Using participatory methods to engage multidisciplinary clinical staff in the embedding of trauma-informed care and practice principles in a sub-acute mental health inpatient unit

Changing multidisciplinary team practice is difficult, even in circumstances where the staff support such change. This methodology paper describes the successful use of respectful and participatory methods and processes to engage multidisciplinary clinical staff in practice change. These methods are described and discussed in relation to a clinical practice change project that sought to embed trauma-informed care and practice (TICP) in a sub-acute mental health unit. TICP is a critical new paradigm for multidisciplinary mental health services that involves the recognition of the high rates of abuse and trauma suffered by those with mental illness and the need to both understand the effects of this abuse and trauma and to respond to them appropriately. The principles of the paradigm need to be introduced throughout mental health services, but especially in inpatient units where a predominantly biomedical perspective can preclude a more holistic approach. This paper outlines the background of TICP and describes in detail the four TICP-compatible, participatory methods and processes used to engage staff in the embedding of TICP principles in their everyday practice. The participatory approaches employed reflected TICP principles and addressed issues including the engagement of staff in the change project, the identification of TICP-compatible care practices currently used in the unit, the identification of issues related to the further embedding of TICP in everyday care, and the generation of solutions to the issues raised. The processes undertaken were underpinned by a heuristic framework to maintain staff engagement. This paper is not intended to be a recipe for TICP change. However, the methods and processes described may be adapted to be of practical use in the design of TICP and other practice change initiatives in multidisciplinary clinical settings.