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Culture and Climate: The Hotspots of Activation Activity
Culture and Climate: The Hotspots of Activation Activity
From Mandy Davis, LCSW, PhD, Director, Trauma Informed Oregon
The July 2026 TIO newsletter is about the Essential Element of Culture and Climate. This element includes organizational practices around creating inclusive environments, having core services that are trauma-responsive, workforce wellness, physical environments that are not activating, a welcoming first point of contact, and centering relationship in policy and practice. Over the years we’ve shared a few tools for these standards (see The Hidden Impact of Space; TIC Physical and Inclusivity Environment Review; and Creating Trauma Informed Policies: A Relationship Centered Approach (aka A Flying “Cat”astrophe)), and today I wanted to share a tool for helping across several of these standards: the Hotspots of Activation activity.
How the Hotspots of Activation Activity Works
When doing this activity, groups of service providers first write down all the ways in which those who are accessing services may be activated. The groups consider smells, sights, sounds, wayfinding, words, questions, furniture, parking, and more – while accounting for age, ability, mobility, culture, language, and more. This exercise helps service providers to understand what might be activating, and for whom.
A framework we use here at TIO is to ask: What helps? What harms? And how does identity impact this? This activity is one way to start exploring possible activation points, or "hotspots."
Once the original list is developed, it can be helpful to share it with other teams, departments, or groups, to notice themes or new learning. List-sharing can also help focus change efforts – if everyone mentions a confusing sign outside, that’s a good place to start.
From there, we ask groups to take one hotspot and discuss:
- Why does the hotspot exist?
- Why is it activating, and for whom?
- What ideas do we have to make it less activating?
Let’s break these down.
1. Why does the hotspot exist?
This is an important first question, because many hotspots are out of our control or sphere of influence. A lack of parking or transportation is a hotspot, but we may not be able to do anything about it. Asking certain medical questions might be activating, but it’s still necessary to determine the best intervention. This “why” question matters because it determines whether you can simply get rid of the hotspot – if no one knows why it’s done in the first place – or whether you need to advocate for change and, at minimum, find ways to mitigate the activation.
Just because something is activating does not mean it isn’t important. And just because something is important does not mean we shouldn’t strive to make it less activating.
2. Why is it activating, and for whom?
After determining that a hotspot can’t be changed, at least for now, it’s important to understand why it may be activating, and for whom. One way to think about this is in terms of how the hotspot takes away a sense of power, value, and/or safety.
The “for whom” matters here. A security screening may help one person feel safe and another feel threatened. Dividers at reception desks may increase a sense of safety for staff, but create a sense of othering for those accessing services.
3. What ideas do we have to make it less activating?
Finally, we ask: What, if anything, can we do to make the situation less activating, assuming we can’t eliminate the practice? This is usually where we hear great ideas that are entirely doable. Often, staff have already found workarounds – they just haven’t been systematically implemented.
Some real-life examples:
- Fix the door that makes a horrible squeaking sound.
- In reminder calls, alert people to the difficulty of parking, and let them know where to park and how much time to allow.
- Move an activating question from the initial interview to the third interview.
- Provide some chairs that are armless, and some with arms.
- Change signage to be clear, in multiple languages, and with images.
Making it Work for Your Organization
There’s a lot you can do with the list of Hotspots and ideas for change. You can sort ideas by impact and cost, so you can prioritize low-cost, high-impact changes now and be ready for the higher-cost changes when funding becomes available. Changes can be prioritized for a specific team, a single site, or an entire organization, to notice differences and themes.
The Hotspots for Activation activity can also be paired with a parallel focus on hotspots for staff, and comparing similarities and differences between lists for service recipients and staff.
It’s always best to ask those accessing services directly what is activating for them. I once observed staff assuming that typing data into the computer in front of a patient was activating – but when we surveyed patients, they said they liked being able to see what the provider was typing.
Plenty of things are activating for one person, while comforting for another. In trauma informed care, we strive for choice: Do you want to wait in the lobby, or outside? I’ll call you when we’re ready.
What I love about this activity is that it gets specific to what an organization is actually experiencing, and those impacted – both service recipients and staff – often have the best answers for reducing or preventing activation.
What helps, what harms, and how does identity impact this? I use this framework constantly – in how a training is set up, the words we choose, the color of a slide, the way chairs are arranged, etc…. This framework promotes awareness of potential activation points to enable prevention when possible – and when prevention is not possible, it prepares us to reduce negative impacts.