The need for a trauma-informed approach to research
September 8, 2023
A few years ago, I was hired to lead research on a new organizational initiative on how we can better support people who inject drugs [1] [2].
As I considered how to approach this, I was aware that participants could be in vulnerable situations and our conversations might touch on sensitive topics. For example, I was concerned with how to best handle conversations about needles with people who are currently injecting drugs — let alone those who were in recovery — without triggering someone. I also assumed that there would be a higher likelihood that folks I met with from these communities would have experienced trauma [3]. And I worried, too, about the impact of the conversations on me, personally. I knew I needed professional help.
Luckily, I was working with a product owner, Steph, who was also a trained social worker. Steph helped me understand what I might expect to observe or hear when I started research. She made hypothetical (which, in turn, can be very alarming) scenarios feel tangible. I learned techniques, like, how to identify triggers with a participant before research, so we could do our best to avoid them in the session. I understood what to do if something went wrong, like if someone appeared under the influence in a session, and how to support both the participant and myself. I practiced helping someone identify who they could lean on for support, so they wouldn’t feel alone after we finished talking.
Steph taught me about trauma and trauma-informed care. And, together, we worked to figure out how these strategies could be applied to our research.
I’ve since learned that “trauma is a response to anything that’s overwhelming and that happens too much, too fast, too soon, and/or for too long and is coupled with a lack of protection or support” [4]. Everyone can experience trauma, but some folks are more likely to, and it can present itself in different ways.
When we do design research, particularly with folks who have disproportionately experienced trauma, we have to adopt a more intentional, caring and flexible approach. Our goal is not to be a therapist, psychiatrist or social worker. Most of us aren’t trained to do so. But we do need to ensure we avoid triggering existing or creating new trauma. [4]
Adopting a trauma-informed approach is not accomplished through any single particular technique or checklist. It requires constant attention, caring awareness, sensitivity, and possibly a cultural change at an organizational level. [5]
It is difficult to measure the impact and outcomes of a trauma-informed research approach. But, I’ve seen how design research which centers care and safety leads to better outcomes. By creating a safer environment for participants, we’re more likely to have grounded and productive conversations. A trauma-informed approach also considers the researchers, particularly researchers who are more likely to experience trauma themselves, ensuring the work we produce is more intentional and useful.
Doing research with people who inject drugs helped us better understand the shame and fear they might experience when considering where to go for new equipment or help. By taking the time to have safe, productive conversations, we learned how our in-person and online services could better meet people’s needs.
The key to building a good service is to learn how to care for people as best as we can. After all, we’re all human.
Thanks
When I joined a project at the Department of Veterans Affairs last year, I was delighted to cross paths with a group of researchers and designers who were starting a grassroots trauma-informed community, led by folks like Rachael Dietkus, Martha Wilkes and Josh Kim [6]. This post is inspired by their eagerness to define safer ways of doing research and draws on many of our conversations.
This was originally published on Medium.
References
[1] With You supports people who have issues with drugs, alcohol, or mental health.
[2] Steph Keenan wrote more about this project and its impact.
[3] Studies show that many people who have substance use disorders have experienced trauma as children or adults.
[4] This guide developed for Advancing Research 2022: Trauma Informed Panel includes definitions of trauma, trauma-informed design and other helpful resources. This resource also specifically calls out how trauma is systemic and structural. Which means that people from marginalized groups, or people who face inequities based on race, class, or gender, disproportionately experience trauma.
[5] Infographic: SAMHSA’s 6 Guiding Principles To A Trauma-Informed Approach | CDC