How trauma-informed are we? A comparative framework analysis of early intervention service guidelines for psychosis and trauma-informed principles

Background This study assessed the extent to which early intervention guidelines for psychosis align with trauma-informed care principles and identifies gaps in integration.Methods Clinical guidelines were sourced through literature reviews and principles of trauma-informed care were identified from previous literature. Using a deductive approach to framework analysis, four overarching themes and sub-themes were developed from existing guidelines. Quantitative analysis allowed the use of scoring and cross-comparison across guideline sets.Results Seven guideline documents, representing international perspectives (UK, Australia, British Columbia, United States) and published between 2005 and 2023, were selected for analysis. The findings revealed notable inconsistencies in the integration of trauma-informed principles across early intervention guidelines. Key areas such as staff supervision and trauma assessment are frequently underemphasised. Nevertheless, there is a clear temporal shift that suggests gradual progress toward the incorporation of trauma-informed principles over time.Discussion This study highlights the necessity of comorbid trauma and psychosis guidelines. It further underscores the need for explicit trauma-informed recommendations in psychosis guidelines to enhance patient outcomes and clinician preparedness.