Nicola works with participants on applied learning during a Training of the Trainers session.
Working on global development projects as a trained mental health professional has me grappling with the nuances of what it means to support trauma-informed approaches in non-clinical settings. I wrestle with the questions of: What does it look like to adopt a trauma-informed approach in our activity design, budget and resource planning, activity implementation, and recruitment processes? How can we evolve our approaches to be trauma-informed? How do we truly get beyond “trauma-informed” being a buzz phrase rather than an applied approach in our proposals, presentations, and implementation? And will using trauma-informed approaches further mystify mental health, or will it make mental health knowledge more accessible?
In my work with Making Cents colleagues, adopting a trauma-informed approach (TIA) entails recognizing the far-reaching personal and societal effects of trauma, honing our empathetic and listening skills, and actively and continuously participating in creating spaces through activities and programs that do not perpetuate additional harm. We use six TIA principles focused on safety, trustworthiness, peer support, collaboration, empowerment, and cultural considerations. These principles can be applied across various contexts and integrated into different sectors such as health, education, youth work, and economic empowerment, actively transforming institutional knowledge and approaches to include mental health and well-being considerations in programs. For example, the USAID-funded Ukraine National Identity Through Youth (UNITY) Activity focuses on integrating TIA strategies throughout the education sector in Ukraine. The Making Cents UNITY team has developed a checklist to help local organizations and educators apply a trauma-informed approach, with practical guidance and fictional scenarios adapted to different ages and settings within the school system, such as teachers and administrators. Our team has also developed a TIA monitoring and evaluation checklist to train interviewers on creating psychologically safe spaces in research activities. To mainstream practical knowledge on TIA, we have also created a three-module training series to introduce organizations, teachers, and public servants to trauma-informed concepts and practical applications in youth programming.
On the USAID Youth Resilience, Inclusion, and Employment Activity in the Caribbean (Y-RIE), Making Cents supports the incorporation of TIA into conflict prevention, workforce development, and youth resilience projects. Y-RIE focuses on meeting the immediate needs and long-term well-being of at-risk youth in the Eastern and Southern Caribbean by incorporating TIA principles into its program activities. The Activity underscores the importance of engaging community members and stakeholders to ensure that programming is culturally relevant and does not cause harm. Y-RIE also acknowledges the significance of addressing broader mental health issues, recognizing that these issues vary across individuals and cultural contexts and often coexist with trauma. Taking an integrated, youth-focused approach grounded in a public health method for violence prevention and Positive Youth Development (PYD) principles, Y-RIE prioritizes the involvement of youth in program design, implementation, and evaluation to enhance mental health and economic structures that guide youth away from violence. Through a combination of an asset-based approach and a contextually sensitive perspective, Y-RIE aims to nurture the potential of youth and reduce risk factors that may increase violence, leading to enhanced well-being within their communities. The integration of TIA strategies within Y-RIE serves as a form of harm reduction and healing response, and also serves a preventive function by reducing future risk factors for violence.
To ensure that trauma-informed approaches go beyond superficial understanding and application, organizations must commit to genuine and systemic transformation. To achieve this, organizations should:
- Contextualize Approach. Program design should promote a sense of belonging and safety while addressing power imbalances and colonial influences in traditional mental health practices. To do this, organizations should consider the importance of contextualizing definitions and cultural understanding of mental health through a localized, historical, and situational analysis that can help tailor their TIA and mental health framework for specific activities. The authors of Toward a New Relationship Between History and Global Mental Health[1] suggest revisiting the colonial roots of psychiatry and their intertwined history to address modern challenges and power imbalances in mental health care and by extension, TIA. The biomedical model—which primarily treats mental health through diagnosis, medication, and psychotherapy—frequently overlooks social determinants like poverty and discrimination. Adopting this historical perspective broadens the discussion on mental health conditions and promotes a shift away from medical-only frameworks to a more participatory, community-led approach.
- Increase Leadership Commitments: It is imperative for leaders to advocate for an expansive framework of trauma-informed concepts that acknowledge cultural perceptions and definitions of mental health. This ensures that the organization’s policies, procedures, and culture align with these values. Setting a good example and persistently advocating for these strategies is also essential.
- Establish Continuous Learning and Formalize Knowledge in Policies: Employees should receive ongoing awareness, information, resources, and training on mental health issues, incorporating the latest research and best practices. Organizations can integrate Indigenous and local knowledge into trauma-informed training by collaborating with Indigenous and local leaders to create programs that incorporate traditional healing practices, cultural rituals, and holistic approaches. An official mental health policy should serve as a reminder of the importance of well-being and thriving. Workplace policies should also include trauma-informed concepts and efforts to understand local dialects and languages’ definitions and interpretations of mental health and healing practices, as the English language often privileges Western[2] ways of knowing.
- Strengthen Supportive Environments: It is essential to create spaces where service consumers and staff feel safe on physical, social, and emotional levels. This includes ensuring that the environment is welcoming, and that communication is respectful and empowering. This can be done through diversifying feedback mechanisms to be able to gather employee perspective regarding activities, different projects, and other decision-making processes, conducting regular emotional support meetings, peer to peer learning sessions, coffee chats, etc. It is critical to make sure that avenues of expression and feedback are diversified.
- Diversify Regular Evaluation Methods: Organizations should use standardized instruments to gauge the success of integrating trauma-informed approaches. This can be done through regularly distributing surveys to staff and participants to gather feedback on their experience and identify areas for improvement. Application of the feedback will enhance programming and support delivery of genuine benefits to those it serves. Regularizing this assessment and feedback loop will further strengthen programming.
- Localize Community Engagement and Involvement for Cultural Sensitivity and Increased Sustainability: Organizations should incorporate cultural traditions and community engagement in trauma-informed care strategies. This can involve community members in developing and implementing care strategies, establishing advisory boards, and seeking input from local cultural and religious leaders. Including historically marginalized individuals in these processes ensures tailored services. Prioritizing long-term support systems and leveraging existing networks for sustainability is also crucial. Building mentorship programs and partnerships with local organizations can further strengthen these networks.
Through Making Cents’ work, we have seen firsthand the necessity and benefit of integrating trauma-informed approaches into our programming to improve individual and community well-being, which is the ultimate goal of our efforts globally.