The First Response project

Trauma and culturally informed approaches to primary health care for women who experience violence
Indigenous women Family violence Intimate Partner Violence (IPV) Violence against women Trauma-informed practice Australia

Research has shown that trauma informed services are effective in reducing the burden of violence against women. This is reflected in Australian policy landscape, including National Plan to Reduce Violence against Women and their Children 2010–22, which calls upon services to deliver trauma informed care. However, much of the research that guides policy is based upon Western concepts of trauma, which may not consider First Nations peoples experiences and perspectives on trauma. To address this, the First Response project explored how the workforce within Aboriginal Community Controlled Health Organisations (ACCHOs) conceptualise trauma and culturally informed care and how this informs approaches to primary health care for women who are experiencing violence.

Fear, shame and stigma prevents women from disclosing experiences of family violence or intimate partner violence (IPV) and accessing support. This can be compounded for First Nations women due to systemic racism and traumatising experiences with police, legal and health services. In response to these barriers, recommendations include the provision of trauma informed care, in which the multiple, complex nature of women’s lives is properly understood and responded to without judgement or shame.

Key Findings:

  • Being trauma and culturally informed differs to having clinical expertise and includes meaningful consideration of women’s lives in terms of their family and community. This also encompasses understanding the context and impact of colonisation, cumulative and historical trauma as well as current day trauma and how this impacts access to services and seeking help.
  • Government services and involvement can be retraumatising for clients, however effective partnerships with ACCHOs can minimise this. Key staff in ACCHOs built strong networks and relationships with external services including Police, Housing, Family and Community Services, Legal services and Justice Health and Forensic Mental Health Network. ACCHO staff frequently witnessed or encountered racism in mainstream and government services, which can be directed at both clients and ACCHO staff also systemically as the ACCHO staff attempted to seek support while engaging with these services.
  • Maintaining boundaries is important for supporting clients and staff, however there are additional challenges for Aboriginal and Torres Strait Islander Health Workers and Practitioners who are very present in community and/or have family and/or kinship connections to clients. It was emphasised that staff are very careful to not make promises that they could not deliver on, as this undermines trust in the ACCHO – and this is particularly important around child protection. There was recognition that overstepping boundaries does not enable clients and could also be a sign that staff needed more support or supervision.
Publication Details