When user testing sessions bring up trauma

Crafting a UX test script that’s empathetic, thoughtful, and considerate — but still gets insights

We don’t all work for shoe companies.

Or chocolate companies.

I kind of wish I worked for one, or even both of them — I’d save a lot of money with that employee discount (chocolate is one of my main food groups, after all).

In addition to being my two biggest vices, these two types of products have something else in common: when they’re the topic of a user interview, they’re pretty unlikely to bring up any uncomfortable feelings for a user (not including traumatic childhood memories, ones which likely involving older siblings and a potential theft that they still deny to this day).

Retail, FMCG, higher education, finance, and tech companies are in abundance — most people who work in UX work for one of these industries (one study reckons large enterprises make up nearly 70% of the global UX market). So, for many of us, we can craft a UX interview script in a way that’s relatively by the book.

But what about if you’re working within a more sensitive area? Does the same approach that you’d use for testing a travel insurance website prototype apply to a digital product for cancer patients?

I’ve interviewed a number of wonderful test participants — who have all faced a life-threatening illness, or had a family member who has — and I’ve found that going by the standard UX interview playbook is impossible.

Being sensitive to the issues that users are going through, while still remaining as objective as possible and gaining valuable insights is challenging, but it is possible. Here’s how.

Tip 1: Do your homework
Although the Godfather, AKA Steve Krug, advises to “Recruit loosely”, you might want to ignore this rule when compiling your recruitment plan.

Many health issues sit on a huge spectrum. Patients can have the same diagnosis, but they’re in different stages of treatment. Some are in the same stages of treatment, but due to other factors, their experiences are totally different from each other. So, if you’re using broad categories in your recruitment plan like “recently diagnosed” or “post treatment”, remember that mindsets and emotional health are likely going to be wide-ranging within each group.

You may want to expand your pre-screening questions, or talk to potential participants first to gauge their overall wellness. If you can, avoid talking to anyone who has just finished a pivotal point in their treatment, or who has just been diagnosed. Likewise with interviewing carers or family members — they’re impacted by the diagnosis too, so try and find out more about their circumstances before recruiting them. If you’re talking to someone who has recently lost a friend to cancer, it may make you rethink, or at least reword, particular questions.

The aim here is to try and avoid, or at least soften, any potential for trauma. The UXPA sum it up really nicely in their code of professional conduct: “UX practitioners shall not expose participants to any unreasonable physical, mental or emotional stress.”

And if you’ve done all that, but you’re still definitely going to talk to someone who has just been through a really harrowing experience? Keep reading…

Tip 2: Change the verb
Let’s think about shoes again (I told you they’re my vice). If you were interviewing a user about a retail website, you might say:

“You want to buy shoes. Show me how you might do this.”

Now, imagine your client is a cancer charity; so, replace the product of ‘shoes’ with ‘cancer information website’.

“You have just been diagnosed with cancer. Show me what you would look for first.”

Awkward. And possibly very confronting. After hearing a phrase like that, many people are instantly transported back to the time when they received that news. It’s also just a bit weird to say to a cancer patient: you’ve been diagnosed with cancer. Duh.

Instead, take a step back and remember that homework you did in Tip 1; then, you can tweak the question so that it acknowledges the user’s experience. Perhaps like this:

“Reflecting back to when you were first diagnosed…if you had visited this website at that time, can you show me where you may have looked first?”

It’s all about changing the verb: instead of you have been, you are, or imagine, it’s reflecting, or thinking back. It’s the same question, but softer and it acknowledges their personal experience.

Tip 3: Reframe the back story
Some questions are more of a practical nature, so you might assume that you can just dive straight in and use the same wording for both patients and non-patients. But, consider this question, which asks a user to find financial help information:

“You are worried about the impact your diagnosis will have on your finances. Find information on how you’d manage your finances.”

This is probably okay for someone who isn’t a patient. If they’re fresh to this subject matter, they probably need that little bit of back story, to see that link between a diagnosis impacting on finances.

But what about for a patient? They know a diagnosis impacts finances. So, let’s just simplify, and get rid of the backstory:

“Can you show me where you’d find information on managing your finances?”

Tip 4: Review your prototype
Some people are triggered by seeing certain images or statistics; reading about mortality figures can be upsetting for people facing a life-threatening illness. You can’t control what people see on a site once it’s live, but you can hopefully control what’s on the prototype you’re testing.

Keep it in your mind when you’re getting your prototype ready for user testing: is there anything on there that could distract, or upset users during testing? Maybe you’ve quickly copied over some text from the current live site, or a random image in thinking, “Whatever, it’s just the prototype”. Just have one more look before you test.

Tip 5: Be a Good Human
Poor rapport (say that five times fast) spells the ultimate UX interview doom. Great rapport = comfortable users, and better research outcomes.

If an external UX agency is doing your testing, try and get a representative from your organisation sitting in on the sessions. Maybe that staff member could also do introductions at the start, between the interviewer and interviewee.

Other fast rapport tips when working with vulnerable testers:

• Be flexible with taking breaks. Allow more time just in case, and don’t schedule interviews back to back.
• Reassure the interviewees at the start of the session. Let them know that if anything is triggering, you can stop and take a break.
• Touch base with the interviewee a day or two before. Life happens. Things change. A user may have been happy to participate last week, but yesterday they’ve found out they’ve just relapsed. Emails are convenient, but it helps if someone can talk to the interviewee at least once on the phone beforehand. You can pick up a lot more verbally and gauge how someone is feeling.

Tip 6: Use your colleagues
Chances are if you’re at a charity or in a human services organisation, you work with health or other industry professionals in some capacity. Run interview questions by them first and get their feedback, or do a practice interview with them. They are a wealth of information and insight into your users.

Tip 7: Close that loop
Always get back to your interviewees and thank them! Shoot them an email once the product they were testing is live, rather than them just seeing a random social media post along with everyone else.

For a lot of users, the scripts you’re running with them are actually their reality. UX test sessions and interviews are forcing them to take on an additional mental load, during a time when they already have so much going on. It’s vital to ensure these users are treated with dignity, respect, and empathy.