The blog of the Urban Institute
August 30, 2021

Guidelines to Incorporate Trauma-Informed Care Strategies in Qualitative Research

August 27, 2021

Since the inception of trauma-informed care in the medical field in the late 1980s , the practice has evolved and permeated peripheral fields, including behavioral health, advocacy, and, in the past 20 years, research. The Centers for Disease Control and Prevention recently partnered with the Substance Abuse and Mental Health Services Administration to create guiding principles of trauma-informed care in public health, and adjacent fields are establishing specialized trauma-informed practices.

Researchers seeking better understanding of the infrastructures, stakeholders, and experiences that affect people who have experienced trauma have a responsibility beyond standard research ethics to appropriately conduct trauma-informed research and recognize people’s lived experiences. How can researchers incorporate the principles of trauma-informed care into their work?

What is trauma?

Trauma is defined as “any disturbing experience that results in significant fear, helplessness, dissociation, confusion, or other disruptive feelings intense enough to have a long-lasting negative effect on a person’s attitudes, behavior, and other aspects of functioning.” 

Our understanding of trauma and its effects on people and communities is constantly evolving, but we know trauma adversely affects a person’s psychological and physiological states. There is no single or “right” reaction to trauma—it can result in a wide spectrum of responses.

The key tenets of trauma-informed qualitative research 

If researchers don’t use a trauma-informed approach, their methods—especially interviews and focus groups—can retraumatize people and perpetuate harm. 

I spoke with Urban Institute researchers with expertise and experience working with practitioners to create trauma-informed methodologies, and together we developed the following key tenets of trauma-informed qualitative research. These four methodological guidelines can be adjusted depending on project and population specifics.

 

Researcher-interviewee relationships and power dynamics
  • Reflect on your social location and consider how your social identities, privileges, marginalization, and lived experience relate to or differ from the populations you study. Consider how the diversity of a research team will affect the study’s development and outcome without tokenizing anyone’s identity.
  • Involve practitioners in research development, recruitment, and dissemination to bridge the gap between researchers and interviewees. Community voice and practitioner expertise is integral to project development. Specialized advisory boards can provide necessary practitioner insight, survivor voice, and stakeholder input. At the Urban Institute, the community engaged methods group has spearheaded this work.
  • Partner with communities and ensure research findings reach interviewees. Urban’s Housing Opportunity and Services Together initiative created Data Walks to share data with communities. 
Transparency 
  • Be explicit about the purpose of the research and what interviewees should expect. If the research is about the context of the trauma rather than actual traumatic event, make it clear that details of the trauma will not be discussed. This can minimize the chances of making an interviewee feel obligated to discuss uncomfortable details.
  • Preface discussion topics before diving into questions to prepare the interviewee or give them a chance to avoid a certain topic. Being consistently transparent about the overall project and upcoming discussion topics acts as a continual informed consent process and helps researchers avoid raising unwelcome questions.
  • Bookend an interview between a warm-up and a debrief to help establish trust with the interviewee and inform future interviews. The warm-up can be used to build rapport, go over informed consent, and ask for the interviewee’s pseudonyms (for anonymity and confidentiality) and pronouns. The debrief can be a space to talk about what went well during the interview or if anything made them uncomfortable. 
Autonomy 
  • Create a confidential and welcoming space where interviewees can speak freely without judgment or any expectation of disclosing their traumatic experience, using soft skills, such as emotional intelligence, self-awareness, active listening, and empathy.
  • Avoid labeling someone else’s experience whenever possible unless the interviewee indicates a preferred term. If or when they do, mirror their language.
  • Before the interview begins, establish clear communication with the interviewee about skipping a question, stopping the interview, or connecting them with helpful resources, such as a clinical practitioner, if needed.
Agility and flexibility 
  • Be reasonably prepared for a range of reactions but stay flexible to make the interview experience positive for the interviewee—a must in all ethical research methodology, but especially salient in interviews about potentially sensitive material.
  • Create space for connection. Even in a professional capacity, there is space for human connection, especially when an interviewee discloses a deeply personal experience. Although researchers may not be able to provide clinical support, they should still acknowledge the interviewee’s experience and employ active listening, compassion, and empathy.

Elevating lived experiences through human connections

Researchers are leveraging their experience, privilege, and research to elevate lived experiences and motivate social change. Trauma-informed research should strive to create a human connection within the researcher-interviewee power dynamic. With mindfulness and strategic intent, researchers can minimize harm while involving lived experience in their work.


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