Implementing Trauma Informed Care in Human Services: An Ecological Scoping Review.

Area of Science:

• Public Health
• Health Services Research
• Psychology

Background:

• Trauma and toxic stress are significant public health issues impacting morbidity and mortality.
• Trauma-informed care (TIC) is an organizational approach to mitigate adverse effects and promote healing.
• Empirical evidence on TIC implementation within systems remains limited.

Purpose of the Study:

• To conduct a scoping review on the implementation of trauma-informed care in adult-serving human services.
• To identify challenges and implications of implementing TIC across different service systems.
• To present findings through an ecological lens (macro, mezzo, micro) for practice, policy, and research.

Main Methods:

• A systematic scoping review adhering to PRISMA and Arksey/O'Malley guidelines.
• Searched four databases (PubMed, Scopus, Embase, PsychINFO) for English articles published since 2000.
• Included studies reporting on TIC implementation in adult services with organizational implications; 22 of 1099 articles met criteria.

Main Results:

• Trauma-informed care is being adopted in various human services, including city/state level initiatives.
• Implementation research in this field is nascent, highlighting early-stage development.
• Several systemic challenges to implementing TIC were identified.

Conclusions:

• TIC implementation is occurring across diverse human services, indicating growing adoption.
• Further research is needed to address the identified challenges in systemic TIC implementation.
• An ecological framework provides insights into practice, policy, and research needs for advancing TIC.