Marymead CatholicCare Canberra & Goulburn: An organisational approach to trauma-informed practice

In 2024, Emerging Minds was privileged to work closely with Marymead CatholicCare Canberra & Goulburn (MCCG) and the Australian Capital Territory Health and Community Services Directorate’s Youth at Risk Project to deliver a 16-week training package on trauma-informed practice with children and young people. The participants from MCCG included staff from all levels of the organisation – from senior executives to team leaders, psychologists and practitioners to reception staff.

As our work progressed with staff from MCCG, we came to realise that many important aspects of trauma-informed practice were integral to their everyday values and practices. This was primarily demonstrated in their case examples of work with children and young people. It was also shown through their curiosity in difference, the respectful ways they described children and young people, and in the executive team’s demonstrations of care and collaboration.

We asked MCCG staff if we could interview them about what we were observing. The interviews and quotes throughout this paper demonstrate the thinking and planning that has supported their organisational approaches to trauma-informed practice with children and young people.

Trauma-informed practice developed in the 1990s in recognition of institutionalised child sexual abuse and empirical evidence regarding the high proportion of children who were experiencing one or multiple traumas (Berliner & Kolko, 2016; Wilson, Pence & Conradi, 2013). This prompted a political response from organisations and practitioners who wanted to move beyond medicalised accounts of people’s stories of trauma – from ‘what is wrong with you?’ to ‘what happened to you?’ (Sweeney et al., 2018).

Trauma-informed principles and frameworks consistently include interventions that privilege safety and trust, transparency and choice, context, collaboration, empowerment and cultural safety (Department of Families, Fairness and Housing, 2022; MacDonald et al., 2024; Prevention and Response to Violence Abuse and Neglect Government Relations, 2023; Trauma-Informed Care and Implementation Resource Center, n.d.). As part of this paper, we interviewed MCCG staff specifically about the principles of safety and transparency, collaboration and choice, and context.

Trauma-informed practice recognises that (NSW Health, n.d.; Wall, Higgins & Hunter, 2016):

• Experiences of trauma can be common in children who regularly experience heightened distress or mental health difficulties.
• The impact of trauma on social and emotional wellbeing may be lifelong if children and young people are not supported to recover. As such, organisations have a responsibility to support children and young people to disclose trauma in safe and supported ways.
• Interactions that respect children’s diversity, safety and right to be heard are all critical to service design.
• Trauma can impact a child’s relationships or emotions at any time and staff should be able to respond to distress in calm, safe and supportive ways.
• The principles of trauma-informed practice hold practitioners and organisations in good stead in work with all children, regardless of their previous experiences.

Rather than focusing only on treating specific young people in specialist sexual abuse or family violence services, organisations have used trauma-informed practices as overarching principles. These practices of safety and transparency, context, choice, and cultural safety can be applied in many contexts and systems. Trauma-informed practices not only support the many children and young people who have experienced trauma but hold organisations in good stead to work respectfully with every child and young person (MacDonald et al., 2024; Sweeney et al., 2018).

As we began to hear and see more about the trauma-informed values and practices of the staff at MCCG, it became obvious that this was not happening by accident. Considerable planning and thought had gone into establishing a consistent approach to trauma-informed practice with children and young people.

We heard that there was a history of commitment across the ACT mental health service system to increase consistency of trauma-informed service delivery throughout the territory. This commitment was generated from a whole sector acknowledgement of the importance of consistent approaches to children and young people in mental health services. This commitment has resulted in numerous strategies that include government and non-government organisations. Examples of these strategies include:

• ACT Position Statement on Trauma Informed Practice for Children and Young People: This position paper outlines the ACT Government’s guiding principles in trauma-informed practice for children and young people, and provides practice examples of how this can be achieved collectively. The paper was presented at the Tenth Legislative Assembly for the ACT (ACT Health, 2023).
• ACT Child and Youth Mental Health Sector Alliance: Created by the Office for Mental Health and Wellbeing, Capital Health Network and Youth Coalition of the ACT, this alliance connects representatives from over 40 services, and builds awareness of trauma-informed and good practice in youth mental health services (ACT Health, 2023).
• ACT Health and Community Services Directorate’s ‘Youth at risk of developing mental ill health project’: This project has examined strategies to enhance system, organisational and practice responses to children and young people who have experienced trauma (ACT Health, 2023).

In 2021, two of Canberra’s most prominent social services organisations, Marymead and CatholicCare, decided to merge. This merge was in response to rapid population growth, changes to the community and social services sector, and a desire to deepen the mission of caring for those in need (Catholic Voice, 2021). In June 2023, MCCG officially launched and began operations across the ACT and regional NSW. Employing over 600 staff, MCCG’s footprint extends across Canberra into Queanbeyan, Goulburn, Young, Wagga Wagga, the South Coast and through the Snowy Mountains.

As part of their first strategic plan, the two organisations created a single entity to establish a values-based evaluation that ensured consistency in service delivery to all clients, particularly children and young people. Trauma-informed principles were developed as part of the new strategic plan, clinical governance framework, practice and supervision frameworks, and models of care.

A major goal for the newly formed organisation was to use trauma-informed principles to honour children’s individuality, diversity and preferences. The development of a trauma-informed culture recognises the historical role that institutional power has played in the perpetration of abuses experienced by children and young people. This includes developing specific strategies to ensure that service responses avoid coercion or control (Sweeney et al., 2018).

A trauma-informed organisation considers power at every level of its operations, developing support mechanisms for clients and staff based on curiosity, choice and respect for difference. These considerations do not seek to eradicate power but rather to recognise the responsibilities of those with greater hierarchical privilege (Sweeney et al., 2018; ACT Health, 2023). This leads to the development of bottom-up accountability, with leaders in the organisation taking responsibility for a vibrant, diverse and supported culture. Similarly, the onus of responsibility rests with practitioners to ensure that children and young people receive the kinds of services that fit their individual needs.

Watch the following video (5 minutes, 38 seconds) as staff from MCCG discuss the importance of trauma-informed values in developing a consistent organisational culture.

When trauma-informed practice is owned by every staff member within an organisation, children and young people are more likely to be encouraged to tell their stories in ways that increase safety, choice and positive identity. Conversely, where trauma is seen to be a ‘specialist’ area, attempts made by children and young people to disclose information about their lives might be unintentionally disqualified because staff lack the confidence or authorisation to remain curious. Without a carefully planned organisational approach, trauma responses are left to the skill and comfort of individual practitioners (Sweeney et al., 2018).

Increasing organisational capacity to support children and young people who have experienced trauma can guard against the corrosive effects of secrecy in the lives of children. Organisations that are trauma-informed are more likely to provide consistent opportunities for children, young people and their families to disclose trauma and be supported effectively. This moves beyond the assumption that children and young people can only be supported by ‘trauma specialists’ (Guy, 2020; Moss & Klapdor, 2022).

If trauma-informed safety and care is truly to become everyone’s business, organisational mechanisms that plan, monitor and evaluate the effectiveness of these practices are vital (Emerging Minds, 2019).

The opportunity to provide key messages to potential staff can begin at recruitment. Position descriptions, job advertisements and interviews can create the expectation that all staff in all roles will develop trauma-informed practices (Emerging Minds, 2019). This doesn’t necessarily mean that the successful applicant will already have highly developed trauma-informed skills. An organisational commitment to supervision and reflective practice should also be part of the position description. This tells applicants that the organisation will help them to develop these skills, and that systems will be put in place to support this expectation (Emerging Minds, 2019).

Watch the following video (7 minutes, 2 seconds) as staff from MCCG discuss how trauma-informed principles are supported in important governance processes within their organisation.

Trauma-informed organisations consider the professional relationships and environments that help children feel safe, and in which all practitioners can respond supportively and confidently to disclosures (NSW Health, n.d.). This ensures that children and young people are always believed, and disclosures are met with calm and considered responses (Guy, 2020; Sweeney et al., 2018). Children and young people are informed of the processes that follow disclosure and the next steps wherever possible (Guy, 2020).

Creating environments that promote safety and transparency for all children is an important part of trauma-informed practice. This begins from the very first moment of service delivery (NSW Health, n.d.). To ensure an immediate sense of safety, waiting rooms can be designed to be welcoming and inclusive from the moment children step through the door.

Transparency is the best way to ensure that professional practice creates fair and equal relationships. Practitioners can help to establish a sense of transparency in their first meetings with children and young people. This can involve the practitioner letting the child know what they know, sharing the details of the referral, and striving to understand if the child’s versions of events are like the ones described to them (NSW Health, n.d.).

During initial assessments and engagements, it is important for practitioners to widen the practice scope beyond only an investigation of behavioural concerns or problems (Emerging Minds, 2022a). This ensures that something separate from the problem becomes known, and helps children and young people to feel that conversations are moving at a safe and manageable pace. Recognising the ways that children and young people contribute to their relationships and connections can help them develop a growing sense of possibility and agency (Emerging Minds, 2022a). Relationships with others and connections to what children and young people value are often diminished or silenced as part of the trauma process (Vermeire, 2022).

In trauma-informed organisations, children, young people and their families are provided with implicit and explicit messages that build confidence and offer scaffolding if they wish to disclose trauma (Guy, 2020; Moss & Klapdor, 2023). Where children and young people do disclose trauma, it is important for practitioners to exercise care in the questions that they ask. A detailed description of the trauma itself may bring back vivid recollections or visions, which can lead children and young people to relive the feelings of powerlessness and fear they experienced at the time (Moss, 2024). When practitioners show an interest in children’s active responses to trauma, it can help to alleviate feelings of hopelessness or complicity (Moss, 2024).

Safe and calm responses to children’s first disclosures of trauma significantly enhance their recovery journey and long-term mental health and wellbeing (Wall, Higgins & Hunter, 2016). Being believed by a trusted adult can mean that children are more likely to talk to other supportive professionals or family members, which helps them to move beyond self-blame or secrecy (Sweeney et al., 2018).

Practitioners can reassure children that they are believed and have made the right decision in disclosing, while providing honest and realistic information about next steps (Guy, 2020). Children tell professionals about their trauma experiences when they see them as a safe and trusted adult. Children’s biggest hope is that they will be believed (Sweeney et al., 2018).

Watch the following video (4 minutes, 32 seconds) as staff from MCCG discuss an organisational approach to the trauma-informed principles of safety and transparency.

Engaging in organisational practices of collaboration and choice means that children, young people and their families are immediately included as influential and meaningful partners.

Collaborative practice privileges mutuality in decision-making. It accounts for the preferences, histories and values of children and young people, who are acknowledged as the experts in these aspects of their own lives (ACT Health, 2023; MacDonald et al., 2024). One of the ways that practitioners can engage in collaborative practice is by asking children about their preferences for the conversation: what is talked about, when it is talked about, for how long and with whom (Emerging Minds, 2022a).

Collaboration and choice guard against the assumption that all children and young people who have experienced trauma experience its effects in the same way (Moss, 2024). Practitioners focusing on collaboration and choice are less likely to make immediate diagnostic claims regarding the neurobiological effects of trauma on children and young people (Moss, 2024). As part of this work, children and young people are supported to name and describe the effects of trauma and other problems in their lives, using their own language and meaning-making (Emerging Minds, 2021; 2022b).

Practitioners can become interested in when the problem is most or least present, and what makes it bigger or smaller, as part of their collaborative practice. This makes it more possible to consider how children and young people’s relationships, contexts and preferences interact with the problem (Emerging Minds, 2022a).

Organisations working in this space, including MCCG, take care to examine processes such as referral, intake and assessment to ensure they provide pathways for collaboration and choice, rather than only an investigation or diagnosis of the problem. They also consider how the lived experiences of children and young people can meaningfully contribute to governance and service design (MacDonald et al., 2024).

Watch the following video (4 minutes, 28 seconds) as staff from MCCG discuss the importance of collaboration and choice for every child and young person who attends their service.

Whether children have disclosed trauma or are contemplating disclosures, the influences of power will play a major part in their considerations. When the power differences between adults and children are not made overt, children can be convinced of their own complicity. Adult perpetrators explain their actions as part of a ‘relationship’ with children and young people, minimising their intentional power abuses (Guy, 2020).

Making power visible for children helps them to move beyond assumptions of complicity or self-blame. Contextual practices allow for consideration of the differences in power between adults and children, particularly related to factors such as size, knowledge, language, understanding, ability, privilege and choice (Emerging Minds, 2021, 2022b).

Understanding how perpetrators have abused their power before, during and after trauma can help to find cracks in dominant stories of complicity. This can support children and young people to move beyond self-blame (Vermeire, 2022). When children and young people are supported to name and consider these power differences, they are less likely to see their trauma as the outcome of an equal relationship (Emerging Minds, 2021, 2022b).

Children and young people are best placed to remember or notice the actions, resistance or protests they have made when the power differences between them and adult perpetrators are made visible (Vermeire, 2022). A contextual approach assumes that they are never passive recipients of their trauma. In all cases, they find ways to minimise, resist or protest during trauma events. These resistances might have been small actions like crying, hiding or getting angry. In normal circumstances, these resistances might be disqualified or overlooked by adults or by the child or young person themselves (Emerging Minds, 2021, 2022b).

Through a contextual approach, children and young people begin to make meaning of these small resistances and actions. They become the evidence that stand against explanations of complicity often used by perpetrators to ensure children and young people stay silent (Emerging Minds, 2021, 2022b).

Watch the following video (5 minutes, 24 seconds) as staff from MCCG describe their focus on the individual context of every child and young person who attends their service.

While Emerging Minds and MCCG worked together, the message that has been most reinforced is the important link between values, processes and practices.

In this paper, Emerging Minds has provided examples of MCCG’s trauma-informed work, as well as outlining some trauma-informed principles. It should be noted that the trauma-informed principles explored throughout this paper are not exhaustive. For example, the principles required to ensure cultural safety and responsiveness within a trauma-informed lens need further consideration.

MCCG is an example of an organisation that strives for consistent, trauma-informed practices and processes. Importantly, their commitment to learning supports their recognition that practices need to constantly evolve and improve.

Where an organisation is clear about the values it strives for within a trauma-informed framework, it can plan for the processes, relationships, discourses and practices that will make this happen. An organisation becomes more than a collection of services with different funding sources and theories of change; it becomes a single entity that can allow consistent, respectful and safe experiences for every child and young person.

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