Exploring principles of trauma-informed care to strengthen service delivery for parents of children with complex support needs

Parents of children with complex support needs can experience multiple traumatic events which are ongoing and highly stressful. Extended exposure to trauma has adverse consequences on physical and mental health leaving parents at high risk of developing complex trauma. To support all parents and promote their wellbeing it is therefore critical that care systems, organisations and service delivery approaches are trauma-aware and trauma-responsive. 
This qualitative multimethod study involved a specific, government funded parent support program delivered by a Child and Family Service in regional Victoria, Australia. An organisational and program document analysis was undertaken along with interviews (n = 11) with parents and practitioners. Principles of trauma-informed care were used as a framework in deductive content analysis to identify the promotion or constraint of these core principles. Findings reveal trauma-informed care was promoted for parents during interactions with practitioners from the specific Program through relational strategies such as, listening to parents and believing them. Frequent constraints were identified during interactions with the wider service system and workforce members external to the program. These potentially trigger or exacerbate parent trauma. Additionally, situations were identified related to positive and negative impact for all practitioners. 
Data synthesis highlighted that although trauma-informed care was not explicitly stated as an approach by the organisation or in Program service delivery it was alluded to within strength-based organisational values and Program documented practices. This was identified as a tension for the organisation as by avoiding language with implied deficit connotations this could lead to a failure to explicitly acknowledge trauma and its consequences. 
The study provides insights about trauma-informed service delivery and practical ways trauma-informed care manifests in real-world practice. The findings are useful for decision makers developing organisational policies, in the design of education and training, and for practitioners seeking to understand and actively implement trauma-informed care. 
Keywords: child and family services, parent complex trauma, principles of trauma-informed care, regional Australia, trauma-informed service delivery.