Translating Scientific Knowledge About Trauma into Action

Author’s Note: Themes from this editorial are adapted from the forthcoming book Every 90 Seconds: Our Common Cause Ending Violence against Women (Oxford University Press), scheduled for release April 2022. Thank you to Joan Cook, PhD, for comments on an earlier version of this manuscript.

Over the last half century, the study of trauma and dissociation has grown exponentially. As a field, we have made incredible strides in documenting the prevalence of trauma and its myriad outcomes, including the pernicious effects of violence and abuse on psychological and physical health as well as educational and economic outcomes (e.g., DePrince, in press). Efforts to prevent violence and abuse have grown too, from visiting nurse to bystander intervention programs (e.g., Labhardt et al., 2017; Van der Put et al., 2018). Empirically supported interventions are now available to address the psychological consequences of trauma (e.g., Asmundson et al, 2019). Organizations – from schools to government offices and businesses – espouse the importance of being trauma-informed (Becker-Blease, 2017).

Despite these developments, we have yet to realize systemic change that ebbs the tide of trauma and violence. Indeed, the important advances in our field are bookended by other seemingly intractable circumstances. Extreme weather makes natural disasters more widespread. In my home state of Colorado, the worst wildfires in recorded history tore through the suburbs of Denver just before New Year’s Day, destroying or damaging more than one thousand homes and business while displacing thousands of people (”Marshall Fire,” 2022). Interpersonal violence continues to be dreadfully common, from mass gun violence in U.S. schools and neighborhoods to intimate violence around the globe. Consider campus sexual assault, for which U.S.-based estimates of one in five have not budged in 50 years (Muehlenhard et al., 2017). Domestic violence increased with COVID-19 lockdown orders (Piquero et al., 2021) and communities have long struggled to meet demands for victim services (e.g., Wright et al., 2022). Legal, medical, and social systems routinely fail survivors from marginalized and minoritized backgrounds (e.g., Decker et al., 2019). Intimate partner abuse predicts negative outcomes for victims and survivors as well as their children, seeding the intergenerational transmission of trauma (e.g., Fenerci & DePrince, 2018).

This juxtaposition of progress at the same time that intimate violence and its consequences persist is at the heart of my forthcoming book, Every 90 Seconds: Our Common Cause Ending Violence against Women. In that book, I argue that years of awareness-building have yet to significantly curb violence against women, in part because many people do not see that they have a stake in ending and responding effectively to violence against women. Instead, violence against women is viewed as someone else’s problem – a woman’s issues, a special interest issue. Yet violence against women matters to each of us. To make the case for our shared interests, the book traces links to some of the most pressing issues of our time – healthcare and economic inequities, legal system and migration reform, education access and gun violence. Drawing on other social movements and community organizing principles, these interconnections are explored as an opportunity to invite new people into the work to end violence against women – people whose passions are in education, climate change, migration, health, racial justice, and so on. Through our interconnected interests, we can discover new approaches to working together for sustainable change.

Of course, that juxtaposition of progress and persistent trauma has implications for our field too – a dialectic of sorts. As a field, we’ve made incredible progress to advance understanding of as well as prevention and intervention for trauma and violence. At the same time, that progress is insufficient to ebb the tide of trauma and its impact at scale. To be sure, in any field of study, there is always more to do and more to learn. However, the stakes are particularly high in our field, where the work that remains undone today can be measured in lives disrupted and diminished by trauma and violence tomorrow. Certainly, neither our field nor each of us individually bears the sole responsibility for changing the course of human history, across which trauma and violence have been ubiquitous. Yet, we do have an opportunity and perhaps an imperative to be part of building a path forward that navigates this dialect – a path that builds on the advances in our field to find new ways to work that can shift the status quo of trauma and violence in our communities.

Part of our path has to include attending to both individuals and systems, as Becker-Blease (2017) pointed in a Journal of Trauma and Dissociation (JTD) editorial that described her reflections on the rapid growth of use of the term trauma-informed. While the growth was inspiring in one sense, Becker-Blease asked whether trauma-informed principles were being watered down in practice to focus on individual-level pathology and change, skipping over the necessary work to dismantle oppression and change systems. She observed that “trauma is tied to oppression … All too often, society is horrified with trauma survivors; their symptoms; and the burdens it places on the health care, child welfare, criminal justice, and educational systems – and insufficiently horrified by the systems of oppression” (p. 134). Frameworks for trauma-informed action, such as that developed by the Substance Abuse and Mental Health Services Administration (2014), make explicit that work has to include system-level change drawing on principles of empowerment as well as gender, cultural, and historical issues. Becker-Blease cautioned, though, that we can use those words while maintaining the status quo. For example, trauma-informed language can masquerade as yet another way that we focus on how victims and survivors should change, instead of the systems and world around them.

Since Becker-Blease’s (2017) editorial, our colleagues have used these pages to advance the case for attending to individuals and systems, oppression and liberation – and importantly – how we work as trauma researchers and clinicians. Recently, Gómez et al. (2021), for example, urged us to “radically and courageously fight” for “true equity and equality in which discrimination and violence are replaced with solidarity and healing” (p. 139). The editors of a special JTD issue on Trauma, Advocacy, and Social Movements (Cook et al., 2020) encouraged that “We can all step outside our traditional comfort zones to use our knowledge and expertise to educate policymakers and the public, change the systems that perpetuate injustice, and to advocate for policies that will ensure inclusion, equity, and fairness” (p. 417).

Colleagues from across our field have proposed specific actions that will be critical to a new path forward – including actions through which we stretch our professional identities and training approaches toward public scholarship. For example, Cook called on us to “disseminate trauma-related behavioral and social science with the goal of educating, consciousness raising, empowering, and influencing public policy” (Cook, 2018, p. 131). She pointed out that we know an incredible amount as individual scientists and clinicians, and invited us to consider the power of that knowledge to influence policy and practice if we share it. In so doing, Cook and others (e.g., Alexander & Allo, 2021) have raised critically important questions about how we see ourselves as scholars and clinicians, including our ethical and professional responsibility to share what we know about trauma science in ways that can contribute to systemic change.

Together, these calls point to an essential element of any path forward: To disrupt the status quo of trauma and violence requires a radical acknowledgment of trauma and its complex interconnections with injustices as well as a commitment to healing and systemic change. With radical acknowledgment comes an opportunity to act in new ways, as our colleagues have urged – and to adapt and evolve the way that we work, particularly the way that we work together.

Radical acknowledgment of trauma’s complex interconnections to myriad other issues highlights the importance of collaboration. Without doubt, collaboration among trauma scientists is important, but changing the status quo will require that we approach collaboration with a widening network of stakeholders, allies, and accomplices – including working with communities. Across the history of our field, working with communities has at times been reduced to the purview of particular methods or scholars, such as those who do community-based research. However, community-engaged frameworks from diverse disciplines offer a roadmap for developing partnerships between professionals and communities that are grounded in equity and reciprocity, regardless of methods (DePrince et al., 2021). These frameworks emphasize scientist–community partnerships developed by building relationships and trust, identifying shared priorities, taking action, and being accountable to each other (DePrince, 2021).

Working together, communities and scholars have a chance to do more – to move science and community solutions forward together, rather than waiting for the policy and practice implications of work to emerge in some distant future. Consider Wright et al. (2020), for example, who described one community–scientist partnership that evolved to ensure that real-time data on crime and barriers to services could be integrated into community decision-making, while also addressing research questions about victim services. Or Pearson et al. (2019), who worked closely with Native American leaders to understand the community’s priorities and build authentic relationships. Ultimately, they built a partnership that led to the co-development of a culturally grounded approach to intervention research for PTSD, substance misuse, and HIV among American Indian women. Thus, the integration of community-engaged approaches to our work is a potentially powerful tool for both improving the science that we do and the impact that it can have for individuals and communities.

A new path forward also requires rethinking how we engage as professionals in social action, such as through public policy or social justice advocacy. As Alexander and Allo (2021) noted, psychologists have been slow relative to other disciplines, such as nursing, to embrace advocacy as part of our work. Yet, we have access to knowledge about trauma science that has the potential to contribute to change strategies that can disrupt the status quo of trauma. As trauma scholars and practitioners, we are well equipped, for example, to bring research into conversations with policymakers and legislative work; to apply trauma-informed principles in organizations advocating for change; and to change how we train future generations of trauma scholars and practitioners to prepare them to bring trauma science to the public square. Where we aren’t equipped, there are resources available to build and hone our advocacy skillsets (see, DePrince et al., 2021 for examples).

We’re also in a unique position to champion survivor-centered and survivor-led approaches to change movements. Across history, the professionalization of social movements has been common, leading to the marginalization of people directly affected by issues and the elevation of professionals – like us – to define and lead change efforts (e.g., Gordon, 2021). Gordon, drawing on examples from education reform, pointed out that professionalization is a slippery slope. Limited time and resources can make it seem as if professionals will be better equipped to move agendas or policy proposals forward faster than nonprofessionals. Those decisions, though, can quickly contribute to the marginalization and even exclusion of people directly impacted by the very issues for which change is sought. From the trauma field, we can bring research on the impact of survivor-led initiatives (e.g., Fields et al., 2020) as well as our own experiences. After all, our field’s knowledge comes from survivors who have contributed stories, aspirations, emotions, thoughts – even heartbeats, cortisol, and brain scans – to research studies and revealed what is required for healing, health, and liberation in our therapy offices. Thus, we have an important opportunity as well as responsibility to work against the marginalization of survivors in change movements with the power that we are afforded as scholars and clinician.

In particular, we can follow the lead of scholars who are paving the way forward in modeling how to establish equitable, authentic, culturally responsive ways of working toward justice in collaboration with survivors and communities. For example, Isaacs et al. (2020) described lessons learned from their work responding in the wake of violence perpetrated against Indigenous Water Protectors and allies at Standing Rock during the #NoDAPL (No to the Dakota Access Pipeline) movement. Through their work to create a way to provide crisis trauma services to Water Protectors, they developed a framework for mobilizing psychologists for action. Their framework centers cultural considerations and delineates specific action steps, from screening and orienting volunteer psychologists to communication and providing culturally appropriate responses.

Ultimately, we have to find ways to build collaborations with people who do not yet realize that they have a stake in working with us to ameliorate trauma and its consequences – which brings me back to the heart of my book and my passion. Building on trends in trauma science to work in more interdisciplinary ways, we each have a role to play in expanding the network of those we reach out to and engage with to do research, to share what we know about trauma, and to generate new strategies for change. Our potential network is vast – because trauma intersects with so many of the pressing problems of our time. As trauma scientists, we have a chance to synthesize and apply lessons from our field, whether about adapting strategies such as community-engaged research or stepping into public scholar roles, in ways that will allow us to work at the intersections – the places where public problems connect to trauma. Working together across problems and priorities with the diverse stakeholders, allies, and accomplices who share interests with us is our path forward. A path with the promise of discovering new strategies for social change that disrupt the status quo of trauma and violence.

Disclosure statement

In addition to her primary academic position, Anne P. DePrince receives some book royalties and sometimes receives honoraria for presentations and consulation.