Background As a consequence of the COVID-19 pandemic, our counselling service experienced a significant rise in bereaved clients with more complex presentations combining complicated grief, high anxiety, late or misdiagnosis and other significant death-related traumas. We recognised the need to become more trauma-informed so that we could work ethically with the complexity of clients accessing our service and remain responsive to the changing climate. Additionally, we found ourselves being used as a resource by other professionals and an ethical imperative encouraged us to develop a service model which could be viewed as a Centre of Excellence (CoE).

Aims To develop and implement a trauma-informed, strengths-based model to address the growing numbers of bereaved clients experiencing elements of trauma; and establish ourselves as a CoE in the field of bereavement and loss.

Methods Researched existing trauma-informed models and through adaptation defined six trauma-informed core principles that ethically established the boundaries of our service offer in line with our organisational remit and professional competencies. Identified the ‘principles of good governance’ (British and Irish Ombudsman Association. Guide to principles of good governance. 2009) as a foundation for facilitating a process of continuous staff and service evaluation. Implemented these through auditing existing policies, procedures, and practices, identifying areas for improvement and executing changes. Trained staff and upskilled supervisors to use a trauma-informed lens, applying consistently to client work. Developed and began delivering a programme of training and resources covering trauma and key topics in the field of bereavement and loss.

Outcomes A multi-skilled team using a trauma-informed approach, better equipped to meet the needs of more complex client presentations; contributing to the education of other professionals in the field of trauma, loss, and bereavement; resulting in a regional CoE.

Conclusion Developing a trauma-informed service alongside becoming a CoE has allowed us to remain relevant to our community, resource associated professionals and improved the regional profile of the hospice.