Glossary

Introduction

This practice guide outlines approaches and principles for doing trauma-informed research and evaluation projects. Trauma-informed approaches are:

Frameworks and strategies to ensure that the practices, policies and culture of an organisation, and its staff, understand, recognise and respond to the effects of trauma on [participant] wellbeing and behaviour (Quadara & Hunter, 2016, p 11).

These approaches are broad in nature and are intended to be useful across a range of contexts, not limited to research and evaluation projects.

Practitioners working in trauma-specific interventions or services (such as domestic, family and sexual violence practitioners and mental health clinicians and therapists) will very likely be familiar with trauma-informed approaches and principles. The focus in such trauma-specific work is to understand and treat trauma-related symptoms and disorders (Substance Abuse and Mental Health Services Administration, 2014). However, this resource is not focused on trauma-specific interventions or services. Instead, we present a case for doing trauma-informed research and evaluations.

The trauma-informed approach and principles presented in this resource provide scaffolding for anyone designing and doing research and evaluation. But first, we outline:

• why it is valuable to do research and evaluation in a trauma-informed way
• who should be doing trauma-informed research and evaluation.

Why do trauma-informed research and evaluation?

Participants may have heightened sensitivity to certain topics and situations

Research shows that participants can have differing experiences of being involved in research and evaluation projects. Even when sensitive topics are being studied (e.g. experiences of violence), participants can have positive experiences associated with emotional release, feeling as though they’re helping others and gaining new knowledge or perspectives (Alexander, Pillay, & Smith, 2018). However, a small number of participants may become distressed, particularly when participation leads to painful reminders, embarrassment or shame (Alexander et al., 2018).

The kinds of events and life experiences that have the potential to be traumatising are diverse. Additionally, the individual impact of trauma looks different for each person. When people do experience negative trauma reactions, this can include depressive symptoms, anxiety symptoms, substance use, burnout, or symptoms of posttraumatic stress disorder (PTSD). Although not all people who experience trauma will develop PTSD, it is the disorder that can have the most severe and pervasive impact on individual functioning after experiencing trauma. Having knowledge about symptoms of PTSD can provide insights and examples of what participants may experience when they engage in research and evaluation projects. The four main types of difficulties people with PTSD experience include (Phoenix Australia, n.d.):

1. re-living the traumatic event (e.g. unwanted memories, experiencing panic when reminded of the event)
2. feeling wound up (e.g. difficulties concentrating, constantly being on the look-out for danger)
3. avoiding reminders of the event (e.g. activities, places, people, thoughts or feelings)
4. negative thoughts and feelings (e.g. feeling afraid, angry, guilty, flat or numb).

A key point is that experiences of trauma can lead some participants to have heightened sensitivity to certain topics and situations. It is not possible to build in safeguards for every project to account for all the experiences and reactions that participants may have. In trauma-informed work we need to:

• be mindful of what trauma reactions can look like
• aim to reduce the likelihood that our work will increase distress for the people we work with
• have a plan of action if participants do become distressed during their involvement in the project.

Ethical requirements

Research organisations and funding bodies are increasingly conscious of the need for research and evaluation that accounts for the trauma experiences of participants. Trauma-informed research and evaluation principles do not replace existing ethical requirements. Similarly, having ethical clearance to conduct your project does not automatically make the project trauma informed.

Rather, there is an overlap between ethical and trauma-informed research and evaluation; they are compatible approaches and should inform one another. For example, the National Statement on Ethical Conduct in Human Research requirements (National Health and Medical Research Council, Australian Research Council, & Universities Australia, 2023), which are highly compatible with trauma-informed research and evaluation principles, include the ethical responsibility to:

• minimise risk of harm or discomfort for participants³
• ensure reasonable equity in recruitment⁴
• not unduly or inequitably burden participants.³

Unless there is an explicit justification (such as a risk of harm), people who have previously or are currently experiencing trauma should not be directly or indirectly excluded from participating in research and evaluation projects.

Two potential outcomes of conducting research and evaluation that is not trauma-informed are:

1. People who have experienced trauma may avoid engaging in projects that are framed or conducted in non-trauma-informed way. They may have had previous negative experiences with services and organisations that did not engage them in a way that promoted safety and individual control.
2. People who have experienced trauma participate in the study and are retraumatised.

Given that experiencing trauma can lead some participants to have heightened sensitivity to certain topics and situations and considering the overlap of ethical requirements and trauma-approaches, there is clear value in conducting research and evaluation in a trauma-informed way. Following the principles for doing trauma-informed research and evaluation means focusing on increasing participants’ sense of control and safety. This is likely to improve the experience of participation for everyone, not just for those who have experienced trauma. Additionally, doing research and evaluation based on trauma-informed approaches does not add undue burden for participants who have not experienced trauma. Taking a trauma-informed approach to research can also improve the accuracy and richness of research and evaluation data because there is an emphasis on building trust between the project team and participants (Anderson, Karris, DeSoto, Carr, & Stockman, 2023; Crosby, McKeage, Rittenburg, & Adkins, 2023).

Who should be doing trauma-informed research and evaluation?

A trauma-informed approach is applicable to all research and evaluation projects, regardless of the topic or focus. Researchers and evaluators often conduct projects involving people who have experienced trauma or who are from communities where traumatic experiences may be more common than in the general population (e.g. adult survivors of sexual abuse or refugees and asylum seekers) (Alessi & Kahn, 2023). Even when traumatic experiences are not the focus of the project, such as when evaluating a program or service that is not trauma-specific, at least some of the participants may have trauma histories (Alessi & Kahn, 2023).

Doing trauma-informed research and evaluation is particularly relevant when researching or evaluating child- or family-focused services because research participants are likely to be current or potential users of these same services and thus may have an increased risk of having experienced trauma.

Further, people who have a history of trauma are likely to be accessing a range of support services, including ‘mental health services, alcohol and other drug treatment services, homelessness and housing services, child welfare services, child protection systems, and juvenile justice and correctional systems’ (Quadara & Hunter, 2016, p 12). For example, up to approximately 90% of adult mental health clients may have experienced trauma (Isobel, 2021). Researchers and evaluators may not be aware of the trauma histories of the people they work with.

There are many reasons why people may not disclose their trauma experiences to services and staff (for more information refer to MacDonald & Quinlan, 2022). Hence, all services can increase the safety and improve the trust of the people they support by working in a trauma-informed way. This dynamic extends to the conduct of research and evaluation.

Additionally, practitioners working in mental health services, who may also have a dual practitioner–researcher or practitioner–evaluator role, have a higher lifetime prevalence of trauma exposure than the general population (Isobel, 2021).

Adopting trauma-informed approaches to research and evaluation has the potential to improve experiences for participants and researchers/evaluators alike. Trauma-informed approaches prioritise safety, sharing power/control and trust, while aiming to reduce the likelihood of retraumatisation.

Trauma-informed approaches and principles

This section outlines trauma-informed approaches and principles. In this resource, we use the term ‘approaches’ to refer to broad frameworks to guide conducting practice or research in a trauma-informed way. We use the term ‘principles’ to refer to the specific items contained with the broader framework.

There is no universally accepted trauma-informed approach. However, one approach that has been influential on practice and research both in Australia and internationally was developed by the Substance Abuse and Mental Health Services Administration (SAMHSA) and is known as SAMHSA’s Concept of Trauma and Guidelines for a Trauma-Informed Approach (SAMHSA, 2014).⁵ Because of its broad influence, we will focus on the SAMHSA approach in this resource. The SAMHSA approach provides guidance across a range of contexts, including for practitioners, researchers, victim–survivors and their families and the wider community (i.e. it is not research or evaluation specific).

The SAMHSA framework includes 6 key principles of a trauma-informed approach (presented in Figure 1). These principles provide a useful scaffolding for all kinds of work with children and families.

Figure 1. Six principles of the SAMHSA trauma-informed approach

The SAMHSA principles are valuable in that they have been used as the basis of much trauma-informed practice and research work. Research-specific principles that are also useful when working with children and families have been developed based on the broader SAMHSA principles as have a range of other sets of practice-focused principles.

While there are variations in the key principles that underpin trauma-informed care, both in number and wording, the meanings are fairly consistent, drawing on what the evidence tells us about the needs of trauma survivors – including recognition of the impacts of trauma, safety, transparency, empowerment, choice, pathways to recovery, collaboration and cultural safety (Quadara and Hunter, 2016, p 6).

Two examples of research-specific trauma-informed principles are listed below and both are originally based on the SAMHSA principles:

• Principles for trauma and resilience for social justice (RSJ) – informed research in health and social care research (Edelman, 2023)
• Principles developed for trauma-informed research with sexual violence survivors (Anderson et al., 2023).

In Table 1 we map the broad SAMHSA principles (which are not research specific) alongside these two sets of research-specific principles. As can be seen in the table, although the different sets of principles contain some common ideas and elements, we do not have a standardised set of principles for conducting trauma-informed research.

Research-specific principles don’t explicitly include all the SAMHSA principles (e.g. trustworthiness and transparency) and have additional principles which don’t directly map to the SAMHSA principles. These variations may in part be explained by the researchers drawing on principles from other disciplines, such as resilience-informed and social-justice-informed research in addition to the SAMHSA principles.

We have mapped these three sets of principles in Table 1 to provide a broader understanding of the principles that may be useful when conducting research and evaluations. When conducting your own research and evaluation projects, it may be necessary to draw from more than one set. Additionally, you may find that you and your team need to adapt or supplement the principles listed in Table 1 to better suit the project and participant needs.

Table 1. Comparison of 3 sets of trauma-informed principles for research and evaluation

Conclusion

Research and evaluation projects of any topic or population focus can benefit from a foundation in trauma-informed approaches and principles. Doing trauma-informed research and evaluation means:

1. understanding the impact of trauma and violence on people and communities
2. assuming that any of the project participants could have experienced trauma
3. applying trauma-informed approaches and strategies to minimise the likelihood of distress and retraumatisation for participants
4. having a plan of action if participants do become distressed.

Trauma-informed approaches to research and evaluation are particularly relevant when engaging participants who currently or formerly have accessed child and family services. Many people accessing systems and services relating to mental health, substance use, homelessness and housing, child welfare and child protection, and youth justice and corrections are likely to have a history of trauma exposure.

Additionally, practitioners working in these contexts – who may be a part of the research or evaluation project team – may also have a higher than average likelihood of having experienced trauma themselves. Common principles underpinning trauma-informed projects include safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment and choice, and consideration of cultural, historical and gender issues.

Doing research and evaluations based on trauma-informed approaches does not add undue burden for participants who have not experienced trauma. Following the principles for doing trauma-informed research and evaluations means focusing on increasing participants’ sense of control and safety. This is likely to improve participant experiences overall, not just for those who have experienced trauma. Using trauma-informed approaches can also help build trust between the project team and participants, leading to more accurate and richer data on participants’ lived experiences.

The intention of the SAMHSA (2014, p 10) principles – and of other principles derived from them – is to provide broad guidance ‘that may be generalizable across multiple types of settings’ rather than providing ‘a prescribed set of practices or procedures’. However, a key ‘challenge lies in determining how the principles should be translated into practice’ of various kinds (Quadara & Hunter, 2016, p 8), including research and evaluation.

Professionals working in direct service provision, research and evaluation ‘may need concrete strategies and tools to embed trauma-informed care in their roles’ (Quadara & Hunter, 2016, p 8). In this resource, we outline what trauma-informed research and evaluation is, who should do it and why. A trauma-informed approach can be applied throughout all stages of a research or evaluation project (i.e. planning and design, participant screening and recruitment, data collection, analysis and dissemination, and project team self-care). In a complementary resource, How to do trauma-informed research and evaluation, we outline strategies for designing and conducting research and evaluations that are trauma informed (i.e. concrete tips for what to do when designing and doing research and evaluations).

Further reading and resources

Understanding trauma and supporting clients

• Helplines, telephone and online counselling services for children, young people and adults
  This resource sheet is designed to provide practitioners and service providers with the contact details and links to helplines, telephone and online counselling services for children, young people and adults. It includes services related to topics such as family and domestic violence, gambling, mental health and wellbeing, alcohol and drug use, legal services and parenting. It also includes services specifically for Aboriginal and/or Torres Strait Islander people, people from culturally and linguistically diverse backgrounds and people living or working in rural areas. Services are grouped according to the location in which they operate.
• Phoenix Australia
  Phoenix Australia is the Australian National Centre of Excellence in Posttraumatic Mental Health. This website contains research and resources designed to help you understand, prevent and recover from the impacts of trauma, and to support trauma-impacted loved ones or communities. Some useful resources from this website include:
• About posttraumatic stress disorder
• Treatment for posttraumatic stress disorder
• Helping children after a traumatic event
• The effect of trauma on the brain development of children
  This AIFS practice guide from the Child Family Community Australia information exchange (CFCA) provides an overview of what we know from research about cognitive development in children who have experienced trauma and provides principles to support effective practice responses to those children’s trauma.
• How to recognise complex trauma in infants and children and promote wellbeing
  This webinar from CFCA and Emerging Minds explores:
  • the evidence about what complex trauma is, how it might present in children and how it can impact their development
  • how to recognise and respond to the effects of complex trauma in practice with infants and children, and their parents and caregivers
  • how to have preventative and early intervention conversations with parents and caregivers of infants and children who have experienced complex trauma.
• Calming the body before calming the mind: Sensory strategies for children affected by trauma
  This short article from AIFS’ CFCA describes how practitioners can use strategies that help calm children’s bodies in order to help calm their minds and emotions – specifically, the Regulate–Relate–Reason approach used in Berry Street’s Take Two program.
• Supporting children who have disclosed trauma
  This webinar from AIFS’ CFCA and Emerging Minds explores:
  • how self-blame operates and how perpetrators may manipulate children to blame themselves
  • how to help children challenge feelings of complicity in their trauma experiences by focusing directly on the power difference between children and adults
  • children’s stories of protests or choices they have made throughout their experiences that kept themselves, or their loved ones, safe to acknowledge that no child is a passive recipient of trauma.
• How to ask adult mental health clients about sexual abuse
  This article outlines: (a) why adult survivors of sexual abuse may not disclose their abuse experiences to mental health practitioners, (b) why practitioners might avoid asking about it and (c) research findings from mental health practitioner samples on how to safely ask clients about sexual abuse histories.
• Managing uncertainty in professional practice
  This practice guide provides an overview of what uncertainty and uncertainty tolerance are and their significance to professional practice. It also outlines the individual, practice and organisational factors that can contribute to uncertainty and describes evidence-based strategies for how practitioners can manage practice uncertainties. This resource includes a reflective practice activity that may be used in professional supervision (one-on-one or peer group setting) to help practitioners reflect on practice situations that contribute to uncertainty and identify ways to adaptively manage and respond to uncertainty in their practice roles.

Trauma-informed practice

• SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach
  This manual explains the SAMHSA framework, referred to throughout this practice guide, for becoming a trauma-informed organisation, system or service sector. The manual provides a definition of trauma and a trauma-informed approach and offers 6 key principles and 10 implementation domains.
• Principles of trauma-informed approaches to child sexual abuse
  This paper provides clarity on the concept of trauma-informed care. Drawing on the international evidence, it reviews the emergence of trauma-informed care in Australia and overseas, how it is being implemented in practice, trauma-informed systems and service settings, trauma-integrated interventions, and the utility, strengths, and limitations of this approach.
• Building Trauma Informed Organisations
  This Phoenix Australia video describes what trauma-informed care is and how organisations can apply trauma-informed principles.

Research and program evaluation

• Trauma-informed evaluation: Tip Sheet for collecting information
  This tip sheet covers types of data collection, informed consent, instrument development, interviewer training and confidentiality.
• National Statement of Ethical Conduct in Human Research
  The Australian National Statement is intended for use by researchers, ethical review bodies, individuals involved in research governance and research participants. Of particular interest in relation to the present practice guide is section 4 which focuses on ethical considerations specific to participant subgroups.
• Ethical research related to Aboriginal and Torres Strait Islander peoples and collections
  This page of the Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS) website contains links to useful resources relating to ethical research, including a template for a participant information sheet and informed consent form.

Co-design

• Supporting children: How does co-design invite us to think differently?
  This Emerging Minds paper provides insights for practitioners about engaging in co-design. In the paper, a series of reflective questions are responded to by a lived experience consultant, a practitioner and a researcher.
  This two-part podcast series by Emerging minds provides practical insights for implementing co-design in your work with children and families:
• Co-design: Disrupting business as usual part 1
• Co-design: Disrupting business as usual part 2

Why and how this resource was developed

This practice guide was developed by the Australian Institute of Family Studies’ Child Family Community Australia (CFCA) information exchange. The CFCA project provides evidence-based resources and interactive assistance for professionals working to protect children, support families, and strengthen communities across Australian jurisdictions. The target audience includes practitioner–researchers who conduct research studies and/or service or program evaluations as part of their role (e.g. program leads and managers).

Through various consultation methods, such as the annual Needs and Impact Survey, the CFCA team identify topic areas that the CFCA audience would like more evidence about to inform practice. Topics that are consistently rated amongst the most popular or needed are trauma and mental health and wellness. This resource is part of a broader evidence package on trauma-informed approaches from CFCA. The literature reviewed was identified through a rapid review and synthesis of international research.

Acknowledgement

Dr Jasmine B. MacDonald, Kylie Butler, Dr Melissa Willoughby and Dr Pragya Gartoulla work in the Child Family Community Australia (CFCA) team at AIFS. Dr Will Dobud is Lecturer in Social Work at Charles Sturt University. Dr Jasmine B. MacDonald designed the review protocol and conducted the literature search. Literature screening was conducted by Dr Jasmine B. MacDonald, Dr Melissa Willoughby, Kylie Butler and Dr Will Dobud. Gillian Lord provided support accessing full-text research articles in the literature search and screening phase of this review. Data extraction and evidence synthesis was conducted by Kylie Butler, Dr Jasmine B. MacDonald and Dr Pragya Gartoulla. This resource was written by Dr Jasmine B. MacDonald, Kylie Butler, Dr Melissa Willoughby, Dr Pragya Gartoulla and Dr Will Dobud. This resource was planned and revised in collaboration with Dr Stewart Muir, Katharine Day, and Kat Goldsworthy from AIFS.

References

Alessi, E. J., & Kahn, S. (2023). Toward a trauma-informed qualitative research approach: Guidelines for ensuring the safety and promoting the resilience of research participants. Qualitative Research in Psychology, 20(1), 121–154.

Alexander, S., Pillay, R., & Smith, B. (2018). A systematic review of the experiences of vulnerable people participating in research on sensitive topics. International Journal of Nursing Studies, 88, 85–96.

Anderson, K. M., Karris, M. Y., DeSoto, A. F., Carr, S. G., & Stockman, J. K. (2023). Engagement of sexual violence survivors in research: trauma-informed research in the THRIVE study. Violence against Women, 29(11), 2239–2265.

Crosby, E., McKeage, K., Rittenburg, T. L., & Adkins, N. R. (2023). Amplifying marginalised consumers’ voices: A case for trauma-informed qualitative methodologies. International Journal of Market Research, 65(2–3), 320–339.

Department of Families, Fairness and Housing. (2022). Framework for trauma-informed practice Supporting children, young people and their families. Victorian Government. www.dffh.vic.gov.au/sites/default/files/documents/202302/Framework-for-trauma-informed-practice.pdf

Department for Health and Wellbeing. (2019). Mental Health Services Plan 2020-2025. Government of South Australia. www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/resources
/mental+health+services+plan+2020-2025

Edelman, N. L. (2023). Trauma and Resilience Informed Research Principles and Practice: A framework to improve the inclusion and experience of disadvantaged populations in health and social care research. Journal of Health Services Research & Policy, 28(1), 66–75. doi:10.1177/13558196221124740

Isobel, S. (2021). Trauma-informed Qualitative Research: Some methodological and practical considerations. International Journal of Mental Health Nursing, 30(S1), 1456–1469. doi:10.1111/inm.12914

MacDonald, J. B., & Quinlan, E. (2022). How to ask adult mental health clients about sexual abuse. Melbourne: Australian Institute of Family Studies.

National Health and Medical Research Council, Australian Research Council, & Universities Australia. (2023). National Statement on Ethical Conduct in Human Research.

Phoenix Australia. (n.d.). About posttraumatic stress disorder. www.phoenixaustralia.org/wp-content/uploads/2022/07/About-Posttraumatic-Stress-Disorder.pdf

Prevention and Response to Violence Abuse and Neglect Government Relations (PARVAN). (2023). Integrated Trauma-Informed Care Framework: My story, my health, my future. St Leonards: NSW Health. www.health.nsw.gov.au/patients/trauma/Publications/itic-framework.pdf

Quadara, A., & Hunter, C. (2016). Principles of trauma-informed approaches to child sexual abuse: A discussion paper. Sydney: Royal Commission into Institutional Responses to Child Sexual Abuse.

Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach (Vol HHS, Publication No (SMA) 14-4884). Rockville, MD: SAMHSA.

Wall, L., Higgins, D., & Hunter, C. (2016). Trauma-informed care in child/family welfare services. Melbourne: AIFS aifs.gov.au/sites/default/files/publication-documents/cfca37-trauma-informed-practice_0.pdf

¹The definition provided here was developed by the AIFS research team and is based on a synthesis of relevant literature.

²Although a trauma-informed approach involves assuming that any participants could have experienced trauma, screening for trauma is not required unless it is directly related to the aims of the research or evaluation.

³The ethical principle of beneficence (National Health and Medical Research Council et al., 2023).

⁴The ethical principle of justice (National Health and Medical Research Council et al., 2023).

⁵Although SAMHSA is based in the United States, its approach has been applied to child and family health and welfare in Australia (Wall, Higgins & Hunter, 2016), e.g. in New South Wales (Prevention and Response to Violence Abuse and Neglect Government Relations, 2023), South Australia (Department for Health and Wellbeing, 2019) and Victoria (Department of Families, Fairness and Housing, 2022).

⁶Although recovery and resilience are not specifically listed in the SAMSHA principles, the SAMHSA framework (2014, p 10) states more broadly that ‘it is critical to promote the linkage to recover and resilience for those individuals and families impacted by trauma’.

Featured image: © gettyimages/JackF