Enhancing ‘best practice’ in trauma-informed social work education: insights from a study exploring educator and student experiences

ABSTRACT

This paper reports findings of a study exploring educator and student experiences of teaching and learning trauma-material. Two participant samples were recruited. Sample one included seven educators teaching trauma-material across two Higher Education Institutes (HEIs) delivering Social Work Programmes approved by Social Work England. Sample two included eight student social workers enrolled at the HEIs. Methods included educator semi-structured interviews and a student survey. Analysis used a deductive-inductive thematic approach. Highest frequency of comparable statements within data were coded into five themes indicative of trauma-informed teaching principles identified within literature including: (1) ensuring safety (2) maximising choice (3) encouraging collaboration (4) establishing trustworthiness and (5) prioritising empowerment. A sixth theme (6) promoting resilience was identified. Findings highlight educators’ understanding of vicarious trauma and relevance for risk of (re)traumatisation in the classroom of students’ experience of childhood adversity. This understanding was embedded in educators’ pedagogical practice(s) and how trauma-informed teaching principles were implicitly applied was identified. Experiences of receiving teaching in a trauma-informed way were shared by students. Findings indicate essential to ‘best practice’ is educators’ need to enhance awareness of trauma-informed teaching to help moderate risks to students and themselves associated with exposure to trauma-material in the classroom.

KEYWORDS:

• Vicarious trauma
• secondary traumatic stress
• trauma-informed social work education
• Adverse Childhood Experience, Trauma-informed teaching

Introduction

Background

In the general population there is high prevalence of people who have had adverse childhood experience (ACE) resulting in trauma (Cunningham, 2004). However, where student social workers are concerned, prevalence of different kinds of ACE including different forms of abuse may be statistically higher than across the general population (Butler, el al. 2017). For example, Butler et al. (2017) found 77.8% of students entering a postgraduate social work programme reported one or more ACE. Previously, Didham et al. (2011, p. 553) found a majority of students at undergraduate and postgraduate levels reported experience of adversity in childhood and/or as an adult. In the same study, the authors noted that by the programme’s end a majority of students reported exposure to trauma-related material of significance to them including at least one ‘personally upsetting or disturbing event’ during their practice-based learning. Informed by the evidence-base, Butler et al. (2016) highlight the importance of a trauma-informed approach to teaching which acknowledges the potential impact of exposure to trauma-related material for social work students.

Butler et al. (2016) draw attention to importance of pedagogical practices which help avoid risk of vicarious trauma and/or secondary traumatic stress, while assisting students in personal development to allow them to ‘work effectively with the traumatised clients they will inevitably encounter.’ As Bride (2007) found, nearly all qualified practitioners in his study were working with people who had experienced trauma and 70.2% of participants reported at least one symptom of secondary traumatic stress. Given exposure to traumatic events can cause symptoms of secondary traumatic stress, vicarious trauma and/or post-traumatic stress disorder (PTSD; see Bride, 2007; Butler et al., 2016) it is vital educators develop trauma-informed ways of teaching social work students about sensitive and potentially distressing topics. However, there is little empirical evidence of how educators teach trauma-material or how sensitive and potentially distressing subject matter is received by students. The present study positioned itself to address this gap.

In practice, social workers provide interventions to people living with poverty, oppression, social injustice, domestic violence, abuse and neglect (Gilin & Kaufmann, 2015). In addition to presenting problems, many users of services will have been exposed to adversity in childhood and as adults resulting in risk of vicarious trauma and/or secondary traumatic stress later. Sanders (2021) highlights how practitioners’ exposure to others’ adversity and traumatic experiences, whether they themselves have ACE or not, can have an enduring social, psychological and physiological impact. Identified by Figley (1995, p. 1) as the ‘cost for caring,’ the personal risks many social workers are exposed to can result in vicarious trauma and secondary traumatic stress. However, Vasquez and Boel-Studt (2017) found trauma-informed teaching strategies to help reduce trauma risk and promote resilience often occur at post-qualifying level and/or as supplementary curriculum to undergraduate work training programs. This highlights how, where exposed to trauma-material in the classroom, if this is delivered in a way where trauma-informed teaching strategies are not adopted students can be at risk of the potential cumulative effects of their social work education curriculum on their own health and well-being.

Vicarious trauma and secondary traumatic stress

Within the social work literature (e.g. Carello & Butler, 2015; Conrad & Keller-Guenther, 2006; DePanfilis, 2006;; Lloyd et al., 2002), vicarious trauma and secondary traumatic stress—along with compassion fatigue and professional burnout—have been presented as synonymous concepts. However, while vicarious trauma and secondary traumatic stress are risks potentially presenting due to exposure to trauma-related material in the classroom it is important for educators to understand differences between these allied concepts (Newell & McNeil, 2010). Consequently, for the present study, a brief exploration of differences between vicarious trauma and secondary traumatic stress was undertaken.

Vicarious trauma

McCann and Pearlman (1990, p. 144) describe vicarious trauma as a process of cognitive change which can occur as a ‘cumulative effect’ when a person is repeatedly exposed to the distressing material presented by a traumatised individual. Discussing this in the context of therapeutic encounters, Pearlman and Saakvitne (1995, p. 31) define vicarious trauma as the permanent ‘transition in the inner experience of the therapist that comes about as a result of empathic engagement with clients’ trauma[tic] material.’ Similarly, Pearlman (1999, p. 52) describes vicarious trauma as ‘a process of [cognitive] change resulting from [chronic] empathic engagement with trauma survivors.’ Similarly, examining vicarious trauma within therapeutic encounters, Jenkins and Baird (2002, p. 424) emphasise the importance of understanding the main symptom being an enduring disturbance in a person’s ‘cognitive frame of reference.’ Examples of change in a cognitive frame of reference may include, for example, a female social work practitioner’s possible view about all men as potential perpetrators of abuse after constant exposure to stories of male physical and sexual violence shared by female ‘victims’ and/or ‘survivors.’ It is acknowledged those who have experienced physical and/or sexual violence may view themselves the same or differently to the constructs used here and as presented in the literature.

Secondary traumatic stress

Secondary traumatic stress is defined by Figley (1983, p. 3) as emotional distress a person can experience during contact with a ‘trauma survivor’ who may be a significant other and/or individual with whom they (over)empathise and/or share a traumatic experience. Figley (1995) argues secondary traumatic stress can be seen as an occupational hazard across caring professions. However, unlike vicarious trauma, which has an ‘[ac]cumulative’ effect potentially leading to permanent cognitive/perceptual changes, secondary traumatic stress is identified as an immediate adverse reaction when one person is exposed to another’s traumatic experiences (Newell & McNeil, 2010). On discussing symptoms of secondary traumatic stress, Figley (1995) describes three response domains including (re)experience of the primary victim’s traumatic event, active avoidance and/or impassiveness in response to traumatic event reminders and persistent psychological arousal and/or hypervigilance. While describing how symptoms of secondary traumatic stress are similar to post-traumatic stress disorder (PTSD), Jenkins and Baird (2002) highlight key differences. These include how, despite symptomatic similarities, a person who has been traumatised may experience ongoing symptoms of PTSD which include anxiety and depression. In contrast, where secondary traumatic stress is experienced without PTSD diagnosis, PTSD symptoms may be present yet remain less persistent (Figley, 1995). It is important to note other terms are sometimes used within the literature as a substitute to secondary traumatic stress including, for example, ‘compassion fatigue’ and 'professional burnout' (Figley, 1995, p. 1). ;).

Trauma-informed social work education

Student life histories and ACE

The links between social work students’ life histories including ACE, choice to enter the profession and risk of trauma in education and training have been researched since the 1990s. In a formative study, Russel et al. (1993) compared experience of family dysfunction of 147 graduate mental health social work students (MSWs) with those of students in different subjects including guidance and counselling, education and business. Using a self-administered questionnaire the researchers found prevalence of sexual abuse, for example, was 31% higher among MSWs than a comparative number of students in the other graduate groups. Additionally, social work students reported higher percentages of living with family members during childhood who had experienced problematic substance misuse and/or engaged in acts of violence. Black et al. (1993) found a higher reported frequency of ACE and family-oriented trauma in masters-level social work students compared to those in a comparative group of masters level business students. Similarly, in a study examining influences upon choice of 415 students to undertake social work education and training, Rompf and Royse (2014) found higher prevalence of self-reporting on experience of alcohol misuse and mental illness in family members compared to a comparative number of non-social work students.

In their study, Gilin and Kauffman (2015) utilised a self-reporting survey with 162 MSW students which explored ten ACE-related questions informed by the pioneering work on the impact of childhood abuse, family dysfunction and other ACE by Felitti et al. (1998). The researchers (Ibid) found 78.3% of participants reported one or more ACE and 27.3% reported four or more. Butler et al. (2017) undertook a comparative study utilising an online survey with 195 MSW students. With their survey, which combined the use of two additional questions on social work students’ experience of bullying and community violence with a ten-item ACE calculator, Butler et al. (2017) found, prior to the age of eighteen, 77.8% of students reported one or more ACE and 31.3% reported four or more. Most commonly reported ACE among social work students highlighted by Butler et al. (2017) were related to parental separation and/or divorce and (dys)function of other household members which included mental illness, drug and/or alcohol use. In addition to reporting ACE, surveying graduate students returning to Post-Qualifying Social Work Education, Didham et al. (2011) found practitioners experienced practice-based traumatic events. These included incidents of verbal and sexual harassment, stalking by service users and other distressing behaviours towards them by practice educators and/or supervisors.

Trauma-informed teaching strategies

Taking study findings into account, several authors propose ‘best practice’ strategies for teaching which help reduce risk of (re)traumatisation in the classroom. These include Cunningham (2004) who acknowledges not all students will have ACE leading to risk of secondary trauma due to exposure to others’ traumatic experiences. Nevertheless, Cunningham (2004) highlights how some students are more at risk of vicarious trauma when exposed to trauma-material encountered through, for example, reading about abuse and/or real-life adverse experience shared in the classroom. Where lecturers and/or Educators by Experience (EbEs)¹ may share real-life experiences of case work and/or personal trauma, Cunningham (2004) argues, as a symptom of vicarious trauma, some students may have their perceptions about adults, children and/or the family altered. Arguing this to be the most distressing aspect of the phenomenon, Cunningham (2004) describes possible (re)traumatisation in the classroom which can lead to shifts in students’ worldviews about human nature resulting in stress, anxiety and concerns about their personal safety.

To facilitate a safe learning environment, Carello and Butler (2015) suggest application of five principles of trauma-informed care (TIC) in classroom settings. These five principles include: (1) ensuring safety (2) establishing trustworthiness (3) maximising choice (4) maximising collaboration and (5) prioritising empowerment. Describing this as fundamental, Carello and Butler (2015, p. 269) suggest the importance of prioritising application of the trauma-informed principle of ‘ensuring safety’ across several domains. These include knowledge of student’s individual personal characteristics, moderation of taught content, for example, checking teaching materials and including content warnings, classroom setting, assignment requirements, educator and student behaviour and instruction on and practice of (student and educator) self-care. While utilising TIC principles to practice safely, educators are required to be knowledgeable and skilled in presenting trauma-material while vigilant in identifying signs and symptoms of existent and/or emergent trauma in students. Most of the relevant research on this subject area has been undertaken within the USA (see Carello & Butler, 2015). Nevertheless, compatible with international social work education contexts, this body of work demonstrates the positive impact of trauma-informed teaching for social work students.

Gilin and Kaufmann (2015) argue students should be taught about ACE, vicarious trauma and secondary traumatic stress and associated risks and how to identify these in themselves and others. While ethically challengingly, this is an approach advocated by Carello and Butler (2014) who argue, while some trauma-material will need to be retained, educator previewing of taught content, verbal and written warnings about potentially disturbing subject matter and select omission of unsolicited trauma evoking material is essential. Gilin and Kaufman (1995, p. 390) highlight importance of this particularly in relation to use of visual learning mediums (e.g. YouTube and DVDs etc), arguing students should have opportunities to (pre)view material in advance and/or be allowed to step out of classrooms if required. Similarly, Carello and Butler (2015, p. 270) discuss how to ‘inoculate’ students and assist them in managing trauma-material by providing verbal and/or online warnings ahead of posting electronic links for viewing and/or where planning use of visual and/or verbal learning aids in the classroom. Written check-ins at the start and end of exposure to trauma-material which offer opportunity to share thoughts, feeling and emotions and/or encourage classroom discussions which invite verbal feedback can empower students to reorientate and/or (re)gain emotional distance following review of difficult subject matter (Carello & Butler, 2015). Use of reflective journals recording personal reactions to reading, discussions and viewing of trauma-material to enhance self-awareness and personal development have been proposed by Gilin and Kaufmann (2015). However, the authors highlight how, while choice to collaborate in their preferred way needs to be emphasised, students should not be expected to share personal histories and/or thoughts or feelings either in written form or verbally in the classroom.

The impact of personal disclosures from students is important to consider within a trauma-informed approach. In relation to assignments, Carello and Butler (2015) suggest educators should consider how guidance requirements might trigger a traumatic response, for example, where students writing reflective pieces may offer disclosures while seeking to exceed their emotional limits, excel in assignments and/or otherwise influence markers. Additionally, where students are exposed to in-depth verbal accounts and/or detailed graphic imagery about trauma some may become overwhelmed while others may be inspired to engage in classroom disclosure. Strategies proposed for mixed responses include the provision of support with assignment planning, preparing students for exposure to content in classrooms and setting ground rules. For example, directing students to be appreciative and empathetic of differing views and experiences being shared while avoiding ‘othering’ and/or seeing distress as a ‘normative’ reaction (Carello & Butler, 2015; Catherall, 1995, p. 239). Attention has been drawn to importance of group dynamics and ‘styles’ of presentation (Cunningham, 2004). Cunningham (2004) highlights educator presentation styles can risk devaluing the experience of students who may have similar life experiences where trauma-materials are shared in an emotionless and/or detached way. Defined by Newell and McNeil, 2010, p. 62) as the ‘utilisation of skills and strategies … to maintain [one’s] own personal, familial, emotional and spiritual needs while attending to … the needs and demands [of others],’ the importance of student and educator personal safety and self-care is underscored in the literature. In relation to personal safety and self-care, approaches to teaching underpinned by trauma-informed principles can be linked to what Hooks (1994, p. 15) calls an ‘engaged pedagogy’ which is concerned with teaching practice that ‘emphasises wellbeing’ and joy in the classroom.

The literature highlights the importance of incorporating trauma-informed approaches into social work education. However, most examples identified for the purpose of this paper were based on anecdotal approaches where educators offer ideas about how best to apply trauma-informed principles. Consequently, a gap in the evidence-base is identified in relation to understanding educators’ practical application and students’ experience where pedagogical approaches in social work education involve explicit application of trauma-informed principles within the classroom. As (Sanders, 2021, p. 4) commented “research is required to establish ‘best practice’ guidelines for broad integration of trauma knowledge that fosters an optimum learning environment for all students.” To inform research in the subject area a study was designed and conducted across two HEIs providing Pre-Qualifying Social Work Provision (PQSWP) to undergraduate and postgraduate students.

The study

Aims and objectives

Beginning in January 2021 the study took place across a three-month period. The aims of the study were to explore: (1) how potentially distressing topics are presented by educators in PQSWPs and received by students and (2) how trauma-informed principles are understood and embedded within social work teaching and learning environments across HEIs. The study objectives were to: (1) gather evidence to further inform research in the subject area and (2) contribute to enhanced knowledge of best practice in trauma-informed teaching in social work.

Participant samples and recruitment

Two purposeful sample participant groups were recruited to take part in the study. Sample one included seven (n = 7) social work educators teaching trauma-related material at undergraduate and postgraduate levels across two Higher Education Institutes (HEIs) delivering PQSWP approved by Social Work England. The two HEIs were selected for pragmatic reasons, for example, both were local to the researchers, part of the same Teaching Partnership and provided pre-qualifying social work education at both undergraduate and postgraduate level. Educators were not selected on the basis of particular modules in recognition of the fact that trauma-material can be presented across modules in multiple teaching contexts. Sample two included a total of eight (n = 8) undergraduate and postgraduate student social workers enrolled at the same two HEIs with a range of personal characteristics as shown in Table 1.

Table 1. Showing student participants year of study, age, gender and ethnicity.

Student pseudonym	Year of study	Age	Gender	Ethnicity
Alice	Undergraduate—second year	35 - 44	Female	White
Cassandra	Undergraduate—final year	25 - 34	Female	White
Kerry	Undergraduate—final year	25 - 34	Female	White
None	Masters—second year	35 - 44	Male	White
Lily	Undergraduate—final year	35 - 44	Female	White
Sheila	Masters—second year	45 - 54	Female	Asian/Asian British
Lex	Undergraduate—first year	35 - 44	Female	White
Ruth	Undergraduate—final year	45 - 54	Female	White

Recruitment for educators was undertaken via the programme directors² and/or senior staff at each HEIs. Invitation emails with information sheets attached were disseminated through the social work teaching teams and interested parties invited to contact the researchers directly. Students were recruited via senior staff including Programme Leaders who had responsibility to oversee individual social work programmes and who shared information about the study posted electronically on main Programme sites. Students were also contacted directly via their HEI email addresses.

Research questions

Based on a review of the literature, the questions guiding the study were:

1. How do social work educators teach and help students learn about sensitive and potentially distressing topics to students?

2. How/Do social work educators utilise trauma-informed teaching principles in teaching practice?

3. What are social work students’ experiences of teaching and learning where exposed to trauma-material?

Methods

Educators were invited to take part in semi-structured interviews to explore their views and experiences in depth. Interviews were conducted via Microsoft Teams as the Covid-19 pandemic and associated lockdown restrictions meant researchers were not able to meet face to face with participants. Participants were asked questions about their teaching practice and how they dealt with teaching difficult topics. They were also asked to share their existing knowledge of trauma, ACE and trauma-informed principles and how these might be embedded within teaching practice.

Social work students were invited to complete an online survey. This provided an opportunity for students to take part in the research and offer their views anonymously, without the need to take part in face-to-face data collection. The survey was used to collect predominantly qualitative data with some descriptive data capture. Questions were focused on students’ experiences of learning about potentially distressing topics as part of their course including the strategies educators used with them and what support they were offered or received.

Ethical considerations

The study received ethical approval by one of the researcher’s University Ethics Committees. Research adhered to standards agreed by the Committee and ethical considerations included: (1) use of an information sheet explaining the study aims and objectives to ensure participants were fully informed in advance of interviews and surveys (2) use of a consent form. All data was anonymised and extracts presented within this paper use pseudonyms to protect participants’ identities. As the study created conditions for participants to share personal experience, the researchers were alert to the possibility of risk of secondary traumatic stress. As such, the principles of trauma-informed practice were embedded within the research design and as researchers we continued to critically reflect on the work and the ethical implications throughout the study process. Students were reminded that they could access support through their personal tutors and through university student support systems, with the links for this provided within the information sheet and within the survey which they completed. Educators were also signposted to additional support which they could access via staff wellbeing services.

Data analysis

Based on ideas for data analysis taken from Fereday and Muir-Cochrane (2006), a deductive-inductive thematic approach was utilised. The approach complemented study questions and starting with deductive analysis used what Crabtree and Miller (1999, p. 165) describe as a ‘template organising style.’ This entailed a four-stage process beginning with development of an ‘a priori’ coding template utilising a categorisation of trauma-informed principles including: (1) ensuring safety (2) establishing trustworthiness (3) maximising choice (4) encouraging collaboration and (5) prioritising empowerment. A second stage involved development of a ‘description’ of individual trauma-informed principles to complement each code. Concerned with identifying ‘qualitatively rich’ descriptions of the different trauma-informed principles as these were described by participants as applied to their teaching and learning, a third stage involving a search for ‘legitimising samples’ within the transcribed data was undertaken. Within individual transcripts, legitimising samples representing participants’ descriptions of how, for example, how educators ‘ensured,’ and/or how students ‘experienced’ safety in the classroom were highlighted. A fourth stage involved cross-referencing legitimising samples of participants’ application of individual trauma-informed principles across transcripts and clustering together data extracts including student surveys which offered comparative examples of each a priori code. A deductive code example is presented in Figure 1.

Figure 1. Deductive code sample.

While deductive data analysis was guided by a template organising style, among themes identified as separate from a priori codes via inductive analysis was the principle of ‘promoting resilience’. The inductive analysis used a four-stage process with the first stage involving a review of individual transcripts and surveys without reference to the a priori coded template. A second stage involved recognition of data patterns of ‘rich descriptions’ identified as separate from deductive analysis. The third stage involved development of a ‘description’ to complement each new theme to be used as a guide to identify ‘legitimising samples’ (Fereday & Muir-Cochrane, 2006, p. 4) across the data set. The fourth stage involved cross-referencing legitimising samples of the inductive theme clustering together those extracts from across the data including student survey and educator interview transcripts which offered comparative examples.

Findings

Study findings revealed a range of strategies used by educators that fit within a trauma-informed framework. However, during the course of interviews and data analysis it became clear educators had differing levels of knowledge and awareness around the concept of vicarious trauma and secondary traumatic stress and in relation to the principles of trauma-informed pedagogical practice. Despite this, it was evident there was an implicit use of the principles in examples educators provided about how they taught difficult topics. This was supported by the students’ responses. Representative samples of each of the themes identified in the data are presented below.

(1) Understanding trauma and trauma-informed principles

As noted, it was clear that educators had different levels of knowledge and understanding of different types of trauma, and there was little explicit knowledge of trauma-informed principles and how these can be applied to inform practice:

in terms of an actual method of … trauma-informed teaching … I [don’t] have … really any knowledge of that. (Becky, social work educator)

However, when considering the impact of trauma in the classroom, educators were very conscious of the need to acknowledge this and described how they took steps to manage this while sharing how this could be difficult. Consequently, highlighted is how trauma-informed principles were implicitly being used within teaching practice:

… I don’t use it explicitly … . it is implicit within the way in which it works … part of everything else … in the way that I do my teaching. (Bob, social work educator)

It was also clear students appreciated the need for difficult topics to be handled sensitively:

It’s important to understand traumatic situations or experiences may trigger emotions/feelings of past events in our own lives. (Sheila, social work student)

Although direct knowledge of different trauma types or of a trauma-informed framework were limited, there was clear recognition of the need ‘to always be aware of the fact that anybody could have had any kind of trauma when … and not just obviously childhood, but at any point’ (Tom, social work educator).

(2) Ensuring safety

Ensuring safety includes examples of where educators have created a structured and predictable learning environment, which fosters and allows students to experience a shared sense of safety. Educators actively took steps to create this environment:

My intention is always with the best … to try and make it as comfortable and safe as possible. (Bob, social work tutor)

Safety was established in a number of ways. These included, for example, ‘alerting them [the students] to the nature that it could be a sensitive topic’ (Bob, social work educator). ‘So that people are prepared for what that’s going to be [explored]’ (Alice, social work educator). Educators also shared how they provided debriefs at the session end. These included space to discuss what they had learned about so students had a safe space to ‘express shock, or upset, or whatever emotion it is’ (Tom, social work educator). Other participants spoke about the need to share emotions as being an important aspect of creating a safe learning environment:

I think showing emotion is really important in a safe space. (Sally, social work educator)

Students’ responses included references to ‘disclaimers’ (Cassandra, social work student) being given before sessions and students being ‘told there may be sensitive topics before the session is delivered’ (Alice, social work student). It was clear from student responses they recognised and appreciated steps educators took to create a shared sense of safety and they commented on how they had‘ … found the topics covered in a sensitive way’ (Sheila, social work student).

Safety was also created through opportunities for additional support. For example, signposting students to University student support and wellbeing services and ensuring online module pages included ‘a link to wellbeing and things like that’ (Bob, social work educator). Tutors were also very aware of what was happening in the classroom so they could be ‘quick to spot the signs that somebody is becoming distressed or someone’s having difficulties’ (Bob, social work educator). In these circumstances, educators would often offer one-to-one support for students, as well as signposting to other services:

If necessary people can come and talk to me afterwards or … talk to their personal tutor. (Kenny, social work educator)

Again, student responses echoed this with students reporting they were signposted to services and were aware of the ‘Support from all tutors, personal tutors and through the University well-being team … ’ (Alice, social work student) they could access, should they need to do so. ‘Peer support from other students’ (Ruth, social work student) and the students’ own personal networks, while mentioned less by educators, was something students referenced when asked about support:

I have my peers to discuss information with and if the learning is distressing I also have my own family/partner to talk to. (Sheila, social work student)

There was an acknowledgement ‘It has been a difficult year with the pandemic” (Les, social work student) and the associated shift to online teaching had made provision of support harder. For example, online teaching made it ‘more difficult … to recognise and identify somebody might be distressed by something!’ (Alice, social work educator). However, some educators commented on how this could help to establish trust and safety when teaching about difficult topics as it offered students the chance to ‘ … easily kind of just go out of the room or switch off you know their camera or just log-off completely’ (Alice, social work educator).

(3) Maximising Choice

Maximising choice includes examples of where students are offered choice and control over their engagement with difficult topics. This mainly related to choice over participation in class when difficult topics were being discussed, for example, as shared by one educator:

I did all my safety stuff, I did all of the … announcements beforehand, saying please look through, this is a very difficult topic, … don’t attend if you feel you’re not able to. (Sally, social work educator)

Maximising choice also meant offering other ways to catch up, should a student feel unable to participate in a particular session with the need ‘to be flexible’ highlighted by educators (Tom, social work educator). Again, it was clear from student responses they were aware of choices they were offered:

I feel most lessons have been delivered with students allowed choice. (Sheila, social work student)

They [lecturers] advise us [topics may be distressing] and offer us an opportunity not to participate. (Lex, student social worker)

However, educators indicated they would not do this for every session, for example, if they did not perceive the topic being covered would raise any difficulties for people:

I don’t give people the option of that for every session … I suppose I do make a judgement about whether the teaching is going to have any potential emotional impact. (Lucy, social work educator)

However, educators also recognised this could be a problematic approach as any topic could potentially cause upset:

… any topic that I would teach I think has the potential to … to strike a chord with a person. And in a way you’ve got to be even more wary of those topics! They may seem innocuous on the surface. (Tom, social work educator)

(4) Encouraging Collaboration

Encouraging collaboration relates to examples where students were offered opportunities to engage in learning and collaborate with educators and peers around the topic. For example, educators spoke about the need for student feedback to help inform the way they approached and taught difficult topics: ‘I ask for feedback constantly actually’ (Bob, social work educator). Feedback from colleagues was also identified as a useful way to review teaching:

… if there’s two of you [two educators team teaching together] in a session … you could [reflect with each other and] sort of say, well did I do a good job of explaining those principles at the beginning of the session? (Alice, social work educator)

The students supported this commenting on how this was included within their teaching:

There is a briefing [about the teaching material content] at the start of session and discussions have allowed collaboration [about how best students wish to engage with the material]. (Sheila, social work student)

References to peer support students made (noted above) also demonstrate collaboration was an important aspect of working with difficult topics and one which students engaged with outside of systems and spaces set up by the educators.

(5) Establishing Trustworthiness

This theme encompasses examples of where educators took measures to establish trust with their groups of students. For example, educators discussed how they used ground rules to establish trust within their teaching groups:

And we do establish the ground rules in those sessions saying … this is for within the room, it’s confidential, you can challenge each other’s ideas, but … I suppose I won’t tolerate you challenging each other … the person. … that’s kind of the first thing they learn as well. So it’s setting that right at the very beginning … (Alice, social work educator)

The development of relationships between students and educators was an important aspect of building trust:

Something I think we need to [do] much more on … in the induction process, [is] to start building up that kind of trust. (Alice, social worker)

The development of trust was linked to discussions about transparency in teaching, for example, being open about the topics that need to be covered and the realities of practice:

I think what also helps though is … being really honest with students and using examples from my own practice. (Becky, social work educator)

Students also acknowledged the need for this:

… social work is about protecting vulnerable [people] so some sensitive case studies are to be expected. (Ruth, social work student)

(6) Prioritising Empowerment

Educators provided examples of techniques and approaches used to empower their students. Students expressed feelings of self-confidence in their ability to manage difficult topics and emphasised the importance of being able to manage different situations:

I feel the desire to become a social worker requires me to be exposed to information on every type of difficult scenario or situation that will help develop my understanding of potential cases in future practice. (Sheila, social work student)

Educators discussed ways in which they empowered, or enabled, students to be able to work with difficult areas, for example, by adopting a strength based approach in interactions with students:

So what I tend to do with anyone who’s interacting with me … always looking for … where is the positive thing that they’re doing that I can draw attention to? (Bob, social work educator)

Other educators echoed this approach and emphasised the importance of reminding students it was okay to ‘struggle’ sometimes, that this was natural and ‘ … human nature and everybody struggles sometimes and actually being reflective and identifying and recognising that is a strength. And just reminding students of that message and … and reiterating it’ (Tom, social work educator). Prioritising empowerment was something educators had at the heart of their practice which was closely linked to promoting resilience.

(7) Promoting Resilience

Promoting resilience includes examples where educators and students spoke about how they developed resilience and ability to cope with difficult topics and experiences. Promoting resilience was discussed as the ability to be absorbed in and work with these topics. Particularly important to students was how, during discussion, emotions were identified and used to acknowledge and manage their own previous experiences and reactions to the material. Educators spoke about the need to support the development of resilience and students’ ability to talk about and work with trauma and difficult areas of practice. Also the promotion of resilience was linked to ‘the importance of self-reflection … and knowing what you can deal with and what you can’t’ (Becky, social work educator). Students also commented on the need to ‘be able to attend topics, learn about situations and hear stories that may be the most horrific situation’ (Sheila, social work student). Educators and students spoke of the strategies used to promote resilience:

… I would start with … exploring their current understanding of … vicarious trauma or abuse, etcetera. And then talk about how it feels to talk about those things, why we don’t talk about them … (Kenny, social work educator)

We are given lots of advice by the lecturers on coping mechanisms and self-care. (Cassandra, social work student)

The use of humour was also cited by some as a way of learning to deal with difficult topics:

… there is a lot of … humour … and I think people [educators and students] do use … humour sometimes as a way of coping with things. (Alice, social work educator)

The role of emotions was discussed and educators and students acknowledged the importance of being able to share emotions and feel supported to do so:

[I] … make it clear that it’s upsetting, make it clear that maybe I get upset by it as well and that that’s fine, and that’s natural … it isn’t something that will be you know overly picked upon or frowned upon or anything like that. (Sally, social work educator)

I feel listened to and understood. Staff always thank students for sharing. (Kerry, social work student)

However, there were caveats to this and it was clear from responses there were limitations in when and how people felt able to share emotion. For example, one student commented they would not always feel comfortable sharing emotions in case this reflected badly on their professional status and suitability for the role:

I feel that it is okay, but it carries a risk of appearing to be fragile and as a student, possibly not suited for the profession. (Brian, social work student)

This student went on to say:

[Educators] … did acknowledge particularly difficult and distressing aspects of their previous work. I found this to be insightful, helpful and honest. I feel [they] were in a better position to disclose previous feelings of distress as they had already proven their competence and ability to cope as a social work practitioner. (Brian, social work student)

Educators acknowledged this was an important area, but one of balance. Sally (social work educator), for example, did not want students to feel ‘they have to be hard,’ but also commented on the need to be professional when sharing emotions with educators and other students:

Obviously it needs to be professional and … the right time and the right place, but I think showing emotion is really important in a safe space. (Sally, social work educator)

This ‘balance’ that needed to be struck was one where educators sought to teach to their students it is alright to show emotion, but it should be done in a way that does not ‘make it all about you [as that] … doesn’t help or encourage people’ (Bob, social work educator). One student was concerned that the space to share emotion and experience was often dominated by ‘oversharers in class … ’ (Lily, social work student), again supporting the need to find a ‘balance’ in when and how sharing takes place.

Discussion

As the starting point for developing ‘best practice’ in trauma-informed social work teaching, a review of literature highlighted how educators need to develop and/or enhance knowledge of vicarious trauma, secondary traumatic stress and the potential longer-term effects of these phenomena on students’ wellbeing. Linked to this is the importance of considering risk of (re)traumatisation during teaching of trauma-related material for all students, especially those who have experienced ACEs (Newell & McNeil, 2010). The present study findings revealed educators were aware of the potential for their students to have experienced various ACE and/or traumatic events, and the potential impact of learning about difficult topics on their students’ wellbeing. However, there was a lack of explicit, in-depth knowledge and understanding of these areas and in particular about the different types of trauma and of trauma-informed principles and pedagogical practices. As noted in the literature, critical understanding and application of knowledge about vicarious trauma, secondary traumatic stress and ACE and safely facilitating exposure to other trauma-material utilising trauma-informed principles is essential to support students’ professional learning and personal development (Carello & Butler, 2015). The present study revealed, whilst not working to an explicit framework, educators implicitly applied strategies and techniques which aligned with the five trauma-informed principles of safety, trustworthiness, choice, collaboration and empowerment presented in the literature and a sixth principle, promoting resilience which was identified through data analysis.

Trauma informed principles in the classroom

Whilst educators’ knowledge of trauma was disparate, all were ethically aware of the potential for trauma-related material to be distressing to students and each took steps to address and manage this sensitively. Likewise, students recognised the importance of learning about these topics and appreciated ways subjects were approached and taught. While none of the participants framed their responses within an explicit trauma-informed approach, it was apparent this was implicit in their teaching. Overall, it is clear a range of strategies and techniques are adopted by social work educators to support their students. Although they are linked to particular principles it should also be noted each of these also intersect. For example, it would be very difficult to ensure safety without also establishing trust. As such, there is considerable overlap between strategies educators adopted. Promoting resilience was not part of the original framework considered within this research. However, it was an important aspect of the data, particularly in relation to how emotions are managed when learning and working with difficult scenarios. An overview of the principles of a trauma-informed approach and the techniques and strategies adopted that fit within this is provided below in Table 2:

Table 2. Trauma-informed principles and application.

Trauma-informed principle:	Examples of principle application:
Ensuring safety	Telling students ahead of time what topics are to be discussed Making space to express reactions to topics and express emotions Acknowledging that topics and content may touch on students’ personal experiences Providing support—including a range of different options and ensuring students are aware of them Being very aware of what is happening in the classroom so that can quickly spot signs of someone becoming upset or distressed Peer support between students
Maximising choice	Choice over participation in class Different options for engaging with the class and the content of the class Flexibility in the classroom and different options for engaging students in their learning Offering different types of support
Encouraging collaboration	Gaining and making use of feedback—from students and other educators Encouraging discussion of the topics and how to approach them
Establishing trustworthiness	Use of ground rules in teaching Development of trusting relationships between educators and students and amongst the student cohort Transparency in teaching—e.g. being upfront about topics to be covered and the need to speak about them Being open and honest with students—about their learning and about the realities of practice
Prioritising empowerment	Use of a strength-based approach with students Reminding students that it is okay and natural to struggle sometimes or to be upset by the content Enabling students to take some control over their learning journey
Promoting resilience	Not shying away from working with and teaching difficult topics—giving students the chance to learn about them in a safe environment Developing students’ ability to be reflective and self-aware Teaching students about various coping and self-care strategies The use of humour Supporting students to understand when and how to share emotion and personal experiences—helping them to find a balance with this Supporting students when they did share emotions or experiences

As presented within the literature review, some of the above examples have been proposed by other authors and the present study suggests they are being adopted in teaching practice, regardless of whether a trauma-informed approach is explicitly applied. For example, the literature suggested educators should instruct on self-care, check in at the start and end of teaching, and ensure students have choice in how they engage with taught material (Carello & Butler, 2015). Each of these strategies was present within our own data. Additionally, Carello and Butler (2015) suggested having knowledge of individual students was useful in this context and our participants also highlighted the importance of developing relationships with students which would allow for greater awareness of the potential impact of their learning so educators can quickly spot signs and symptoms of existent or emergent trauma and distress within the classroom. To mediate and/or ‘buffer’ any potential temporary (dis)stress responses students may have on exposure to trauma-material, educators need to use relationship-based strategies which encourage choice over amount and exposure to trauma-material in class to help promote a sense of trust and safety. These may include a range of classroom-based activities including agreeing ground rules at the start of teaching, for example, agreeing students must be respectful in their response where other participants may be observed as upset and/or where group members may feel willing/compelled to share lived personal experience(s) and/or otherwise become anxious and/or (dis)stressed. Self-awareness regarding presentation style in the classroom is important where response to material content should be appropriate, open and proportional. Written and dialogical group reflection activities are useful at the start, mid-point and end of sessions to ‘check the temperature’ of group members and these alongside other self-care exercises can offer an opportunity for students to communicate, process and manage (dis)stress and/or powerful emotions while feeling, safe respected and supported (Carello & Butler, 2015; Cunningham, 2004; Sanders, 2021).

Findings from this research also add to existing literature in a number of ways. For example, there were strategies and approaches adopted by educators that were not found in our review of the literature on trauma-informed approaches. Adopting a strength-based approach was one important aspect of teaching difficult materials in a sensitive and trauma-informed manner. Strength-based approaches focus on the inherent strengths, capacity and potential of the person and seek to support people in acknowledging and drawing upon them (Smith et al., 2018). This links to social work practice where strength-based approaches are commonly advocated and where empowerment is a key practice principle. Participants in this research talked about taking a strength-based approach through direct acknowledgement of the positives in students’ learning journeys.

Promoting resilience

Educators acknowledged the need to support students in developing resilience so they can manage the demands of the course and the profession. Others have also considered the role educators play in promoting resilience (e.g. Grant & Kinman, 2012). However, this paper adds to the literature by positioning this within the context of a trauma-informed approach, aimed at reducing/eliminating vicarious trauma and/or secondary traumatic stress. The concept of resilience has been much debated within the literature but is often defined as ‘the ability to adapt to stress and adversity’ and understood as ‘a trajectory of coping that defies expectation of negative outcomes’ (Liu, Reed and Girard, 2017, p. 111). Strategies employed by educators to promote resilience included supporting students to be reflective and self-aware, teaching about self-care (see Grant & Kinman, 2012) and coping strategies and the use of humour. The role of emotion in promoting resilience was also highlighted in the study. The importance of managing emotions is raised by Grant and Kinman (2012) who argue emotional intelligence is an important predictor of resilience.

The role of emotion in the classroom in relation to trauma-related material was an important aspect of the findings. Participants broadly agreed that showing emotion was important, but this could be challenging for a number of reasons. For example, concerns were raised by a student about whether openly showing emotion in reaction to classroom teaching content would cause them to be viewed as lacking competency and the ‘resilience’ required to undertake the role. The importance of acknowledging and allowing a range of positive and negative emotions has been raised previously, for example, in relation to research when difficult topics are discussed (e.g. Lonbay el al. 2011; Wilcock & Quaid, 2018).

This research highlighted, whilst participants felt emotions should be expressed within the classroom, there were caveats to this. For example, many stated there needed to be a balance and students needed to understand when and how it was appropriate to share emotion. Such a balance has been widely discussed and as Grant et al., (2014) pointed out, this has created some ambiguity in terms of how a balance between acknowledging emotion and limiting the impact of emotional reactions is to be achieved. One way in which this might be addressed is through educators modelling this behaviour to students, as was the case in this research as educators primarily agreed on the need for them to show emotion to students. Students’ responses suggested they valued it when educators were open about their emotional reactions to learning content and previous research has suggested not doing so can cause stress. For example, in Barlow and Hall’s study (2007, p. 409), students in their sample who participated in relation to their practice-based learning expressed feeling confused in situations where they experienced distress while their ‘field instructors’ did not.

Study strengths and limitations

This was an exploratory study with a small participant sample within two HEIs located in England. Therefore, findings are not generalisable across all HEIs delivering PQSWPs. However, the study captured ‘rich data’ in the descriptions of participants which offered a range of examples of ‘best practice’ identified within and beyond the scope of the existing literature. Due to the pandemic the approach to gathering data was limited to student surveys and gathering evidence from educators via semi-structured interviews conducted live online. Consequently, opportunities for a wider triangulation of data, for example, through classroom-based focus groups with either participant samples, while limited for the purpose of this study, is encouraged as an approach to future research in the subject area. Future research could be undertaken across other locations and include a more diverse sample.

Conclusion

Highlighting essential knowledge for promoting ‘best practice’ where teaching about trauma, this paper examined literature (e.g. Carello & Butler, 2015) which discusses links between students’ life histories including ACE, choice to undertake social work training and risk of (re)traumatisation³. Identified by Carello and Butler (2015) is the importance of incorporating trauma-informed principles into social work education which include: (1) ensuring safety (2) establishing trustworthiness (3) maximising choice (4) encouraging collaboration and (5) prioritising empowerment. Also identified in this study is the importance of promoting resilience and how exposure to trauma in preparation for practice is acknowledged as essential learning (see also Gilin & Kaufmann, 2015; Strand et al., 2014). Teaching and learning experience approaches underpinned by trauma-informed principles can be likened to an ‘engaged pedagogy’ (Hooks, 1994). ‘Engaged’ pedagogical practices focus on the empowerment of students and educators as well as actively working in an informed way to avoid risk and reproducing biases. This requires a degree of vulnerability from students and educators through a willingness to be open to learning about and sharing trauma-material and life experiences which was something we found within this study. Although, with some complexity and uncertainty around how best to navigate vulnerability and risk to self and others at different times and under different circumstances within the classroom. Nevertheless, as found in the study, an ‘engaged pedagogy’ reinforces educators’ role in ensuring safety while having essential knowledge and skill to deliver trauma-material, alongside self-awareness and ability to respond ethically and expertly to students willing to share their emotions, concerns, beliefs and lived experiences. As educator Bell Hooks suggests teaching difficult material should facilitate a process of empowerment and transformation through students’ development of critical self-awareness as they are safely encouraged to make sense of and revise the meaning of their lived experience.

‘There are times when I walk into classrooms overflowing with students who feel terribly wounded in their psyches … yet I do not think that they want therapy from me. They want an education that is healing to the uninformed, unknowing spirit. They do want knowledge that is meaningful. They rightfully expect … my colleagues and I will not offer them information without addressing the connection between what they are learning and their overall life experiences (Hooks, 1994, p. 75).

Adopting trauma-informed principles in social work education offers a way to address this connection and this paper has shared insights into how these principles should be and are enacted in practice.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

John Cavener

Dr. John Cavener is a Senior Lecturer in Social Work at Northumbria University

Sarah Lonbay

Dr. Sarah Lonbay is an Associate Professor of Social Sciences and Engagement at Sunderland University

Notes

1. The term Educators by Experience (EbE) describes people who are involved in social work education through virtue of their personal experiences with social services. The term is explained in more detail in a paper by Lonbay, Cavener, O'Driscoll and Chappell (2020).

2. Programme directors is the term used here to describe educators who were in a position of overseeing all social work programmes within the HEI.

3. While the reader is directed to review the essential literature (e.g. Egan et al., 2011) which explores important related issues including the complex relationship between ACE, (re)traumatisation, neurological development, emotion regulation, problem-solving and capacity to learn, it is acknowledged a detailed outline is beyond the scope of this paper.