Childhood trauma and trauma-informed care in early intervention in psychosis

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Date
2024
Authors
Hunt, Evan
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University College Cork
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Abstract
This doctoral thesis explores the integration of Trauma-Informed Care (TIC) within Mental Health Services (MHS) and examines the prevalence and impact of childhood trauma in individuals experiencing First-Episode Psychosis (FEP). Through a systematic review, the research identifies core principles and practices of TIC in MHS, leading to the development of a framework that encompasses therapeutic environment, sociocultural responsiveness, and workforce development, providing a blueprint for operationalising TIC within mental healthcare. Building on this foundation, an empirical study establishes the demographic and clinical profile of service users accessing an Early Intervention in Psychosis (EIP) service in Ireland. Findings reveal the complex and diverse needs of the population, including significant gender differences in age of onset, substance use, and functional impairments, emphasising the necessity for tailored interventions in EIP services. Further research investigates the prevalence of childhood trauma among FEP service users, revealing a high rate of trauma exposure (78%), with emotional abuse and neglect being most common. Gender differences were also found, with females reporting higher severity and cumulative trauma. These findings highlight the importance of integrating trauma-informed approaches into EIP services to address the multifaceted needs of individuals with psychosis. Finally, the thesis examines the longitudinal impact of childhood trauma on clinical outcomes in FEP. While trauma severity was linked to self-harm, it did not significantly affect other baseline clinical characteristics. Over the course of 12 months of treatment, significant improvements in symptomatology and functioning were observed, regardless of trauma history, highlighting the effectiveness of EIP services in supporting individuals with FEP. This research collectively emphasises the need for trauma-informed, individualised care to optimise outcomes for individuals with early psychosis.
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Keywords
Trauma-informed care , Mental health services , Early intervention in osychosis , Psychosis , Childhood trauma , First episode psychosis
Citation
Hunt, E. 2024. Childhood trauma and trauma-informed care in early intervention in psychosis. DClinPsych Thesis, University College Cork.
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