Table 3 Themes of intervention usefulness identified through qualitative analysis of participant interviews (n = 16)

Implement more flexible, less-punitive policies towards clients

We like to think that the way we implement it (programs) is very compassionate and trauma-informed. One of the things that we definitely have shifted since doing the training is that we aren’t quite as rigid. We’ve loosened up a bit. We’ve become less attached to how it has to look, as far as the session goes. We’re meeting them more where they are. [social services #002]

If somebody comes down and were having a difficult conversation, we don’t force the session, we allow clients to retreat, we check on them later…and if a client needs a break we say how about we pick up this conversation later. If somebody is extremely agitated, we sit in silence and help them catch their breath, we try and maintain a steady tone of voice with them…we talk about ways that they can take care of themselves between that session and the next session. [social services #008]

Just more patience. More understanding, and to not write a kid off as – as being inherently bad or “young criminal” or something. You kind of understand that there are different things at play. [law enforcement #001]

And the other component that has helped me is not making it so rigid... I sometimes have people who seem nervous, so I sit with them outside and we just sit outside and talk. And I don’t need to have the papers in front of me and have notes. I can just go back and write that we had a meeting and write it down and it helps them not be so nervous to talk to me. Those are the things that have been really helpful to keep in the back of my mind to remember that people may not be comfortable in this room, they may not be comfortable talking to me for lots of reason. Those have been really helpful. [law enforcement #002]

For me I made stuffed animals available for the children. I switched the way I talked and how I approach them. Knowing that the way that the child is used to an authority figure talking to them is always yelling. So lowering my voice and changing the inflection in my voice. I offer them hugs. I ask them what do you need today to be successful. [parks and rec #001]

Just a better, better sense of listening. I let them vent, I let them scream, I let them howl, I let them yell. You know whatever it takes for them, and when you’re quiet then the person says, “Hello, you still there?” “Yes ma’am, I’m still here, I’m just listening to you.” You know, so that I know that our house has served you, how to get you to the right person if I can’t help you, you know. [311 operator #001]

Adopt trauma-informed workplace design

We have set up our offices a little differently, we give them options to either face the door or have their back to the door. we have redone our front office so it’s a little less chaotic and a little more soothing when they come in. [social services # 003]

I recognize that you can actually design workspace in the environment in a remarkable easy and cost effective way to implement the trauma informed approach to care [social services # 004]

We all discussed it and we felt like clients when they came into the office were not feeling welcomed and that had a lot to do with the pictures on the wall, it had a lot to do with the color of the office, and so we had volunteers come in and they had redesigned our office and they painted so it’s more brighter, it’s more calming, you know, the pastel colors, as opposed to dark or gray or like, hospital or padded entry (?) type, one color wall. We’ve made it more brighter, like I said, we changed the layout of the desks. They’re now, they’re going to be in an L-shape as opposed to when you come in, there’s an I. [social services # 005]

You make sure that their space is clean and that it smells and good and you know so that’s the kind of physical and environmental stuff that I integrate into the work. I turned off the light in my office and put up a lamp in it to make it a softer light… I had brought stuff for children in my office. I had done that before, but stopped it. I – I brought it back in. I have kind of adjusted the arrangement of my desk and how the residents approach my door, I notice a whole difference in my interactions with them that does not lead to me being overly stressed out. [social services #007]

Heightened awareness of own traumatic stress and need for self-care

The training really prompted me to look at my own trauma and figure out if I was really able to access it. I’d say I’ve become more inclined, like, to be aware of – like, “Hey, you know, I’m kinda stressed. I need to take some time off.” I definitely realize that I’ve got stuff going on, that whole secondary trauma thing. I’m more aware of that than I was before. The need to do that. It’s very hard for me because, you know, I’m kind of 24/7. I have my phone on all the time… I have always understood self- care and I you know, I have started writing, or I started painting, or I dance, or I journal… I think the training started to bring me back to a place where I needed to do some introspection. Introspection I needed to find an outlet, to really take care of myself. [social services #001]

Now I take more time for myself. I’ve learned not to feel guilty, not thinking about the residents when I get home. I started it about two years ago- I have two corners that I turn to get home. Once I turn that second corner, I had to train myself to let go and I will be back tomorrow because that’s when I have to start focusing on me, my children, and my home, I know I did a good job, so while I’m driving those two corners, I think about what good I did in a day and what did I accomplish and I give myself a pat on the back, and I keep it moving. So that’s how I train myself not to bring the job home. [social services #005]

After our training was completed, we had a pretty in-depth team meeting around self-care. We do encourage especially more aggressively taking those mental health days. I make it a priority to try and kind of des-stress and create an environment for myself at home, not bringing work home… I do my best, but you know sometimes it’s just a really crappy day and you can’t just say I’m just gonna leave that at work and not bring that home. [social services #009]

You’re feeling a certain way and you don’t really understand it and then you get to subjective presentation of the effects of secondary trauma and, um, how that affects you and you’re like, “Oh, okay. That’s kind of why I feel the way I do.’ [law enforcement #001]

Greater sense of camaraderie and empathy for colleagues

When you’re not at a good place or feeling overwhelmed by the work, or feeling stuck, there is a willingness and openness on supervisors that were aware of it, and were able to support staff in a way that’s not making them feel like they’re incompetent or that they are failing. [social services #001]

Senior management keeps an open-door policy where we can um come to them if there, you know, is anything bothering us or anything that we just need to get off our chest, anything anytime we need to express any concerns, um that they definitely maintain an open-door policy for us. I do the same for my stuff um and we make sure that we have certain um procedures in line so that um if someone does start to feel um burnt out that they, they have that access to um have that, take the time off that they need or you know take that break that they need, so that we can encourage that, that healthier workplace. [social services #008]

I do the same for my staff and we make sure that we have certain procedures in line so that if someone does start to feel burnt out that they can take the time off that they need or take that break that they need, so that we can encourage that, that healthier workplace. [social services #009]

I feel like you helped me understand my fellow officers better. And then, um, I saw, even though I’m not patrol anymore, I saw how understanding trauma-informed care would help, you know, patrol officers, um, kinda go into a situation with a little bit more confidence and understanding. [law enforcement #001]

I try to recognize that the secondary trauma and the burnout from the things that we do so I try to make sure that the staff have breaks that they need, if I just tag team if you need to tag out and get a little breather I can tag in or we can rotate the groups so that it’s possible that they can kind of “woo-saw” and take that deep breath and then we have staff meetings regularly, kind of changed the format to allow more open discussion instead of, what happens is the center directors have meetings with our area managers and so instead of it just being information being disseminated to kind of do pulse checks with the staff. [Parks and Rec #001]

We had several cookouts, well cook-ins, several cook-ins. We had a relaxed dress code for probably about a month and a half; we’re still in it till September 2nd. That has kinda lifted everybody’s spirit a little bit. Try to bring everybody together as a whole because we as a group, we were really divided, so it’s kind of brought some of us together. [311 operator #001]