Effect of a Trauma-Awareness Course on Teachers' Perceptions of Conflict With Preschool-Aged Children From Low-Income Urban Households: A Cluster Randomized Clinical Trial

Relational Health as a Pathway from Trauma to Flourishing in School Communities

BACKGROUND

Because traumatic life experiences are common, teaching and learning can be difficult without recognizing how trauma can make people feel psychologically unsafe. Safety can be restored through healthy relationships.

CONTRIBUTIONS TO THEORY

We present a framework for how relational health-the capacity to develop and maintain safe, stable, and nurturing relationships with others-may allow flourishing in school communities, even amidst past and ongoing adversity. We propose four key assets for relational health-awareness of self, acceptance of self, awareness of others, and acceptance of others. To support this framework, we developed a relational asset score using data from a survey of 214 early childhood education professionals and examined its association with meaningful work, purpose in life, work satisfaction, and intention to stay in one's program.

IMPLICATIONS FOR SCHOOL HEALTH

School health requires relational health. Research should evaluate the associations between relational assets and the perceptions of safety and connection in school communities. Leadership can prioritize relational health by supporting staff in building and using their relational assets.

CONCLUSIONS

School communities may be more likely to flourish, even amidst adversity, if all adults in the community prioritize relational health, which provides the psychological safety required for teaching and learning.

Child Maltreatment and Long-Term Physical and Mental Health Outcomes: An Exploration of Biopsychosocial Determinants and Implications for Prevention

Child maltreatment rates remain unacceptably high and rates are likely to escalate as COVID-related economic problems continue. A comprehensive and evidence-building approach is needed to prevent, detect and intervene where child maltreatment occurs. This review identifies key challenges in definitions, overviews the latest data on prevalence rates, reviews risk and protective factors, and examines common long-term mental health outcomes for children who experience maltreatment. The review takes a systems approach to child maltreatment outcomes through its focus on the overall burden of disease, gene-environment interactions, neurobiological mechanisms and social ecologies linking maltreatment to mental ill-health. Five recommendations relating to the accurate measurement of trends, research on brain structures and processes, improving the reach and impact of teleservices for detecting, preventing and treating child maladjustment, community-based approaches, and building population-focused multidisciplinary alliances and think tanks are presented.

Early Childhood Professionals’ Perspectives on Dealing with Trauma of Children

Childhood trauma is a significant concern in Australia and internationally. Professionals working in the early childhood education sector (i.e., providing early childhood education and care to infants, toddlers, and children from birth to age eight) are positioned to provide valuable support for children affected by trauma. However, there is less research on early childhood professionals’ perspectives and experiences of supporting trauma-exposed children compared to other education professionals (e.g., primary and secondary school teachers). This study explored early childhood professionals’ perspectives and experiences in relation to supporting children exposed to trauma. Semi-structured interviews were conducted with 14 early childhood professionals in Victoria, Australia, and data were analysed using thematic analysis. The findings illustrate that while educators develop valuable skills and experience growth from supporting trauma-exposed children and their families, they also experience emotional distress and challenges. Educators noted that there are limited professional development opportunities to learn about childhood trauma, and limited access to qualified and knowledgeable staff who can help them when supporting these learners. Implications from this study emphasise the importance of designing and delivering trauma-based professional learning opportunities and policies for early childhood educators.

Implementing a novel self-care clock strategy as part of a trauma awareness intervention in a university setting

PURPOSE

This study compared post- and preintervention trauma-informed care attitudes, explored relationships among outcomes, and identified self-care behavior changes participants are willing to make.

DESIGN AND METHODS

A quasi-experimental study with content analysis was conducted with 96 adults that took part in a Trauma Awareness Intervention including a novel self-care clock.

CONCLUSIONS

Participants' trauma-informed care attitudes improved (p ≤ 0.05) compared to baseline and were positively related to their post-intervention compassion scores (p < 0.05). Qualitative analyses revealed self-awareness, self-care, empathy, applying a trauma lens, changing the narrative, and student-centeredness as the main themes in participants' responses.

PRACTICAL IMPLICATIONS

This university-based initiative had a positive impact on attitudes toward trauma and should be explored in other settings, as there is an unmet need for trauma-informed care strategies at the community level.

A case study addressing trauma needs during COVID-19 remote learning from an ecological systems theory framework

Mental health conditions related to trauma among American children are a concern, particularly because of the impacts of the COVID-19 pandemic. Children, as students, carry the trauma they encounter with them into the classroom. Students impacted by trauma learn differently due to effects on the brain that relate to several impairments, causing them to perform poorly in school. However, teachers may not always understand this issue. This case study shows how certain dynamics within the EST layers impacted one school during the pandemic. The purpose of this study was to examine how teachers at the school experienced a trauma-informed online PD and SEL program intended to improve student outcomes, teacher perceptions, and teacher–student relationships. The six participants included teachers in a K-8 low-income, minority population charter school. The assessment tools used were the Teacher–Student Relationship Scale, Teacher Perception Scale, and Student Outcomes Survey. The teachers’ outlook on SEL improved, particularly online. This improvement helped the teachers implement community circles and SEL infused with mindfulness in their online classrooms, which may have helped them maintain their relationships with the students and may have helped the students with academic and stress outcomes. During unprecedented times, the maintenance, rather than the deterioration, of student outcomes and teacher–student relationships is an accomplishment and an area that necessitates further research.

The Potential for Teacher-Student Relationships and the Whole School, Whole Community, Whole Child Model to Mitigate Adverse Childhood Experiences

BACKGROUND

Adverse childhood experiences (ACEs) are associated with poorer health and educational outcomes. With over 20% of children experiencing multiple ACEs, interventions must target protective factors to improve outcomes among these students. Teacher-student relationships (TSRs) integrated with the Whole School, Whole Community, Whole Child (WSCC) are one promising approach to building resilience to overcome ACEs.

METHODS

A narrative literature review was conducted on ACEs, resilience, TSRs, and the WSCC model to explore the evidence and potential of TSR interventions integrated within the WSCC model to build resilience in students experiencing ACEs.

RESULTS

Supportive adult relationships are one of the strongest protective factors against ACEs. TSR interventions have improved student and relationship outcomes. Few studies have explored the relationship between TSRs and ACEs or TSR ACEs interventions. The WSCC model provides opportunities to integrate TSRs and other protective factors into a schoolwide health model to build resilience.

CONCLUSIONS

TSRs and the WSCC model are promising approaches to target protective factors to mitigate ACEs. Research is needed to further establish TSRs as a protective factor, explore TSR ACEs interventions, and determine best practices for integrating TSRs and resilience in the WSCC model.

Reconciling mixed messages from mixed methods: A randomized trial of a professional development course to increase trauma-informed care

In a previously reported randomized trial, we used both quantitative and qualitative methods to assess the impact of a professional development course, Enhancing Trauma Awareness, to increase trauma-informed care among preschool teachers in a large, urban, US school district. Although quantitative data from surveys showed no impacts of the course, the qualitative data from focus groups suggested that the course had positive, meaningful impacts on the teachers. These contrasting results are reconciled here by describing our experience of conducting and analyzing the focus group data. We explain how the course impacted the teachers and the implications of these mechanisms for implementing and evaluating approaches to increasing trauma-informed care. The course combined content about the effects of trauma with a key ingredient-a group-based relational process carried out over 12 weeks by two trainers. Through their engaged presence, the trainers allowed the course participants to feel emotionally safe. This safety allowed the participants to develop awareness and acceptance of trauma in their own lives and those of others. Teachers described the course as healing. They developed relational capacities manifested in their own engaged presence, characterized as a compassionate approach to addressing trauma experienced by children and families.

Population Health and Trauma-Informed Practice: Implications for Programs, Systems, and Policies

Population studies indicate that trauma exposure is ubiquitous and has a significant impact on health. Trauma-informed practice seeks to address the health consequences of trauma through integrative responses that incorporate an understanding of the effects of trauma, the multiple pathways to recovery, and the potential for re-traumatization. Current trauma-informed practice considers trauma exposure an individual clinical problem rather than a societal problem with population health consequences. Population health refers to the aggregated health status of individuals who share some characteristic, such as trauma exposure, and includes the study of determinants that shape the distribution of health outcomes in specific populations. In this paper, we describe a population health perspective for trauma-informed practice that complements the current clinical perspective, and then discuss implications of that perspective for programs, systems, and policies. We summarize essential concepts about trauma over the life course and describe principles of population health science relevant to trauma-informed practice. We then discuss implications of these principles by identifying four priorities for trauma-informed practice from a population health perspective: (a) adopting trauma-informed policies to prevent trauma exposure and to foster resilience in the aftermath of trauma; (b) infusing trauma-informed practice into everyday activities so it is a routine part of interpersonal transactions; (c) incorporating trauma-informed practices into existing service systems; and (d) adapting existing treatments to incorporate trauma-informed principles for population health impact.