913 Trauma-informed care for children and young people who have been trafficked: from theory to practice

• Published in: Archives of disease in childhood 2021-10, Vol.106 (Suppl 1), p.A159-A160
• Main Author: Boutros, Sarah
• Format: Article
• Language: English
• Subjects: Abstracts; Birth weight; Children; Children & youth; Embryology; Human rights; Human trafficking; Interviews; Mortality; Palliative care; Pediatrics; Population; Reproductive technologies; Semi Structured Interviews; Siblings; Slavery; Training; Trauma; Young Adults
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2021-rcpch.277

BackgroundModern slavery human trafficking is a human rights violation and a crime affecting millions of children and young people (CYP) around the globe. Research suggests a high prevalence of physical and mental health consequences from the trauma experienced, with potentially profound neuro-developmental and life-long health consequences for survivors. Trauma-informed care (TIC), which aims to meet the complex and unique needs of trauma survivors, is suggested as a way of working with trafficked CYP. However, little research exists on the particular needs of trafficked CYP and how to implement TIC to best address their needs.ObjectivesThis study aimed to understand current TIC practices for CYP who have been trafficked and to contribute to the evidence base regarding strategic care provision for trafficked CYP.MethodsTwelve experts working with trafficked CYP from a variety of professions were interviewed on their experiences of using TIC in practice. The semi-structured interviews included four main sections: (1) Defining trauma-informed care, (2) Participant’s background, (3) Sharing a story of an anonymised case illustrating good quality TIC in practice with a trafficked CYP, (4) Reflections and vision for the future. A thematic analysis of the data was then undertaken to gain a deeper understanding of TIC in practice. Particular attention was paid to ensuring confidentiality of the CYP whose stories were being shared throughout the interviews.ResultsAnalysis of the data suggested 4 key themes, each with several sub-themes, as detailed below:(a) TIC starts with a holistic understanding of human trauma that includes understanding trauma and how it manifests, understanding CYP specific needs, and professionals seeing and hearing CYP.(b) TIC is primarily a relational model of care. Safety is a prerequisite to building a trusting relationship between provider and CYP, giving choices and collaborating with CYP helps give them back control, time is needed to build these relationships, and empowering trafficked CYP through a strength-based approach is key for recovery.(c) For TIC to be effective the whole system needs to be trauma-informed as currently the system causes a lot of re-traumatisation. A trauma-informed system would work collaboratively and training would need to be an integral part of that system.(d) The foundations of TIC already exist in current care practice. It is a model of care that is CYP-centred, holistic, and compassionate. Creating TI