Frontiers in child and adolescent psychiatry
Nurturing environments for shaping trauma-responsive care and recovery: a realist coproduction study protocol
By Parry S, Wong G, Ariss S and 6 others.
Abstract
Background/rationale
Children and young people in residential care often face multiple, complex traumas, including the distress of being removed from familiar environments. Trauma-responsive care (TRC) offers a framework for understanding and responding to these experiences, yet there is no standardised TRC intervention specifically designed for children's homes in the UK. This lack of tailored guidance contributes to inconsistent care quality and limited support for staff and service providers.
Objectives/aims
The NEST Study aims to co-produce, pilot, and evaluate a trauma-responsive care intervention for children's homes through co-production and realist methods. NEST seeks to understand how, when, and why TRC interventions work for cared-for children and to develop an implementation toolkit that supports sector-wide improvement. Study design overview: This multi-phase realist co-production study comprises three workstreams: 1. A Rapid Realist Review to develop an initial programme theory of TRC in residential settings. 2. Experience-Based Co-Design (EBCD) with children, staff, and stakeholders to co-create the intervention, in alignment with the programme theory. 3. A Realist Evaluation of the intervention across six children's homes in Northern England, followed by refinement of the implementation toolkit.