What I’ve learned about trauma informed content design

I recently had the opportunity to attend an event hosted by Content Folks on applying trauma-informed principles to content design. Senior Content Designer Rachel Edwards shared insights on how content design can support people hijacked by stress, anxiety, or trauma.

As a member of the Design Academy, I’ve been exposed to many different talks, training and learnings across all fields of design, but this one particularly struck me and made me realise how impactful content design can be.

I learned that stress, anxiety, and trauma make it harder to understand and process information. And it is precisely in the middle of this complex interplay that content can empower users and help them make the right decisions, by making information more accessible and easier to digest.

These are my personal key takeaways and how I will be taking these learnings further.

Stress has an impact on how we consume content

Stress, anxiety and trauma impact the way people consume content and make decisions. In simple terms, the brain activates the ‘fight or flight’ response and prioritises immediate survival over anything else. The thinking part of the brain can’t work effectively, which results in difficulties concentrating, processing information logically, or making sound judgments.

In fact, during the pandemic, 32% of adults were so stressed that they struggled to make basic decisions, such as what to wear and what to eat.

This is why it's important to consider how we design content for people. We will never know what the user is going through on the other side of the screen, and that’s because of the nature of content — which is essentially one-sided. We need to be able to anticipate what users may bring to their interaction with the material they are reading. 

Assumptions disempower users

Rachel talked about the work she did for Scotland's Redress Scheme — which provides compensation and support to survivors of abuse in care. She emphasised the two types of users who could apply for a redress – one group they assumed would be willing to talk and another they assumed wouldn’t.

For the users that they didn’t think would want to talk, the team’s priority was ensuring their safety, by encouraging them to disclose only essential information. To facilitate this, Rachel and her team designed a fill-in-the-blank form to guide users and help them understand what information to provide. 

They essentially had to complete this one sentence:

The sentence Rachel asked users to complete - “When I was (age), in (date), in (place), (this) happened to me.”

Nice, safe, and literally contained in a little box. But it backfired. Rachel said that when they showed it to the survivors, they hated it.

They said it disempowered them. They wanted the choice and the power to say as much or as little as they wanted. They didn't want their trauma to be reduced to one single sentence. The team believed they were providing safety, but in the process, they had taken away their choice and empowerment. 

There are five principles to trauma-informed practice:

• Safety
• Trust
• Choice
• Empowerment
• Collaboration

Depending on who you ask, cultural, historical and gender issues may be a sixth trauma-informed principle. 

These principles trauma-informed principles are closely interconnected with each other and need to be carefully balanced when working with users who’ve experienced trauma. In this case, proving the team's assumptions wrong wouldn’t have been possible without collaboration, and users wouldn’t be able to safely talk about their abuse without feeling empowered to do so.

Designers need to recognise when to let survivors lead the work 

We are not the main character. Sometimes, we may need to remove ourselves from the project, or take on a more supportive or facilitator role.

Rachel reflected on a situation where she initially had a well-meaning idea — to translate consultation materials for a protection order into the main languages spoken by communities affected by Female Genital Mutilation (FGM). 

However, upon consulting with an organization that worked closely with FGM survivors, she learned that the literacy rates of the women in those communities were so low that translating written materials wouldn’t be effective. 

It became clear to Rachel that she should become a content producer rather than a content creator, taking on more of a commissioning role and helping the survivors to share their experiences in a safe and supportive way. So she worked with the women, helping them write their own scripts, and producing videos that could give evidence to the committee in a safe and anonymous way. 

The women had the choice of what to include and how to share it, rather than having someone speak for them.

How I used what I learned

A question put to Rachel during the talk was “can trauma-informed principles be applied to other everyday circumstances?” She said they might, giving us an example: do we know why a person might change or cancel their energy provider? 

• Is it because they can't afford to pay for fuel? 
• Is it because they've had to move house suddenly and unexpectedly? 
• Is it because their parents are going into supportive care and they're trying to sort out utilities?

While the challenges of doing so might not be equivalent to psychological trauma, applying the same principles could still be beneficial. It got me thinking — could I apply these principles to the project I was working on?

In my first project as part of the Design Academy, my team was tasked with redesigning the UK’s train ticketing system to provide a more integrated, efficient and user-centred experience for passengers. During our research, it became clear that passengers were being heavily affected by the complexity of the system. Some even reported feeling stressed or anxious every time they hopped on a train.

Learning about trauma-informed content helped my team understand where and how to reduce stress for passengers during their journey, in an attempt to avoid re-traumatisation. And that was particularly useful when thinking about push notifications around train cancellations, for example.

It’s clear that incorporating trauma-informed principles into our work can open doors for impactful initiatives, capitalising on our efforts to create a more inclusive approach. It is critical we bring users on the journey with us. Let them be part of the process and make decisions based on their needs. 

As we say at TPXimpact, do research with people, not to people.

If you are interested in similar projects, make sure to read about how we co-designed mental health support with marginalised communities.

Additional resources

• Trauma-informed practice: toolkit

• The impact on stress and anxiety on learning

• Helen Lawson, who works for Co-op Funeralcare, details the importance of empathetic language and content around death in this podcast.