We have another guest blog this week looking again about the work of the Tomorrows Women Glasgow service.
This article first appeared previously in Scottish Justice Matters.
Anne McKechnie is a Forensic Clinical Psychologist with Tomorrows Women Glasgow.
I am employed as a consultant forensic clinical psychologist in the NHS Greater Glasgow and Clyde Psychological Trauma Service, which has been running for decades, offering psychological assessment and treatment to individuals presenting with complex Post Traumatic Stress Disorder; a disorder which can occur after prolonged, repeated interpersonal trauma and is often severely disabling. Our clients range from survivors of Child Sexual Abuse, to asylum seekers, refugees, trafficked victims, the homeless and people leaving care.
With the publication of the Angiolini Commission on Female Offending and the recommendation that Women’s Justice Centres be established, Glasgow City Council, in partnership with Greater Glasgow and Clyde Health Bard, Glasgow Housing Association and the Scottish Prison Service established, with initial Scottish Government funding, Tomorrow’s Women Glasgow. The aim being to provide a “one stop shop” to meet the complex needs of high risk female offenders.
When the service was being planned, all involved were aware of the high incidence of abuse and trauma that was a key feature in the development of women’s difficulties. Glasgow has a long history of understanding the complex trauma that has played a pivotal role in the development of social and mental health problems; so being trauma-informed, as well as offering trauma-specific therapies, was viewed as essential to the ethos of Tomorrow’s Women Glasgow.
The NHS GG&C Psychological Trauma Service is in the unique position of offering a service to both Tomorrow’s Women Glasgow and female offenders in the Glasgow area. While psychological assessment and therapy is offered, in my view the biggest impact on services and therefore the women has been the establishment of a service which strives continually to be trauma-informed.
Many academic articles have been written on trauma-informed practice (TIP) (e.g. Fallot and Harris 2001) and to be trauma-informed a service is expected to
- Acknowledge that trauma is pervasive
- Provide safe environments to service users
- Build trust
- Offer choice
- Be compassionate
- Support and train staff in trauma
When developing services to be trauma-informed, the thinking should be similar to that in building new properties; all must now be disability- friendly so that disabled people are not stigmatised by not being able to access areas as easily as others. We do not know who has been exposed to trauma and who has not. People with traumatic histories are not necessarily easily identified. So treating everyone as if they have been exposed to, or are vulnerable to, trauma establishes practice that is non-judgemental, compassionate and accepting.
Within Tomorrow’s Women Glasgow the environment is key to providing the basic of TIP; rooms are light, airy and decorated with art work prepared by the women, alongside photographs illustrating activities and achievements. Staff are always available to welcome women with no alarm systems, safety being relational rather than physical. All women are allocated a key worker who completes a care plan with each woman, identifying and prioritising their need.
As anticipated in dealing with such high risk women whose lives are so chaotic, engaging them in any meaningful contact has been the biggest challenge. Referrals come from criminal justice social work and prisons; the women have high levels of need, often homeless, with histories of poor contact with health and social work, experience difficulties with family contact and are burdened with substance misuse problems. Above all, they are hugely mistrustful. There is invariably a history of traumatic life events; abuse in childhood, frequent moves through the care system, witnessing violence, exposure to domestic abuse and losing their own children to care. For our women, the trauma of entering prison is often less than that associated with leaving custody; they frequently leave jail with no accommodation, limited access to money, poor social support and are at risk, not only from and to others, but also to themselves.
Maxine Harris, Roger D. Fallot, Envisioning a Trauma-Informed Service System: 2001
This article is in two parts. The second part will feature soon.