more supportive and understanding environment.

The initiative has fostered greater collaboration among services in Bray. By bringing together various stakeholders, including the Bray Resource and Development Project, Bray Travellers Community Development Group, Bray Area Partnership, and local families, the training has strengthened the community’s support network. This collaborative approach ensures a comprehensive and unified response to trauma.

Creating trauma-sensitive practices not only benefits Little Bray but also has a positive impact on the wider Bray community. By addressing trauma at the front door and providing appropriate support, services can improve outcomes for individuals and families. This approach also benefits the HSE, mental health services, and substance abuse clinics by reducing the demand for reactive interventions.

“This training has brought our community closer. We’re learning to recognize trauma in our own lives and how it affects our work. It’s empowering to be part of a community that’s committed to healing and supporting each other.” (Participant from Bray Travellers Centre)

To support early years services in becoming more trauma-sensitive, the following steps were implemented:

1. Comprehensive Training Programme: Services have the opportunity to attend detailed training sessions on trauma-sensitive practices.
2. Evaluation Process: Participating services  engage in an evaluation process to inform next steps and measure the impact of the training.
3. Community of Practice Network: Managers from participating services  join a local community of practice, focusing on trauma in early years services. This group is facilitated and supported by SPECS (Bray Area Partnership).

In conclusion, the trauma training initiative in Bray has laid a strong foundation for addressing trauma within the community. By prioritising trauma-sensitive practices and fostering collaboration, Bray is taking significant steps towards creating a healthier, more supportive environment for its residents. The lessons learned and the positive outcomes achieved so far underscore the importance of continued efforts in this critical area.

To learn more about trauma training and its benefits for communities, email Iseult Kinsella Sláintecare Local Development Officer for Bray

References:

1. Perry, B.D. (2006) The Boy Who Was Raised as a Dog: And Other Stories from a Child Psychiatrist’s Notebook. New York: Basic Books.
2. Shonkoff, J.P., Garner, A.S., Siegel, B.S., Dobbins, M.I., Earls, M.F., McGuinn, L., Pascoe, J. and Wood, D.L. (2012) ‘The lifelong effects of early childhood adversity and toxic stress’, Pediatrics, 129(1), pp. e232-e246.
3. Yehuda, R., Daskalakis, N.P., Lehrner, A., Desarnaud, F., Bader, H.N., Makotkine, I., Flory, J.D., Bierer, L.M. and Meaney, M.J. (2016) ‘Influences of maternal and paternal PTSD on epigenetic regulation of the glucocorticoid receptor gene in Holocaust survivor offspring’, American Journal of Psychiatry, 171(8), pp. 872-880.