Trauma Informed Care Training: A Theory-Driven Qualitative Evaluation and Recommendations for Improvement.

IntroductionTrauma-informed care (TIC) has been promoted as a way for services to be aware and respond to the potential impact of trauma. Although professionals are encouraged to adopt it in routine practice, understanding of TIC is often unclear. A TIC training provider sought advice how to improve training for professionals working with children and adolescents.MethodThis qualitative study explored participants' understanding of TIC after being trained, experiences of barriers and facilitators to implementing TIC, and recommendations to improve training. Nine professionals from health, social and education services completed semi-structured interviews. Participants varied in age and experience but lacked ethnic and gender diversity.ResultsA model of behavior change (COM-B: capabilities, opportunities, motivation, behavior) guided analysis. Participants described an understanding of TIC consistent with current guidelines, with some divergence regarding responsibility for using TIC and the conceptualization of trauma. Facilitators and barriers to TIC implementation were shaped by these perceptions. Some barriers could be addressed through training, while others require more systemic change, (e.g. shared TIC language; increased resources). Suggested training improvements included clarifying definitions and roles, increasing hands-on practice, and training of supervisors.DiscussionFindings offer theory-driven contributions to the evidence-base of TIC understanding, facilitators and training improvement.