Making trauma-informed care happen in the real world: Where are we and where next?

We now know that childhood adversities are associated with psychosis, and empirical evidence investigating the causal mechanisms underlying this association is accruing (Bentall et al, 2014; Gibson et al, 2016; Varese et al,... [ view full abstract ]

We now know that childhood adversities are associated with psychosis, and empirical evidence investigating the causal mechanisms underlying this association is accruing (Bentall et al, 2014; Gibson et al, 2016; Varese et al, 2012). People with psychosis are also at an increased risk of revictimisation and are more likely to experience a range of post-traumatic stress difficulties. In line with these findings, NICE (2014) recommend that trauma and Post-traumatic Stress Disorder (PTSD) are routinely assessed in people with psychosis, and therapy offered when indicated. Unfortunately, it is rare for traumatic experiences and post-traumatic stress to be recognised in psychosis services, preventing access to psychological treatments. The challenge is to effectively disseminate trauma-informed practice within frontline services and ensure people’s needs are met. This symposium will reflect on progress and challenges in the area, illustrating our current theoretical understanding, clinical trial evidence, routine service developments and the survivor perspective. Filippo Varese will first provide an overview of research highlighting the complex and multiple pathways from trauma to psychosis. David van den Berg will present the results of a large randomised controlled trial of trauma-focused therapy for PTSD in psychosis. A mini-documentary, produced by a filmmaker with lived experience of psychosis, will showcase four service users’ experiences of the trial therapy and its impact on their recovery. Amy Hardy will describe service initiatives aiming to implement and build on these research findings in the psychosis services of the South London & Maudsley NHS Foundation Trust. Eleanor Longden will reflect on issues from the survivor perspective and what is needed to make real change happen.