Summary - Trauma informed approaches in research

Brief overview

This webinar raises awareness and gives examples of trauma informed practice in research by providing practical steps intended to build confidence and help you adapt your approach. 

Presenter information 

Dr Megan Kenny – Senior Learning and Development Officer, Research in Practice 

Dr Helen Close – Senior Research Methodologist, RSS Hub delivered Newcastle University and Partners 

Alex Bevin-Nicholls, Public Involvement and Engagement Manager, RSS Hub delivered by Newcastle University and Partners 

Key takeaways and top tips (time stamped) 

• (03.21) What does trauma mean to you?

Take a few minutes to reflect on Dr Megan Kenny’s question – what does trauma mean to you? 

• (04.41) What is trauma informed research?  

The UK Trauma Council definition says that trauma refers to the way that some distressing events are so extreme or intense that they overwhelm a person’s ability to cope and this results in lasting negative impact.   

WHO data suggests that around 70% of individuals have experienced some form of trauma but the lifetime prevalence of those longer-term impacts like PTSD is relatively low compared to the percentage of people who have experienced traumatic events. However, more recent research does suggest that trauma related disorders are becoming more prevalent.  It may be that people are becoming much more open to discussing mental health and trauma. 

• (07.19) If we accept that experiencing trauma is a widespread experience, then we as researchers need to be aware of this even when the subject of trauma is not the focus of our research.  We should not assume all participants have experienced trauma or continue to experience negative consequences of trauma but should rather be alert to trauma and frame our research accordingly. 

• (09:58) Megan presents Edelman’s framework to help us to think about how we address inequalities and practice in a trauma and resilience informed way, addressing the adversity context that might underpin the lives of research participants. A key assumption of the framework is the idea that the research context can exacerbate or present new adversity to participants. Research could retraumatize participants or negatively impact participation from those who face trauma or who face chronic adversity.

• (12.57) Edelman’s Framework is available as an open access paper 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 - Natalie L Edelman, 2023 

• (13:10) Megan summarises Edelman’s eight principles for trauma informed research, first walking us through principles one to three taking in 1) the importance of taking active steps to seek participation from disenfranchised groups and individuals, 2) uniting with social justice and 3) framing the researcher-participant relationship as warm and relational.

• (15:39) Megan weaves examples of taking an individual approach – a participant becoming upset does not always require stopping the interview - one participant may wish to withdraw from the study; another may experience distress and wish to continue. A participant may wish to avoid some aspects of the study, and we can build in supportive mechanisms to allow for this. 

• (16:34) The fourth principle is participant empowerment and encourages co-production and thinking about control and choice during the study, encouraging that we revisit this frequently. The fifth principle encourages active listening and validation, leading into principle six, minimising re-traumatisation by using data protection strategies and avoiding intrusive questioning.  

• (19:18) Principle seven offers practical steps for recognising the potential impact of trauma and adversity in all participants, thinking about where the research takes place, building our skills in responding to disclosures, and finally principle eight encourages researchers to strive to be culturally competent and actively promote safety. 

• (21:00) Megan summarises by saying that the strength of this framework is that it synthesizes both trauma-informed and resilience informed principles rather than favouring one perspective or another. If we just focus on trauma, there's a potential for us to reduce people to victims of their experience without acknowledging that they have survived that trauma. If we only focus on resilience, we can lose sight of the fact that resilience only develops in the face of adversity. 

• (24:00) A trauma and healing informed toolkit for research 

Dr Helen Close presents a framework, part of a programme called See Me to Care for Me co-produced with ARC Adoption NE and the Belay Foundation, using Edelman’s framework and seeking to improve the lives of adopted children, young people and families. 

• (27:00) "I really want to be involved in research, but I'm frightened of all kinds of things happening that would just take too long to explain."   This is a quote from an adult adoptee which Helen shares to illustrate Edelman’s approach to seeking a diverse range of participants. 

• (28:00) Helen introduces polyvagal theory and a sense in the research of ‘lending our calm,’ taking the time to ensure consent and anonymity and confidentiality processes are carefully worked out and exploring the role of research in being conducive to healing. 

• (31:33) Adoption, care experience and similar topics and characteristics can be really hidden, anyone coming into contact with the research, the finance team, ethics committee members, could be affected and we might not be aware, so we can think really broadly about who might need to be included in our signposting to support.

• (32:00) A core concept in the toolkit is ‘glimmers’ - a key part of polyvagal theory - glimmers are tiny moments of joy that impact on our nervous systems to keep us at the top of that regulation ladder.  Creating a list of glimmers can help us build a felt sense of safety.  A glimmer might be listening to a favourite song, blowing bubbles, or standing with the sun on our face.  

• (34:39) Helen presents the toolkit checklist walking through lists for before, during and after the research 

Top tip: Think everybody every time – consider the effects your research might have on everyone who connects with it every time they do. 

• (39:00) Support, sensitivity and care in patient and public involvement 

Alex walks through examples of trauma informed practice that might require different considerations than those we might think of for participants. The suggestions Alex walks through include that involvement is not subject to ethical approval, that the focus is less on someone sharing their story and more on them feeling comfortable sharing their views and potentially challenging a researcher’s ideas.  

• (42:40) Alex shares a ‘bubble’ diagram she developed encouraging that we delineate all the interactions that might happen in an involvement meeting i.e. meeting others, interacting with researchers, hearing a topic discussed, hearing others’ experiences. Alex added a line to the diagram showing that outside the meeting there was a before point, and there will be an after point where we have some opportunities to embed trauma informed approaches. Before a meeting this might include summarising topics and giving a choice over topics. And after a meeting this might include a de-brief.  

• (45:00) Alex presents a list of ideas for embedding sensitive support you might like to review. 

• (49:00) and finally some reflections, these are ways of working and not rigid policies, develop and embed your own practice, remember that this is quiet work that is hard to demonstrate and takes extra time, and ask for help – support is available from NIHR colleagues. 

• (50:00) The session ends with a Q and A – questions focussed on managing expectations and boundaries, incentives, and role expectations particularly around the role of the researcher in being careful not to step into a more therapeutic role.