A Cross-Comparison Multiple Case Study on Building Trauma-Informed Workplaces

Background and Purpose: Over 70% of adults in the United States experience trauma, with 64% of them experiencing adverse experiences in childhood. Trauma theory and practice have led to a meaningful focus on implementing trauma-informed care in social services, medical care, and educational settings. However, an essential social system has been neglected in social work research: the workplace. Given that people spend more time working than any other daily activity, accumulating approximately 90,000 hours over a lifetime, there is a need to focus on providing a trauma-informed workplace for employees. The purpose of this study is to understand how to build trauma-informed workplaces that support employees’ well-being, creativity, meaning-making, and social connection.

Methods: In this interdisciplinary, multiple case study, we uniquely combine social work and business management theories and methods. We collected original empirical data from four diverse businesses and organizations, including a statewide nonprofit focused on behavioral health and child development support services; an international business focused on providing psychological support for medical providers, doulas, midwives, and birthing parents; a locally-owned-and-operated hair salon; and a regionally-focused entrepreneurial support organization supporting minority entrepreneurs. Organizations were recruited through social media and professional connections. We purposively selected positive deviant cases based on leadership commitment to a trauma-informed workplace and congruence in perspectives across the organization . Data collection involved individual and focus group interviews with leaders and employees, ethnographic observations of team meetings, trainings, and day-to-day interactions, and reviews of archival documents and artifacts. The analysis used Eisendhardt’s (2021) cross-case comparison approach and an abductive process that moves between theory and data, with established trauma-informed care principles as an analytic guide.

Results: Across cases, the importance and timeliness of building trauma-informed workplaces were evident. As one employee from the hair salon described, “We’re an industry that attracts a lot of traumatized people, and we also see a lot of traumatized clients. It would be hard to sit and listen to people talk about their stuff if you aren’t being supported on the back end.”

Results demonstrated practicable examples of trauma-informed principles, such as trustworthiness (“My team knows that if they tell me something in confidence, it stays in confidence”) and empowerment (“In team meetings, our founder will ask ... ‘how do we solve this?’ and then looks for everyone’s input”). Analysis of physical spaces showcased how the built environment fosters physical and psychological safety.

Finally, trauma-informed principles were interconnected, as in this example of empowerment and collaboration: “We run the business together. ... There's a collaboration in terms of it's not top-down, saying, this is what you will do, but very much a, this is what we need to get done...What is your piece of this puzzle?”

Discussion and Implications: Workplaces are a critical part of the social ecosystem. This research lays the groundwork to support employees’ mental health, advancing an empirically grounded vision for building trauma-informed workplaces. Interdisciplinary research bridging social work and business is key to democratizing knowledge.