Social Work Advocacy: Towards a Trauma-Informed Model

Social work advocacy is a crucial aspect of the profession and a tool that allows social workers to promote social justice by standing up for the rights of individuals and communities so their needs can be met (International Federation of Social Workers, 2014). Paradoxically, despite being eligible for services and benefits, people often do not realize their rights (Finn & Goodship, 2014). Thus, advocacy is particularly important when working with the most marginalized groups (Tarshish, 2023). Social work advocacy takes two main forms: case advocacy and cause advocacy. Case advocacy addresses individual needs by assisting service users in receiving benefits and services. Cause advocacy aims for systemic change, promoting policies that benefit groups or communities (Abramovitz & Sherraden, 2016; Dalrymple & Boylan, 2013). The two traditions are intrinsically linked, so this dichotomy does not capture its complexity (McLaughlin, 2009).

Various models of social work advocacy assist social workers in the intricate work of advocating for rights on behalf of service users. However, these models tend to view advocacy instrumentally, that is, as a tool rather than part of a therapeutic process. Thus, they often fail to take into account the key role trauma plays in an individual’s ability, or lack thereof, to access benefits and services. In a parallel fashion, various social work advocacy models based on a trauma-informed perspective focus on supporting service users by creating a safe environment for healing but do not consider the advocacy of rights, such as access to benefits, suitable housing, or health services. There is a lack of scholarly knowledge and professional expertise regarding ways in which the realms of advocacy and trauma-informed practice can be connected.

This article aims to bridge these two separate bodies of knowledge conceptually. Specifically, it examines the basis of trauma-informed approaches to practice and reviews existing models of social work advocacy to point a common ground. This is done using the integration of trauma-informed components into the Active Take-Up Advocacy (ATA) model of advocacy. We begin by presenting various advocacy models and discussing the principles of the trauma-informed perspective. Next, we focus on the original ATA model (Krumer-Nevo, 2020), elucidating existing components that align with trauma-informed principles and suggesting trauma-informed guidelines that should be integrated into a new trauma-informed model (TI-ATA). Finally, we discuss the implications of our findings for social work practice.

Advocacy of rights has been described as an integral element of the social work profession from its inception (Dalrymple & Boylen, 2013). The International Federation of Social Workers’ (IFSW) global definition of social work and the National Association of Social Workers’ (NASW) code of ethics strengthen the profession’s commitment to rights advocacy (IFSW, 2014; NASW, n.d.).

The multifaceted nature of advocacy has led to the development of various models of advocacy practice, most of them in the context of case advocacy. We present four of them here. Three are dominant in the existing literature: the Differential Model of Advocacy in Social Work Practice, the Social Work Advocacy Model, and the Advocacy Practice and Policy Model. The fourth model, Active Take-Up Advocacy, incorporates psychodynamic principles and social work tenets into a new advocacy framework. We leverage this approach as the foundation of a proposed trauma-informed advocacy model. We briefly outline key aspects of Active Take-Up Advocacy here and elaborate on them below.

The Differential Model of Advocacy in Social Work Practice (DMASW) (Fredolinno et al., 2004) focuses on differentiating four advocacy types based on who determines and controls the process. The first, “best interest advocacy,” protects vulnerable people while the social worker holds the means and determines the ends. In the second, “consumer-controlled” advocacy, the client determines the ends and controls the means. The third, “enabling advocacy,” allows the client to decide what will be achieved while the social worker controls the activities. Finally, in “client-centered” advocacy, social workers identify the needs, but the client is actively involved in advocacy. This model comprises an important contribution to social work advocacy by characterizing types of advocacy that focus on issues of control and participation in the advocacy process. Its limitations are that it does not address dynamic moves between types during the advocacy process or elaborate on the connections between case and cause advocacy.

The Social Work Advocacy Model (SWAM) includes five main components outlined by Bliss (2015): (1) cause, referring to the question of whether one advocates for individuals or groups, (2) outcome, which focuses specifically on practical changes the advocacy aims to bring about, (3) target audience, which refers to the people whose opinions and attitudes need to be swayed, (4) strategies and tactics, which emphasize the development of coordinated action blueprints and grassroots activation efforts to drive change, and (5) evaluation, which prioritizes real-world impact assessment and feedback monitoring. These five central elements are the building blocks of the SWAM’s approach to effective social work advocacy. Sanders and Scanlon (2021) added a sixth component to the beginning of the advocacy process: the development of an appropriate structure for coordinating advocacy efforts.

Using the initial five components, Bliss (2015) created and tested a systematic operational guide for advocacy with great promise for social work education since it addresses strategies and tactics in a structured framework that enhances capabilities and includes an evaluation process. Nonetheless, while this model is based on social work values and ideals, it does not specifically touch upon core social work and social justice issues of power, disempowerment, and participation in advocacy.

The Advocacy Practice and Policy Model (APPM) facilitates advocacy by drawing on the theoretical basis of four fundamental pillars of social work: systems theory, empowerment theory, the strengths perspective, and the ecological perspective (Tice et al., 2019). The model emphasizes key tenets of advocacy, including economic and social justice, a supportive environment, human needs and rights, and political access, and structures advocacy efforts around these (Cox et al., 2017; Tice et al., 2019). This model stems from generalist social work practice, highlights concrete social work values, and presents a dynamic cycle of advocacy and evaluation. However, it does not specifically address the clinical implications of advocacy for the partners involved, i.e., the social worker and the client.

The original Active Take-Up Advocacy model (ATA) was developed in the framework of the Poverty-Aware Social Work paradigm in Israel. Since 2015, it has been implemented nationwide by the Israeli Ministry of Welfare (Krumer-Nevo, 2020). The model consists of three steps for social work advocacy. The first is defining individuals’ problems regarding rights, which requires social workers to translate individual needs and behaviors into the language of rights. The second step is standing by claimants in concrete and symbolic ways during the advocacy process. Standing by concretely means disseminating information and preparing or accompanying service users to administrative agencies. Standing by symbolically means providing recognition, validating service users’ experiences, and processing them collectively. The third step is shifting from case advocacy to cause advocacy. In this step, social workers may use policy practice and community social work practices to change policy and institutions. This last step may include varying degrees of client involvement, from high involvement to non-involvement. The model’s contribution is its integration of psychodynamic tenets connected to validating individual experiences and providing recognition with case and cause advocacy. Specifically, the model incorporates psychodynamic principles, principles of rights-based social work (Tarshish, 2023; Gateno-Gabel, 2016), and the tenets of social justice. The model also addresses core social work principles such as empowerment, participation, and critical awareness of issues of power, racism, and othering (Krumer-Nevo, 2020). However, it contains no direct reference to trauma, so a lacuna exists in its implementation.

“Trauma is the result of an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening [sic] and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being” (SAMHSA, 2014, p. 7). In its global survey, the World Mental Health Consortium reported that over 70% of its respondents had experienced a traumatic event, while more than 30% had experienced four or more such events (Benjet et al., 2016). Empirical evidence indicates an association between traumatic events, poverty, and race (Bruner, 2017; Edwards, 2019). There is no surprise here since some populations, marginalized either because of poverty, race, or the intersection of these and other factors, have the least access to social, physical, educational, and economic opportunities. This situation compromises their ability to live in safe and stable environments (Bruner, 2017).

Marginalization goes beyond poverty and race, but the idea remains the same. People from marginalized communities experience a multitude of chronic life stresses, such as violence, economic hardships, family conflicts, and discrimination (Broaddus, 2020; Conradt et al., 2020; Lacey et al., 2022). Children living in poverty are more likely to be exposed to adversities in their surroundings and families (Saar-Heiman, 2019; Walsh et al., 2019). These traumatic experiences accumulate, creating a burdening effect with negative consequences such as physical and emotional illnesses in adulthood and high-risk behaviors (Bruner, 2017; Felitti et al., 1998; Petrucceli et al., 2019). Research on trauma has demonstrated its pernicious effects. Complex trauma, for example, which refers to multiple and prolonged exposures to trauma, often of an interpersonal nature, from an early age, causes a wide array of difficulties in learning, emotional regulation, and the ability to receive comfort and protection from caring relationships (see, for example, Nurius et al., 2019; Marusak et al., 2015; Van der Kolk, 2005).

A trauma-informed perspective is a holistic framework used across systems and professions to understand, recognize, and respond to the pervasive effects of trauma (David, 2022; Harris & Fallot, 2001a; SAMHSA, 2014). A traditional approach to trauma emphasizes diagnosis and professional knowledge. A trauma-informed perspective prioritizes fostering safety and trust while empowering individuals through collaboration and focusing on their strengths (Harris & Fallot, 2001b). The trauma-informed perspective is considered a gold standard in the practices of social workers (Bent-Goodley, 2019), educators (Stokes & Brunzell, 2020), and health professionals (McNally et al., 2023).

A trauma-informed perspective has been established in law by states in the United States and at the federal level. This legislation supports actions such as screening for trauma, training staff, testing new trauma-informed strategies, and promoting trauma-informed service delivery (Maul, 2017). A designated guide developed by the Substance Abuse and Mental Health Services Administration (SAMHSA, 2014) for agencies that provide trauma-informed services is widely quoted and considered a significant contribution to the field of trauma-informed practice.

The guide emphasizes four main assumptions and six key principles of practice. The assumptions are that professionals must have a basic understanding of the effects of trauma, be able to recognize its symptoms, respond by applying trauma-informed principles in their work with clients, and strive to avoid the retraumatization of clients and staff. The key principles include spotlighting safety, trustworthiness, transparency, peer support, mutual self-help, collaboration, and mutuality; ensuring empowerment, voice, and choice; and acknowledging and respecting cultural, historical, and gender issues (SAMHSA, 2014).

Other models provide similar guidelines. For example, in their model, Peck and Capyk (2012) identify core principles of trauma-informed practice: (1) trauma competence, which pertains to understanding the impact of trauma and attempting to minimize retraumatization, (2) understanding the client using the strengths perspective and giving meaning to context, (3) client empowerment, achieved by maximizing choice, control, collaboration, and respect, and (4) safety as a key for healing and as promoting trust. Similarly, Knight (2015) outlines five core principles of trauma-informed practice: safety, trust, empowerment, choice, and collaboration. Finally, Levenson (2020) addresses ten trauma-informed principles for social work practice, including safe relationships and spaces, conceptualizing through the trauma lens, recognizing that help-seeking can be traumagenic, avoiding confrontational approaches, teaching de-escalation, self-regulation, and relational skills, asking instead of telling, reframing resistance, using person-first language, and neutralizing power struggles and sharing power.

Recently, some have argued that a trauma-informed perspective focuses on the individual, and especially on what happened to survivors, how they were affected, and what is needed to aid them, but ignores socioeconomic factors that influence both the traumatic event and how it is addressed in treatment. Boylan (2021) points out that while the current understanding of childhood adversities and their impact may motivate practitioners to adopt trauma-informed interventions, it may also, from a social justice perspective, reinforce a pathologizing view of the client or misidentify marginalization, discrimination, and oppression and the mechanisms that create them.

Thinking about trauma from a social justice perspective and understanding it as a social phenomenon adds a vital layer to critical trauma studies (Hamburger, 2021). Terms such as collective trauma (Hirschberger, 2018) and insidious trauma (Ziv, 2012) describe forms of social and racial oppression that systematically and institutionally discriminate against minorities and disadvantaged populations. While some trauma-informed principles address issues of power, political participation, and working with marginalized communities, they do not fully incorporate rights advocacy as a vital aspect of practice. Moreover, social work models of advocacy do not incorporate trauma-informed principles or reflect an awareness of the effect of trauma on the success or failure of rights realization among marginalized populations.

In summary, social work advocacy and trauma-informed models already have much in common. Recognizing the intersection of traumatic experiences, systemic oppression, and social injustices highlights the importance of a holistic framework that takes into consideration both trauma and rights. Like advocacy, a trauma-informed perspective is non-stigmatizing, asking, “What happened to you?” rather than “What’s wrong with you?” to understand how social structures and past experiences influence behavior (Perry & Winfrey, 2021). Trauma-informed models’ emphasis on safety, empowerment, and collaboration (Levenson, 2020) directly aligns with the mission of social work advocacy to “help clients become independent and exercise influence and control over their own lives” (McLaughlin, 2009, p. 53). Both types of models use collaborative casework with clients and recognize the challenges involved in establishing trust with those who have faced previous adversities (Krumer-Nevo, 2020; Knight, 2015). In addition, both promote clients’ sense of control and dignity.

Given the evolving understanding of the far-reaching consequences of trauma, the limited integration of trauma-informed principles into advocacy models points to a significant oversight. Recognizing the broad impact of trauma on individuals and communities, social workers must engage in case and cause advocacy as interconnected tools, for example, by using case advocacy to protect and empower individuals and cause advocacy to confront the root causes of oppression.

The limited integration of the trauma-informed perspective and advocacy can be attributed to several factors. First, clinical social workers with a trauma-informed orientation may not view active advocacy as within the scope of their therapeutic practice, while advocates may hesitate to fully engage with the complexities of trauma and its repercussions for their clients. Second, as research on the two perspectives evolved, each concept grew to accommodate its own theoretical foundations, terminology, and intervention strategies, creating two complex fields that are not easy to organize or practice, opening up the possibility for misapplication or misuse. Finally, applying both concepts holistically with clients requires a simple and broad practice-oriented model, ‘connecting the dots,’ and organizing the practice. In what follows, we propose integrating a trauma-informed perspective and advocacy by adapting the Active Take-Up Advocacy model.

The Trauma-Informed Active Take-Up Advocacy Model (TI-ATA) assumes that past and present traumatic experiences, feelings of alienation, and mistrust in the system significantly impact the ability of marginalized populations to access their rights. Traumatic experiences originating in individuals' and families' pasts are mirrored in everyday experiences of othering, micro-aggression, disrespect, and humiliation that characterize encounters with bureaucratic agencies in the process of accessing rights (Krumer-Nevo, 2020). Past traumas reverberate into the present in experiences of not being seen, heard, or recognized. Thus, they can negatively influence marginalized individuals’ perceptions of their chances of successfully realizing their rights and affect their behavior when they attempt to claim them (Krumer-Nevo, 2020).

As noted above, the model involves three steps: defining problems in terms of rights, standing by clients in the process, and moving from case to cause advocacy. Although the original ATA model is presented as an integrative model that responds to advocacy needs and psychological needs (Krumer-Nevo, 2020), the model does not fully address the actual strategies through which social workers mediate traumatic experiences or other components of a trauma-informed perspective. Hence, we have attempted to incorporate into it elements of trauma-informed practice: creating a sense of safety, trustworthiness, empowerment, choice, and collaboration within the worker-client relationship (Knight, 2015; Levenson, 2020) to enrich advocacy practice and create guidelines for a TI-ATA model. For each of the three steps of the model (see Fig. 1), we include a discussion of the stage, its trauma-informed components, and two case study examples, the first of which exemplifies casework and the second of which exemplifies clinical social work settings.

Blueprint of the Trauma-Informed ATA model

Full size image

Defining Problems in Terms of Rights

The first stage of the original ATA model (Krumer-Nevo, 2020) suggests that practitioners define problems in terms of rights. To do so, social workers must listen to the life stories of service users, pay attention to issues related to rights, and translate individuals’ problems into the language of rights. Social workers should listen to service users’ accounts of their encounters with representatives of the establishment and its bureaucracy. The worker should listen to service users’ descriptions of their efforts to realize their rights, even if these efforts have been unsuccessful and are described with anger or hostility. Additionally, social workers should assist service users in identifying rights of which they may be unaware.

A good example of defining problems in terms of rights in a clinical setting can be found in the work of Sucharov (2013). Sucharov, a clinical psychiatrist, illustrates the identification of rights in the case study of Betty, who was sexually abused by her father as a child. Betty came to therapy after being suspended from her work because of a finding of impairment due to alleged psychotic mental illness. Rather than understanding her problem as stemming from a personality disorder or a mental health issue, Sucharov asked himself what rights were involved in the situation, what rights were violated, and what rights corresponded to Betty’s needs. The answers to these questions lead him to delve into the details of the legal proceedings that resulted in her suspension and intervene in both the internal and the external. He characterizes his perspective as “a radical contextual view of the psychotherapeutic process whereby the sociopolitical dimension constitutes a continuous and vital presence in the therapeutic field” (p. 29).

This type of practice requires social workers to unlearn the traditional reasoning that locates the cause of service users’ problems in their individual characteristics or emotional problems and draw new connections between the situations of individuals and their access to rights. To do this, social workers should learn about rights and regulations, eligibility, and barriers to social rights.

Defining problems in terms of rights in the adapted TI-ATA model means using the same principles described above and applying an additional trauma perspective. Social workers must learn about trauma and answer questions at the intersection of trauma and rights: How have past or present traumas led to the client’s current state of affairs? What are the traumatic effects of poverty and other forms of marginalization? Does the client belong to a social group subjected to insidious or collective trauma? What are the effects of trauma on the individual, society, and surrounding circles? This knowledge will heighten social workers’ awareness of the interconnectedness of trauma and rights and the fact that social or personal traumatic events from the past may lead to certain actions. For example, not taking up disability benefits could be caused by a personal traumatic history related to a client’s disability. Alternatively, it could be the result of traumatic experiences of humiliation during previous encounters with bureaucratic agencies. The examination of the exact reason a client does not realize her right to disability benefits becomes an important part of the therapeutic process, which takes into consideration both inner conflicts and real-world obstacles. Working through inner conflicts and coping with external obstacles may lead clients to find the strength to take up their benefits, thus improving their material and emotional well-being.

Case study Illustration I

As a child, Sarah struggled when her parents left her alone for days at a time with no power or heat. Now a single mother with crippling debts, she once again faced utilities being shut off in her home. She and Amanda, her therapist, often speak about how it feels to be overburdened with debts as a single mother. Amanda became more informed about debts and advised Sarah to meet with the Execution System (the government debt collection authority that enforces legal judgments or orders) to find a solution. She suggested this to Sarah delicately, making sure not to force it on her or blame her for being “irresponsible.” She validated Sarah’s feeling that the lack of electricity was a real problem and assured her that she deserved electricity.

Case study Illustration II

Emily, a college student struggling with her studies and social life, began therapy with Olivia. She initially presented with anxiety and depressive symptoms. Following trust- and rapport-building, Emily eventually disclosed a significant and overwhelming experience: she was recently sexually assaulted at an off-campus party. Olivia employed trauma-informed principles, validating Emily’s feelings, emphasizing her courage in sharing, and assuring her the assault was not her fault. In addition, Olivia told Emily about her rights as a victim of sexual assault, resources for medical care, and reporting options, and they discussed the obstacles to the realization of rights.

Standing By

The second stage of the original ATA model pertains to standing by service users and involves the social worker and the service user working together to determine the most appropriate course of action and deciding what roles they will assume in the process. Research indicates that the very fact that social workers refrain from blaming the client for their problems and demonstrates warm curiosity regarding the circumstances that brought them to their current situation may be perceived by clients as a manifestation of the social worker standing by them (Brand-Levi et al., 2021). The social worker can provide advice, advocate for or with the client, or prepare the client for the bureaucratic encounter. Taking an active stance at this stage requires the social worker to follow up and take the necessary steps to do everything possible to help clients realize their rights. Since service users may face micro-aggressions, such as mistreatment or disrespect, in their encounters with bureaucrats (Tarshish, 2022, 2023), workers may physically accompany them to the administrative authorities to validate their experiences and stand with them in the face of oppression. Furthermore, standing by service users may involve appealing decisions to reject service users’ requests.

In terms of trauma, standing by comprises the essence of a trauma-informed perspective. Active listening to service users’ reports of past and present traumatic experiences in the first stage of the model enables workers to validate these experiences, enhance service users’ voices, and help them work through negative experiences, all of which promote the development of healing relationships, trust, and cooperation that transcend previous harmful relationships associated with trauma. Validating a client’s experience of their problem as a real-world problem and not only an emotional one significantly reduces shame. Preparing clients for the bureaucratic encounter is a way to provide such validation. This preparation could include discussing potentially stressful or disempowering parts of the process in light of past trauma and the possibility of retraumatization. When the social worker accompanies the client to the bureaucratic encounter, the worker can actively prevent retraumatization or intervene to reduce it (See Krumer-Nevo, 2020 for examples).

The validation of the service user’s experience, i.e., naming it as an injustice, is crucial for working through trauma, which is critical since trauma survivors mainly experience authorities as entities that will, at best, ignore their needs or abuse and, at worst, take advantage of them (Altman, 2011). People who experience complex or persistent trauma during childhood often feel they do not deserve to be well taken care of and may feel shame about needing help from others. Thus, the social worker acts as either a source of information or an active advocate to ensure that service users feel they have voices, deserve respect, and are entitled to their rights.

Case study Illustration I

Although Amanda advised Sarah to meet with the Execution System, Sarah was hesitant and procrastinated. Meanwhile, her physical and mental health deteriorated. Knowing Sarah and being familiar with her history, Amanda found this behavior unusual. To better understand the situation, Amanda gently asked whether she preferred that Amanda help her prepare for the meeting or accompany her there. To Amanda’s surprise, Sarah asked her to come with her, stating, “It’s good that you’ll come with me because if I’m jailed, you’ll be able to call somebody to take care of the kids.” Amanda compassionately addressed the issue. She could not have imagined that Sarah had such fears connected to her childhood memories. They talked about Sarah’s fears, and Amanda assured Sarah it was now legally impossible to arrest Sarah over unpaid bills.

Before entering the office, Amanda and Sarah discussed what would happen during the meeting to ease Sarah’s tension. They agreed that Amanda would only intervene if the clerk dismissed or ignored Sarah. Unfortunately, when they sat with the clerk, he spoke only to Amanda despite Sarah’s attempts to engage. Sarah’s face fell. The experience reminded her of feeling invisible and ignored by authority figures throughout her life. Remembering their plan, Amanda respectfully asked the clerk to address all questions to Sarah directly. In a later therapy session, a shaken Sarah opened up about how difficult it had been when the clerk disregarded her, and they discussed the experience in light of Sarah’s history.

Case study Illustration II

Though clearly distressed, Emily expressed deep hesitancy about making any formal reports. Olivia carefully probed these concerns, using sensitivity and without being judgmental. In response, Emily shared that she recently supported a friend through a similar situation, who ultimately reported the assault to the university and the local police. Her friend’s experience was marked by dismissal, lack of support, and hurtful skepticism from the authorities, adding to her original trauma. Fearful of experiencing a similar dismissal, Emily was willing to disclose her experience formally, but only if Olivia accompanied her. Before her appointment with the university’s Title IX office, Olivia and Emily had a preparatory session to outline how Emily would initiate the conversation and discuss potential questions.

From Case to Cause Advocacy

Finally, the third step of the original ATA model pertains to shifting from case to cause advocacy. If the same problem affects multiple individuals, stems from policy design or implementation, and can be solved systematically by change, social workers should consider taking the third step. For example, the worker can decide with the client that they should secure resources to pay the bill (case advocacy) as a first step and later initiate steps for policy practice aimed at changing the policy of cutting off electricity to poor households (cause advocacy). Since cause advocacy can occur with or without the service user, this stage also involves discussing the roles of the service user and the social worker. The main tension in this step of the model is between the need to create immediate policy changes, usually meaning less client involvement, and collaborating with service users, which usually takes more time. The principles of a trauma-informed perspective and social work call on advocates to prioritize working together with affected individuals whenever the parties agree and it is feasible to do so, even if more time is required.

Multiple avenues of client participation can facilitate such collaboration. The service user may be interested in writing a brief letter to the newspaper or other media channels to raise awareness of the circumstances that led to the power being cut off and the effects of this action in the context of trauma. If the service users are interested in being more involved in policy practice, they can join organizations that are already actively working to change this policy with the social worker or alone. Clinical evidence indicates that involvement in policy practice alongside practitioners allows service users to experience validation, recognition, and a sense of power (Saar-Heiman, 2019; Sucharov, 2013).

This step plays an important role in creating better trauma-informed advocacy. Here, the social worker takes on policy change to tailor services and bureaucratic systems to trauma survivors. Many organizations and systems are uninformed about all types of trauma—insidious, collective, and personal—and their effects, and, as noted, sometimes even cause retraumatization. The social worker’s role is to highlight these issues and suggest improvements and changes, both in organizational rules and regulations and in training executives in the administrative agencies to better relate to trauma. This may be done by advocating for trauma survivors or employing community practice as part of the solution. Service users can take an active part in changing the system as experts on trauma.

Case study illustration I

Speaking with a colleague, Amanda learned that Execution System clerks frequently ignore women of color who live in poverty (such as Sarah) when they visit the office alone, triggering negative emotions and distress. Amanda and her colleague, an expert advocate, requested a meeting alongside Sarah to advise the Execution System manager on implementing compassionate practices. They pointed to research that demonstrated the harmful effects of microaggressions and the risk of retraumatization they pose to vulnerable women and suggested practical solutions such as raising clerks’ awareness through educational workshops.

Case study illustration II

Deeply affected by their joint work, Olivia had asked Emily for permission and drafted a piece for the local newspaper. She shared her observations on how lonely the disclosure process could be, carefully protecting Emily's privacy. Emily had proudly supported the publication, which struck a chord among young women from nearby campuses. These young women then reached out to Olivia, sharing similar experiences and demonstrating a thirst for change. Olivia connected them with a seasoned community organizer. Together, they created Students Safe Together, a student-led support network to help young women navigate the Title IX process. They educated students on their rights, offered trauma-informed guidance, and, most importantly, provided caring accompaniment to those hesitant to face official investigations alone.

Taking Care

Finally, it is important to note that working with people and communities affected by trauma can take a toll in the form of “costs of caring” (Figley, 1995; LoboPrabhu et al., 2019) such as burnout, transference and countertransference, secondary traumatization, compassion fatigue, and vicarious trauma. Working from a trauma-informed perspective also means applying these principles to therapists themselves: recognizing the impact of trauma on them and regularly screening for signs of secondary traumatic stress. It is crucial to respond when these effects emerge by using relaxation and self-care techniques, setting boundaries, and seeking peer support.

The Trauma-Informed Active Take-up Advocacy (TI-ATA) model proposed in this article integrates trauma-informed principles in two key ways. First, it employs the four Rs: realizing the impact of trauma, recognizing its symptoms, responding to trauma and resisting retraumatization. This approach ensures that advocacy actions are sensitive to the potential impact of existing trauma. However, since advocacy is a practice wherein power is not always equally distributed between clients and advocates, the model also incorporates fundamental trauma-informed guidelines into advocacy to ensure a sense of safety, trustworthiness, empowerment, choice, and collaboration with clients (Knight, 2015; Levenson, 2020).

These guidelines align directly with the suggested model, mirroring its goals and approach. Safety can be promoted via an action alliance between the client and the worker (Krumer-Nevo, 2020). Trustworthiness can be seen a by-product of a strong helping relationship facilitated by advocacy (Tarshish, 2022). By defining the problem in terms of rights, the practitioner can make connections between past traumas and current events in a non-stigmatizing fashion (Leveson, 2020). ‘Standing by’ and engaging in advocacy put to the test the idea of trustworthiness, and the bond created can overcome previous problems concerning trust issues.

Empowerment is another critical focus of the trauma-informed approach. In the TI-ATA model, empowerment is achieved initially in the first stage of defining the problem in terms of rights by validating clients’ feelings of injustice. Next, empowerment is achieved through the act of standing by, which reduces feelings of alienation and loneliness and encourages clients to act in their own interest. The trauma-informed principle of collaboration necessitates a social worker-client partnership rather than a purely directive approach. It creates a commitment to "working with" rather than "doing for" that aligns perfectly with the collaborative spirit of social work advocacy (Benish & Weiss-Gal, 2023) and specifically of the TI-ATI model. Finally, recognizing the intersection of traumatic experiences, systemic oppression, and societal injustices underscores the need to address these root causes of adversity. Moving from case to cause advocacy provides a framework in which to challenge these broader injustices, directly promoting self-determination and well-being for individuals and communities alike.

The two case studies illustrate the three steps of the model in practice. In line with the first stage, both social workers used knowledge regarding trauma and rights to define the problem in terms of rights, i.e., to recognize Sarah’s need to deal with mounting debts and Emily’s depression as connected to her fear of disclosing her trauma. Reframing problems and needs in terms of rights is also a clinical tool that shifts away from stigma and pathologization to consider problems in a sociopolitical context (Berthold, 2015; Sucharov, 2013).

By standing by, the social workers prepared their clients for the encounter. In Sarah’s case, the worker actively intervened at the meeting to minimize potential retraumatization and ensure the client’s voice was heard. The social worker’s active intervention comprised a significant trust-building step in this therapy, as she stood together with her client as a unit and expressed their concerns to the clerk. This step is also highly sensitive since it mandates the social worker to engage with other street-level bureaucrats from the client’s point of view and thus requires balancing tensions and competing commitments. This step also necessitates an open preliminary discussion with the client on the roles and boundaries of standing by. Such discussion took place in both cases described here. Usually, it is recommended that the social worker be passive (e.g., preparing the client for the encounter, engaging in role-play, or passively shadowing them during the encounter) to minimize the client’s disempowerment. However, under certain circumstances, such as in Sarah’s case, social workers should actively engage, for example, by accompanying the client, defending them, or filling out forms for them to increase dignity and promote a safe environment. The decision whether to take a more passive or active stance should be based on a participatory clinical evaluation regarding the client’s emotional needs, history, support system, social context, and need for urgent material assistance. Incorporating the trauma perspective into advocacy also means acknowledging that some service users experience the worker’s active involvement as a manifestation of recognition and support, not disempowerment. Thus, the decision regarding the worker's specific stance should be based on a careful clinical evaluation using a collaborative process.

According to the model, social work advocacy could have ended here, but since, in both cases, social workers identified a social problem common to several people, they decided to move to policy practice. In most cases, the worker does not need to have all the relevant knowledge on policy practice. In both the cases described here, partnerships and collaboration were the solutions. One option for social workers at this stage is to inform policymakers of the problem using various means, as Olivia eventually did with her op-ed article. In the other case, Amanda decided to approach the Execution System manager directly, and together with a colleague and Sarah, as an expert by experience, was able to create immediate change. These are only two examples that illustrate how advocacy and trauma are interlaced in therapy, and how the TI-ATA model can serve as a powerful tool for practitioners, fostering access to rights, and policy change, together with clinical benefits.

The case studies highlight the model’s advantages as a powerful tool for practitioners, fostering access to rights and policy change in various forms, together with clinical benefits. Nonetheless, implementing the model may pose significant challenges. First, social workers may only moderately engage in advocating for rights and do not always share the profession’s ideological commitment to social advocacy (Sabag & Levin, 2022; Weiss-Gal & Gal, 2009). Second, due to the large caseloads and burnout experienced by social workers in the field (Strier, 2019; Travis et al., 2016), advocacy is sometimes seen as an impossible task. Last, a deep sense of disempowerment in their encounters with social workers, agencies, and services may lead individuals or communities experiencing long-term systemic oppression and trauma to hesitate to take action, causing them to become passive. Cultivating trust and a sense of agency, as emphasized in standing by, is crucial in this situation but can be very slow and challenging.

The model was constructed as a broad set of guidelines suited to the changing contexts in which professionals encounter trauma address these concerns. This flexibility makes the model highly translatable to other languages and contexts. Additionally, by focusing on overarching concepts that directly impact practice, the model allows practitioners to adopt stages, parts, or just the “spirit” of the model as a starting point, for example, in more clinical settings. Thus, the model has the potential to contribute to the practices of clinical social workers, who are less familiar with rights advocacy practice as a tool for overcoming critical life barriers and advancing new therapeutic goals. It can also inform the work of case managers, who use advocacy in day-to-day practice but are unfamiliar with or not engaged with trauma-informed approaches.

The implementation of this model in clinical settings raises some questions. Clinical social workers who wish to step out of the secure boundaries of the therapeutic setting and accompany their clients in their efforts to realize their rights must engage in open discussion on the roles of the client and the therapist in such situations. These decisions must be made while respecting clients’ self-determination regarding the process and their active participation in it. In Sarah’s case, presented above, Amanda offered to accompany her to the Execution System office, something she had rarely done previously. Her decision was prompted by her understanding that disconnecting the electricity supply had a significant negative impact on Sarah’s emotional well-being and her recognition that Sarah could not deal with the problem on her own. In this case, in a collaborative decision, Amanda and Sarah felt that the helping relationship was strong enough to allow the exceptional step of them driving together to the Execution System office and handling the problem in the real world.

The primary contribution of the adapted TI-ATA model is that it aims to promote advocacy that ensures safety, respects service users and their life journeys, and promotes voice, autonomy, and trust to create a healing therapeutic relationship and improve people’s lives through the realization of rights (Sucharov, 2013). This combination of rights-based and trauma-based models for advocacy practice is unique to social work. Therefore, this article can be regarded as the first step in a broader effort to ‘trauma-inform’ core social work roles and action strategies and redefine the boundaries of advocacy as a therapeutic tool for people with histories of trauma. Further studies should continue theorizing the common core of social work advocacy and trauma-informed perspectives to promote a holistic approach that recognizes social work’s unique ability to provide tangible support alongside emotional healing and empowerment.