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The Trauma-Informed Care Supportive Climate Scale for Forensic Services: Development and preliminary validation
Eavan McKenzie1, Alethea Charlton2
1Forensic and Specialist Care Group, Kent and Medway Mental Health Trust.
Psychological Trauma : Theory, Research, Practice and Policy
|August 3, 2026
Summary
This study developed the 19-item Forensic Trauma-Informed Care Supportive Climate Scale (Forensic TICSCale) to measure patient experiences in secure psychiatric hospitals. The new scale shows good reliability and validity for assessing trauma-informed care in forensic services.
Area of Science:
- Psychiatry
- Clinical Psychology
- Forensic Mental Health
Background:
- Secure hospitals aim to integrate trauma-informed approaches.
- Existing measures lack validity for assessing trauma-informed care in secure forensic settings.
- There is a need for a psychometrically sound scale to evaluate patient perceptions of trauma-informed care in secure services.
Purpose of the Study:
- To develop and validate the Trauma-Informed Care Supportive Climate Scale for Forensic Services (Forensic TICSCale).
- To create a reliable tool for measuring patient experiences of trauma-informed care in secure psychiatric facilities.
Main Methods:
- A preliminary 22-item scale was developed from patient focus groups.
- Expert review refined the scale, followed by a pilot study with 80 patients in secure English hospitals.
- Principal component analysis, reliability (internal consistency, test-retest), and convergent validity analyses (helping alliance, restrictiveness) were conducted.
Main Results:
- Principal component analysis confirmed a unidimensional structure, resulting in a 19-item scale (Forensic TICSCale).
- The scale demonstrated good internal consistency and strong test-retest reliability.
- The Forensic TICSCale showed significant positive correlations with helping alliance and negative correlations with restrictiveness.
Conclusions:
- The 19-item Forensic TICSCale is a promising tool for measuring trauma-informed care climates in secure forensic services.
- Further research is needed to fully establish its psychometric properties.
- This scale represents a significant advancement in assessing patient-centered, trauma-informed care within secure mental health settings.
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