Trauma-Informed training and service redesign

What is it?

Trauma occurs when an event or set of circumstances causes physical and/or emotional harm which leads to lasting adverse effects on wellbeing. Research on trauma has often focused on Adverse Childhood Experiences (ACEs). ACEs are a set of negative childhood experiences. ACEs can include experience of abuse or neglect, having a close family member in prison, or witnessing violence in the home. These experiences can affect a child’s development and may increase the risk of becoming involved in crime or violence.

This summary focuses on trauma-informed training and service redesign whose primary aim is to improve how organisations and staff understand the impact of trauma, recognise its signs, and adapt how services engage with children and young people to prevent retraumatisation. The summary does not include specialist therapeutic interventions designed to support recovery from trauma such as trauma-specific therapies, or broader programmes where trauma is only one part of the approach, for example, some anti-bullying programmes.

Trauma-informed training and service redesign usually involves a combination of staff training and making changes to services and policies that guide them. It is often delivered as a whole-service or multi-agency approach, for example across schools, youth services, social care, and youth justice. In practice, this means supporting organisations and their staff to:

• Realise the impact that trauma can have on children;
• Recognise the signs and symptoms of trauma;
• Respond to trauma by integrating knowledge and research on trauma into policies, procedures and practices; and
• Prevent retraumatisation by avoiding practices that could inadvertently trigger painful and traumatic memories.

Most approaches focus on workforce development, for example by:

• training staff on the impact of trauma and how to recognise it.
• building skills to respond effectively and reduce re-traumatisation.
• supporting staff wellbeing and addressing secondary trauma.

Some approaches also include wider service redesign, such as:

• updating policies and procedures to reflect trauma-informed principles.
• adapting environments to improve safety and reduce potential triggers.
• introducing screening or assessment tools to identify trauma-related needs.
• improving access to specialist support for children and young people.

Trauma-informed training and service redesign may reduce violence by improving practitioners’ understanding of how trauma affects children and young people’s behaviour and development. This can help reduce practices that may retraumatise children and young people and improve their sense of safety, trust, and engagement with services. At the same time, changes to organisational policies, environments, and systems can create more predictable and supportive settings, improve identification of needs, and increase access to appropriate support. Together, these changes aim to strengthen relationships, support emotional regulation, and reduce behaviours associated with violence and offending.

Although not primarily designed to prevent violence, the approaches are widely used within violence prevention strategies and are included in this Toolkit to reflect current practice.

Is it effective?

The research suggests that, on average, the impact of trauma informed training and service redesign on preventing violence is likely to be low.

Trauma-informed training and service redesign approaches were also found to have a small desirable positive impact on staff knowledge and attitudes towards trauma-informed approaches, but had no effect on children’s other outcomes, including behavioural difficulties, regulating their emotions, and mental health.

How secure is the evidence?

We have moderate confidence in our estimate of the average impact of trauma informed training and service redesign on violence.

We gave this rating because our estimate is based on 4 studies that we rated as high-quality research designs. All 4 studies were undertaken in the UK.

The studies that produce the impact rating on violence assessed the effectiveness of these approaches for 12,739 children and young people.

Who does it work for?

The review did not find any studies that explored the impact of trauma-informed training and service redesign on age, disability, neurodivergence or care experience.  Two studies conducted in the UK explored the impact of the approaches on gender, ethnicity, socio-economic status and SEND, and found no differences in impact.

How can you implement it well?

Evidence related to implementation of trauma-informed training and service redesign is based on 14 studies. Of these, 13 studies were conducted in the UK, and one study was conducted in the US.

Establish and communicate core principles for trauma-informed approaches

Delivery should begin with a clear articulation of what constitutes high-quality trauma-informed practice, including core principles, expectations for delivery, and how these translate into day-to-day interactions.

Embed trauma-informed approaches across the whole system

Trauma-informed approaches should be embedded across organisational structures, policies, and partnerships. Strong leadership is essential to align systems, allocate resources, and sustain implementation, ensuring trauma-informed practice becomes part of everyday service delivery. This can be a resource-intensive process and organisations should plan for the necessary time, funding, and staff capacity from the beginning.

Deliver training that focuses on changing practice

Deliver practice-oriented training for staff to improve understanding and to lead to real changes in practice. This can be through facilitated discussions, self-reflection activities, and collaborative learning opportunities.

Build strong and trusting relationships through flexible and responsive engagement

Build strong, consistent, and trusting relationships with children and young people by responding flexibly to their individual needs, developmental readiness, and priorities. Adapt delivery approaches to address immediate emotional, developmental, and practical challenges, and use community-based and activity-focused environments to promote engagement, while maintaining core trauma-informed principles throughout. These approaches may increase demand on staff, so prioritise sufficient staffing to minimise staff burnout, turnover and competing pressures.

Promote trauma-informed multi-agency integration and shared practice

Prioritise services working together across education, mental health, social care, housing, youth justice and voluntary services to deliver a consistent trauma-informed approach. Agencies should use shared trauma-informed language, aligned practices, and clear communication, supported by joint training and integrated working, to improve access to services and provide more consistent support.

Make trauma-informed approaches equitable and accessible

Prioritise equitable access from the outset to reach and engage children and young people with complex, multiple needs, including those who are underserved by traditional services or fall below statutory thresholds.

How much does it cost?

On average, the cost of trauma-informed training and service redesign is likely to be moderate.

Cost estimates from current UK programmes suggest an average cost of £196 per child, for example for programmes delivered in schools, up to £5,980 per child for intensive targeted programmes.

Costs usually involve workforce training, supervision, intervention delivery, leadership involvement, and multi-agency collaboration.

Topic summary

• Trauma-informed training and service redesign aims to improve how organisations and staff understand and respond to the impact of trauma on children and young people, and to prevent re-traumatisation. It often combines workforce development with wider organisational change, including reflective supervision, leadership support, and improvements to how services work together.
• Trauma-informed training and service redesign is estimated to have a low impact on reducing violence. The research suggests that this approach may reduce violence by 6%. We have moderate confidence in this estimate because it is based on 4 high-quality studies.
• On average, the cost of trauma-informed training and service redesign is moderate, but costs vary greatly depending on the interventions provided. 

Take away messages

• All systems working directly with children should operate in ways that acknowledge trauma and the impact it can have on children.
• Practitioners should be curious about the causes of children’s behaviour, and develop strong, trusting relationships with children to support them.
• If your main goal is to reduce violence, cautiously consider whether you can deliver trauma-informed training and service redesign that is intensive enough to change outcomes for children. One-off training programmes are unlikely to shift practice.
• Ensure children with experience of trauma are offered appropriate support, including evidence-based interventions such as trauma-specific therapies.

What programmes are available?

Fostering Connections

Fostering Connections aims to strengthen communication between social workers, improve support for foster carers, and embed trauma-informed practice to reduce emotional and behavioural difficulties among children aged 10–17 in family-based foster care or supported lodgings.   

More Good Days at School (MGDAS)

More Good Days at School (MGDAS) aims to use whole-school trauma-informed training and support for staff to improve children’s behaviour and wellbeing.

Relationship Building Together (RBT)

The programme, developed by the Trauma Recovery Academy and Bridgend Council, provides three to five days of training and support to practitioners across multiple services. Services involved include early support (e.g. Early Help Hubs and Youth Development), targeted prevention and family support (e.g. Edge of Care Services), and Youth Justice Services.

Trauma Informed Schools UK (TISUK)

The Trauma Informed Schools UK (TISUK) training and implementation programme aims to improve pupils’ wellbeing and behavioural difficulties and overall school culture by supporting secondary schools to adopt a whole-school, trauma-informed approach.

External links

Trauma informed practice: learning from experience

This document shares practice among violence reduction units (VRUs) and with sector partners for implementing programmes to develop and embed trauma-informed practice (TIP).

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