Date Presented 03/31/2022

With the prevalence of gun violence in the United States, and as health care providers in a variety of settings with people of all demographics, OT practitioners are very likely to encounter clients who have experienced trauma from a gun-related incident. This presentation will provide comprehensive resources about occupation-based trauma-informed care ( TIC) for gun violence survivors. It will discuss the six guiding principles of TIC and mental health of gun violence survivors, viewed through the lens of OT.

Primary Author and Speaker: Manisha Sheth

Additional Authors and Speakers: Sara Macaluso, Grace Agnes, Tatevick Sargsyan, Kristen Galvez

PURPOSE: With the prevalence of gun violence in the U.S., occupational therapists must be equipped to provide occupation-based trauma-informed services to clients.This study examined the relationship between the six principles of trauma-informed care (TIC) as defined by SAMHSA (2014) and the mental health of gun violence survivors viewed through the lens of occupational therapy.

DESIGN: Participants were recruited through purposive and convenience sampling; eligibility criteria included gun violence survivors, 18+ years old, read/speak English, and are members of a closed Facebook group for gun violence survivors in California.

METHOD: Thirteen participants completed online surveys through SurveyMonkey. A 20-question online survey was used to collect quantitative data. Survey data was analyzed through Jeffrey’s Amazing Statistics Program (JASP). Eight participants from our sample completed semi-structured interviews through the Zoom platform or phone call and qualitative data was analyzed by identifying codes and themes. Trustworthiness was ensured by triangulation, saturation, member checking and peer debriefing.

RESULTS: Descriptive statistics were used to report quantitative data, which revealed that all six trauma-informed care principles ‘safety; trustworthiness and transparency; peer support; collaboration and mutuality; empowerment, voice, and choice; and sensitivity to cultural, historical, gender issues’ were beneficial to survivors’ mental health if one or more was incorporated in their care. Qualitative themes that emerged were not heard, not understood; empowerment, voice, and choice; remodeling beliefs physically and mentally; and trauma is not one size fits all. Coping strategies were also assessed to provide a better understanding of how participants managed their own care.

CONCLUSION: While results indicate that trauma-informed care plays an important role in the perceived mental health of gun violence survivors, this study reveals a gap in occupational therapy services and an opportunity for occupational therapy professionals to expand into areas of practice that include this population. More research is needed to examine the application of occupation-based trauma-informed care in healthcare settings for this population.


Everytown for Gun Safety. (2019). A nation of survivors: The toll of gun violence in America.

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. Substance Abuse and Mental Health Services Administration.