Work-related trauma across helping professions: a research portfolio consisting of two chapters including: A systematic review of evidence-based interventions for the treatment of work-related trauma in helping professions; &, “Well, we’ve just got to keep going, I suppose”: an IPA study into the experiences of adult mental health workers and trauma-informed care

Abstract

BACKGROUND: Through the nature of their roles, helping professionals are likely to be continually exposed to various traumatic events, narratives and/or situations. Recognition of work-related trauma across the helping professions is ever-growing, particularly following the Covid-19 pandemic and the increasing pressure on health, social and public care systems. However, the examination of interventions for treating work-related trauma is lacking. As such, there is a need for a clear-evidence base for treatment options for work-related trauma. Moreover, evidence has rarely accounted for the experiences of those working in adult mental health settings, which are under increasing strain and where contact with distress and trauma is likely. Finally, with the introduction of Trauma-Informed Care across Scotland, using the National Trauma Training Programme, little is known about the implementation of the approach in healthcare systems.

METHOD: To this effect, the current portfolio utilises two research methods to examine work-related trauma. Firstly, a systematic review of quantitative papers (N=13), assessed the efficacy and overall study quality of evidence-based treatments for work-related trauma in the helping professions. Results were presented using a narrative synthesis, detailing the type and duration of intervention. Secondly, an empirical paper employed a qualitative design to explore the experiences of NHS staff members (N=11) working in an adult mental health setting with distress and trauma, who had all attended the National Trauma Training Programme. Participants were interviewed using semi-structured interviews and Interpretative Phenomenological Analysis was applied to explore the impact of working in this setting and the impact of the National Trauma Training Programme.

RESULTS: The systematic review indicated good efficacy for a variety of evidence-based treatment options for work-related trauma. This included therapeutic interventions, mindfulness-based interventions, and psychoeducation, providing different treatment options for helping professionals. Efficacy was further supported by large effect sizes. Interventions were generally found to be feasible and acceptable in relation to patient satisfaction. However, there was an overall limited quality of included studies which restricts the generalisability of this review. Findings of the empirical project yielded four Group Experiential Themes: ‘Role Identity’, “Well, We’ve Just Got To Keep Going I Suppose”, ‘Service Pressures’ and ‘The Implementation of Trauma Informed Care’, each of which contained another two-four subthemes.

CONCLUSION: Work-related trauma represents a distinct type of trauma. Results from the systematic review contribute to the evidence base for clinicians who are actively engaged in trauma-work, providing favourable evidence for serval different types of interventions for treating work-related trauma. The review highlighted that trauma-work can be commenced in helping professionals who are likely to be continually exposed to traumatic events and provide some longer-term protection from re-traumatisation. However, the review is limited by methodological quality and future reviews should expand to include qualitative studies and other professions that may be exposed to work-related trauma. Qualitative findings suggested that there is a passion and commitment amongst NHS staff members to working within adult mental health settings and there are benefits to trauma-informed approaches within these settings. However, the demands and pressures of the service are ever-increasing and threatening to staff wellbeing and thus antithetical to the implementation of Trauma-Informed Care.