Changing the client lens: giving voice and meaning to mental health clinicians’ experience of trauma informed relational care training

Introduction: Existing research on Adverse Childhood Experiences (ACEs) confirms that ACEs are endemic in the lives of many of the people who attend and use mental health services. Although the trauma caused by ACEs is known to have enduring impacts on adult mental health, mental health services in Ireland have not taken a systematic approach to trauma-informed relational care and it is difficult for clinicians to obtain formal training in this topic. The current study therefore carried out research on clinicians’ experiences of a locally-devised, trauma-informed relational care training and how this experience impacted on their perception of self, client and clinical practice in the twelve months afterwards. Methods: A qualitative design using purposive sampling and semi-structured interview was used to explore participants’ experiences. Interpretative Phenomenological Analysis (IPA) was used as a method of analysis to give voice and meaning to eight clinicians’ experiences of training and how it impacted on their perception of self, client and clinical practice. Results: Four superordinate themes were identified using IPA. These themes were best conceptualised as a process of change or metamorphosis which included; Engagement of Self; Changing the Lens; Change in Self as Clinician; and Change in Clinical Practice. Conclusion: The study provided insight into the metamorphic process clinicians experienced through training. For clinicians to change the client lens, they had to subjectively and objectively connect with the client experience through reflection which developed empathy and mentalisation skills. This is the first known evaluation of trauma-informed relational care training in an Irish context. Implications and recommendations are discussed for clinical practice, education and future research with a particular emphasis on how the client lens impacts the relational aspect of care.