Content strategy design for people in crisis or trauma

Content strategy design for people in crisis or trauma

A session at the South Australian Council for Adult Literacy’s 2018 Conference presented a training program for women in crisis or trauma. I sat in on it, and came away with some significant takeaways for those of us in content design.
TL;DR: The laws of simplicity become even more important. But, your usability study design may also have to change.

Trauma profoundly impacts your ability to concentrate, remember, and ‘learn’.

When women arrive at Catherine House, they have an ability to concentrate for about ten minutes at a time. They may have come from a situation — even a lifetime — of trauma. This affects their ability to concentrate and remember.
Now, I want to point out to you that I have put the word ‘learn’ in inverted commas for two reasons.
The first reason is because concentration and memory are critical components of learning. The second is because I think that throwing everyone under ‘impaired ability to learn’ umbrella is a huge assumption. Not everyone reacts the same way to trauma.
However, studies show that, in general, that trauma affects the ways in which people ‘learn, plan, and interact with others’
This is why Susan Stewart designed Catherine House’s Live Your Best Life program the way she did. 
In brief, the program helps women to rediscover their choices and confidence in life. 
The program has some key principles. They are:
  1. Saying NO is encouraged. If they didn’t do their homework, there is no shame; it’s just, NO I didn’t do it
  2. Saying SORRY is discouraged, in situations where it’s not called for. There are a large number of ways in which women in crisis apologise. They apologise for their actions, thoughts, beliefs, and statements.
  3. Sit in the silence, and allow each other to think and consider, before making a decision. For trainers, this is a big deal: People are often used to filling in the silence, not sitting inside it. 
  4. Providing options is better (in some circumstances) than allowing just an open-​ended response.
  5. Consent is paramount. And if you don’t give you consent, say NO (see point 1). Asking people to contribute isn’t appropriate. You need to read non-​verbal and verbal language, and be encouraging without being prescriptive.
  6. Never assume you have a clear picture in your mind of what someone in trauma or crisis is or looks like. And, even if you can see and understand that trauma has occurred, never assume you know its depth.
In the session, Susan had five women from Catherine House with her. They had either completed or were going through Live Your Best Life. Presenting was an incredibly big deal for them, and I was absolutely in awe.
These women’s insights were significant. They explained their experiences of the learning and interaction. They showed how, when it designed right, it can be empowering and confidence-building.

There are lessons here for content strategists and content and UX designers

As a content strategist, this session introduced me to some concepts in designing content and user studies — for those in trauma. Doing some quick searching through the internet, I found nothing comparable.
But this issue is something that needs to be picked up by the broader community and introduced as a best practice.
Below are my key takeaways. I encourage you, particularly if you create or deliver content for those in trauma or crisis, to add to this conversation. Agreeing on principles for content design and user experience studies with people in trauma is critical if online services are going to be useful and effective.
So, here we go.

1. Create time and space

Susan spoke to us at length about the need for creating time and creating space for those who are in crisis. What does this mean for those of us in content, content strategy and UX?
The first thing it means is that interfaces need to be sparse. Distractions need to be kept to an absolute minimum — or exclude them altogether. No popups. No bars. No clusters of content, or cluttered interfaces.
The second thing is means is keep everything simple. Make your sentences short. Make the paragraphs short. Give people loads of white space, ‘rest areas’ for their eyes. Reduce the complexity of any interaction, so that decision-​making can be both simple and effective. Studying users’ top tasks is fundamental. This article may be useful reading for you. 
The third thing is to reduce cognitive load, by reducing decision-​making points. This may mean removing pop-​ups that demand action, and eliminating time-​pressure countdowns. Users in trauma need time and space to be able to make decisions. Creating unnecessary pressure points in their online experiences won’t be helpful to them.

2. Really think about consent. I mean, really.

When it comes to women in crisis in particular, consent isn’t just a legal term. Consent is about empowerment. The reason is because many women in trauma have had consent removed from their lives in ways many of us can’t even imagine. Their abilities to direct their lives have been, in many cases, completely removed.
Consider what you are doing if you remove the ability to consent, and what are your assumptions.
This might mean questioning your assumptions about:
  • content delivery channels
  • formats
  • what you track and why
  • how you contact people and why
  • how you start conversations online
  • … and any number of other things.
The issue of consent is about the issue of choice. Allow these people to choose what their experiences will be like. Giving them choice reinforces the creation of positive living patterns.
Think, too, what it might mean for you if your end-​users don’t provide their consent. In what other ways can you capture the information you need? Creative thinking and alternative problem solving become your greatest assets.

3. Consider what giving a limited range of options might mean; and then consider the reverse of that.

Depending on your audience, giving people a limited range of options may give rise to fear or anxiety. They may have been in situations in which the options they chose were thrown back at them. They may not be capable right now of making a choice from an open-​ended range.

4. Change your usability study design

You may need to change the fundamentals of your usability studies. 
You may need to:
  • design very short studies (at most 10 minutes)
  • allow for many more times in which you interact with someone
  • allow long periods of time in which you wait for a response
  • design studies that allow people to give their consent (or not) at every single point
  • design different questions, ones that don’t rely on memory
  • prepare to hear what your participants think you want to hear.
  • allow time for familiarisation and trust-​building before you even get to your study
  • encourage positive involvement in the outcomes of the studies somehow
  • co-​create the studies with your users. This may help them feel that they are creating resources, rather than ‘being studied’.

You can’t expect your standard methods to work for people in crisis or in trauma

Accessibility standards only go so far. People in crisis or trauma have specific needs, because their experiences have changed how they relate to the world.
What we can’t do is assume that we understand the impact of the trauma on a person, or the depth of that impact. Accessibility standards go a long way, particularly in areas of consistency and choice, but it may not be enough.
Being advocates for our audiences isn’t just about ‘finding out’ what their needs are. It also means being flexible enough to change how we approach them.

Do you have experience designing content for those in crisis or trauma? What do you think about all this?

Leave a comment below and share your experiences.
Leticia Mooney

The Brutal Pixie is Leticia Mooney. Race: Eladrin, Class: Publisher. --- Leticia is Australia's foremost authority on publishing in a business context. She ghostwrites for, and advises, entrepreneurial individuals in the professional services.

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