Training needs of exercise professionals working with people who have experienced trauma and violence: A qualitative analysis of expert perspectives

Introduction Exposure to trauma and violence is common and linked to adverse health outcomes such as chronic pain, cardiometabolic conditions, and mental health disorders. Many of these health consequences are common reasons for referral to exercise professionals, including physiotherapists and exercise physiologists. However, these professionals often lack training in trauma and violence-informed care (TVIC). This study aimed to identify existing training gaps, articulate core competencies, and examine preferred delivery to inform the development of a competency framework for TVIC training for exercise professionals. Methods A qualitative exploratory design was used, involving semi-structured interviews with experts in TVIC. Data were analysed using reflexive thematic analysis. A competency framework was then developed and validated through member checking, with participants rating each competency's relevance on a Likert scale. Competencies were mapped across three domains: knowledge, applied skills, and attitudes. Results We interviewed 15 participants from 7 countries, comprising clinical psychologists, academics, and exercise professionals. The findings highlight significant gaps in the current knowledge and training of exercise professionals and underscore their potential role in the prevention and treatment of trauma. Specific training needs identified include awareness of types of traumatic events and diverse trauma experiences, identifying and responding to signs, responding to disclosures, adapting exercise prescription and assessments, and creating psychologically safe exercise environments. Conclusion This study identified key knowledge gaps and training needs among exercise professionals. The findings inform the development of core competencies in TVIC, which should be embedded into education and practice guidelines to enhance care quality and improve outcomes for trauma survivors.