1. The use of content and trigger warnings

Although there may be overlap between the terms, content and trigger warnings are sometimes used to have different meanings and defined separately. Definitions of content and trigger warnings vary.¹

The meaning of both terms isn’t about being static - it’s about being ‘a shared cultural concept that can meaningfully shift over time’.²

Definitions often involve elements of:

• Content warning (CW): A content warning is a statement alerting attendees to the presence of potentially sensitive content in a session. This could refer to topics such as images of surgery, sensitive political issues, or descriptions and images of graphic injuries.
• Trigger warning (TW): A trigger warning alerts people to content that could lead to a strong emotional, physiological or psychological response, particularly for individuals with past trauma. Common triggers might include content related to abuse, self-harm, or specific potentially traumatic events.

The purpose of content and trigger warnings, if used at conferences and events, is to allow people to make informed decisions about whether and how they want to engage with a session that contains particular material some delegates may find difficult.

There is mixed evidence on the effectiveness of content and trigger warnings, and there are various debates around their use. 

Some studies³ have suggested trigger warnings might be ineffective or harmful. These have included suggestions that they might not help reduce distress, may increase anticipatory effects, and could cause harm by increasing focus on difficult content and cause people to dwell on it.

Others⁴ suggest that trigger warnings are inclusive, promote a more compassionate space, enabling people who have experienced trauma to feel more in control. 

There have been discussions about whether trauma-informed working in educational settings should focus less on trigger warnings and more on flexibility and other aspects of trauma-informed work (trauma-informed pedagogy).

A study with medical students examined perceptions of trigger warnings in medical education, with a range of support and non-support across the study group. Some expressed that warnings allowed students to know what is coming and to prepare themselves. Some felt they needed to learn and cope with highly sensitive material as part of their job. Trigger warnings were felt by some to help students understand the severity of the material.⁵

Used alone, trigger warnings may not be protective, but they can be a useful tool when embedded in a broader holistic approach.⁶

The International Association for Suicide Prevention (IASP) has produced guidance⁷ on trigger warnings, highlighting research suggesting that trigger warnings are not helpful, and at times might be potentially harmful, but that many expect trigger warnings to be given and are upset when they are not. They recommend that trigger warnings should provide a resource for reliable information on the content rather than overly sensationalising or emphasising that it is disturbing. 

They also recommend:

‘When communicating or sharing content that might be difficult, hard, painful or even hurtful to others, it is important to think first. Ask yourself these questions: 

• What is the reason I am sharing this content?  
• What do I hope I and/or others will get out of me sharing this content?
• Is the content appropriate for all age groups to see or hear?  
• Could the content hurt someone who has a connection to the content that I am sharing? (Keeping in mind that different people can often react differently to the same content).'

At veterinary meetings and events many clinicians may be familiar with graphic images of surgery. However, there are often others who may be less accustomed to such images, for example, nonclinical members of the veterinary team, as well as support staff around the venue. Online meetings may also be overlooked by children, and providing information about session content may help people to plan about what they want themselves or those with them to see.

Effective and clear titles for sessions may serve the function of a content or trigger warning where they are descriptive and make clear the main topics covered in a session. Ambiguous or humorous titles as sometimes used at conferences do not do this. 

Whether or not you use content and trigger warnings may also be determined in part by the context and by your audience. Content and trigger warnings may be more valued by some groups. Knowing the community you are speaking to is important. 

Consider the purpose of your session – is provocation necessary or is the focus to be inclusive, or to develop specific competencies? This may help inform decision making about content and trigger warnings. 

Critique of using content and trigger warnings alone has shown they are more likely to be effective in a wider context and considerate trauma-informed environment.

If using content and/or trigger warnings: 

• Be clear and specific. Specific warnings may be better than general ones. For example, rather than ‘sensitive content’, instead describe the material covered. For example, ‘this session contains descriptions of fatal injuries and photographs of surgery’, or ‘this session discusses sexual harassment and sexual violence’. 
• Give advance notice. Consider whether warnings should be included in the programme, the event website, and email communications before the event as well as at the start of a session.
• Support opt in/opt out. Try to make it straightforward for people to leave a session or not attend if they feel uncomfortable.
• Reflect whether the content is needed. Encourage speakers and chairs to consider whether graphic detail or shock content supports the objectives of their session. Some content may be more easily justifiable than others.
• Provide support and quiet spaces. Ensure that signposting to resources and the supports available are visible in advance of, during, and at the end of sessions with potentially disturbing content. Consider offering a quiet space for delegates to use if they are needing a break.