Trauma-Informed Care for Young People with Intellectual Disabilities: Perspectives of Residential Support Workers

Background: The long term, serious impact of trauma on health and wellbeing has been extensively researched in the general population, however, it is only recently that people with intellectual disabilities have begun to be represented in trauma literature and very few studies have considered young people with intellectual disabilities specifically. Young people with intellectual disabilities are more likely to experience trauma, compared to the general population and those living in residential care are particularly at risk. Evidence of the need for multi-systemic, trauma-focussed intervention has been provided. Residential support workers make up a key part of the system around young people with intellectual disabilities in residential care and accessing their views and experiences may be crucial for the development and implementation of trauma-focussed initiatives.

Aims: This research aimed to explore how residential support workers understand and respond to trauma in young people with intellectual disabilities, alongside barriers and facilitators to support, with view to understanding how to upskill services in trauma-informed practice.

Method: Semi-structured interviews took place with ten residential support workers from nine organisations, eight were recruited via social media and two through their organisation. Participants were two males and eight females, and experience ranged from 1.8 to 15 years. Reflexive Thematic Analysis was employed.

Results: Analysis generated three themes: ‘Trauma in the system’, ‘Recognising, Responding and Resistance to Trauma’ and ‘More Than a Job’, within which nine subthemes were generated.

Conclusions: Residential support workers of young people with intellectual disabilities described working within a system which causes and perpetuates harm at various levels. They demonstrate a broad knowledge of the prevalence and impact of trauma on this population and described a particular focus on attachment as key for the young people they support. Findings highlighted the need for staff support, trauma-focussed training, and systemic change, including the consideration of trauma-informed care by residential organisations, intellectual disability services and within policy.