Trauma informed practice in health and social care

References to trauma-informed principals and care were around in the 1980s and 1990s. However, in 2001 Maxine Harris and Roger Fallot's edited book (a book compiled from multiple authors expert on trauma and mental health), 'Using Trauma Theory to Design Service Systems', formalised trauma-informed care principals and helped establish trauma-informed approaches in healthcare and social services. Triggering widespread interest in trauma informed principals. Their contributions included:

• Defining trauma theory and its application to mental health services
• Explained the need for trauma-informed systems
• Provided guidance on implementing trauma-informed care in service systems
• Discussed future directions for trauma-informed practices.

How did trauma informed research start

In the mid-2010s practices for qualitative research started to incorporate trauma awareness when working with vulnerable users who have experienced trauma or have some protected characteristics. Researchers in public health, social work and psychology started to adopt trauma-informed methods to qualitative research. 

By late 2010s, trauma informed user research was starting to take shape, researchers across tech and government adopted trauma informed principles and an emergence of ethical guidelines for conducting research with vulnerable people started. Publications and talks on ethical research, consent and avoiding re-traumatisation starting to gain attention. 

Emphasised through the COVID-19 pandemic, there was widespread adoption by the early 2020s of trauma-informed design and research ethics. With large scale private organisations Microsoft, Google and large UK government departments DWP, incorporating trauma informed principals into user research frameworks. This also started the emergence of a wide range of industry publics such as 'Compassionate UX' and 'trauma-aware design'.

Publications have continued and iterated over time to focus on application across all User Centred Design professions, including the recent publication of 'Designed with Care', focused on creating trauma-informed content from a wide range of professions including the recent publication of 'Designed with Care' authored from 15 leading experts in content design.

Trauma informed user research principals

Trauma informed research principals vary dependent on organisation and their focus. These are my  'Trauma Informed User Research Principals' synthesised from a wide range of good practice, which focuses on the participants without bias of organisation. 

4. Minimizing Retraumatization

• Be sensitive to past trauma and adjust the research approach to avoid triggering distress.
• Use research methods that do not force participants to relive or detail distressing past experiences unless absolutely necessary.
• Provide emotional support or signpost participants to support services if needed.

5. Inclusivity and Accessibility

• Ensure research is inclusive and that it accommodates participants from diverse backgrounds, including those with disabilities, mental health challenges, or other vulnerabilities.
• Follow accessibility guidelines (e.g., ensuring digital interfaces are easy to navigate and information is presented clearly for all users).

6. Ethical Responsibility and Aftercare

• Take an ethical approach to all stages of the research, ensuring that participants’ rights are respected and that their well-being is prioritized.
• Offer aftercare, providing resources or referrals to support services if the research process causes distress.
• Maintain confidentiality and ensure participants’ privacy is respected.

7. Trauma-Aware Design

• Design services that account for trauma: This includes creating user interfaces that avoid overwhelming or triggering users and ensuring that any required personal information is gathered respectfully and with empathy.
• Research with understanding of systemic trauma, especially within government services like DWP, where individuals may already feel marginalized or mistreated by previous experiences with bureaucratic systems.

8. Training and Awareness for Researchers

• Equip researchers with trauma-informed skills: Train staff to recognize and respond to signs of distress, understand trauma responses (fight/flight/freeze), and practice empathy.
• Ensure researchers understand the potential power dynamics and vulnerabilities of participants, especially in government and welfare research settings like DWP.

These principles combine the ethical sensitivity from general trauma-informed research with the specific needs of vulnerable populations in DWP and digital government services at GDS, providing a solid foundation for conducting responsible, compassionate user research across sectors.

Would you like further insights on methodologies or best practices for applying these principles in real research projects?