Childhood trauma is pervasive and can have devastating consequences for the health and wellbeing across the lifespan (Felitti et al., 1998; Felitti and Anda, 2009). Hence, there is growing interest in the adoption of trauma-informed practice to help ameliorate the impacts of trauma (O’Toole, 2021). However, the embedding of trauma-informed practice in schools is not a simple, standard, or linear process. If we are to embed trauma-informed practices in schools, the means by which we do so, must also adhere to trauma-informed principles such as those proposed by the Substance Abuse and Mental Health Services Association (2014) -  (1) safety, (2) trustworthiness and transparency, (3) peer support, (4) collaboration and mutuality, (5) empowerment, voice and choice, and (6) cultural, historical and gender issues (SAMHSA 2014).  It is not sufficient to develop a programme for schools to follow without taking into consideration the context of the school, as well as, the needs, experience, expertise and expectations of the staff and students in the school.

Co-design has been used in many different arenas, from business to architecture.  Co-design in trauma-informed care is a process that considers the impact of trauma and the negative operation of power, while prioritising building safe, trusting and collaborative relationships, thus addressing many of the principles of trauma informed care.  It is a person-centred method which foregrounds the experiences of people who are centrally involved in or impacted by a situation.  In this research project, the people involved are the staff and students working in two specific schools, at a particular point in time. 

Co-design is a method that can be placed under the rubric of participatory action research or community-based research, both of which are related.  One of the tenets of participatory or community-based research is “no research about us, without us!”, and co-design addresses that by either working directly with the people involved or handing the power over to the people so that they develop their own solutions to the issue at hand” (McTaggart, 1997).

Co-design is not possible without building relationships with those others involved in the co-design process.  As steps are taken the researcher must always question whether the actions taken, are inclusive and facilitate power sharing and capacity building. The process therefore necessitates deep and sustained reflective practice on behalf of the researcher to ensure the inclusion in decision making of those who may be coming in from the margins.  Unless attention is paid to building strong relationships based on trust their involvement may remain tokenistic.  Thus, those with more power should create the conditions of safety and hospitality to make it possible for people with less power to speak and to be heard. 

Taking a case study approach, this paper describes the co-design process underway in two urban primary schools that are working to become trauma-informed. The process included the creation of core teams, one in each school, consisting of a cross section of staff in varied roles in the schools. The core teams were formed by seeking volunteers from the whole school staff and were first convened in October 2022. Each team met with the researcher and discussed local issues in their school as well as looking at the existing frameworks available for use to develop as a trauma informed school. Each core team worked closely in a research-practice partnership (Penuel and Gallagher, 2017) with the researcher to develop a bespoke programme of Continuing Professional Development (CPD) for their school, taking their local issues into consideration. Both schools developed a programme of eight sessions of CPD with some overlap and some differences in the courses. The delivery of the eight modules was dictated by the schedule of time available in each school, with the core team determining the order in which sessions would be delivered and providing feedback to the researcher after every session. Such feedback informed the development of the next, and further, sessions so that the programme that was envisaged at the beginning of the work was not necessarily exactly as predicted by the end. This programme of CPD has now been delivered in both schools. At the time of writing, the core teams are continuing their work with the researcher to develop their schools as settings that adhere to trauma informed principles. Both core teams meet regularly to review policy documents as well as discuss strategies that are in use throughout the school. In addition, both schools have indicated that they wish to share what they have learned during the process with other schools. To that end, both core teams are engaging with the researcher to write a short handbook for school staff that will reflect the content of their CPD modules, with a view to publication online. The research project has thus empowered these two groups of school staff to develop a resource that may be useful to other schools in similar situations.

Preliminary results indicate that the co-design process fosters staff engagement, collaboration and the sharing of ideas and good practice suggestions. However, it can be time consuming and requires a high level of flexibility as well as a willingness to relinquish control. The programmes of CPD have been well received in the two schools, with staff reporting that they see the programme as being relevant to their setting. Staff have reported that they have experienced barriers to in-class implementation of some of the strategies proposed as part of the programme of CPD, and this feedback has been taken on board with strategies modified accordingly. Staff appear to feel a level of ownership of the programme and an eagerness to impart information to their colleagues in other local schools. This project commenced in two schools in October 2022 and is ongoing with an upcoming process evaluation focus group, which will consist of staff who have not been involved in the core team, so as to minimise bias. In addition, an arts-based activity, using Photovoice (Wang and Burris, 1997) will be undertaken with a small group of students in each school investigating what they like/dislike about school. Concurrently, data is being collected annually to determine whether the introduction of trauma informed principles and practices in the schools has any impact on staff and student wellbeing and their relationships. Overall, the preliminary data from this research project suggests that despite the challenges, co-design helps develop a better understanding of local context, ensuring that initiatives are tailored to the specific needs of students, teachers and local community. It also allows for greater innovation and fosters a sense of ownership, which can lead to improved engagement and sustainability in the long-term. Ultimately the study highlights the importance of co-design in health and wellbeing interventions in schools.

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