Every day we’re inundated with horrific videos and images of violence on our social media timelines. While most of us will remain unaffected, there is a large portion of the population who find themselves in the midst of a PTSD episode just browsing Facebook. With digital well being in its infancy, it is time for designers and technologists to look to health and wellness to learn about trauma informed care. Join interaction designer and rape survivor Theresa Slate as she introduces us to what Trauma Informed Design is and why it’s important.

1. Intro to Trauma
Informed Design.
How trauma informed care can teach us how to design
responsibly and eliminate re-traumatization in our work
UXPA • JANUARY 29, 2021

2. Bienvenides Kamusta こんにちは ‫שלום‬ Olá Hello! 你好 Bonjour ‫مرحبا‬ Ciao Salve Xin Chào
Welcome and Thank You
to UXPA for inviting me
to speak today

3. Theresa Slate (she/her/hers) is a designer who has
been crafting meaningful experiences in a range of
industries for almost a decade. She is also a fierce
advocate for creating spaces for designers of color in
the industry, including increasing access to the design
industry for people of color.
Design Practitioner
and Trauma Survivor.

4. Trigger Warning
This webinar and the following courses will have frank and open discussions around
various types of trauma including sexual assault, PTSD and its symptoms, emotional
abuse, racial abuse and others. The purpose of these discussions is to illuminate
taboo topics and show how re-traumatization occurs. These discussions may
overwhelm and trigger you, especially of you are a trauma survivor. I ask everyone to
create an atmosphere of mutual respect and sensitivity for everyone. And if at any
point it becomes too much, feel free to take a break and re-join if you are able.

5. Group Norms
Stay Engaged
To stay engaged is a refusal to let your heart and
mind “check out” of the conversation while leaving
your body in place. It is a personal commitment each
person makes, regardless of the engagement of
others. It means remaining morally, emotionally,
intellectually, and socially involved in the dialogue
Patterns of Participation
Everyone’s voice is important and is a valuable
contribution to the conversation. This includes
watching our air time, “Stepping Up” if we tend to
process silently in our heads, and “Stepping Back” if
we are verbal processors to allow ourselves to do
some internal reflection.
Speak Our Truths
Use actual examples and experiences you’ve had.
Don’t try to generalize for other people. We’re here
to have real conversations and having them also
means being honest and specific about our
questions.
Embrace Impact
We’re going to talk about uncomfortable and taboo
topics. Many of us are not well versed in these and
will inadvertently say something harmful and
insensitive. When that happens, resist the urge to
defend yourself and instead listen, learn, and make
amends to the people you’ve hurt.

6. Today we’re here because we’re…
Interested in learning how to be more responsible designers. We know Human
Centered Design is a powerful tool, and also, it doesn’t have all of the answers.
Today we want to learn and apply lessons from trauma informed care to our work
to make our products safer for everyone.
Objective
Education on and introduction to
trauma, and how it shows up in
products.
Goal
Set you up with the knowledge and
tools to view your work though a
trauma informed lens

7. Let’s Get Started

8. We’re going to enter a time
machine and go back to the
Autumn of 2016…

10. Turned on by default, the integration allowed facebook access to the
entire history of my call logs and text messages from the beginning of
my device. With it, they brought back an even more helpful feature
“People you may want to contact”
Facebook re-released SMS and
phone integration.

11. My rapist’s smiling face.

12. If you’re unfamiliar, post traumatic stress disorder shows up in a variety
of ways, especially when triggered. For me, I spent the next 4-6 hours
suffering in silence and finding spare time to cry in a phone booth at
work. I couldn’t tell anyone I needed to go home because I was suffering
a PTSD episode.
Facebook triggered my PTSD at
the beginning of my work day.

13. Here’s the thing, I’m not
alone in this happening
There are many examples of people being triggered by news and social
media for a variety of reasons.
Veterans Shown War Videos
Many vets suffer from PTSD and any
images and sights and sounds similar
to war time can trigger an episode
that changes them.
People Suffering a Loss
Being reminded of a child, friend, to
family member you lost in a traumatic
way. Even being reminded of a
memory when you were pregnant
and ended up losing the child.
Black People Inundated with
Video of Black People Being
Killed
With the uprisings and continued
violence against BIPOC in the United
States, people share the videos of
these killings which sends people in
those communities into emotional
distress.

14. Consider the statistics
8M 1 in 4 60% 50%
8 Million Americans
Suffer from diagnosed
PTSD. Considering the
other figures, there are
many more who go
undiagnosed.
25% of Women
Experience some for of
sexual assault or sexual
abuse. This number
changes when we add
race and class.
6 in 10 Men
Suffer trauma in their life
time. So there are more
men walking around with
trauma than not.
5 in 10 Women
Suffer trauma in their life
time. Half of women are
walking around with
trauma.

15. There isn’t a one size fits all definition of trauma. What someone finds
traumatic is rooted in their lived experiences, so it makes it difficult to
really get a number of how many traumatized people are walking around.
Often, we only have one idea of what trauma looks like and this can
cause people to diminish their own experiences as “not that bad”
Trauma is an extremely personal
experience.

17. Trauma literally changes your brain structure. This means, people who
have experienced trauma and have not received treatment are wired
differently at a physiological level.
These responses, aren’t the
traumatized person’s fault
Diagram courtesy of PESI
The Brain on Trauma
In this diagram we see the brain’s response to a
situation when it has been traumatized. For
most people, their logic center (pre-frontal
cortex) kicks in to assess the danger.
In a traumatized brain, this center is under-
active and the fear center (the amygdala) is on
over drive. This means the traumatized person’s
brain can not distinguish between what is a
genuine threat.

18. So, if millions of people are
walking around moments from
being triggered, how do we
responsibly take this into
account?

19. Luckily, we don’t have to start
from scratch. There are many
industries we can look at as
analogues.

20. These industries are using
Trauma Informed Care.
Defined as understanding and considering the pervasive nature of trauma
and promotes environments of healing and recovery rather than practices
and services that may inadvertently re-traumatize.

21. Patients who’ve been traumatized express that trauma in a myriad of
ways. This includes not showing up to appointments, not following
doctor’s orders, and general “non-compliant behavior”
Healthcare is a prime example
of providers grappling with
traumatized patients.
From “What’s wrong” to “What happened”
On method healthcare providers are combating
this is shifting the conversation on non-
compliant behavior. Instead of asking the
patient what is wrong with them, they ask if
something happened that might cause them to
be non-compliant
Creating a safe environment
Safe is different for different people, but
providers have a variety of ways to train staff
and create calming environments for patients. In
many instances, it helps patients understand
they are in control of their care since lack of
control is a big trigger for trauma.

22. The wellness industry is another area where an understanding of
trauma can make all the difference in treating patients and re-
traumatizing them. Mindfulness is one area where people who’ve
experienced trauma have found help. But, without a proper
understanding of trauma, can do more harm than good.
Wellness also serves as both an
example and a treatment of
handling trauma.

23. Because social workers work with a wide range of people experiencing things
such as housing insecurity and childhood abuse, it is important for them to
have an understanding of trauma and its impacts on an individual.
Social workers are also trained
to handle trauma.
Understanding Personal Histories
Social workers much look at the whole person
in order to understand their vulnerabilities and
triggers. This helps foster trust and build a
deeper understanding of needs.
Tailoring Treatment and Interventions
As a result, social workers can tailor their
treatments and interventions. How this might
show up is, if a child experienced food insecurity
growing up, a social worker might do their best
to inform a care provider not to judge or scold a
child for how they consume their food and give
them steps to reassure the child this food
source is stable.

24. Every industry using Trauma Informed Care is guided by the following
The Five Principles of Trauma
Informed Care
Safety
Ensuring physical and emotional safety
through welcoming common areas and
privacy is respected.
Choice
Individual has choice and control
through clear and appropriate
messaging on their rights and
responsibilities.
Collaboration
Making decisions with the individual
and sharing power through allowing an
individual to play a significant role in
planning and evaluating services.
Trustworthiness
Task clarity, consistency, and
interpersonal boundaries through
maintaining professional and respectful
boundaries.
Empowerment
Prioritizing empowerment and skill
building through providing an
atmosphere that allows individuals to
feel validated and affirmed at each and
every contact at the agency.

25. By abiding by these principles,
we’ve seen better outcomes
There is improved health outcomes for patients including better compliance
and reduced relapse into drugs and alcohol use. There is also a suggestion it
reduces turn over and burn out among health practitioners.

26. How we leverage trauma
informed care to create
trauma informed design

27. Human centered design is great when it is able to categorize and
simplify people into a single problem space. We have to change this
concept in order to ensure our designs reduce harm.
Avoiding re-traumatization is all
about holistic thinking
Move Beyond the Persona
While personas are useful for establishing
patterns, they aren’t useful or seeing a whole
person who brings themselves to an experience.
Consider layering on other sociological
information onto your personas to track potential
traumatic experiences.
Realize, Identity Matters
So much of the work we do aims to create a
person without a gender identity, sexual identity,
racial identity, or disability identification. This
flattens the work. People are treated differently
based on all sorts of identity classifications and to
remove it from our work is dishonest and harmful.

28. Three considerations
to guide your work.

29. Brainstorm how your design can be manipulated. Worst-case scenario
planning will help you see what traumas will be tangentially related to a
design you’re working on. Especially when we work with social based
applications think about if someone were to see a dead relative or friend,
their abuser, an estranged family member, and other connections that
are less than warm.
Think Black Mirror
Consideration # 1

30. Do a 10-15 minute post it activity to brainstorm how your product might
be used to cause harm. Think through the human response if your
product or service:
• Surfaced a deceased relative or friend?
• Allowed a rapist or abuser to get into contact?
• Communicated a sudden and out of control event such as loss of
money?
• Freely played a traumatic video involving the user’s community or a
close family member or friend?
Black Mirror Activity
Consideration # 1

31. In a global and diverse society, do unto others as you would want to be
treated doesn’t really hold water. This puts your experience at the center
and, if you have been lucky enough not to experience any trauma, you’re
not going to know how to handle it, let alone someone’s specific type of
trauma. This is where a new rule emerges, do unto others better than
you would do for yourself.
Think Beyond the Golden Rule
Consideration # 2

32. Put your devil’s advocate to good use. Host a 10-20 minute debate
where you or you and a partner argue both sides of a feature. Debate
should be rooted in:
• Demographic and sociological information (e.g. issue impacting a
specific community)
• The human cost or impact
Golden Debate Club Activity
Consideration # 2

33. We need to look at power structures in society. When creating a design,
consider how it might be harmful or used to harm the more marginalized
people in society such as women, trans people, people of color, and
other groups. Be intersectional in your thinking to identify where there
are gaps in the platform that don’t allow for the emotional support
required for these groups.
Think About Power
Consideration # 3

34. Here is where you get to role-play as a real life villain. Use your product or
service and assume bad intent. This means, use it from the perspective
of someone who is (non exhaustive):
• Racist
• Homophobic
• Transphobic
• Mysogynistic
• Ableist
• Likes Ketchup on Chicago Dogs
Abuse of Power Activity
Consideration # 3

35. We covered so much today,
so let’s do a quick recap of
everything we learned.

36. Because trauma is a personal experience, there are many people with
unresolved traumas walking around and using our products. Many of
them are moments away from being triggered into relapses and
potentially self harm.
There are more people
traumatized than not.
Key Takeaway #1

37. Organizations that used trauma informed care have reported improved
health outcomes, patient compliance, and general improved sense of
wellness in their patients.
Many industries use trauma
informed care to reduce harm
and improve outcomes.
Key Takeaway #2

38. Taking these three elements into consideration for your next design will
set you on the right path for reducing harm to trauma survivors using
your products.
Remember to think Black
Mirror,Beyond the Golden Rule,
and About Power
Key Takeaway #3

39. The Body Keeps the Score, Bessel van den Kolk, M.D
A first of its kind work exploring the mind body connection and how trauma changes the body
University at Buffalo, What is Trauma Informed Care
An overview of trauma informs care and its principles
Additional Resources

40. The only stupid question
is an unasked question,
so ask away!

41. If you want to go more in-
depth join me in February for
my short course.

42. Now go forth, and push your
companies to do better and be
more responsible.
theresa@theresa.is
@theresaslateis