Prison Officers’ Perceptions of Delivering Trauma-Informed Care in Women’s Prisons

ABSTRACT

Since 2015, women’s prisons across England have been working toward providing trauma-informed care (TIC) given the high rates of psychological trauma in the prison population. Research into TIC in prisons has been limited to date. This qualitative study explored the perceptions of 35 prison officers from two English women’s prisons about their experiences of providing TIC, including the role of training. Four main themes were identified using thematic analysis: Creating trauma-informed settings was noted as a dynamic process, complicated by prisons being triggering environments for women. Prison officers described attempting to negotiate the power (im)balance between them and women in prison, to allow them to nurture positive relationships with them. Operational practices reportedly regularly undermined these efforts by reinforcing the power differential. Staff also observed variable and limited capacity and opportunities for TIC, further reducing the ability to create settings conducive to TIC. These findings have important implications for women’s prisons, including the need to review and revise TIC training for new and existing staff; prioritize staff well-being and support, and improve recruitment processes to develop a staff group with the aptitude and skill to deliver TIC.

KEYWORDS:

• Prison officers
• qualitative research
• staff training
• staff well-being
• thematic analysis
• trauma-informed care
• women in prison

Internationally, research has shown that women in prison have high rates of life-course trauma (Stensrud et al., 2019), and imprisonment can be (re)traumatizing for those with trauma histories (Crewe et al., 2022; Kelman et al., 2022). In the Female Offender Strategy, the Ministry of Justice (MoJ) published its commitment to a program of work to meet the needs of women in contact with the criminal justice system. This included providing trauma-informed care (TIC) in women’s prisons (MoJ, 2018). Although there is a growing body of literature signifying the importance of TIC for people with trauma histories (Goodman, 2017; Harris & Fallot, 2001), little is known about the perceptions and experiences of staff working in services that provide TIC.

Whilst there is no universally agreed definition of TIC, the Substance Abuse and Mental Health Services Administration (SAMHSA, 2014, p. 11) describes six fundamental principles: safety, trustworthiness and transparency; peer support; collaboration and mutuality; empowerment, voice and choice; and cultural, historical and gender issues. The definition of TIC used across His Majesty’s Prison and Probation Service (HMPPS) women’s prisons is similar to SAMHSA’s: safety, trust, empowerment, collaboration, choice and staff self-care (Covington, 2018). The goal within HMPPS is to make changes at the system, organizational and environmental levels to make women’s prisons trauma-informed, and to make alterations at the level of people and processes so that TIC can be provided to women in custody. The overall aim is that the environment will be safer for individuals living and working in prisons, by ensuring that staff have the knowledge and skills to interact with people in prison in ways sensitive to trauma, whilst minimizing the likelihood that individuals will be triggered or retraumatized by their imprisonment or their treatment in custody. This is in recognition of the high level of trauma within the population.

Since 2015, HMPPS has been working toward the provision of TIC across all women’s prisons. Activities to support this have included reviewing policies and practices; the introduction of “Trauma Guide Teams” and “Trauma Champions” at each site to coordinate progress and maintain focus on embedding principles of TIC; increased availability of trauma therapy service, and the roll-out of one-day staff trauma training: Becoming Trauma Informed (BTI) (Covington, 2018). This training aims to provide staff knowledge about the extent and nature of trauma in the lives of women in the criminal justice system. The activities undertaken to date have largely been small-scale and prison-specific, with the implementation of the BTI training representing the most coherent and widespread organizational change across women’s prisons. Further coordinated and comprehensive organizational changes are still required.

Whilst the aim of making women’s prisons trauma-informed accords with the rehabilitative goal of prisons, prisons are primarily places of order and control (Craig, 2004). Individuals in prison have reported feeling physically or psychologically unsafe (Kelman et al., 2022), mistrusting staff due to their experiences with them (Crewe et al., 2022; Kelman et al., 2024), and described limited control and agency over their day-to-day lives (Crewe et al., 2022). There are challenges in providing TIC within an environment that can replicate the dynamics from prior trauma experiences and where individuals have limited power and control (Kelman et al., 2022). Women in prison have identified how cultural and procedural barriers impact their experiences of TIC in prison, including staff demonstrating uncaring attitudes and behaviors, and the scarcity of time for staff to spend supporting them (Kelman et al., 2024).

Relationships between caregivers and recipients of care are at the heart of TIC, and women in prison’s perceptions of TIC appear largely contingent on the nature and quality of their interactions and relationships with staff (Auty et al., 2022; Kelman et al., 2024). However, there are a variety of daily stressors perceived by prison officers to be present in their daily work (Siqueira Cassiano & Ricciardelli, 2023), and Crewe et al. (2022) highlighted the challenges for staff and prisoners navigating the often complex and intense relational dynamics and flow of power between the two groups. Indeed, King (2009, p. 270) described the work of prison officers as “a complex balancing of custodial and human service roles,” which can impact on the nature of their relationships with those in prison.

As part of a project to develop a robust measure of TIC in prisons Auty et al. (2022) examined the definition and concept of TIC. They identified disparities between the aspirations and reality of TIC, as well as discrepancies between the way staff and women in prison appraised the ability of staff to deliver TIC. As well as beginning to surface the challenges of delivering TIC to women in prison, these findings highlight the crucial role of staff in doing so. Given that TIC is intrinsically relational, prisons cannot aspire to be trauma-informed unless the staff group understands trauma and its impact. Supported by One Small Thing (www.onesmallthing.org.uk), a charitable initiative supporting criminal justice reform, trained trainers began cascading BTI training to colleagues in women’s prisons in 2015. The ambition was for all women’s prison staff to be trained, although staff turnover and competing training requirements have impacted this. As DePrince and Newman (2011, p. 213) state, “all the high-quality training in the world is for naught if practitioners do not integrate trauma training and trauma-informed treatments into their practices.” Whilst women’s prisons in the UK have been working toward providing TIC, further research is required into the lived experiences of staff whose roles are pivotal to implementing TIC, and to understand how BTI training impacts staff working practices. The current study explores the following questions:

1. In what ways do prison staff feel the BTI training has influenced the care provided for women in custody?

2. What do staff perceive are the barriers to and enablers of TIC within prisons?

Method

Design and data collection

The present study forms part of a wider project examining TIC in English women’s prisons (Kelman et al., 2022, 2024). Semi-structured interviews with 35 prison officers from two prisons were undertaken. One of the sites was a large, multi-functional, privately managed prison for women coming straight from court either on remand or newly sentenced. It also catered for women serving long prison sentences. The other site was a smaller public sector prison, housing only sentenced prisoners. Fourteen face-to-face interviews took place at the smaller prison between October 2019 and February 2020 and twenty-one video interviews using Microsoft Teams at the larger prison during February 2021. All interviews were undertaken by the first author.

Recruitment and participants

Staff who might have received additional specialist training for their job roles were excluded, with only people working in nonspecialist residential areas being invited to participate. Participants also had to be working on the scheduled interview days. Written approval was obtained from the Governor/Director of the prisons for the research interviews to take place during work hours. At the site where in-person interviews occurred, convenience sampling was used, whereby all eligible staff working on the days of the research interviews were scheduled an appointment to speak to the researcher, working around the operational requirements of the prison. A minority of the staff (n = 2) did not attend their scheduled appointments, due to unavailability for reasons of sickness or alterations to their shift patterns. At the site where video interviews were used, only eligible staff who gave written consent to participate were given appointments. All staff were given written information about the research in advance. They were invited to ask questions about the process at the outset of the meeting and were given the option to decline to take part at this stage. Every individual who attended the appointment gave their written consent to engage, with no dropouts. Each participant was reminded that they could choose which questions they answered and were free to leave at any time. None of the interviews were cut short, either for operational reasons or because participants chose to leave. Participant demographic information is included in Table 1.

Table 1. Demographic information about staff participants.

Demographic characteristic	Number of participants
Gender
Male	10
Female	25
Years in service
0–2.5 years	13
2.5–5 years	10
5–10 years	3
10–15 years	3
Over 15 years	4
Unknown	2
Completed BTI training
Yes	30
No	5

Overall, the participant sample broadly matched the 70/30 gender split of female to male staff required for women’s prisons. The greater number of female officers is defined in organizational policy, due to the nature of some job roles which can only be undertaken by female staff (for example, searching of women in prison).

Procedure

Face-to-face interviews took place in a private location within the prison, while video interviews took place in an administrative office within the prison. All participants provided written consent for interviews to be audio recorded and transcribed. Any potentially identifiable information provided during the interviews (such as names or places) was anonymized during transcription, with each participant given a unique identification number.

Interviews lasted between thirty minutes and one hour, with most taking almost the full hour session. Scheduling sessions for one hour minimized the impact on the prison regime caused by staff being away from their duties. Questions related to participants’ working practices and experiences, with all participants initially being asked whether and when they had completed the BTI training. Those who had received training were asked questions including, “can you describe how the training has impacted the way you work?” and “in what situations do you find it easiest to apply the learning from the BTI training?” To understand the level of participants’ trauma awareness, they were asked, “in what ways do you think somebody’s prior trauma might impact the way they behave in prison?” with follow-up questions to explore their understanding further. Given that many participants had undertaken training some time ago or not attended at all, the key principles of trauma-informed practice, (safety, trust, collaboration, choice, and empowerment) were highlighted to all staff before they were asked how they applied these principles to their work. For example, “in what ways do you contribute to making people in prison feel safe when you are doing your job?” and “what do you think helps people in prison to feel that they can trust staff?”

Ethical Considerations

Approval was obtained from King’s College London Research Ethics Committee (HR-18/19–8105) and the Ministry of Justice National Research Committee (2018–189). Involvement was voluntary with potential participants informed that there would be no positive or negative consequence of not engaging and that they were free to terminate the interview at any time. At the end of the interview, each participant was informed about available staff support options.

Analysis

The qualitative method of Reflexive Thematic Analysis (TA) (Braun & Clarke, 2022) was adopted to enable the identification, analysis, and organization of themes in the data contained within and across the interview transcripts. The data from the interviews was explored in a “bottom-up” way, given the absence of a preexisting coding framework, which enabled the development of the themes to come entirely from the data, without being influenced by any existing constructs. NVivo version 12 (QSR International, 2018) was used to manage the data. The analysis was structured using the six phases outlined by Braun and Clarke (Braun & Clarke, 2022) – familiarization with the data; coding; initial theme generation; theme development and review; theme refining, defining and naming, and finally writing up the analysis. The first author moved back and forth between the phases until the themes generated provided a good fit for the data.

The “data familiarization” stage involved reading and re-reading each transcript until a good understanding of the issues and experiences pertinent across the sample as well as within the individual interview data had developed. The “coding” stage of analysis consisted of identifying meaning within the data systematically. Using NVivo, each transcript was read with code labels ascribed to sentences or parts of text which had a particular meaning. Implicit meaning of the data segments collated under the code labels were then considered, to establish whether the code labels were representative of the contents of the data.

The third stage of the TA process – “initial theme generation” - involved grouping the code labels into clusters with similar meanings. This was an iterative process, involving systematically reading and re-reading the data segments under each code label, and amending the label to reflect the deeper meaning of the data, as well as grouping similar code labels. Initial “theme” names were identified, recognizing that these would evolve over the course of the analysis. The fourth stage of the TA – “theme development and review,” involved reviewing each collated group of coded text to further develop the latent (deeper) meaning of the codes. The first author refamiliarized themselves with the raw data then considered each grouping of codes to determine relevance and conceptual coherence, both to the entire dataset and the research questions.

During the fifth stage, “theme refining, defining and naming,” each of the data extracts within a theme were read and reviewed, to ensure both that the semantic themes were captured and that the latent meaning of the data fit within each theme. The “essence” of each theme was captured by a process of reading and analyzing the data extracts and making detailed notes which examined the meaning of, and connection between, each theme. Once the theme meanings could be clearly understood and articulated, the themes were named in a way that most accurately captured and reflected the concepts they represented. The final write-up stage of the TA involved establishing a logical and coherent order and flow of the data to address the research questions. Differences by gender, prison type, and site training methods were considered during the analysis and are discussed where relevant.

Reflexivity

The first author’s employment as a psychologist within HMPPS gave them familiarity with the prison system, and concepts discussed, although they had not been employed at the research sites nor worked directly with any of the participants. Throughout the study, the first author engaged reflexively, noting ways in which their professional role might have impacted the research process, and utilized meetings with the other coauthors to discuss the findings. This reduced the influence of prior assumptions and ensured the findings were data led.

Findings

Four major, interlinked themes were identified. Creating trauma-informed settings (theme 1) was identified as an ongoing, dynamic process underpinning all other themes. Foundational to this was the ability of staff to nurture positive relationships (theme 2) with women in prison. Such relationships are necessary for TIC but require staff to continuously negotiate the power (im)balance (theme 3) between them and those in prison whilst maximizing their capacity and opportunities for TIC within their role (theme 4). Capacity and opportunity for TIC varied over time and across situations and was contingent on ongoing staff commitment and motivation to create trauma-informed settings (theme 1).

Creating trauma-informed settings

For TIC to be delivered in prisons, the context must first be conducive to its development and maintenance. This theme includes two subthemes relevant to the creation of trauma-informed settings (becoming “trauma-informed” staff and recognizing and minimizing prison triggers) and addresses the first research question about participants’ perceptions of the contribution of staff training to their delivery of TIC.

Becoming ‘trauma-informed’ staff

Thirty participants confirmed they had completed BTI training, with the remainder aware of the training program. Whilst most participants who had completed BTI were positive about it, when specifically asked how it had impacted their working practices and contributed to their delivery of TIC, none were able to attribute any changes in their working practices to the training. Despite this, some participants reflected how the training highlighted the way women’s trauma histories may shape their prison behaviors and how this might influence staff’s working practices:

… from the training, I remember to look, when specifically dealing with the women in here, to look at the bigger picture, the broader picture because… . This might be affected by something else that’s happened in their past, and that kind of shapes the way they are behaving now. (S2; female)

Other participants believed that they already had the required caring attitudes and skills to provide TIC, describing the training as “common sense” (S3 and S26; both women), rather than providing any new information. Others perceived the training to reinforce their existing knowledge and reaffirm the effectiveness of their established working practices, “I suppose what I took away from the training was just talking to people. And that’s something that I certainly wasn’t not already doing, so I don’t think I took much away from it” (S13; female).

Several participants stated that they could not remember anything from the training, with some suggesting that this was because they completed it a long time ago: “You’re really testing my memory now!” (S27; male); “… it’s a bit vague, because it’s been quite a long time ago … ” (S30; male). Some participants suggested that “refresher” training could aid knowledge recall: “I did [BTI] when I first came … in 2018… . it should be something we do as a refresher, maybe every year or … two … it shouldn’t just be at the start of your career … ” (S18; female).

Recognizing and minimizing prison triggers

When asked about the barriers to TIC, participants commonly referred to stimuli within prisons that might elicit a trauma response among women. The general noise and chaos within the prison environment was recognized by staff at both sites as potentially triggering for women who might be hypervigilant to possible threats because of their trauma histories. Several staff from both prisons recognized that male staff shouting was particularly triggering for women in prison who had histories of male perpetrated intimate partner violence and reflected on the possible impact: “ … you could be shouting at people, and then all of a sudden it will trigger something off [for] them” (S1; male); “we have to be mindful … if somebody might have been in an abusive relationship where there’s constantly shouting … and then we as an officer go there and start shouting, that might trigger memories for them … and they’d be traumatized … ” (S24; female).

Keys were frequently cited as triggering by participants from one prison based on the prior domestic violence experiences of a single individual. This had evolved into a well-intentioned but oversimplified belief amongst staff that the sound of keys was triggering for all women, and that knocking on cell doors with their hands (instead of tapping with keys) constituted trauma-informed practice, and nothing further was required of them to deliver TIC: “ … when you’re knocking on the door, not using your key … a lot of [staff] bang on the door with [the] key, so it’s actually knocking with your hand” (S23; male).

Several participants reflected that, when faced with multiple persistent and pervasive triggers endemic to the prison environment, they were unable to control or know all potential triggers for those in their care, and therefore felt they could not adequately create and maintain trauma-informed settings:

… at the end of the day we’re still a prison, and unfortunately there’s going to be loud noises … you’re going to hear the jangling of the keys … people have to shout… as much as you can try to alleviate that … because of the environment we’re in, you’re not always going to get rid of it completely … (S29; female).

Nurturing positive relationships

To provide TIC, staff must be both willing and able to nurture and maintain positive relationships with people in prison. The willingness to develop such relationships was described, primarily by female staff, as an attitude of sensitivity and compassion, whilst ability referred to its enactment, i.e. listening, noticing, and responding to the women’s needs. Participants, especially male staff, also recognized the importance of demonstrating trustworthiness in their behavior toward women in prison, to earn their trust, and maintain the positive relationships necessary for TIC.

Sensitivity and compassionate attitudes

Staff’s compassionate and empathetic attitudes were described as contributing to their motivation and willingness to understand women’s needs and demonstrating care. The demonstration of such attitudes was described as contributing to creating rapport and trust between staff and women: “ … I’m … in tune with the prisoners’ emotions and how they’re feeling … when the ladies are upset about their children, I can see that side of things … ” (S9; female); “ … if [women] perceive you care and you’re empathizing with their situation then they’re going to recognize it and go, ‘okay, yeah, so they do care … they will help me. I can talk to them’” … (S5; female).

Compassionate attitudes were comprised of a mindfulness about women’s need to feel safe, with several participants giving examples when their sensitivity and empathy had helped women to feel safe in prison:

I make them feel safe by being approachable … they’re humans at the end of the day, and … there’s a reason why they’re here and there’s going to be trauma, so … just treat them like you would want to be treated, so that is how I make them feel safe. (S12; female)

Listening, noticing, and responding

Those participants who showed willingness to develop positive relationships also described their ability to do so, by using specific skills to attend to the needs of women. This involved listening to them as individuals; noticing changes in behavior or mood; identifying their needs and providing individualized trauma-informed responses. In combination with a willingness, these skills were described as essential for the development of positive connections with women in custody, enabling staff to effectively discern when women required support:

There have been the occasions when I’ve … recognized that a resident isn’t feeling too great and I’ve unlocked them … and told them to come and sit in the office whilst I do my work and … chat with me … because I didn’t feel comfortable leaving them (S14; female);

… just showing that you’ve noticed they’re feeling a bit down today, and they’re not themselves, then just sort of telling them … ’I’ve noticed that … ’ so that they know that someone’s aware. And just basically being present and offering support whenever you can. (S31; female)

Participants recognized that active listening practices allowed women to feel “heard,” encouraging trust and enabling engagement with staff to share their own insights and experiences: “ … you generally do find that those that do really trust you and feel that you listen to them, and you’ll help them, they’ll open up more … you end up in a massive conversation, and they feel better at the end of it” (S9; female).

Many participants described responding to women’s needs by intentionally engineering opportunities for individual interactions with them to nurture positive relationships. Such engagements created the context from which staff could provide bespoke TIC to meet the needs of individuals rather than simply following generic principles or practices. Once a relationship was established, participants acknowledged that even relatively short interactions could be helpful in responding to the needs of women: “ … it’s very important to get to know the women, to find out what they’ve been through … I think if we had more time with the women we could … get to know … how we should work with that individual” (S25; female); “Little things like … I will try and wander the landings and just like pop my head in and just check everyone’s alright … I like to go and ask people how they are … ” (S5; female).

Demonstrating trustworthiness

Staff deemed it essential that they demonstrated trustworthiness to earn and maintain the trust of women in their care – many of whom had difficulties trusting others because of their trauma histories prior to prison. Several participants, predominantly men, described their efforts to demonstrate that they were reliable and honest, recognizing the potential negative consequences for relationships with women, and therefore delivering TIC, if they were viewed as letting women down: “Just be straight up and honest with them … you’d probably find that with most of these women, everybody in their life has let them down and lied to them. They don’t need that from us as well. They are expecting it … ” (S21; female).

Trustworthiness also hinged on staff’s abilities to show fairness toward people in prison. However, staff had different perceptions about what constituted fairness and consistency, with some indicating that fairness was treating everybody the same. Others saw fairness as recognizing and responding to the differing needs of women, rather than treating everyone identically: “ … everybody’s different … you’d like to treat everybody the same, but sometimes you have to go about things differently with different people” (S1; male).

I keep a calm wing … there is no “one rule for one and one rule for another” … I think [the prisoners] feel safe … that this person isn’t trying to do me out of something, or that person’s getting extra, why are they getting extra when I’m not?… . (S13; female)

Even when staff engaged consistently with individuals in custody, several participants explained the potential for staff to undermine each other due to differing degrees of leniency or strictness across the staff group. This impacted whether women experienced their treatment as fair: “I think inconsistency across the prison is always a problem … and each staff member has their own different opinion on how something should work or what punishment someone should get … ” (S28; male);

… when there’s another member of staff that … is very strict … it just makes your job harder, because you just think, “everything I’ve just done!” … and you can understand why [women in prison are] acting that way, because you just think, “oh well, this is inconsistent!.” (S8; female)

Several of the male staff reflected on the deliberate actions they took to demonstrate their trustworthiness to women who may have previously been mistreated by men: “Some of the ladies have had trauma … to do with men … so we need to make sure that we show them that we’re [a] positive role model, instead of the negative that they’re used to” (S16; male);

… a lot of women go through domestic abuse … by treating them with respect, by helping them, by listening to them, by being patient and understanding … I can change their viewpoint on men … I think it’s good for women to understand that not all men are violent or abusers … that there are men out there that are good, that will help… . (S30; male)

Negotiating the power (im)balance

Power differentials between staff and women were described as often complex, with participants explaining how they were continuously negotiating the power (im)balance in their interactions and relationships with women in custody. Many participants described challenges navigating conflicting roles due to their inherent authority as prison officers. This was negotiated using a range of cognitive strategies that facilitated power blindness – namely, practices of denying, avoiding or minimizing the reality of the power dynamic between themselves and the women in prison.

Navigating conflicting roles

Many participants identified inherent conflicts between some of their work duties and the provision of TIC. Tasks necessary for the security of the prison, including giving orders and physically restraining people exhibiting challenging behavior, required them to overtly use and demonstrate their power over women: “ … having to be one minute an authoritative role, and the next minute you actually have to listen without talking … many different roles … ” (S27; male); “I build up … trust and then suddenly I see them on drugs, and I [have to punish them] … ” (S4; female).

Many staff described discomfort that their actions were sometimes triggering, or made women feel unsafe, especially if they knew their history. Participants appeared to acknowledge the tension between their provision of compassionate care and the reality for them of holding the power as prison officers, positioned within the traumatizing system:

… I do know quite a lot of the women’s past traumas, and especially if they’re … getting a target search, or they’ve been [forcibly] relocated … they’re like, “you know what I’ve been through!” … and I do, because they’ve spoken to me about it … and then I have to say, “this is protocol, we have to do this.” (S3; female)

Power blindness

While many staff deliberately acknowledged the differences in power between themselves and the women and the tensions this could cause with TIC, several engaged in denial or minimization of the power they held over women in prison, both cognitively and in their practice. Some staff described attempting to find common ground, to level the power between them and people in prison. Staff explained how talking to women about non-prison related subjects enabled them to temporarily step out of their disciplinarian roles, and women to step out of their prisoner roles. They identified how this encouraged freer connection with those in their care and helped to carve out normalized relational spaces outside of the power structures of the prison: “ … trying to connect with them on a level. There’s a couple of girls … I talk to them about Eastenders – just a little thing … it’s something we chat about. I just think it feels a bit more like normal life” (S16; male).

Several participants emphasized their own similarities with those in prison as a means of humanizing individuals in custody. Some expressed the view that bad luck or different circumstances might have meant that staff themselves could have ended up in prison, suggesting that any differences between them and prisoners were due to different life chances. Engaging in this form of power blindness enabled them to minimize or deny differences between many staff and people in prison (for example, in terms of power dynamics, life chances and advantage). This approach encouraged empathy, reminding staff of the need to treat women in custody as they would want to be treated if they were in the same situation: “ … anyone could end up in prison you know … ? You accidentally could run someone over driving, and you could end up in prison…Or remand – it wasn’t you, it was mistaken identity … ” (S16; male).

Capacity and opportunities for trauma-informed care

Even if staff were willing and able to provide TIC, and could manage the power differentials effectively, the ability to provide TIC appeared to be undermined by restrictions on capacity and opportunities due to time and resource pressures, staff trauma and organizational betrayal and the prison system inhibiting TIC.

Time and resource pressures

Many participants perceived that insufficient staffing levels and multiple job roles and responsibilities substantially impacted their capacity to provide individualized care despite a strong desire among staff to do so: “ … the officers … they want to be trauma-informed … they can’t always be because it’s like one of you, 39 of them … it’s one thing after another. You haven’t got time to speak to 39 people and see if they’re okay” (S3; female);

… I genuinely do care about the women … we have self-harmers, we have people that are suicidal, we have women who are in crisis, we have women who are angry … and I feel like we are doing them a disservice … because we can’t possibly spend as much time with them as they need… . (S11; female)

A new national system assigned all people in custody to a named prison or probation officer as their key worker, with whom they had weekly individual meetings. Within women’s prisons, each key worker provided one-to-one support for a small number of women, enabling them to develop positive relationships and provide practical support and assistance as required. This was hailed as a positive potential solution to the lack of capacity to provide individualized care: “Sometimes when we have 1-1s, that gives us more chance of applying [trauma-informed principles] … ” (S15; male); “I’m really looking forward to … key working coming in, when you’ve got more time, because I think that, when you’ve actually got an allotted time to sit down with people … I think that would be [good]” (S10; female).

Staff trauma and organizational betrayal

Several participants described the job as stressful and mentally draining, with some reporting experiencing trauma at work or disclosing their own personal trauma histories. Most staff recognized their own need for support to enable them to provide effective support to others and to protect them against burnout. However, some reflected that the organization seemed to put staff needs secondary to the needs of people in prison:

… I think [TIC] should be more focused on the officer rather than the prisoner, because you can’t help someone unless you’re mentally stable … everyone deals with trauma. There’s lots of officers in here that are going through a lot of things right now … a lot of people have broken down on that wing – crying. I myself, first couple of months, I did start crying because I did not know how to handle it all. (S4; female)

Some participants identified the lack of tangible support from managers as problematic but had evolved informal support networks within their peers as substitute for this absence: “ … just even seeing a [senior officer] on there might be nice … there’s a lot of new staff, who have got no leadership from anyone. It must be hard for them. I don’t know how they cope” (S6; female); “We work like each other’s therapists on here really … that’s really important as well, to remind people to be supportive of your colleagues because we’re all doing the same job … and feeling the same feelings … ” (S4; female).

When those staff with a strong desire to support and care for women in prison were unable to provide TIC due to time and resource pressures, this was described as leading to disillusionment, frustration and betrayal at their truncated ability to make a difference to the lives of people in prison: “Honestly, a lot of staff here are just tired … worn out and unappreciated … ” (S5; female);

When I was doing my training, I had this vision of what kind of officer I’d be, and it’s just gone downhill … I was under the impression I would get … to know the women, and I’ve not really had much of a chance. (S14; female)

The prison system inhibits trauma-informed care

Participants recognized that the nature of the prison system and the rules and processes required to manage people within it substantially limited options for staff to support women to make meaningful choices or collaborate in decisions about their daily lives, key principles of TIC. Some staff expressed concerns that prison further restricted prisoners’ already limited agency and choice, meaning that women were unable to choose to use established means of coping with distress: “To us it sounds … petty … they’ve come into jail and … they can’t smoke … that may have been a relief mechanism for them for … trauma that they’ve gone through. It’s how they cope … we’ve taken that coping mechanism away … ” (S32; female).

Many participants also identified the limited control women had over their lives in custody, and the particular parallels this had for some women with prior domestic abuse. This created substantial barriers to the provision of TIC, and highlighted the lack of opportunities for women to be empowered to take responsibility: “…someone’s controlled them for so long … now we’re controlling them … ” (S32; female).

… they’ve probably been … in relationships where everything else has been dealt with for them, especially if they’ve been in controlling relationships. We’re not helping that and we’re not supporting that … if we’re doing everything for them then it’s not really working. (S14; female)

Discussion

This study is one of the first to explore the lived experiences of UK prison officers in managing the challenges and realities of implementing TIC in women’s prisons. The findings build on the work of Auty et al. (2022), which focused on conceptual understanding of TIC from the perspectives of staff and women in prison. The current study provides greater depth to our understanding of the specific skills and strategies used in practice by prison officers to provide TIC, as well as the barriers and enablers perceived by staff to affect their ability to provide TIC. This adds to the growing understanding of the practicalities of implementing TIC in UK prisons, in particular prior research examining the perspectives of imprisoned women of their care in prison (Kelman et al., 2024). Based on participants’ accounts, the BTI training was not seen as having a lasting effect on TIC delivery. They described the challenges of continuously creating opportunities for TIC within a system and environment consisting of many potential triggers for women with histories of severe trauma, many of which were outside the control of staff. Despite the environmental and systemic hindrances, staff who fostered positive relationships with women in prison described improvising delivery of TIC on a relational basis.

Before TIC can be anything other than aspirational staff must be trained to understand the effects of trauma on the behavior of women in prison, as well as being supported to develop and embed skills and strategies into their working practices. They must also be provided with the right environmental context and resources for their skills to be realized. Participants struggled to identify impacts of BTI training on their practices. Findings suggested that the training may have led to oversimplified views about triggers among staff, due to its short duration and infrequency, as well as the absence of a refresher course. This would accord with prior research showing an association between reported recall and recency of training attendance (Unick et al., 2018), as well as evidence that effective training to support the implementation of TIC tends to be in-depth and experiential, with ongoing coaching or supervisory support (Bryson et al., 2017), rather than brief stand-alone training events. Further evaluation and potential revisiting of current trauma training would be beneficial.

Participants demonstrated familiarity with “trauma” language and understood how trauma might impact prison behavior. It is unclear whether this knowledge was created by the training itself; by the broader organizational focus on TIC, or whether it reflected the increased use of “trauma” terminology within society (Haslam & McGrath, 2020). This increased use of “trauma” language might create a false impression that staff are delivering TIC simply by their use of words without concordant or appropriate actions as described by Auty et al. (2022). Additionally, the perceptions amongst some participants that TIC was common sense could indicate a misconception that TIC was simply good practice (Isobel, 2016) and was already part of how they worked (Sweeney & Taggart, 2018), rather than something requiring specific training to develop understanding and ongoing attention and effort to ensure effective delivery.

Participants in the current study recognized many triggers impacting women’s safety within prison but felt powerless to change these, significantly impacting their provision of TIC. This matched the perspectives of women in prison (Kelman et al., 2022, 2024), who reported feeling unsafe due to the many triggers in the prison environment. The finding that many triggers were viewed as outside the control of staff raises complex questions for the organization about how achievable it is for staff to be trauma-informed within systems that are not. A specific trigger identified by staff in the current study which mirrored findings from prior research (Kelman et al., 2024) was male staff shouting. This was the only area where findings suggested that the gender of staff was perceived to negatively impact their provision of TIC, and the current study highlighted the care taken by several male participants who sought to counter the way their gender might have impacted the extent to which women in prison trusted them.

Prison officers play major roles in the lives of people in prison (King, 2009), and therefore have a significant potential contribution to the provision of TIC. It requires compassionate attitudes, advanced skills, and the ability to recognize signs of “need” in their behavior, as not all women may ask for help explicitly. The willingness and ability of staff to nurture the positive relationships required to provide TIC to women in prison, fit with the “staff engagement” and “care and recognition” factors identified by Auty et al. (2022) as underlying the construct of TIC. However, care is not trauma-informed care unless the principles of TIC are attended to. Care provided in an environment which feels unsafe to those living in it cannot be TIC; care without collaboration still perpetuates the power imbalance that is destructive, and care from the same staff who sometimes use force to restrain them is undermined by mistrust. This is highlighted by the deep discomfort participants felt due to the incongruence between routine security activities (including searching and use of restraint techniques) and TIC. This reinforced the power imbalance between staff and people in prison, eroded trust, and fractured relationships between staff and the women. This was consistent with the way women in prison perceived the impact of such activities on their relationships with staff and their TIC (Kelman et al., 2022).

The varied and conflicting nature of the job roles of prison officers is well established (Craig, 2004; King, 2009), and findings from the current study accorded with the way correctional staff in Canada perceived the role conflict inherent in their jobs as a source of stress (Siqueira Cassiano & Ricciardelli, 2023). The current findings demonstrate the dissonance for those participants who were motivated to provide TIC, whilst recognizing the traumatizing and triggering nature of their actions, which instilled a sense of powerlessness and frustration in them. This was compounded by their own lack of power and capacity to create opportunities in the system for staff to redress the balance and give power and control to the women in prison. Even when participants described good trauma awareness, and a strong motivation to provide TIC, systemic barriers thwarted staff’s efforts. Insufficient opportunities reportedly existed for them to spend time building and nurturing trusting relationships with women, which jeopardized their provision of TIC. This lack of time to engage individually with people in prison was also identified by women in custody as a barrier to their TIC (Kelman et al., 2024).

The emotional distress and frustration reported by participants in response to the various systemic barriers that impacted their efforts to provide TIC paralleled the powerlessness felt by women in prison (Kelman et al., 2022). It also reflected features of betrayal-based moral injury (Haight et al., 2017). Some participants felt the organizational commitment to TIC was not matched by adequate means or resources to do so, resulting in frustration and betrayal due to the perceived insufficiency of the time and resources available for them to effectively provide TIC. Further research on moral injury among prison officers is required to explore this issue more fully.

The reported lack of organizational support for staff, which has previously been found to be a stress amongst prison officers (Siqueira Cassiano & Ricciardelli, 2023), also undermined the provision of TIC, with some participants feeling disillusioned and resentful because they found the job traumatic and stressful but did not receive appropriate institutional care. Whilst many described having created informal support networks, there was a need for the organization to recognize and appropriately respond to the impact of psychological trauma on frontline prison staff, by providing effective support to maintain their motivation, resilience and capacity to provide TIC (Substance Abuse and Mental Health Services Administration, 2014).

Strengths and limitations

The current study provides valuable evidence in an under-researched area. Obtaining the perspectives of front-line prison staff about the realities and challenges of delivering TIC is an essential part of service development. This study provides evidence from those with lived experience about whether delivery of TIC is possible within custodial environments, and what efforts are required to work toward this. The voices of 35 prison officers from two prisons provide a breadth of experiences from a range of perspectives and is a critical part of this evidence. The use of thematic analysis provided a way of rigorously exploring the data iteratively by moving back and forwards through the phases, without a pre-conceived theoretical framework but with robust strategies and methods of triangulation using peer discussion to review interpretations of the data.

There are limitations to this study that should be considered, including that it only reflects the views of main-grade prison officers. Including managerial staff could have disrupted prison operations due to relatively low staffing numbers in women’s prisons. There are practical challenges inherent in securing the availability of prison officers to participate in research interviews during their core working hours, however, this was considered preferable to attempting to interview them outside of work. Whilst having appointments scheduled into the working days of staff was the most reliable way of collecting data from a diverse sample, it was also a limitation of the research. It is possible that this approach might have generated a sense of obligation to participate. This was mitigated by the first author discussing the process and reiterating that participants were in control of their decision to engage, and the degree to which they participated. All individuals confirmed their consent to participate. Despite the interviews having to be limited to one hour so as not to negatively impact the prison regimes, participants shared their contentment with the process, including about the depths of their disclosures. Whilst some priming might have occurred through participants having been told about the principles of TIC at the outset of the interviews, this ensured a shared understanding about the concepts, enabling a focused discussion about the application of the principles to their practice. Although several participants denied being able to recall information from the training, they might have subconsciously retained certain facts or practices without being about to identify the training as the origin.

The gap in the data collection between the interviews at the two sites was due to the COVID-19 pandemic, when all research activity across HMPPS was suspended between March 2020 and approximately February 2021. This meant that interviews at the first site all occurred prior to the pandemic, and those at the second prison happened afterward. During interviews at the second prison, the researcher clarified that the focus was on TIC generally, rather than on TIC during COVID-19. This was because the pandemic led to severely curtailed regimes, and prisoners had little time to engage with staff. The impact of COVID-19 was not the focus of the research, however, working in COVID-19 conditions during the previous year could have affected staff attitudes toward their work, strains within the prison environment and ultimately influenced participants’ perceptions of their ability to provide TIC. It is possible that either the job role of the researcher; the nature of the subject matter, or both, could have increased staff motivation to present themselves favorably by responding positively. Additionally, the possibility of selection bias cannot be ruled out, given that responsibility for the identification of potential research participants rested with employees of both prisons rather than the researcher. For instance, the selected employees may have included those who were deemed eloquent or personable, had more positive experiences and/or were more available to take time out to engage with the research, rather than those who might be less positive or willing to engage. However, participants were informed that their data would be anonymized to clarify that there was no advantage to staff of providing overly positive responses. Staff with less favorable views about TIC would be an important cohort of staff to engage with in future research.

Implications

These findings highlight the ongoing challenges for HMPPS to realize the ambition within the Female Offender Strategy (MoJ, 2018) for women’s prisons to provide TIC, especially given that the BTI training is cited within the strategy as the primary vehicle for achieving this. It is laudable that the clear organizational commitment to TIC across women’s prisons meant that all participants appeared to recognize the significance of trauma in the lives of women in custody. However, questions remain about the effectiveness of the existing training relative to the strategic prominence and organizational investment in it. Refresher training for staff and involving incarcerated women in co-producing and co-facilitating an ongoing program of training could improve its effectiveness. A fundamental revision of the program and thorough evaluation of its impact are necessary. Whilst new staff would benefit from trauma training during induction, experienced staff may require more support to change established practices and prevent burnout. However, training is only part of the answer to the provision of TIC, and these findings highlight the resource pressures perceived to impact the capacity of staff to provide TIC, as well as the complexity of the skills and attitudes needed for them to effectively deliver it. Some participants described prior experience of jobs in caring professions as having prepared them to deliver TIC in prisons. Proactively advertising prison officer jobs in sites working toward providing TIC as having a strong “caring” component could be advantageous in recruiting staff able to provide TIC as well as dealing with the challenging relational dynamics inherent within women’s prisons.

There are wider challenges for HMPPS to create prisons and staff groups which can deliver TIC, and the substantial barrier caused by the tension between the care and control aspects of the prison officer job role warrants organizational focus and innovative solutions. Continuation of practices like “use of force” within prisons which are aiming to provide TIC should be fundamentally questioned, given its inconsistency with, and capacity to undermine, the principles of TIC.

Opportunities for staff to have meaningful and supportive interpersonal interaction with people in prison should be maximized, whether through the provision of additional funding to expand the numbers of staff available to care for women, or through the further development and protection of key working. Such engagements appear significant to the provision of TIC, and the absence of such opportunities contribute to dissatisfaction amongst staff about their roles. This could impact burnout and attrition in the prison officer group if their motivations for joining HMPPS included helping people in prison, yet the reality did not match these expectations.

Finally, to provide TIC in prisons, support systems for frontline staff must prioritize their emotional well-being and safety. This would help them effectively care for incarcerated women and manage the role conflict of their job, whilst also protecting them from potential moral distress or injury. Many participants have shown dedication to finding or creating opportunities to provide TIC in difficult circumstances, laying a strong foundation for support system development.

The findings are relevant to other organizations working toward the provision of TIC, as they highlight challenges in providing TIC to a group of service users instead of individuals. This and other related studies (Kelman et al., 2022, 2024) lead us to conclude that training cannot eradicate the barriers that prison creates for the provision of TIC. Rather it forms an important element of the wider cultural and systemic change required to afford staff the resources and opportunities to successfully provide TIC. Providing TIC in prisons presents a substantial organizational challenge (Auty et al., 2022), and questions remain as to whether TIC can ever be achieved within the (re)traumatizing environment and cultural context of prisons.

Ethical standards and informed consent

All procedures followed were in accordance with the ethical standards of the King’s College London Research Ethics Committee (HR-18/18–8105) and the Ministry of Justice National Research Committee (2018–189) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Acknowledgments

The authors would like to thank the staff who participated in the research, who spoke so openly about the challenges and rewards of their work, as well as the managers and staff who authorized and coordinated the research at both sites.

Disclosure statement

No potential conflict of interest was reported by the author(s).