The effects of a specialized staff training on trauma-sensitivity in professionals working with patients with a psychotic disorder: A pilot study

ABSTRACT Background Studies show that the trauma-sensitivity of professionals working with patients with psychosis is insufficient. As a result, trauma-related problems remain undetected and untreated, which may impede recovery in this group. This study explored the effects of a specialised staff training on six trauma-sensitivity factors (i.e. knowledge, credibility, expected burden, harm expectancy, diagnostic competency and organizational support), self-reported trauma-sensitive behaviour and objective indicators of trauma-sensitive behaviour in medical files. Method Professionals (N = 56) rated the six trauma-sensitivity factors and their own trauma-sensitive behaviour at pre-training, post-training and at 6- and 12-months follow-up. Changes in indicators of trauma-sensitive behaviours were assessed by a review of medical files (N = 97). Results The specialized training increased knowledge, crediblity and experienced diagnostic compentence. The training decreased burden and harm expectancies, and enhanced self-reported trauma-sensitive behaviour. However, this positive change could not be objectified by indicators of trauma-sensitive behaviour in medical files. Discussion These findings support the notion that specialised training has a positive effect on increasing trauma-sensitivity and decreasing burden and harm expectancies, but not necessarily on observable trauma-sensitive behaviour. In addition to training staff, structural implementation and organisational support are argued to be essential to attain actual behaviour change.

[1]  P. R. Fuller Psychosis, trauma, and dissociation: evolving perspectives on severe psychopathology , 2020 .

[2]  Carlton J. Fitzgerald,et al.  CHILDHOOD ADVERSITY , 2020, EDULEARN20 Proceedings.

[3]  D. V. D. van den Berg,et al.  Trauma Therapies in Psychosis , 2020 .

[4]  J. Ruzek Dissemination and implementation of trauma research findings. , 2019, Practice Innovations.

[5]  A. Aleman,et al.  Prevalence Rate and Risk Factors of Victimization in Adult Patients With a Psychotic Disorder: A Systematic Review and Meta-analysis , 2019, Schizophrenia bulletin.

[6]  Andy P. Field,et al.  Discovering Statistics Using Ibm Spss Statistics , 2017 .

[7]  M. van der Gaag,et al.  Exposing therapists to trauma-focused treatment in psychosis: effects on credibility, expected burden, and harm expectancies , 2016, European journal of psychotraumatology.

[8]  K. Trevillion,et al.  Improving mental health service responses to domestic violence and abuse , 2016, International review of psychiatry.

[9]  M. Gaag,et al.  Trauma-Focused Treatment in PTSD Patients With Psychosis: Symptom Exacerbation, Adverse Events, and Revictimization , 2016 .

[10]  C. Gillmore,et al.  Evaluation of a tailored training programme to improve the assessment and treatment of trauma in an Early Intervention in Psychosis (EIP) service , 2016 .

[11]  M. van der Gaag,et al.  Predictive validity of the Trauma Screening Questionnaire in detecting post-traumatic stress disorder in patients with psychotic disorders , 2015, British Journal of Psychiatry.

[12]  R. Murray,et al.  The impact of childhood adversity on the persistence of psychotic symptoms: a systematic review and meta-analysis , 2015, Psychological Medicine.

[13]  L. Rifkin,et al.  Transcending Bias in Diagnosis and Treatment for Women with Serious Mental Illness , 2015 .

[14]  M. van der Gaag,et al.  Prolonged exposure vs eye movement desensitization and reprocessing vs waiting list for posttraumatic stress disorder in patients with a psychotic disorder: a randomized clinical trial. , 2015, JAMA psychiatry.

[15]  Gene Feder,et al.  Disclosure of domestic violence in mental health settings: A qualitative meta-synthesis , 2014, International review of psychiatry.

[16]  Mark van der Gaag,et al.  The effects of individually tailored formulation-based cognitive behavioural therapy in auditory hallucinations and delusions: A meta-analysis , 2014, Schizophrenia Research.

[17]  L. Howard,et al.  A survey of mental health professionals' knowledge, attitudes and preparedness to respond to domestic violence , 2013, Journal of mental health.

[18]  Anna Daiches,et al.  Asking about trauma: the experiences of psychological therapists in early intervention services , 2013 .

[19]  K. Laurens,et al.  Childhood adversity in schizophrenia: a systematic meta-analysis , 2012, Psychological Medicine.

[20]  J. Read,et al.  Childhood Adversities Increase the Risk of Psychosis: A Meta-analysis of Patient-Control, Prospective- and Cross-sectional Cohort Studies , 2012, Schizophrenia bulletin.

[21]  L. Howard,et al.  The Response of Mental Health Services to Domestic Violence , 2011, Journal of the American Psychiatric Nurses Association.

[22]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[23]  L. Egede,et al.  Trauma exposure and posttraumatic stress disorder in adults with severe mental illness: a critical review. , 2011, Clinical psychology review.

[24]  P. Kendall,et al.  Training Therapists in Evidence-Based Practice: A Critical Review of Studies From a Systems-Contextual Perspective. , 2010, Clinical psychology : a publication of the Division of Clinical Psychology of the American Psychological Association.

[25]  A. Beck,et al.  Public-academic partnerships: the Beck Initiative: a partnership to implement cognitive therapy in a community behavioral health system. , 2009, Psychiatric services.

[26]  K. Restifo,et al.  Trauma and Posttraumatic Stress Disorder (PTSD) in Patients with Schizophrenia or Schizoaffective Disorder , 2009, Community Mental Health Journal.

[27]  B. Thombs,et al.  A validation study of the Dutch Childhood Trauma Questionnaire-Short Form: factor structure, reliability, and known-groups validity. , 2009, Child abuse & neglect.

[28]  Robert E Drake,et al.  The role of staff turnover in the implementation of evidence-based practices in mental health care. , 2008, Psychiatric services.

[29]  D. Goff,et al.  Posttraumatic stress disorder, cognitive function and quality of life in patients with schizophrenia , 2008, Psychiatry Research.

[30]  A. Üçok,et al.  The effects of childhood trauma in patients with first‐episode schizophrenia , 2007, Acta psychiatrica Scandinavica.

[31]  J. R. van Veldhuizen,et al.  FACT: A Dutch Version of ACT , 2007, Community Mental Health Journal.

[32]  L. Hamberger,et al.  Domestic Violence Screening in Medical and Mental Health Care Settings , 2006 .

[33]  J. Read,et al.  Mental Health Services and Sexual Abuse: The Need for Staff Training , 2006, Journal of trauma & dissociation : the official journal of the International Society for the Study of Dissociation.

[34]  J. Read,et al.  Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications , 2005, Acta psychiatrica Scandinavica.

[35]  J. Read,et al.  Sexual Abuse Inquiry and Response: A New Zealand Training Programme , 2004 .

[36]  L. Braitman,et al.  Applied Longitudinal Data Analysis for Epidemiology: A Practical Guide , 2004, Annals of Internal Medicine.

[37]  P. Meyer,et al.  Barriers to Assessment and Treatment of Posttraumatic Stress Disorder and Other Trauma-Related Problems in People with Severe Mental Illness: Clinician Perspectives , 2004, Community Mental Health Journal.

[38]  J. Read,et al.  Asking about abuse during mental health assessments: clients' views and experiences , 2002 .

[39]  E. Foa,et al.  Brief screening instrument for post-traumatic stress disorder , 2002, British Journal of Psychiatry.

[40]  J. Read,et al.  Evaluating and overcoming barriers to taking abuse histories. , 2001 .

[41]  R. Casten,et al.  Results of a domestic violence training program offered to the staff of urban community health centers. Evaluation Committee of the Philadelphia Family Violence Working Group. , 1998, American journal of preventive medicine.

[42]  J. Read,et al.  Abuse histories of psychiatric inpatients: to ask or not to ask? , 1998, Psychiatric services.

[43]  D. Charney,et al.  The development of a Clinician-Administered PTSD Scale , 1995, Journal of traumatic stress.

[44]  J. Pruitt,et al.  Routine inquiry into sexual victimization: A survey of therapists' practices. , 1992 .

[45]  S. Eisen,et al.  The reliability of abuse history reports: a comparison of two inquiry formats. , 1991, Comprehensive psychiatry.

[46]  J. Briere,et al.  Sexual abuse histories and sequelae in female psychiatric emergency room patients. , 1989, The American journal of psychiatry.

[47]  S. Briggs,et al.  The role of factor analysis in the development and evaluation of personality scales , 1986 .