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Trauma-informed services: placing survivors at the heart of care

This week saw the launch of a groundbreaking and vital new specialist health service in Glasgow for survivors of sexual violence.

The My Body Back project, which is based at the Sandyford Centre in Glasgow, is an excellent example of the way that when services are ‘trauma-informed’ [increasingly a focus for health and support services in Scotland, as well as for workplaces more generally and recognised through support from the Scottish Government] they can far more effectively meet the needs of survivors of sexual violence (as well as others who have undergone traumatic experiences) than many mainstream services do. My Body Back embodies within the services it offers the recognition that many survivors of sexual violence can for a number of reasons, face difficulties in accessing health services and screenings, because of what they have experienced.

Intimate procedures such as smear tests, for example, can be very difficult for survivors to contemplate, so constructing a service based on survivor consultation and focused on centring their needs, while maximising available support throughout, can make an enormous difference to individuals contemplating this vital health check. Pavan Amara, a survivor herself who founded ‘My Body Back’ in London in 2015 said ‘I started My Body Back after I was raped myself, and found there were no services for how awful being raped left me feeling about my physicality. There was a lot of emotional support, but zero support that recognised how being raped had hugely affected my body image, and how terribly I felt about it afterwards. This left me with lots of problems, but no support services to deal with it. So, I started the project myself, to help other women who I know are experiencing the same problems.’

Building on NHS Education for Scotland’s Trauma Knowledge and Skills framework around which a great deal of work has been done, and also ACES – Adverse Childhood Experiences, trauma-informed services are those which build on the experiences of survivors, and place their needs place right at their heart at every stage from the design of a service all the way through to the detail of its delivery, including staff training, appointment times, production of written materials and other factors. These are services which prioritise the needs of their users above convenience to the service, or a demand that users should have to accommodate and fit into that.

‘We want people to change the way they think about people’s difficulties and ask not “what’s wrong with you?” but “what has happened to you?” This approach fits well with our increasing understanding of the broader impacts for individuals and society of adverse childhood events (ACE’s).There is emerging evidence that trauma informed systems can have better outcomes for people affected by trauma. This evidence based framework involves recognising the need for trauma related knowledge and skills across the whole workforce, not just for those with a remit to respond directly to the needs of those affected by trauma.’ [Maureen Watt MSP, Minister for Mental Health]

Crucially, this approach is committed to overcoming the barriers that individuals who have experienced trauma can face when accessing the care, support and treatment they need. The starting point for services, in order that this can happen and that they deliver services safely and effectively, is a recognition that trauma is common, and that its many impacts can affect people in very different ways. Many of these people also need additional, trauma-specific interventions, in order to aid their recovery.
Absolutely key to the delivery of services which are trauma-informed is the need to resist re‑traumatisation by ensuring that they are delivered safely and in line with the following key principles:

· choice

· collaboration

· trust

· empowerment

· safety

Inevitably, an important feature of trauma-informed practice is partnership working – e.g. statutory services working in partnership with rape crisis and other voluntary sector services. Emotional support at the My Body Back service at the Sandyford, for example, is provided by Glasgow and Clyde Rape Crisis Centre. If you are (or if someone you know is) a survivor wanting to book an appointment for a smear test at the new specialist clinic (which opens in Glasgow this weekend) you can do so online at http://www.mybodybackproject.com/book-clinic-appointment/

Media coverage of the launch of My Body Back in Glasgow:

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