Residential Out-of-Home Care Staff Perceptions of Implementing a Trauma-Informed Approach: The Sanctuary Model

The aim of this study was to explore and better understand the enablers and barriers of implementation and how these impact on the organisational successes and challenges of adopting The Sanctuary Model, as perceived by residential care staff. Following ethics approval, three semi-structured interviews and six focus groups were conducted with residential care staff between February and July, 2020. Participants identified a number of enablers, presented in the subthemes: (a) social support systems and resources; (b) shared trauma-informed knowledge and understanding; and (c) leadership and champions. These enablers influenced organisational successes in adopting: (a) the Sanctuary Commitments; (b) the S.E.L.F Framework; (c) Reflective Practice and Supervision; and (d) Trauma Theory. A number of barriers hindering implementation were identified. These were reflected in the subthemes: (a) informal practice; (b) lack of practice-based training; (c) poor introduction to young people; and (d) resources. These barriers impacted on organisational challenges faced in residential out-of-home care including: (a) The Sanctuary Model Toolkit and (b) young people's behaviour and engagement. Comparisons from this study and previous findings identified by executive and upper management staff (decision makers) are discussed. Key findings indicate that when implementing, sustaining and embedding The Sanctuary Model, organisations need to become trauma-informed rather than 'do' trauma-informed care and organisations need to "live and breathe" The Sanctuary Model Commitments, be connected and inclusive of one another, use trauma-informed language and feel safe.