Part One - Trauma Informed Practice as the New Tick Box

The Dilution of Transformative Language in Professional Practice

I’ve been working across education, children’s services, health and criminal justice for many years now with a mission to create environments that infuse trauma informed practice into their services. In the last couple of years, we have seen a huge dilution and overuse of the term ‘trauma informed’, so much so, that I don’t even like using it anymore. In this short 3-part series, I will explore how this has happened, the consequences and what we can do about it.

Introduction

The term ‘trauma-informed’ once carried so much transformative potential, representing the hard-won insights about how to serve people, centralising safety and dignity. Yet we find ourselves in a situation where the term is overused, diluted and increasingly serves as a tick box on funding applications, bullet points in job descriptions and performance review criteria that measure compliance rather than commitment. What began as a vital call to fundamentally rethink practice has become reduced to a label, a 2 hour training session, or a section on a policy statement that changes little in the day-to-day reality of service delivery. I regularly short training sessions, meaningless job descriptions and ridiculous claims about an organisation’s qualities.

When powerful concepts are reduced to meaningless jargon, we lose more than clarity; we lose the tools for genuine transformation and risk causing harm while believing ourselves to be helping. Doors are also wedged open to allow for the weaponisation of the term by those working within services which then prevents opportunities for personal and system growth and accountability (showing up as ‘I can do what I like becuase of what happened to me’ and ‘you’re just not being trauma informed’).

We can explore how this happens through looking at the process of how other concepts have been bastardised in this way.

How Language Loses Its Power

Drawing from other concepts we can deduce that the dilution of professional terminology follows predictable stages, a pattern that has repeated itself throughout the history of helping professions.

Stage 1: Emergence from Practice

A concept typically emerges from practitioners or researchers who identify a gap between current practice and what people actually need. The language is born from intimate knowledge of a problem and carries specific, actionable meaning.

For example, the concept of trauma informed care emerged in the 1990s from recognition that traditional mental health and social services were inadvertently re-traumatising the very people they aimed to help. Early proponents like Maxine Harris and Roger Fallot described concrete core practices; understanding how trauma affects brain development and behaviour, recognising trauma symptoms, integrating trauma knowledge into policies and procedures, actively resisting re-traumatisation and emphasising safety, choice and collaboration (Harris & Fallot, 2001).

Stage 2: Recognition and Legitimisation

As the concept proves valuable, it gains wider recognition. Research validates its importance, early adopters demonstrate positive outcomes and professional organisations take notice. The language moves from the margins to mainstream discourse. For those of us who have worked in this area for a long time, we will remember when trauma informed practice was seen as ‘fringe’ and when it became terminology we could hear in the mainstream.

This legitimisation phase is crucial and often productive. However, this stage also begins the process of dilution, as the concept must be simplified to be communicated broadly. Nuance gives way to soundbites, complex frameworks become bullet points and the messy reality of implementation gets smoothed into neat presentations. Social media exacerbates this with its ‘meme’ communication style and limited characters, alongside our increasing lack of capability to read anything too long (Poles, 2025).

Stage 3: Institutionalisation and Requirments

With success comes requirements. Funders begin requiring demonstration of the concept in grant applications. Accrediting bodies incorporate it into standards. Job descriptions list it as a required competency and new positions are created with the terminology in the title. The concept becomes mandatory rather than aspirational. The idea that there is an end goal is born. It is no longer an ongoing journey. It now believes that there is a destination.

At this point, the incentive structure shifts dramatically. Organisations now need to claim adherence to the concept regardless of whether they genuinely embody it. A compliance industry emerges; consultants offering certification, the selling of training modules and the development of assessment tools. There is a shift from considering how to genuinely transform a service and a culture to demonstrating compliance.

Stage 4: Superficial Adoption and Dilution

Organisations adopt the language without the substance. Staff attend short training sessions and the organisation declares itself transformed. Mission statements are updated, posters are adapted and the term appears in every document, while actual practice remains largely unchanged.

The concept becomes a tick box. Have you attended the training? TICK. Have you updated your policies to include the language? TICK. Are you trauma informed? Yes! Well actually, NO!

The term becomes so broad it can mean almost anything and therefore means almost nothing. Every practice can be labelled with it, even practices that contradict its original principles!

Stage 5: Cynicism and Backlash

Eventually, practitioners and recipients of services alike recognise the gap between rhetoric and reality and the term becomes associated with performative compliance rather than genuine commitment. Critics dismiss it as a buzzword or worse, as cover for harmful practices. The people using the service know this on a deep level!

Where have we seen this before?

A Repeating Pattern

Client-Centreed Care (1940s-Present)

Carl Rogers developed client-centred therapy in the 1940s as a radical alternative to the expert-driven, diagnostic models dominating psychology (Rogers, 1951). Rogers proposed that clients possess the inherent capacity for growth and that the therapist’s role is to provide unconditional positive regard, empathic understanding and congruence, rather than to diagnose, direct or prescribe.

The concept spread beyond therapy to healthcare, social services and education. By the 1990s, virtually every helping organisation claimed to be client centred. Yet research consistently shows provider-driven decision-making and power imbalances that Rogers would have immediately recognised as barriers to genuine client-centred care.

The language of client centred was adopted without the philosophical transformation Rogers demanded. Organisations called themselves client centred while maintaining hierarchical structures, standardised interventions and expert-knows-best attitudes. The term became marketing copy rather than practice philosophy.

Evidence-Based Practice (1990s-Present)

The ‘evidence-based practice’ movement emerged in medicine in the early 1990s with a clear and specific meaning, integrating the best available research evidence with clinical expertise and patient values in making decisions about individual patient care (Sackett et al,1996). It was never intended to mean simply following protocols or applying research findings mechanically.

Yet as the concept spread, the integration of clinical expertise and patient values often disappeared. The result was that practices that were labelled as evidence-based lacked the very elements that the term was meant to ensure such as responsiveness to individual circumstances, incorporation of professional wisdom and respect for patient preferences.

Cultural Competence (1980s-Present)

Cultural competence emerged from recognition that healthcare and social services were failing to serve diverse populations effectively. Early frameworks emphasised ongoing self-reflection about one’s own cultural identity, recognition of power dynamics and structural inequities, commitment to learning about different cultural worldviews and development of culturally responsive practices.

As it became institutionalised, cultural competence was frequently reduced to cultural awareness training sessions where participants learned lists of cultural traits or sat through presentations about holidays and foods. The uncomfortable work of examining one’s own biases and privileges, confronting institutional racism and changing power dynamics was replaced with the consumption of cultural facts.

This superficial adoption sometimes caused more harm than good, encouraging stereotyping based on demographic categories while allowing systemic inequities to continue unchallenged. Critics eventually rejected the term itself, arguing for alternatives like cultural humility that might resist similar dilution. I like to think of cultural humility as ‘I cannot know what I have not lived’, which is in a bid to try and ensure that dilution cannot happen here.

Why Dilution Matters

When terms can mean anything, they mean nothing. More dangerous than confusion is the false sense of accomplishment. Organisations believe themselves transformed when they’ve merely changed the labelling on the side of the packet! Staff trained in trauma informed practices may feel competent while continuing harmful practices, now with the added conviction that their approach is evidence-based.

I see this display in all sectors. In education settings it can look like them saying they’re trauma informed (or have embedded relational practice) while maintaining behaviour policies that shame, exclude and isolate. In children’s services it can look like their social workers having impossible ‘caseloads’, no time for lunch and poor quality supervision. I see it in therapy where people are pushed to tell their story before safety or trust is established, where behaviour is interpreted as resistance rather than adaptation and the professional is presumed as the expert and the person is the problem. In health (and I experience this personally), it shows up as rigidity, power imbalance, being treated as a patient not a person and a dismissal of responses to this. By now, you’re probably also throwing services under huge pressure as a reason for this dilution into the mix and you would be right to do so, although that aspect, requires a different analysis and a different article!

Importantly, superficial adoption prevents deeper transformation. Once an organisation has declared itself trauma-informed and gained recognition for this claim, what motivation remains to undertake the difficult work of actually becoming trauma informed? The label satisfies external requirements while actual practice continues unchanged. This dilution undermines the capacity for meaningful change.

Next time, in Part Two, I’ll be further addressing how this dilution happens and how it can be assuaged at an individual level, at an organisational level and at a system level.

Until then…

References

Fallot, R. D., & Harris, M. (2009). Creating cultures of trauma-informed care (CCTIC): A self-assessment and planning protocol. Washington, DC: Community Connections.

Harris, M., & Fallot, R. D. (Eds.). (2001). Using trauma theory to design service systems. New directions for mental health services. San Francisco, CA: Jossey-Bass.

Poles, A. (2025). Impact of social media usage on attention spans. Psychology, 16(6), 760–772.

Rogers, C. R. (1951). Client-centered therapy: Its current practice, implications, and theory. Boston, MA: Houghton Mifflin.

Sackett, D. L., Rosenberg, W. M., Gray, J. A., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn’t. British Medical Journal, 312(7023), 71-72.

Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach (HHS Publication No. SMA 14-4884). Rockville, MD: Author.