Transforming Built Environments Through Trauma-Informed Design

• Trauma-informed design ultimately focuses on reducing chronic stress in built environments to promote well-being for all occupants.
• The approach integrates environmental psychology, human-centered design, and biophilic principles to enhance emotional and psychological safety and comfort.
• Ongoing research aims to provide measurable outcomes for trauma-informed design effectiveness.

As awareness grows around the impacts of trauma on human health and behavior, the application of environmental psychology has led to a practice known as trauma-informed design. With expanded industry support and insight, interior designers can seize the opportunity to create spaces that support well-being, inclusivity, and human resilience.

Why Do We Need to Understand Trauma?

To fully grasp the value of trauma-informed design to commercial interiors, it’s vital to understand what trauma is, how it manifests in everyday experiences, and how design can either mitigate or magnify its effects.

According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) 2014 Concept of Trauma and Guidance for a Trauma-informed Approach:

“Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functional and mental, physical, social, emotional, or spiritual well-being.”

Although we may immediately connect these concepts with behavioral and public health facilities, the intent behind trauma-informed design demands recognition that trauma impacts people across all aspects of life and, in turn, in any built environment—regardless of whether that environment is healthcare oriented.

Defining Trauma-informed Design in Practice

To provide more context to the mission of trauma-informed design, Spacesmith principal and environmental psychology educator Ámbar Margarida pointed to synergies with better-known frameworks such as environmental psychology, human-centered design, evidence-based design, and biophilic principles.

“Essentially, it is another way of looking at design through an empathetic lens and saying we are not designing purely for beautiful aesthetics or function,” Margarida explained. “We are designing knowing that human beings are animals with needs. In particular, some people have life experiences that have led them to difficult circumstances. How do we become aware and empathetic about these things so that we design spaces that do not retraumatize individuals? That’s an all-encompassing strategy.”

Indeed, co-founders Christine Cowart and Janet Roche of the Trauma-informed Design Society distilled the main charter of trauma-informed design practice to this: reducing chronic stress in built environments. Meaning absolutely anyone—and everyone—can benefit from successful trauma-informed spaces.

Stress Is a Universal Design Concern

Cowart, a policy analyst, certified trauma professional, and chief operating officer of the Trauma-informed Design Society, noted that “by self-report, 90% of the U.S. population have experienced at least one traumatic event. And we know the long-term health impacts of having high stress levels.”

Indeed, SAMHSA’s approach guidance states, “[Emerging] research has documented the relationships among exposure to traumatic events, impaired neurodevelopmental and immune systems responses and subsequent health risk behaviors resulting in chronic physical or behavioral health disorders.”

Despite the established connections between trauma and long-term health outcomes, current accepted design processes don’t specify the emotional and psychological components of occupant safety, leaving a gap between what we know about trauma and how we design for it.

Bridging Code and Care

There are safety and life preservation requirements in building code—checklists for physical egress, emergency light levels, fire protection ratings, and so on. For NCARB or NCIDQ certification, architectural and interior design professionals are tested on their knowledge of those things. But there is no standardized framework for applying environmental psychology to creating environments that don’t retraumatize occupants.

“These empathetic insights into design currently aren’t seen as protecting the health, safety, and welfare of the people in the buildings,” Margarida revealed. Until they are required for licensing, certified architecture and design programs offered through academic institutions probably won’t insist on trauma-informed design as a core curriculum requirement.

Enter efforts by the Trauma-informed Design Society to work across disciplines, engaging with healthcare professionals, counselors, policy advocates, educators, and designers to understand the scope of trauma and how this can influence better environmental design.

After co-founding the society with colleague Dr. J. Davis Harte, whom she met at Boston Architectural College, Roche met up with Cowart and knew that her input was invaluable to what Roche and Harte wanted to develop for the design community.

According to Roche, a former social worker and production company owner, what began as a clearinghouse for showcasing work that incorporated trauma-informed design principles solidified into an initiative to outline industry standards and best practices, develop professional credentialing and CEUs, conduct ongoing research, and offer consultative services.

Combining Cowart’s expertise in trauma with Harte’s and Roche’s experience as educators in design for human health, the society leaders have focused on bringing SAMHSA’s trauma-informed care approach to the built environment, working with partners such as the American Society of Interior Designers (ASID) to spread awareness through presentations and CEUs.

The society also offers several online research and practice guides. Most recently, they published their combined guidance in Trauma-informed Design: A Framework for Designers, Architects, and Other Practitioners, available for purchase through tidsociety.com.

Countering Stakeholder Skepticism

Demonstrating the growing body of research and educational resources targeted toward the design community is one thing. Still, trauma-informed design can present a tough selling point with clients and stakeholders who may be skeptical about its pertinence to their day-to-day.

Cowart and Roche conceded that some stakeholders will likely demand “hard evidence” showing that trauma-informed design has measurable outcomes, rather than being based “on how people feel.” One of the society’s future undertakings is a study that would use biomarkers to measure stress levels and responses to environmental factors, which is awaiting funding approval.

In the meantime, the Trauma-informed Design Society continues to recommend population research during project consulting, with in-depth interviews that include as many people as possible who will be working and using the space.

Still, Cowart noted that sometimes the terms themselves can bring up discomfort or resistance. In some cases, she said, it comes down to not wanting to acknowledge the widespread occurrence and impact of trauma.

As a proponent of trauma-informed design, Margarida acknowledged that the need to tailor language to increase understanding of good design principles may depend on the client and the project environment.

“With some clients, I might not use the term ‘trauma-informed design,’” she explained. “I might say this [design] is for our nervous system… This seat with your back to the main aisle is not a good seat for your nervous system. Why? Because as human beings, we have developed over time an aversion. […] We don’t feel safe if we don’t know who is behind us.”

Roche advised educating both design professionals and building stakeholders that conversations about trauma may not be comfortable, but they are vital to ensuring that people feel seen and heard for positive results. “We need to bring [trauma] out from underneath the bed, turn on the light, and start getting rid of the ‘monster,’” she said.

Social Impact Beyond the Building

When applied with fidelity using proven methods, Roche and Cowart stated, trauma-informed design can positively influence a number of community health measures.

Based on her experience in policy via family and correctional services, Cowart said not only can mental and physical health be improved through thoughtful, evidence-based design, but also factors such as “academic achievement, family and community violence, incarceration rates, and substance abuse rates…because we have to recognize that so many of the behaviors that people are involved in that are criminalized are actually self-medicating behaviors.”

In other words, behaviors that may arise from being unequipped to deal with the causes of chronic stress and reacting “from a place of survival,” as Cowart put it.

Margarida concurred, and said that facilities throughout the U.S. justice and social services systems could benefit from a trauma-informed design approach such as the one espoused by the Norwegian system, bringing the benefits full circle to those who may need them the most.

Regardless of a building’s purpose, the potential scope of trauma-informed design is of paramount importance.

As Cowart explained, “If we are actively trying to prevent traumatization and saving lives, I don’t take that lightly. I see it as helping society understand those long-term health outcomes, and building services and environments that can have a positive impact.”

REFERENCE

Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.