The implementation and effect of trauma-informed care within residential youth services in rural Canada: A mixed methods case study

Psychol Trauma. 2018 Nov;10(6):666-674. doi: 10.1037/tra0000327. Epub 2017 Oct 9.


Objective: The prevalence and associated risks of trauma have led youth-serving institutions to adopt trauma-informed care (TIC). A limited research base has linked TIC with improved outcomes. Associations between TIC and vicarious traumatization (VT) are even less commonly studied. The purpose of this case study is to evaluate the implementation and effect of TIC within 1 residential youth services division in rural Canada using the curriculum-based Risking Connection (RC; Saakvitne et al., 2001) and Restorative Approach (RA; Wilcox, 2012) trauma training programs, with a focus on VT.

Method: We used an explanatory sequential mixed methods design and a participatory action research approach to evaluate the implementation and effect of RC and RA. Study 1, the quantitative program evaluation, used a prepost design to evaluate the effect of RC and RA on staff. Study 2, the qualitative study, used participant observations and interviews to develop a deeper understanding the quantitative findings.

Results: This study replicated previous findings that RC improves attitudes favorable to TIC but found that staff experience of VT increased after TIC training. Qualitative findings suggested that the division was successfully implementing TIC and that increased awareness and discussion of VT were potentially responsible for increases in VT scores.

Conclusions: This case study documents improvements in staff attitudes favorable to TIC post-RC and RA and presents an in-depth analysis of TIC implementation. The study also highlights the complicated relationship between TIC implementation and staff experience of VT. Finally, this study provides a blueprint for conducting program evaluations of TIC. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel
  • Canada
  • Child
  • Child Health Services*
  • Female
  • Health Personnel / psychology
  • Humans
  • Male
  • Middle Aged
  • Program Evaluation
  • Qualitative Research
  • Residential Treatment* / education
  • Residential Treatment* / methods
  • Rural Health Services*
  • Stress, Psychological / therapy*
  • Young Adult