Developing trauma-responsive organisations

Karen Treisman presents a wealth of information and resources to develop 'adversity, culturally, and trauma-informed, infused and responsive practice, at a whole-system organizational level' (p.135). Across two volumes, Treisman covers the what, why and how of trauma informed services. With theory, baseline assessment guidance, values, and the application of ideas into practice with reflective exercises, full-page visuals and worksheets, Treisman guides organisations to identify their individual needs.

The theoretical and ideological grounding is in narrative approaches, compassion focussed and community psychology, culture and politics, e.g., quoting authors and political ethicists. Treisman's language consistently humanises organisations as 'live' systems of people, and she models a non-judgemental curious lens. She promotes evaluation and evidencing real and meaningful change in people's lives. 

Treisman's analogy of a trauma river frames the process of change as a journey where learning and practices develop. She offers a stage-like developmental frame; moving from trauma sensitive, trauma aware, trauma informed and trauma responsive, whilst acknowledging that the process is more than a linear progression between points along a river. She emphasises a river's differences, in depth or width, places where it moves fast and slow, runs clear or cloudy. An organisation will not be in the same point along the river for all areas of practice, eddies or boulders can impede its flow, and external influences like the weather have an effect. Whilst the analogy isn't a perfect fit, I like the scope for creative thinking. 

Treisman returns to her emphasis on humanising organisations: a river is made of millions of individual water droplets, and every drop together make the river what it is. She acknowledges the bravery of services engaging in these reflections, and as with other mentalization-based approaches, safety and epistemic trust are central. Treisman stresses the importance of meeting an organisation where it is at. Only once an organisation can support the people within it to regulate and relate, can they step onto the riverbank, the position affording greatest reflection.

This book seems especially relevant now. As the jaws of the Covid crocodile loosen their grip on organisations, they have potential to become less reactive and recover their reflective capacity. The baseline assessment allows them to ask, 'what is happening in our organisation?' and identify a realistic vision of 'what do we need to prioritise?' The resources have much potential for creative application, but might benefit the development of peer support networks for those working through it.

- Reviewed by Dr Jo Kirk, Chartered Clinical Psychologist in CAMHS, Fostering and Adoption