Johanna Margaret Lynch ^1* Kurt C Stange ^2,3 Christopher Dowrick ⁴ Linn Getz ⁵ Pamela J Meredith ⁶ Mieke L Van Driel ¹ Meredith G Harris ^7,8 Kate Tillack ¹ Caley Tapp ^7,8

• ¹ General Practice Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Australia
• ² Center for Community Health Integration, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States
• ³ The Weatherhead Institute for Family Medicine and Community Health, School of Medicine, Case Western Reserve University, Cleveland, Ohio, United States
• ⁴ Primary Medical Care, The Institute of Population Health, University of Liverpool, Liverpool, UK, Liverpool, United Kingdom
• ⁵ General Practice Research Unit, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway, Trondheim, Norway
• ⁶ Occupational Therapy, School of Health, University of the Sunshine Coast, Queensland, Australia, Sunshine Coast, Australia
• ⁷ School of Population Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia, Brisbane, Australia
• ⁸ Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Brisbane, Australia, Brisbane, Australia

Objectives: This research describes four aspects of the development of the Sense of Safety Theoretical Framework for whole person care: exploring the meaning of the phrase ‘sense of safety’-the language; defining the range of human experience that impacts sense of safety - the content; the dynamics that build sense of safety - the process; and identifying personal and cross-disciplinary practitioner skills that build facilitate sense of safety - the practitioner response. Methods: This qualitative participatory study was conducted in two phases. Researchers iteratively explored the concept of sense of safety using focus groups and semi-structured interviews. The overarching research questions was: ‘Does the transdisciplinary concept of Sense of Safety make sense as an approach to the whole person in distress?’ Phase One involved rural and urban family doctors, mental health clinicians across multiple disciplines, people with lived experience of mental distress, and Indigenous Australian academics. Phase Two widened the scope of disciplines involved to include international family doctors, physiotherapists, occupational therapists, social workers, teachers, multidisciplinary rural clinicians and multidisciplinary clinicians with a lived experience of physical trauma, grief, and severe mental illness. Results: The everyday words “sense of safety” were found to describe a whole person experience that integrates awareness of self, others, and context. The range of human experience that impacts sensed safety was found to be most relevant include seven domains: Environment, Social Climate, Relationships, Body, Inner Experience, Sense of Self and Spirit/Meaning (Whole Person Domains). Five dynamic processes were identified that built sense of safety: Broad Awareness; Calm Sense-Making; Respectful Connection; Capable Engagement; and Owning Yourself (Sense of Safety Dynamics). Five practitioner skills that facilitate sense of safety were also named: Valuing the Whole Picture; Holding Story; Being with You; Learning Together; and Validating Dignity (Sense of Safety Practitioner Skills). Conclusions: This study focusses on an experience that is a fundamental prerequisite of health across the whole person. The Sense of Safety Theoretical Framework translates practitioner, lived experience, and First Nations wisdom, and a wide existing transdisciplinary literature into a framework and language ready for quality healing-oriented and trauma-informed care in health, education and public policy.