Training and research
The Institute of Recovery from Childhood Trauma continuously monitors and review the latest research and this is disseminated through our forums and communications to members. We also undertake our own research and this section displays our current research activity along with the lead researcher. Here at the Institute we are always looking for partners to collaborate with both in and out of academia. If you have an idea or proposal for research that has a clear aim to aid recovery from childhood trauma, please get in touch.
The proposed research on trauma recovery core competencies for the children’s workforce in the United Kingdom
Background and Rationale
Over the last twenty years advances in science have helped us better understand the devastating impact of trauma on young children. The impact of severe abuse, neglect, witnessing violence, and chronic exposure to stress have on early childhood brain development has been demonstrated using new neuro-imaging technology (Perry, 2000; 2005; Shonkoff, & Phillips, 2000; Tronick, 2007). Coupled with this research is the landmark Adverse Childhood Experiences Study (ACE) which confirmed that early exposure to negative childhood experiences leads to lifelong, debilitating mental and physical health problems, and ultimately, early mortality (Anda, et al., 2006; Felitti, et al., 1998).
Although progress has been made in what we know about the impact of trauma on early childhood development, there remains a significant gap between what we know and what we do. We at the Institute of Recovery from Childhood Trauma (IRCT) are committed to working to close that gap. An important ingredient in closing this gap is having a workforce that is knowledgeable about trauma and its impact on development and that can employ skills and strategies to support recovery in these children.
In order to develop the children’s workforce’s knowledge and skills in supporting children to recover from the trauma and neglect they have experienced the IRCT is working on developing a set of core competencies for the workforce that are attachment aware, trauma informed and recovery focused. Currently, although there are trauma informed competencies developed in the USA (Child Welfare Committee, National Child Traumatic Stress Network, 2008; The Multiplying Connections Initiative, 2008) and Australia (Queensland Government, 2013) there are none specifically developed for the workforce in the United Kingdom.
The intention is that once developed these competencies will guide workforce development activities including training, curriculum development, and professional standards. The intention of these competencies is that the children’s workforce shares a common base of knowledge, attitudes and values that are attachment aware, trauma informed, and focused on recovery for the child.
In 2015, the IRCT in collaboration with Canterbury Christ Church University embarked on this process to define a set of core knowledge, attitudes, values and skills competencies that children’s services professionals need in order to provide attachment aware, trauma informed and recovery focused care for traumatised children.
Procedure and Methodologies
To address the aims of the study most effectively (to develop an agreed upon set of core competencies) the research methodology needed to be able to do the following:
- To include an adequate number and diversity of people who work in the field of childhood trauma;
- to explore the opinions, experience and therapeutic practice of childhood trauma experts;
- to establish patterns of commonality and difference among the participants;
- to reduce the subjective influence of the researcher as far as possible;
- to include a range of sources in the study; to have a proven record of methodological ‘robustness’.
To accomplish the above, the research design had two parts, a Delphi poll and Q methodology, with the study being framed primarily around Q methodology. Using a Delphi poll and Q methodology will combine qualitative and quantitative methods to explore UK Trauma Experts views on the core competencies needed to support traumatised children to recovery.
To begin the process a literature review was undertaken and experts in the field of trauma recovery were interviewed. Based on this data a list of possible competencies was generated. To further refine this rather long list of skills, knowledge, values and attitudes a Delphi Poll and a Q-sort will be undertaken.
The competency statements derived from the literature have been piloted with a Delphi panel of experts to identify a series of statements they feel relate to recovery practice with traumatised children. The Delphi poll was adapted for this process following the lead of Wallis, Burns, & Capdevila (2009). Usually there are three components (Prochaska, and Norcross, 1982) but this was adapted to two, in order to better fit with a mixed methodology. Delphi panel members were asked to rate each statement according to whether they agreed, disagreed, were uncertain about the statement or found the statement unclear or inappropriate. As this process was being used to develop an agreed upon set of competencies consensus statements (to indicate agreement) were kept and statements that provoke disagreement or inappropriateness were excluded while information about statements that lacked clarity was sort from the panel. Attachment 1 has the Delphi Poll developed from the literature.
A wider group of trauma recovery experts will then rank the statements using a Q sort and make qualitative comments on their sorting. Quantitative methods (principal component analysis) will be used to extract the core competencies needed by the workforce.
Q methodology (van Exel and de Graaf, 2005) is suited to aims of this study as it aims to identify and describe a range of shared stories or discourses among participants (Curt, 1994). In the Q sort, participants arrange cards of statements about a topic into a predetermined grid, ranking them according to a scale according to a specific instruction. In this study participants sorted statements about narrative therapy according to those that were ‘most important to their perspective’ and ‘least important to their perspective’. Q methodology focuses on the meanings people make or ‘constructions’ of a topic rather than the ‘constructors’ (participants). This focus means that Q methodology is suited to topics that are socially contested or debated (Stainton Rogers, 1995).
Q methodology offers a “unique form of qualitative analysis” (Watts & Stenner, 2005, p.71). It does not reduce data into themes; rather it shows the ‘primary ways in which these themes are being interconnected or otherwise related by a group of participants’ (Watts & Stenner, 2005, p.70). Moreover, Q methodology identifies “the range of viewpoints that are favoured (or which are otherwise ‘shared’) by specific groups of participants” (Watts & Stenner, 2005, p.71). The Q-methodology will be administered both face-to-face and online so as to increase the possible sample. Snowball sampling will be utilised to further increase the sample (Brace-Govan, 2004).
If you are willing to participate and feel that you are able to contribute towards this research, the Q-sort should take you about 20 minutes to complete. It happens in 2 stages. The first stage asks you to sort the 42 statements into whether you think the statements are most important, which are least important and about which you feel neutral or unsure about. The second stage asks you to rank the 42 statements on a grid along a continuum from least important over neutral to most important. We realise that all of the competencies listed are important (and have been cited as such in the literature or through interviews with experts in the field), however we need to be able to pull together what professionals and practitioners in the field feel are the key competencies the children’s workforce needs to promote recovery from trauma in children.
In order to participate, please follow the link below and then click on “Questionnaire survey Alex Hassett”.
Anda R, Felitti V, Bremner D et al (2006) The enduring effects of abuse and related adverse experiences in childhood: a convergence of evidence from neurobiology and epidemiology, European Archives of Psychiatry and Clinical Neuroscience, 256, 174-186
Brace-Govan, J. (2004) Issues in snowball sampling: The lawyer, the model and ethics. Qualitative Research Journal, 4(1), 52.
Brown, S. R. (1980) Political subjectivity: Applications of Q-methodology in political science. New Haven: Yale University Press.
Child Welfare Committee, National Child Traumatic Stress Network. (2008). Child welfare trauma training toolkit: Comprehensive guide (2nd ed.). Los Angeles, CA & Durham, NC: National Centre for Child Traumatic Stress.
Curt, B. C. (1994) Textuality and Tectronics. Troubling social and psychological science. Buckingham: Open University Press.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D.F., Spitz, A. M., Edwards, V., Koss, M.P., et al JS. (1998) The relationship of adult health status to childhood abuse and household dysfunction. American Journal of Preventive Medicine, 14, 245-258.
Perry, B. D. (2002). Childhood experience and the expression of genetic potential: What childhood neglect tells us about nature and nurture. Brain and Mind, 3(1), 79-100.
Perry, B. D. (2005) Maltreatment and the developing child: How early childhood experience shapes child and culture. The Inaugural Margaret McCain lecture (abstracted); McCain Lecture series, The Centre for Children and Families in the Justice System, London, ON, https://childtrauma.org/wp-content/uploads/2013/11/McCainLecture_Perry.pdf
Prochaska, J. and Norcross, J. (1982) The future of psychotherapy: a delphi poll. Professional Psychology, 13, 620-627.
Queensland Government (2013) Calmer Classrooms: A guide to working with traumatised children. http://education.qld.gov.au/schools/healthy/pdfs/calmer-classrooms-guide.pdf
Shonkoff, J. P., & Phillips, D. A. (2000). From neurons to neighborhoods. The science of early childhood development. Retrieved from http://www.nap.edu/openbook.php?isbn=0309069882
Stainton Rogers, R. 1995: Q Methodology. In Smith, J. A., Harre, R. and Van Langenhove, L., editors, Rethinking methods in psychology. London: Sage.
The Multiplying Connections Initiative. (2008). Trauma informed & developmentally sensitive services for children. Core competencies for effective practice. Philadelphia, PA: Health Federation of Philadelphia.
Tronick, E. (2007) The neurobehaviourial and socio-emotional development of infants and children. New York: Norton
Van Exel, N.J.A.; and de Graaf, G. 2005. Q methodology: A sneak preview. http://www.qmethodology.net/PDF/Qmethodology%20-%20A%20sneak%20preview.pdf .
Wallis, J., Burns, J., & Capdevila, R. (2009). Q Methodology and a Delphi poll: a useful approach to researching a narrative approach to therapy. Qualitative Research in Psychology, 6(3), 173-190.
Watts, S. and Stenner, P. 2005: Doing Q methodology: theory, method and interpretation. Qualitative Research in Psychology, 2, 67-91.
Dr Alex Hassett