Family Trauma Service

NHS England & NHS Improvement recognise that in order to support clinical teams to reduce the use of highly restrictive interventions such as segregation with children and young people, autistic adults and adults with a learning disability, strong clinical leadership with an underlying person-centred model is critical. Time and resources to focus on individuals with their families, creating culture change and supporting staff teams as well as the individual and their family and the system requires skilled intervention. This has resulted in the development of a partnership between the NHS-Led Provider Collaboratives and the Centre for Perfect Care at Mersey Care NHS Foundation Trust to deliver the HOPES programme at scale nationally The HOPES model will consider trauma as part of the overall delivery and package of interventions, where a specific trauma need is identified the HOPES practitioner in conjunction with the HOPES clinical director and clinical team will discuss referral for individual trauma work on an as required basis. This provision and cost will be funded by the Procured Provider.

Family Trauma Work

There is evidence from families and organisations that support families of people that they are often traumatised by the experience of their son or daughter being sectioned and spending time in hospital. The whole process beginning with the removal from the family, the experiences of restraint and often segregation and seclusion to eventual discharge and transition out of hospital can be full of difficult and often traumatising actions that leave the whole family changed by the experience.

Leaving families traumatised and continuing to further traumatise them does not lead to a good outcome and can lead to very real complications in the provision of future support. There is also evidence that that families who have experienced complex trauma will need long term trauma informed psychotherapy of at least one year duration.

Alongside the delivery of the interventions to the person and the clinical team, this initiative will deliver family trauma work to those families who wish to engage. The proposal includes the offer of 44 therapeutic sessions (equivalent to one therapeutic year). The aim of the therapy would be to lessen the effect of complex trauma. This would be achieved by:

• building a trusting therapeutic relationship with the family
• enabling the family to be properly heard and understood
• normalising the trauma responses that the family are experiencing
• enabling a reality check about whether the anxiety they may still be experiencing is a valid response to what is happening in reality, or a hypervigilant response connected to previous trauma
• allowing time and space for earlier levels of trauma to surface safely and have time to be processed

The Clinical Case Manager will work in close parallel with the family's psychotherapist to ensure that any actual or perceived challenges within the system supporting the family are addressed. The role of the Clinical Case Manager is to support the family and the supportive network to be able to build more trusting relationships and to address real issues of concern where they exist.