College of Science and Health Theses and Dissertations

Date of Award

Summer 8-22-2021

Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Molly Brown, PhD

Second Advisor

Anne Saw, PhD

Third Advisor

Megan Greeson, PhD


Research indicates that most individuals in the general population experience some form of trauma (Kilpatrick et al., 2013) and that factors such as homelessness place individuals at higher risk of experiencing traumatic events (Deck & Platt, 2015; Ellsworth, 2019; Kushel, Evans, Perry, Robertson, & Moss, 2003). Considering that environments may both promote and impede the trauma recovery process, Trauma-Informed Care (TIC) is a service framework intended to create a culture of trauma awareness and responsiveness (Fallot & Harris, 2006). Preliminary research demonstrates that TIC has positive outcomes for clients and staff (Damian, Mendelson, Bowie, & Gallo, 2018; Hales et al., 2018; Kusmaul et al., 2018). Service environments such as homeless service providers often create settings, or milieus, in which relational and interpersonal factors among clients may impact experiences of TIC. The present qualitative study explores how client-to-client interactions (a) impact client and staff experiences of TIC in homelessness services and (b) highlight TIC principles and their dynamics. The following inductive themes were identified based on 29 client and staff interviews: accessibility, confidentiality and privacy, conflict and conflict management, general environment, individualizing care, mutual support and community building, and policies and policy enforcement. All five TIC principles based on the Fallot & Harris (2006) framework were identified within the dataset: safety, trustworthiness, choice, empowerment, and collaboration. Findings also highlighted inter-principle and intra-principle dynamics, and how they occurred. Specifically, how and the extent to which TIC principles were implemented at times had additional effects for TIC principles. Findings have practical implications for issues relevant to TIC within milieu settings and conceptual implications for ways in which TIC principles interact.

SLP Collection


Included in

Psychology Commons