There is growing recognition of how traumatic experiences can impact on an individual’s physical and mental health and wellbeing. The US organisation SAMHSA (Substance Abuse and Mental Health Services Administration) defines trauma as “an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual's functioning and mental, physical, social, emotional, or spiritual well-being” (SAMHSA, 2014). While not everyone who is exposed to trauma will go to on to experience negative effects, a higher frequency of Adverse Childhood Experiences (‘ACEs’) are correlated with a range of negative outcomes, including physical health issues such as ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease, (Felitti et al 1998, reprinted 2019) and ‘health harming behaviours’ across the life course (Bellis 2014).  

These findings suggest many users of human services are likely to have experienced trauma, and there is increasing interest in Trauma-informed Practice / Care. However, many commentators, including those with lived experience of trauma, have highlighted concerns about the potentially re-traumatising effects of some services. Sweeney and Taggart (2018) suggest ‘by recreating abuse through 'power over' relationships, services can re-victimise service users, preventing recovery’.

There is a need to consider how services are offered, and a suggested reorientation away from a perspective of ‘what’s wrong with you?’ to ‘what’s happened to you’ (Sweeney and Taggart, 2018).  

In response to this, many organisations have started to promote a trauma informed approach. For example, the NHS Long Term plan includes aims to make community mental health services and children’s services trauma informed (NHS Long Term Plan v1.2 2019). In Scotland, NHS Education for Scotland are rolling out the National Trauma Training Programme in three pilot areas, providing training to a range of front line professionals, including police, health visitors and teachers, (NHS Education for Scotland). Though many services are now promoting a trauma-informed approach, there remains a lack of understanding of what works in promoting TI practice, how to delivery optimal training and the steps that need to be taken to promote wider organisational and cultural change.  

This study will evaluate a programme of Trauma-Informed workshops devised and delivered by an independent organisation, the Zebra Collective. The programme involves a series of 8 half-day workshops, delivered over 9 months, to mixed cohorts of staff and volunteers from services in Torbay including drug and alcohol teams, Children’s Services, Sexual Health services, Probation and Police. The workshops include sessions focused on training in trauma informed practice theory, with opportunities for skills development and reflection. Zebra aims to engage with staff at all levels of the participating organisations, to support ongoing change outside and between the workshops to promote wider culture change.   

The evaluation of this programme will consider the impact of the workshops on the skills, knowledge and practice of participants who attend the sessions in relation to trauma-informed practice, along with participants’ views of any wider organisational facilitators and barriers they may have experienced. We will also consider the views of those commissioning this workshop programme. In addition we will consider any unexpected, unintended and negative consequences which may occur, and make recommendations for next steps.  


Research questions/aims/objectives 

We aim to understand the perceptions of workshop participants, managers, commissioners and the programme delivery team as to their experience of the Trauma Informed change programme, any organisational changes as a result of the programme and potential impact.

Specifically, we aim to meet the following objectives, to understand:

Programme delivery:

  • how the programme is being delivered;
  • the extent to which the programme meets the needs of organisations and staff;
  • workshop participants’ perceptions of the programme;
  • impact on participant understanding of trauma informed practice/care
  • how the programme can be improved.

Programme impact:

  • the extent to which workshop participants have been able to apply their learning to practice;
  • the facilitators and barriers to application of learning to practice by workshop participants;
  • the extent to which the programme supports a move toward a trauma informed culture in Torbay services;
  • the organisational and community barriers and facilitators to supporting cultural change.  


Study design and methods 

Mixed methods will be used to answer the above aims and objectives. A survey will be administered to all trauma informed programme participants at two time points: (i) prior to commencing the programme and (ii) immediately prior to the final workshop. Semi-structured interviews will be conducted with workshop participants, organisation managers, service commissioners and workshop facilitators. Focus groups will be conducted in a world café event with workshop participants in the final workshop session.  

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<p>Checklist document in laptop and working desk<br></p>



We will administer a web based survey to workshop participants prior to the first workshop session in January 2022 and again following the final workshop session in September 2022. We aim to conduct semi-structured interviews with up to 20 workshop participants as close to the first workshop session as possible and aim to follow up the same participants with a further semi-structured interview following the final workshop session. Workshop participant interview participants will be selected to ensure inclusion of a range of participating organisations and both front line and managerial roles. Semi-structured interviews will also be conducted with up to 15 managers and five commissioners linked to participating organisations during the course of programme delivery. Programme facilitators will be invited to take part in a semi-structured interview following delivery of the programme. All programme participants will be invited to take part in a world café event following the final programme workshop.

<p>North Campus Map August 2021<br></p>