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It was concluded that EBCD is a suitable methodology for service improvement in mental health settings.

Purpose Studies show that experiences of repeated or complex trauma are very common in patients with severe mental health problems. Unfortunately, many professionals do not routinely ask about abuse, due to concerns about how to ask and respond. There is also a need for frontline staff to be trained in trauma-informed care. The purpose of this paper is to identify the needs of inpatient staff and developed a tailor-made training package. Design/methodology/approach A training programme was developed from focus-group discussion and delivered to the team. Questionnaires were administered pre-, post-training and at three-month follow-up, to assess changes in knowledge, confidence and worries in the assessment and treatment of complex trauma. Findings There was an increase in self-reported staff confidence (p=0.001) and knowledge (p=0.028) about working with complex trauma and their worries decreased (p=0.026) between pre- and post-training. Practical implications In order to sustain the benefits of training for longer, recommendations were made to the service for on-going training, supervision and evaluation. Originality/value Given the recent interest in complex trauma within the literature (Diagnostic and Statistical Manual of Mental Disorders – Fifth Version (DSM-V); International Statistical Classification of Diseases – 11th Version (ICD-11)), the piloting and development of complex trauma training packages is timely. To the author’s knowledge, this is the first published account of complex trauma training for inpatient staff. This paper offers clinical and research implications to services who may want to develop as trauma-informed services within the NHS.

Due to the growing evidence base supporting the hypothesis of common processes across different mental health problems, transdiagnostic interventions are receiving increased research attention. Transdiagnostic approaches have the potential to produce better outcomes, to reduce waiting times and to increase cost-effectiveness in stretched mental health services. Research into transdiagnostic cognitive behaviour therapy (CBT) in group format has demonstrated positive results in participants with anxiety disorders, with some studies extending the inclusion criteria to secondary and comorbid symptoms. This study evaluates a transdiagnostic CBT-based intervention, delivered by a secondary-care mental health team and includes participants with a range of diagnoses typical of this population. The real-world setting and lack of exclusion criteria based upon diagnosis provides an ecologically valid evaluation of a transdiagnostic CBT-based intervention. The results suggest that the intervention was associated with reductions in self-reported symptomatology and improvements in social functioning of individuals who attended in a secondary-care mental health service.

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