Does training change practice? A survey of clinicians and managers one year after training in trauma-informed care

Purpose: The purpose of this paper is to describe the impact of a trauma-informed care (TIC) training programme on practice at the individual and workplace level in mental health and drug and alcohol services and to examine the implications of using training alone as a strategy for achieving system-level practice change. Design/methodology/approach: A total of 271 clinicians and managers from public mental health and drug and alcohol services in Western Australia who had undertaken TIC training were invited to complete an on-line survey 12 months after training. Individual survey items were based on a five-point Likert scale with opportunity being provided for additional comments from respondents. Findings: One year post-training, both clinicians and managers reported that training had increased their awareness and knowledge and had a positive impact on their attitudes towards TIC. Clinicians reported a moderate impact on their individual practice and both groups reported very limited success in bringing about change in their workplaces. Workforce development and organisational factors were identified by both clinicians and managers as being barriers to implementation. Research limitations/implications: Only 30 per cent of the training participants responded to the survey and it is not possible to determine whether they differed from non-respondents. Findings were based on a self-report survey with no objective measure of behaviour change. Originality/value: This “naturalistic” study examines the longer-term impact of training, from the perspective of clinicians and managers, on changing practice at the individual clinician and workplace level. It highlights the critical importance of understanding and addressing contextual factors where collective, coordinated behaviour change is needed in order to effect organisational change.