Bringing trauma informed design to a mature organisation

Definitions

“An event, a series of events or a set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being”.

Substance Abuse and Mental Health Services Administration [SAMHSA] [1]

Trauma is something that is uncomfortable to talk about, partially because there’s a stigma around it, but also because it’s an often misunderstood word. In this context when talking about trauma, it means the psychological impact that someone has suffered as a result of harm.

In this case trauma is how we refer to events that are so overwhelming that they have a lasting negative impact on a person’s ability to cope psychologically.

A person who has experienced a traumatising event often has little to no control over the situation, compounding a feeling of helplessness.

Trauma informed design is part of a new field of research

There are many triggers for trauma, including often overlooked sources such as racism and other forms of group hatred or discrimination.

Trauma informed design is a branch of the growing field of traumatology. Traumatology is a relatively new field, having only really started to develop in the later half of the twentieth century. It was only in 1980 that Post Traumatic Stress Disorder (PTSD) was officially added to the Diagnostic and Statistical Manual of Mental Disorders.

Previously PTSD had been called ‘Shell Shock’ and ‘Battle Fatigue’. People often wrongly assumed that this condition would affect those who had experienced life-threatening events, such as war. Unfortunately those many people experiencing PTSD wouldn’t receive the help they needed. We now understand that trauma can affect anyone.

In 1992, American psychologist Judith Herman was able to coin the term ‘complex trauma’. This is when a person is exposed to prolonged, repeated, and chronic exposure to traumatic events or long term stress. This is most commonly seen in situations of childhood abuse, domestic abuse, or captivity situations.

How does trauma affect design?

Acknowledging that trauma exists has been the first step in understanding how it has an impact on design. Understanding that we’re likely all affected by trauma, at various degrees of severity.

As designers we’re morally responsible to ensure that our work doesn’t cause harm to users, through direct or indirect trauma. There is also an argument for us having a legal obligation as PTSD can be classed as a disability and could therefore be covered by the Equality Act 2010. As designers in the public sector, it is our responsibility to ensure that we design in an accessible way, begging the question, should trauma be considered under accessibility regulations?

In order to remain ethical, we must design services that support our users, keeping in mind the risk of re-traumatising them where possible removing or reducing that risk. We must also remember that trauma-informed design is not there to fix the root cause of harm, but to acknowledge and recognise that trauma is in the room with us.

Traditionally design has usually been a fast paced process with a mentality of ‘move fast and break things’. But what happens when you do that with a traumatised population? There’s an inherent risk that you could risk causing harm, triggering or even re-traumatising a person by using this approach. Maybe a safer approach is to take things slower, giving more time to testing and analysis.

How did I get into trauma informed design?

In 2022 I became the design lead for the work that Government Digital Service did on the Exit this Page component and pattern. As part of the research we wanted to get feedback on the prototype I created from users who had lived experience of domestic abuse to ensure that we were satisfying users' needs.

This was the first time I really became aware of the term trauma informed to describe the type work that we were doing. Katrina Birch, our user researcher, had made it clear that our priorities were to avoid re-traumatising research participants, while also caring for our own mental health. She introduced me to the term that applied to the principle we’d be unintentionally applying to our work, a way of working that we had adopted.

After the publication of the component and pattern, the GOV.UK Design System team hosted a panel about trauma informed design and research at Design System Day 2023. This gave attendees and organisers an opportunity to engage with and learn from a multidisciplinary panel and colleagues across the public and private sector who are working towards more compassionate and aware design.

Finding out where to start with trauma informed design was overwhelming

After this work I immediately knew I needed to learn more about trauma informed principles and design but I didn’t really know where to start. A Google search brought back thousands of results, which made the idea of learning about this topic really overwhelming. There was so much information but I knew that I needed to put a lens on it to make it manageable.

So I looked to cross government and international colleagues who were working in the same spaces. And it was actually at a Services Week session in 2024 I was able to finally learn more about trauma informed design!

Katharine Beer, Steph Batliner and Rachel Edwards ran a session on the exact topic that had inspired me, talking about whether trauma-informed design is a passing trend or should be considered a new aspect of accessibility. I took this opportunity to connect with Katharine about the work that she had spoken about.

I started talking about other difficult topics

I knew that to get any investment in a new area of design, I would need to get momentum which meant showing a lot of enthusiasm. Exit this page was something that I and the team could truly be proud of. At the same time I wanted to find other things to talk about, so I looked at imposter syndrome and the work that Dr Valerie Young had done.

At Design System 2022 I delivered a talk on imposter syndrome in government, explaining what it was and how it had an impact on our lives. It was terrifying to give a talk on something I felt so strongly about myself but the feedback was so helpful, with many people saying that the idea of saving an email telling them that they did a good job was something they were going to adopt doing forward.

I got to help set up a community

Myself, Katharine and Efi (a User Researcher now at NHS Digital) came together. We knew that this was an area that we all really wanted to work within but none of our respective departments had anywhere we could situate ourselves. So we decided to do one ourselves that was open to cross government colleagues.

We ran our first session in April 2024. We had over 30 people attend from various departments and established guidelines for keeping ourselves safe whilst we covered the topic carefully.

We established core values as a group including taking a trauma-informed approach, maintaining accessibility and inclusivity, establishing ethical and safe practices, engaging in enhanced user research and developing professional growth and community support.

We did have some teething issues too, when the group was first set up we used Google meet, however many government departments do not allow their employees to use or even access Google meet. In Government Digital Service we don’t have Microsoft teams as standard, so I needed to get approval to have it installed. Thankfully I had a very supportive line manager and deputy director who made this process as smooth as possible.

I am by no means an expert on this topic, and to develop my knowledge I started reading books such as The body keeps the score by Bessel van der Kolk to learn more about the basics of how trauma affects a person’s body, mind and soul. I attended the international trauma informed design community group spearheaded by Rachael Dietkus to find out what was being done in other countries.

I’ve also been utilising the learning and development offer that Government Digital Service provides to learn more about trauma informed design. So far I’ve attended a virtual workshop learning how to apply trauma-informed design to improve government services.

Networking is hugely beneficial

As my knowledge developed, so has my confidence in talking about trauma informed design. In October 2024 I ran a workshop at International Design in Government on the topic of talking about trauma safety. This has been the highlight of my career so far. It explored language and broadly where we are as a community in terms of understanding this subject.

My hypothesis for this session was that in order to achieve long term change we have to get the basics right first. Creating standardised language and approaches to trauma informed design is the fundamental step in creating a safe and secure space for this area of design to grow.

I believe that until we get things right for users, we risk exposing them to further harm, especially with an issue as subjective as trauma. Additionally currently every team and department has a different approach and therefore working to different standards. This means that we are likely to be duplicating research findings and providing poor user experiences.

So how does this all apply to work at Government Digital Service?

All of these things for me had really been about personal development, but I wanted to take these learnings and share them with the community that we’d set up. I was also grappling with the question of whether we needed an internal community as well as the cross government one. I felt that both had their merits but that I wouldn’t be able to manage them both well. Rather than do both, could I come up with a better solution?

There were also a number of other challenges that I learn from during this time:

Bringing people to the community is hard

There are lots of challenges involved in bringing a new area of design to a workplace. Although I got buy-in from some of the senior leadership to develop this area, trauma informed design is still an unknown area of design. We don’t have any specific work streams for this work, it’s a community engagement piece that I’ve been spearheading within the organisation.

Finding and keeping momentum is challenging

It can be really hard to keep people engaged with work when it is not something they are doing as part of their daily job, and I often find myself beating a lone drum. Keeping momentum and consistency is key to keeping a community alive, and it’s important to acknowledge that that is hard to do, especially when there is no-one else doing the same thing.

Finding time to set up work can be really difficult

I work on a really busy team and it’s only been through trial and error that I’ve learnt how to carve out time for the community. Initially I was attempting to do this without setting aside specific time, and I felt like I was drowning in work. I had to learn the hard way to set an afternoon aside specifically for this work whenever I was planning to talk about it, otherwise I would be working into the evenings or even on weekends.

There is so much overlap between departments but there’s no strategic alignment

With the new blueprint for change I see places where trauma informed design and research can overlap but there no-one has yet identified a way in which this work could be beneficial. People often come to the government in times of crisis such as when a loved one has passed, or if they need help with a disability. However the content can be cold and non-informative. There are also times in which trauma informed design can have an unanticipated benefit.

A recent study on working with trauma in adult probation services in England and Wales identified several benefits for staff of working in a trauma-informed way (HMIP, 2022). In particular, trauma-informed approaches were found to feel intuitive, improve job satisfaction, help to overcome the dissonance between personal and professional values and organisational demands, help to create a meaningful working relationship between the practitioner and the person on probation, and provide a more humane lens through which to redefine the more punitive aspects of practice.

What now?

I've set a personal, community and overall target for this work.

Personal: bring a trauma informed design based to the Government Digital Service design community once every 2 months

I’m a single person trying to run a cross departmental community as well as do my day job. I want others to be inspired by the work that is being done in this field, but not at the expense of my own wellbeing, so in order to avoid burnout, I’ve given myself a personal target of bringing a trauma informed design task, talk or workshop to the Government Digital Service design community once every 2 months.

Community: get senior buy in for departmental wide awareness

I want this to be something that we can take forward in Government Digital Service. Trauma informed design is such a fascinating area of design, and I know that in order to do this I need senior leadership buy in. I’m working out how this looks, and even if I need to go to areas such as life sciences in DSIT for backing.

Overall: keep talking about trauma informed design

The only way to get information out there about the amazing work being done across the civil service is to keep talking about it. I’m not an expert on this topic, but I am passionate about making sure that we get heard. In an ideal world I would love to bring us together and find us the space, time and resources to make this area of design something that is no longer an add-on, but our day jobs.

References

1. Trauma and violence - what is trauma and its effects? (2024) SAMHSA. Available at: https://www.samhsa.gov/mental-health/trauma-violence (Accessed: 15 February 2025).

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Tags: trauma informed design, accessibility, resources

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