Trauma-Informed Care on mental health wards: the impact of Power Threat Meaning Framework Team Formulation and Psychological Stabilisation on self-harm and restrictive interventions

• Published in: Frontiers in psychology Vol. 14; p. 1145100
• Main Authors: Nikopaschos, Faye, Burrell, Gail, Clark, Jordan, Salgueiro, Ana
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 08-06-2023
• Subjects: Power Threat Meaning Framework (PTMF); Psychology; restrictive intervention; seclusion; self-harm; stabilisation; Trauma-Informed Care (TIC); seclusion; Trauma-Informed Care (TIC); Power Threat Meaning Framework (PTMF); restrictive intervention; inpatient; self-harm; restraint; stabilisation
• ISSN: 1664-1078; 1664-1078
• DOI: 10.3389/fpsyg.2023.1145100

The aim of this evaluation was to assess the impact of introducing a model of Trauma-Informed Care (TIC), comprising weekly Power Threat Meaning Framework (PTMF) Team Formulation and weekly Psychological Stabilisation staff training, to a National Health Service (NHS) adult acute inpatient mental health unit over a four-year period.
A retrospective service evaluation design was employed to assess for differences in the number of incidents of self-harm, seclusion and restraint in the four-year period following the introduction of TIC, when compared to the year prior.
Significant reductions were demonstrated in the monthly number of incidents of self-harm (
< 0.01; r = 0.42), seclusion (
< 0.05; r = 0.30) and restraint (
< 0.05; d = 0.55) following the introduction of TIC.
Findings suggest that PTMF Team Formulation and Psychological Stabilisation training can contribute to significant reductions in self-harm and restrictive interventions (seclusion and restraint) on adult mental health wards. Qualitative interviews with staff and service users from the unit will support a better understanding of the mechanisms of this change. Further research, employing a randomised control trial design, could increase the validity and generalisability of findings. However, the ethical implications of withholding potentially beneficial practices from a control group would need to be considered.