Exploring trauma and trauma-informed practice from a social constructionist perspective

Trauma-Informed Care (TIC) is increasingly gaining traction within mental health, social care, and forensic services in the UK. Although many argue strongly for its importance, others have claimed that it is a poorly defined concept with limited practical use, and some service user (SU) critiques have emerged. To date, there are no existing reviews or meta-syntheses focusing on the experiences or views of SUs in the UK. The current review and thematic synthesis sought to answer the following question: What does qualitative research tell us about how service users in mental health, social care and forensic services in the UK describe their experiences of and beliefs regarding trauma-informed care?

A systematic search was undertaken and a critical appraisal and thematic synthesis was carried out on sixteen qualitative papers, identifying five descriptive and three analytic themes. Descriptive themes suggested that some existing ideas about TIC had support amongst SUs, including the importance of relationships, autonomy, safety, and holistic care. Analytic themes identified some relatively novel findings, including that TIC is perceived by SUs as an emergent property of complex systems, and that dialectical thinking amongst staff may be an important aspect of TIC. Implications and limitations are considered in terms of clinical practice and future research.