Effects of Mindfulness-Based Trauma-Informed Care Training Program for Chinese Social Workers: A Pre-Post Study

Background: Adverse childhood experiences (ACEs) can lead to profound psychosocial impacts on children and adolescents. When helping professionals are trained in trauma-informed care (TIC), they are better equipped to recognize that disruptive behaviors and emotional difficulties in clients often originate from past traumatic experiences and take intentional steps to support them. In China, trauma-informed care practice is not yet widely implemented. Chinese social welfare organizations generally do not yet recognize the importance of adopting trauma-informed care when working with clients who have experienced ACEs. Furthermore, many Chinese social workers lack sufficient knowledge related to trauma. Thus, this study aims to explore the effects of mindfulness-based TIC training in the Chinese settings on social workers’ trauma-informed attitudes and professional life quality.

Methods: The study employed a pre-post design with qualitative follow-up assessments conducted between August 2024 and March 2025 in China’s Mainland and Macao. Participants primarily consisted of frontline social workers, especially those working in the fields of mental health and forensic social work. A total of 185 social workers (78.4% female, with 57.3% from Macao) completed a 12-hour mindfulness-based TIC training program, along with pre- and post-training assessments. The TIC approach was developed and structured around six core topics: (1) Concepts and Framework of Trauma-Informed Care, (2) Understanding Trauma, (3) Recognizing Trauma, (4) Responding to Trauma, (5) Preventing Retraumatization, and (6) Self-Care for Professionals. Outcome measures included the Attitudes Related to Trauma-Informed Care-35 (ARTIC-35), the Professional Quality of Life Scale (ProQOL), the Freiburg Mindfulness Inventory (FMI). Additionally, follow-up interviews were conducted with 18 participants to gain deeper insight into the training.

Findings: Participants reported a significant increase in trauma-informed attitudes after the training. Improvements were observed across all five dimensions of the ARTIC-35 scale, including understanding causes, trauma-informed responses, on-the-job trauma-informed behaviors, self-efficacy, and emotional reactions to stress. Significant improvements were also found in participants’ overall professional quality of life. Specifically, compassion satisfaction increased significantly, and burnout scores showed a slight decrease from pre-test to post-test. However, no statistically significant changes were found in secondary traumatic stress. Additionally, mindfulness levels of participants were found to increase significantly. Qualitative findings confirmed that participants developed a deeper understanding of trauma and its impact. Participants also reported enhanced empathy, emotional validation, and patience when working with clients with trauma. They became more attuned to clients’ adverse experiences and expressed a commitment to fostering trauma-informed environments as part of the healing process. Furthermore, the training contributed to improvements in participants’ self-care practices.

Discussions: The TIC training program demonstrated its effects in enhancing trauma-related knowledge, attitudes, responses, self-efficacy, overall professional quality of life, and mindfulness among Chinese social workers. These findings support the value of culturally contextualized trauma-informed training for frontline social workers and other professionals. The TIC program has the potential to be implemented across educational systems, healthcare settings, and the juvenile justice system to enhance the trauma-informed care capacity of helping professionals and educators. However, there is also a call from participants for more trauma-related training to strengthen their competence in practice.