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It’s important to think about the physical set-up and design of the space—be it a fixed site or mobile service—in order to minimize escalation. Harm reduction leaders and others identified two important lenses with which to view physical design and set-up:

  • Sensitivity to Trauma—“Trauma-informed” is basically a sensitivity to the fact that the population being served and the staff serving them are people who have experienced trauma, and that trauma experiences can be triggered in part by the physical set-up of a space/services.
  • Safety—This means being attentive to the physical safety of your participants and staff with regard to accessibility, injury, and violence prevention.

Harm reduction leaders made clear that all decisions made about the physical design and set-up of services should consider safety and sensitivity to trauma, and should err on the side of sensitivity to trauma when they are in conflict. This is because people who are in trauma response are often the least safe when they are agitated, so it’s essential that harm reduction organizations minimize trauma reactivity responses as much as possible.

These leaders also agreed that defining the parameters of the spaces was the most important first step in designing a harm reduction space.

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Once you have grounded yourself during an escalated situation, next engage in active listening with the person who is agitated. This can seem counterintuitive or difficult when you are dealing with somebody who is, for example, screaming at you, and it may feel like you’re rewarding them for being completely irrational. But it is key to getting them more centered and grounded so they’re less agitated and less likely to become a danger to themselves or others.
The term “trauma-informed” emerges from a growing understanding of the far reaching ways that trauma impacts health and well-being. Trauma is defined here, in keeping with the scientific literature, as a deeply distressing or disturbing experience(s) that overwhelms an individual’s ability to cope, and significantly impacts their mental, emotional, and physical well-being.