Promoting Resilience Through Trauma-Focused Practices: A Critical Review of School-Based Implementation

Exploring the Effectiveness and Sustainability of Trust Based Relational Intervention (TBRI®) as a Trauma-informed Approach in Two Tasmanian Child and Family Learning Centres

The impact of adverse childhood experiences (ACEs) is well documented and poses challenges for all those living and working with children who have experienced early adversity. The need to be trauma-informed when working with children in all educational settings is now recognised as essential if healing and learning are to take place. There are an increasing number of trauma-informed approaches available, but empirical evidence that supports their efficacy, particularly in the early years of education, is currently scarce. This paper presents the findings of a small-scale study which explored early childhood professionals' perceptions of the effectiveness and sustainability of one trauma-informed approach, Trust Based Relational Intervention (TBRI®). Used widely across the US and Europe, TBRI® is relatively new to Australia and was trialled for the first time in this Tasmanian study. Substance Abuse and Mental Health Services Administration's (SAMHSA, 2014) concept of trauma and guidance for a trauma-informed approach was used to provide a theoretical framework. Online surveys were used to gather data after each professional learning workshop and three and six-months later. Participants reported several positives of TBRI®, including self-development and improved outcomes for children. Whilst challenges/barriers to using the approach were noted, many related to contextual issues rather than to TBRI® specifically. Findings also showed that equipping families with a similar skill set would be advantageous and integral to effecting sustainable change.

School-Based Interventions for Child and Adolescent Victims of Interpersonal Violence

BACKGROUND

Interpersonal violence against children and adolescents can affect their mental health and functioning in the long term. To reduce mental health problems in children and adolescents, school-based mental health interventions have been shown to be beneficial. A review of school-based interventions designed to mitigate posttraumatic symptoms after interpersonal violence is lacking to date.

METHODS

We searched for original studies published in English or German until November 2019 in 6 electronic databases. Supplementary search strategies to reduce publication bias were implemented. Peer-reviewed original studies assessing school-based interventions for children and adolescents under the age of 21 after interpersonal violence were included. Relevant data was extracted, synthesised and assessed qualitatively. The methodological quality of included studies was assessed.

RESULTS

Of 5,021 unduplicated publications, 15 studies met eligibility criteria. The included studies were almost exclusively conducted in the USA; over half utilised a randomised-controlled design. Studies mainly focussed on Posttraumatic Stress Disorder (PTSD) or depression. In all studies, implemented interventions partially or fully mitigated posttraumatic symptoms. Nine school-based interventions, five of which were based on cognitive behavioural therapy (CBT), were identified. School staff were often involved in intervention implementation besides mental health professionals.

CONCLUSIONS

School-based interventions can be beneficial to reduce mental health problems in children and adolescents after interpersonal violence. Trained school staff aided by mental health professionals can implement trauma-informed practices at school. While school-based interventions may be a feasible way to provide children and adolescents with accessible mental health care, further research on school-based trauma interventions outside the USA is necessary.

The Role of Trauma-Informed Training in Helping Los Angeles Teachers Manage the Effects of Student Exposure to Violence and Trauma

Exposure to trauma, such as community violence, has far-reaching effects on childrens' learning and behavior. While schools are a critical place to provide positive and safe spaces for students, teachers have self-reported a lack of knowledge on how to work effectively with traumatized students. In response to this, there has been an increase in teacher training on trauma-related topics. However, it is unclear how training impacts teachers' trauma knowledge and difficulty responding to traumatized students in the classroom. As such, this exploratory study used a survey (N = 94) with Los Angeles teachers to assess whether training on violence and trauma is related to trauma knowledge and reported difficulty responding to traumatized students. Regression analyses indicate that total training increased teachers' trauma knowledge, which was found to mediate teachers' difficulty responding to traumatized students. Findings from this study support the need for a focus on trauma-informed training within the education context.

A multi-tiered systems of support blueprint for re-opening schools following COVID-19 shutdown

The COVID-19 pandemic will create enormous disruptions for youth and families with respect to economic and health status, social relationships, and education for years to come. The process of closing and intermittently reopening schools adds to this disruption and creates confusion for parents and school officials who must balance student educational progress with health and safety concerns. One framework that may serve as a roadmap in this regard is a multi-tiered systems of support (MTSS) model. This article briefly addresses four main domains of functioning (adjustment, traumatic stress, academic status, health and safety) across three tiers of support (universal, targeted, intensive). Each section draws on existing literature bases to provide specific recommendations for school officials who must address various and changing logistical, academic, and health-based challenges. The recommendations are designed to be flexible given fluctuations in the current crisis as well as focused on maximum-value targets. An MTSS approach adapted for contemporary circumstances can also be used to help address longstanding disparities that have been laid bare by the pandemic.

A Scoping Review of School-Based Efforts to Support Students Who Have Experienced Trauma

The current review sought to describe the published literature relative to addressing trauma in schools. Through a systematic review of peer-reviewed publications as well as gray literature, we identified a total of 91 publications that were coded for study rigor as well as a number of intervention characteristics. Publications included in the review mentioned a variety of intervention components, most notably an emphasis on counseling services, skill development, psychoeducation related to trauma, and parent engagement. We identified a relative lack of empirical evaluation of whole-school approaches and interventions intended to be delivered by non-clinical staff. We also found that less rigorous publications were more likely to highlight the needs of particularly vulnerable groups of youth and to emphasize cultural competence and community engagement in efforts to address trauma in schools. We call for more rigorous evaluation of practices and policies that take a whole-school approach and can be implemented by non-clinical staff. In particular, we highlight the need to evaluate professional development strategies that can help school staff acquire knowledge and skills that can translate into improved outcomes for students—especially students from historically marginalized groups. We also emphasize the importance of ensuring that high-quality research be made accessible to policymakers and school staff to ensure that clear, evidence-based guidance is available to avoid programs, practices, and policies that may inadvertently traumatize students or exacerbate symptoms among students who have already experienced trauma.