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Trauma-Informed Design: What is it?

Written By: Siddharth Ashvin Shah, MD, MPH and Karla Siu, MSW

Trauma, broadly defined, touches everyone. In viewing trauma through a wider lens we see its detrimental impact on human beings, families, communities, and entire cultures. For researchers, clinicians, and practitioners, trauma can also be narrowly defined. The power of looking narrowly with psychological, neurological, and biological sciences is that it allows us to hone in on the nature of trauma to effectively prevent, mitigate, and heal trauma.  

For over 15 years as a clinical social worker, I (Karla) witnessed first-hand the countless ways trauma frays our social fabric. Trauma brings suffering not only to the survivor but through social contagion, also their relatives.

Further, trauma can go on for generations within a society as certain behaviors and coping mechanisms are passed down by those who have witnessed trauma. The social contagion does not stop at relatives, however. Interacting with survivors means that professional helpers, their institutions, and their programs are drawn in and harmed by trauma until it is identified and mitigated.

Balancing the broad and narrow views of trauma looks like this:

  • By viewing trauma through a wide lens, we perceive how the detrimental effects of trauma discriminate against no one – this heavy truth is especially evident in populations on the margins of society.
  • By viewing trauma through a narrow lens we deepen our understanding of how individuals, groups, and communities can counteract the destructive effects of trauma to support healing as well as long-term wellbeing and sustainable health.

If you work with vulnerable populations it’s likely that you’ve heard the term trauma-informed. To be trauma-informed means that you know enough about how trauma exposure influences perceptions, feeling states, and behaviors in individuals, families, and communities. What follows logically from integrating this knowledge into your work is what trauma experts refer to as a trauma-informed approach.

Having a Trauma-Informed Approach

To have a trauma-informed approach entails adjusting your interactions with individuals, families, and communities burdened by trauma. Trauma-informed approaches derive from over three decades of research, beginning with lessons learned in the care of traumatized individuals within social services settings.

We believe it would be a mistake to limit the use of trauma-informed approaches to social services. This evolving body of work brings scientifically based preventive and restorative measures to counteract the negative effects of trauma on individuals and communities. This body of work enhances effectiveness and outcomes.

Like finding an untapped vein of diamonds in a mine – applying a trauma-informed approach can uncover human potential. This has ramifications for all professional sectors that cannot escape the effects of trauma such as legal practice, criminal justice, medical care, public health, anti-racism work, human rights, peacebuilding, community-based organizations, and international development.

Workers who operate in settings with widespread trauma find trauma-informed approaches both intuitive and welcome. This was particularly clear in my (Siddharth) years of disaster response work. My field work placed me in New York City post-9/11, in Sri Lanka and India post-Tsunami, and in Mumbai 2008 for a terror attack.

Assuming the existence of these realities at the outset of my work provides three benefits. First, it reduces the likelihood of preventable harm (such as triggering/retraumatization). Second, it aids in developing rapport/trust. Third, it gets ahead of problems by taking positive steps.

Using Trauma-Informed Design (TID)

So, how do organizations and practitioners across an array of non-clinical disciplines adopt said “trauma-informed approach” when they have never set foot in a clinical training program before? And what about when their scope is neither therapeutic nor psychiatric? This is where Trauma-Informed Design (TID) comes in.

It is our experience that processes matter. You do not have to be a behavioral health practitioner to understand the extent to which processes influence organizational outcomes in any number of industries and service organizations.

TID integrates a trauma-informed approach for use on an organizational level. With TID, an organization is intentional about taking trauma into account when working on its program design, staffing procedures, HR investments, and leadership actions. The objective is to get ahead of trauma rather than be caught by surprise, suffer poor outcomes, and lose ground.

We at Greenleaf curate the latest findings in the fields of trauma healing and neuroscience to provide organizational leaders the necessary tools to help design and implement programming across sectors that face either the direct or indirect effects of trauma. TID offers a framework as well as practical tools for addressing trauma during daily interactions and entire programmatic cycles so that an organization may accomplish its mission. Implementing TID makes for a more efficient use of resources when conducting business, or operating, with traumatized individuals.

Within the workforces of such organizations, TID is of exceptional benefit as well. Workers who deal with the traumatized are known to suffer an indirect form of trauma known as secondary trauma. They may also struggle with the reopening of old wounds given their own personally experienced primary trauma.

Sustained engagement with threat, crisis, and violence tends to have a post-traumatic effect on entire workforces. And sustained concern regarding an impending crisis or danger brings stress of another kind, known as “pre-traumatic stress.”

TID promises to do heavy lifting wherever it is applied. It is unusual to find a design concept that simultaneously enhances the execution of job duties and the wellbeing of workforces and organizations.

In fact, TID has a triple benefit: (1) enhances efficacy by serving the interests of target populations with better outcomes; (2) promotes wellbeing by serving the interests of workers; and (3) ensures sustainability by serving organizational health.

How often have you recognized that trauma affects your work and clients? Why not just design for it?

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