National Trauma Transformation Programme: Trauma-Informed Substance Use Pathfinders – Learning Report

Workforce Knowledge, Skills and Confidence

To be trauma-informed, a workforce needs to be capable of recognising if, where and how an individual may be affected by trauma. They also need to understand how to work in a way that minimises distress, builds trusting relationships and prevents re-traumatisation. Trauma-informed knowledge and skills can help minimise barriers to service uptake and can sustain service engagement and support people to navigate services. These improvements will in turn support recovery, strengthen resilience and improve outcomes for people who use the service and the workforce. This training should be aligned with the Transforming Psychological Trauma Knowledge and Skills Framework to ensure it is evidence based alongside the Scottish Transforming Psychological Trauma Training Plan which offers organisations guidance on how to assess skills level requirements of staff and commission appropriate training resources.

Challenges in the Pathfinder areas

Challenges to workforce training and development included staff attrition and staff availability to attend training (impacted by staffing levels). There was also a challenge in ensuring people trained to deliver Trauma Enhanced Level Training (eg. Safety and Stabilisation) had the ongoing capacity to deliver training and stayed in post.

Enablers in the Pathfinder areas

Workforce training and development was the area most progressed during the pathfinders. TNAs were completed to tailor training to the needs of staff (although this was challenging due to high levels of turnover and attrition). A training plan was then developed for Trauma-skilled workers in addictions services based on staff wellbeing training resources and the Trauma skilled e learning module for those working in addictions available through the NTTP^[11]. Scaffolding was provided for this learning through discussions in individual teams. Staff engaged well with the training and reported through clinical supervision, it had improved their confidence in working with people who had experienced trauma.

Enhanced level Safety and Stabilisation training for staff had already been provided in one area due to input from a Transforming Psychological Trauma Implementation Co-ordinator (TPTIC). A plan was in progress as to how to deliver this training to the other pathfinder team as the trainers who had been trained were currently unavailable. In the meantime, a shared file was set up with Safety and Stabilisation resources for staff with scaffolding temporarily provided through clinical supervision from the pathfinder trauma lead specialist.

Managers have been encouraged to embed the training programme within an induction programme for new staff where possible. Additional training, e.g. Psychological First Aid^[12] practical session and Lifelines Scotland training^[13] has been included within the pathfinders as appropriate. The latter was included due to the existing service design in one area, meaning that staff were operating an Out of Hours Crisis service, and therefore wellbeing training for emergency services staff seemed particularly suitable.

Pathfinder Recommendations relating to Workforce Knowledge, Skills and Confidence

• Consideration should be given by addictions services as to how to incorporate the NTTP resources into their own tailored training plans, which can be useful particularly for induction of new staff. This ensures the training plan becomes sustainable and integrated into training provision.
• Including wider services in TNAs and subsequent training can be beneficial and enhance collaborative relationships, aid understanding and buy in to implementing TI Practice. This can also be beneficial in the use of developing a shared language.
• Scaffolding or coaching post training where capacity allows can support staff to implement knowledge and skills.
• If future capacity and caseloads allow, a more formal coaching process might support training, assist the application of TI Practice or increase embedding TI approaches in practice.