Does training change practice? A survey of clinicians and managers one year after training in trauma-informed care

DOIhttps://doi.org/10.1108/JMHTEP-02-2016-0016
Published date08 May 2017
Pages188-198
Date08 May 2017
AuthorTheresa Maureen Williams,Geoffrey Paul Smith
Subject MatterHealth & social care,Mental health,Mental health education
Does training change practice? A survey
of clinicians and managers one year after
training in trauma-informed care
Theresa Maureen Williams and Geoffrey Paul Smith
Abstract
Purpose The purpose of this paper is to describe the impact of a trauma-informed care (TIC) training
programme on practice at the individual and workplace level in mental health and drug and alcohol
services and to examine the implications of using training alone as a strategy for achieving system-level
practice change.
Design/methodology/approach A total of 271 clinicians and managers from public mental health and
drug and alcohol services in Western Australia who had undertaken TIC training were invited to complete an
on-line survey 12 months after training. Individual survey items were based on a five-point Likert scale with
opportunity being provided for additional comments from respondents.
Findings One year post-training, both clinicians and managers reported that training had increased their
awareness and knowledge and had a positive impact on their attitudes towards TIC. Clinicians reported a
moderate impact on their individual practice and both groups reported very limited success in bringing about
change in their workplaces. Workforce development and organisational factors were identified by both
clinicians and managers as being barriers to implementation.
Research limitations/implications Only 30 per cent of the training participants responded to the survey
and it is not possible to determine whether they differed from non-respondents. Findings were based on a
self-report survey with no objective measure of behaviour change.
Originality/value This naturalisticstudy examines the longer-term impact of training, from the
perspective of clinicians and managers, on changing practice at the individual clinician and workplace level.
It highlights the critical importance of understanding and addressing contextual factors where collective,
coordinated behaviour change is needed in order to effect organisational change.
Keywords Mental health, Training, Implementation, Practice change, Trauma-informed care
Paper type Research paper
Introduction
The impact of trauma in the lives of people with mental health problems has been receiving
increasing attention in recent years and this has led to a call for care to be provided in a way
which is trauma informed (Substance Abuse and Mental Health Services Administration, 2011;
Mental Health Coordinating Council, 2013). A trauma-informed care (TIC) approach has been
described as a programme, organisation or system that:
[] realizes the widespread impact of trauma and understands potential paths for recovery;
recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the
system; and responds by fully integrating knowledge about trauma into policies, procedures, and
practices, and seeks to actively resist re-traumatization (Substance Abuse and Mental Health Services
Administration, 2014, p. 9).
In 2013, a group of international and local mental health commissioners and leaders met in Australia
and issued a communiqué which included a commitment to advocate fo r and promote t rauma-
informed care approaches to strengthen mental health practice across all our communities
Received 22 February 2016
Revised 3 August 2016
28 December 2016
Accepted 10 February 2017
The authors would like to thank Dr
Elizabeth Moore, former Executive
Director Mental Health, South
Metropolitan Health Service, WA
Department of Health for
instigating the research study.
Theresa Maureen Williams is
the Director at the Western
Australian Centre for Mental
Health Policy Research,
Graylands Hospital,
Perth, Australia; and has an
adjunct appointment with the
School of Psychiatry and
Clinical Neurosciences,
University of Western Australia,
Perth, Australia.
Geoffrey Paul Smith is based at
the Western Australian Centre
for Mental Health Policy
Research, Graylands Hospital,
Perth, Australia; and Clinical
Associate Professor at the
School of Psychiatry and
Clinical Neurosciences,
University of Western Australia,
Perth, Australia.
PAGE188
j
THE JOURNAL OF MENTALHEALTH TRAINING, EDUCATION AND PRACTICE
j
VOL. 12 NO. 3 2017, pp.188-198, © Emerald Publishing Limited, ISSN 1755-6228 DOI 10.1108/JMHTEP-02-2016-0016

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