What is it about?

Support staff who work with adults with learning disabilties can find it difficult to understand their psychological needs. We receive high numbers of referrals to our Mental Health of Learning Disabilities service for people who are survivors of trauma: some of whom may have a diagnosis of Personality Disorder. Often the staff and others involved in their care are worried about high levels of risk: to the person themselves, and to others. Sometimes the referred person can engage in psychological therapy, but sometimes they are not able to. In either case it is important that the staff who support them every day better understand their attachment needs. We developed a training programme to help staff understand how childhood trauma has an ongoing effect in adulthood. This training programme helps staff better understand and meet emotional needs of the adults with learning disabilities whom they care for.

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Why is it important?

Trauma Informed Approaches are becoming used in a wide range of settings. Support services for adults with learning disabilities tend to focus more on Positive Behavioural Support (PBS). Whilst PBS approaches are important, this can often result in the impact of childhood trauma being overlooked. One important aspect of the role of support staff is to provide care within an attachment framework. However often there is a denial of this aspect of the role, as the emphasis is on maximising independence. This can result in the attachment needs of service users being overlooked. This training aims to help staff reflect on their experiences at work to inform their understanding of their relationships with people they support. We help staff deconstruct the term "Personality Disorder" and understand needs in the context of trauma. We are developing qualitative and quantitative research projects to look at the effectiveness of this approach. We are hoping to look at whether this training may prevent placement breakdown in some circumstances, and possibly also reduce staff burnout.


It has been a privilege to develop and deliver this training, and to hear the powerful stories from support workers about their demanding, and often emotionally painful work. The feedback we have had has been very positive. After attending the training staff teams have been able to provide a trauma-informed service to provide safety and stability to adults with learning disabilities, who have previously had lots of placement breakdowns due to risk issues, which in turn can result in further trauma to staff as well as to those they support.

Emma Rye
NHS Providers

Read the Original

This page is a summary of: Developing trauma-informed care: using psychodynamic concepts to help staff respond to the attachment needs of survivors of trauma, Advances in Mental Health and Intellectual Disabilities, June 2021, Emerald,
DOI: 10.1108/amhid-12-2020-0033.
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