User:Aonipede/User:Aonipede/Trauma-informed Education

Introduction
Trauma-informed schools (TIS) represents a paradigm shift in education, acknowledging the prevalence of trauma on students, and attempting to mitigate its widespread impact. By adopting trauma-informed principles, educational organizations aim to create supportive environments that facilitate learning and promote the emotional well-being of students. Trauma-informed schools are referred to with varying terminology (e.g., trauma-sensitive school, trauma-responsive school). As articulated by the National Child Traumatic Stress Network (NCTSN), trauma-informed approaches in education aim to engage school personnel and community members—to identify and respond to the potential negative effects of traumatic stress within the school system. This is typically achieved through the integration of trauma-related skills and knowledge into school culture, practices, and policies. Adoption of TIS consists of implementing organizational changes, workforce development, and practice changes that reflect the four key expectations of a trauma-informed approach (i.e., realizing the impact of trauma, recognizing signs of trauma, responding to trauma, and resisting re-traumatization). The goals of TIS, is to improve student, teacher, and school level outcomes not limited to academic performance, psychological wellbeing, socioemotional wellbeing, school climate, teacher-student relationships. To date, the evidence base of TIS currently faces limitations in evaluating if such goals have been met; evaluations of TIS often suffer from constraints such as the lack of randomization and absence of control conditions, impeding the field's ability to definitively establish effectiveness. Due to the breadth of trauma-informed approaches, this article will only provide an overview of key, widely implemented TIS practices.

Impact of Trauma
The roots of trauma-informed schools can be traced back to the broader acknowledgment of the role of trauma in shaping students' behaviors and academic performances. The extensive exposure of children and adolescents to traumatic events stands as a considerable public health challenge. National studies of youth mental health reveal that at least two-thirds of youth have encountered at least one traumatic event in their lifetime. Early experiences with trauma are correlated with late life onset of mental health conditions6 and physical health concerns. Additionally, research indicates that there are academic implications for youth with early traumatic experiences, including difficulties with verbal abilities, attention, and information processing compared to those with no exposure to traumatic events. These cognitive consequences significantly impact academic achievement, likely contributing to poorer reading performance, test results, and lower grades. Given the high prevalence of trauma exposure among youth and the risks identified, there has been a longstanding call for youth serving sectors to prioritize and address the needs of students affected by trauma.

Advent of Trauma-Informed Care
Advocacy for trauma-informed systems change began in the early 2000’s with Harris and Fallot’s theoretical argument that the impacts of trauma are pervasive, and not limited to the traumatic experience itself. Harris and Fallot’s argument posits that trauma does not only impact the individual’s functioning in relation to trauma-specific stimuli, but also impacts other sequelae (e.g., physical health, social, academic, & interpersonal problems), and importantly their ability to interface with help seeking systems; thus changes should be made to these systems to better accommodate and serve the needs of trauma-impacted individuals. In their model for trauma-informed care, Harris and Fallot conceptualize organizational change for health service systems, incorporating an understanding of trauma and the conditions that enhance or interfere with healing, as an imperative response to supporting individuals with traumatic experiences and resisting their re-traumatization. Harris and Fallot’s model assumes a more holistic stance in regards to responding to trauma, compared to traditional, trauma-specific, clinical models which prioritize individual, and trauma-specific interventions that directly target trauma symptoms.

Since this model, multiple models for trauma-informed care have emerged. Across all models, the goal of a trauma-informed approach remains to create an environment that  prioritizes  safety,  choice,  control,  and  empowerment for the impacted individual. This is reflected in the widely accepted core principles of trauma-informed care, published by the Substance Abuse and Mental Health Services Administration (SAMHSA): ensuring safety, trustworthiness & transparency, peer support, collaboration & mutuality, empowerment & choice, and attention to cultural, historical, & gender issues. See Trauma-informed Care page for further information. These principles are typically upheld by general approaches that prompt increased sensitivity towards the impact of trauma and trauma-specific services (e.g., assessment, psychoeducation, treatment) that can address symptoms and trauma recovery. Trauma-informed care principles have become widely disseminated and integrated across numerous different public serving sectors, one of which is schools.

Trauma-Informed Schools
A trauma-informed approach, recognizes schools as a youth serving system comprised of practices, policies, and procedures with the potential for healing or re-traumatization of trauma-impacted youth. Within a school system, a trauma-informed approach facilitates systemic change through the integration of a trauma lens into the operating procedures, policies, and development of the school workforce. Similar to the goals of trauma-informed care, the aim of a trauma-informed school is to create a safe, and welcoming environment that is attuned and responsive to the needs of not only students but all members of the school community (e.g. teachers, administrative staff, families) touched by the effects of trauma. All stakeholders are engaged in supporting the recovery and overall wellbeing of students through approaches that develop a school-wide awareness of trauma, and capacity to respond to student needs with trauma-informed skills. Several frameworks exist describing trauma-informed approaches in schools, some notable frameworks including HEARTS, Neurosequential Model For Education, Sanctuary Model, and Trauma Learning Policy Initiative. Though structured in varying ways, trauma-informed school frameworks consistently promote trauma-informed change in three predominant domains: organizational, workforce development, and educational and clinical practice.

Organizational Change
Trauma-informed organizational changes refer to the active inclusion of knowledge about trauma and its impacts into the development of school policies and procedures. This includes revising or developing new policies and procedures related to areas such as school safety, student discipline; as well as the use of implementation strategies to facilitate the adoption and maintenance of trauma informed changes. An essential underpinning of trauma informed care and approach is the awareness that school procedures and the enforcement of school policies can be re-traumatizing if not approached sensitively. Ubiquitous across trauma-informed school best-practice guidelines, and real-world implementation of trauma-informed education have been calls to reform policies for school disciplinary practice.

Current school disciplinary policies often implement zero-tolerance, exclusionary practices as a response to student behavior – these policies and protocols can be re-traumatizing for youth who have already experienced some form of victimization. Moreover, racially and ethnically minoritized students disproportionately receive exclusionary discipline responses and consequently are disproportionately subject to such re-traumatization. Students who have experienced trauma may be particularly likely to experience dysregulated emotions and behavior in school settings, including poor concentration and difficulty staying on task, disruptive behavior, and even verbal and physical aggression towards peers or staff. Trauma-informed approaches to school discipline first recognize student behavior as a potential response to, or symptom of trauma and resist attribution of student behavior to willful defiance or aggression. In addition, trauma-informed discipline responds to student behavior using techniques that reinforce trauma-informed principles of safety, trust, and collaboration. Rather than emphasizing punitive, exclusionary discipline practice, a trauma-informed school prioritizes the use of therapeutic or behavioral techniques that promote positive behavior supports for students, prevent behavior problems, and support student self-regulatory capabilities. Disciplinary practice changes have included the use of behavior de-escalation strategies, restorative justice practices, social emotional learning interventions as first-line responses to student behavior in place of or prior to escalation to exclusionary practices. To date, no research has explored the direct or indirect effects of disciplinary reform within trauma-informed schools on student’s social, emotional, or academic outcomes. However, research has identified the effects of trauma informed school disciplinary reform on school-level outcomes, such as: reductions in office referrals for behavior, reductions in in-school suspension, and reductions in out-of-school suspensions.

Workforce Professional Development Change
Professional development training is a strategy adopted by schools wherein a structured training opportunity is used to introduce the rationale, disseminate essential knowledge, and teach relevant skills for a new school-wide initiative. In addition to providing school personnel with the necessary knowledge and skills to implement a new initiative, the goal of this training is also to build commitment and support for the new initiative amongst school personnel ( Han & Weiss, 2005). Similarly, the goal of professional development training for trauma-informed schools is to 1. build support for the adoption of a school-based trauma-informed approach, and 2. to equip school personnel with knowledge about the impacts of trauma and the competencies necessary to recognize and respond to students’ signs of trauma. Current models of trauma-informed school professional development augment school personnel knowledge on the prevalence and different types of traumatic experiences youth report, the effects of trauma on students' cognitive and emotional functioning, and the impact of secondary traumatic stress on service providers. In addition to introducing new knowledge, professional development opportunities teach school personnel how to implement trauma-sensitive strategies to respond to youth behavior, and trauma-related needs. This may involve skills and strategies to regulate or de-escalate youth emotion, build trusting relationships, create safe and predictable classroom environments; as well as evidence-based interventions for trauma (e.g., CBT, TF-CBT, CBITS). Additionally, best-practice guidelines for trauma-informed school professional development suggest that schools include cultural responsiveness training for school personnel in order to better understand student’s unique cultural perspectives and counteract the potential for implicit and explicit bias on an institutional level and in individual interactions. Though not discussed explicitly in reviews of trauma-informed school professional development, some published descriptions of trauma-informed schools have described their efforts to include components related to cultural responsiveness in their professional development opportunities.

Important to note, is that there is considerable variability across approaches to trauma-informed school professional development, no standardized version of trauma-informed professional development for school settings exist. To date, there has been no empirical research evaluating what knowledge content, training duration/intensity, or types of school personnel (e.g., teachers, support staff, security personnel, principal, school administrators) is needed in trauma-informed school professional development to facilitate desired change in school practices and consequently student outcomes. Notably, there is mixed evidence about the impact of trauma-informed professional development on student, teacher, and school level outcomes. One review of general trauma-informed professional development found that across studies, staff knowledge and attitudes related to trauma-informed practice improved after training. However, a review of school-based trauma-informed approaches identified variable outcomes – with some studies demonstrating no improvements in teacher knowledge and attitudes about trauma-informed practice.

Educational & Clinical Practice Change
Educational or Clinical Practices concern the provision of student-facing trauma-informed clinical interventions and educational practices. This can include trauma-informed teaching pedagogy or curriculum design; or trauma-specific clinical services such as trauma screening, mental health referrals, and multi-tiered intervention practices. Trauma-informed teaching pedagogies acknowledge the cognitive, and learning consequences of trauma exposure, not limited to difficulties with attention, information processing, memory, and behavior dysregulation. Thus a trauma-informed approach to teaching adopts learning practices and classroom design that align with trauma-informed core areas (e.g., ensuring safety, trustworthiness & transparency, peer support, collaboration & mutuality, empowerment & choice, and attention to cultural, historical, & gender issues). A review of existing trauma-informed teaching pedagogies have two primary focal points: repairing dysregulated responses to traumatic stress, and fostering strong student-teacher relationships to support healthy student attachment styles. Examples of practices used to support students in developing appropriate responses to stress, and building healthy attachment capacities include: establishment of clear and consistent classroom expectations, self-regulation strategies (e.g., mindfulness techniques), classroom regulation strategies (e.g., “brain breaks”), and academic accommodations (e.g., extended assignment time or individualized academic supports). By integrating trauma-sensitive strategies, teachers can create an inclusive learning environment that supports the emotional and academic growth of all students. Permeating across majority of trauma-informed educational approaches are multi-tiered intervention systems. A multi-tiered intervention system, is designed to support schools in providing clinical services to students impacted by trauma with varying levels of need (Tier 1, Tier 2, and Tier 3). Tier 1 Practices refer to whole school or classroom interventions that strengthen students emotional and social skills and aim to prevent development of clinically severe trauma. Common Tier 1 practices are trauma psychoeducation, social emotional learning interventions (i.e., emotion regulation techniques, healthy coping mechanisms, social skills development), and Positive Behavior Implementation and Support interventions. Tier 2 Practices are interventions or supports for students with demonstrated deficits in social/emotional/behavioral risk characteristics (e.g., elevated emotion dysregulation, attentional challenges, hyperactivity behaviors). These typically include aggression prevention interventions, relaxation interventions, play therapy, and intensive skill building (e.g. social skills, emotion regulation skills, and cognitive processing skills). Tier 3 Practices refer to clinical treatments or interventions for students with indicated trauma problems or diagnosed mental health needs. These supports include individual psychotherapy with school-based clinicians, and trauma focused evidence-based therapies (e.g. Trauma-Focused Cognitive Behavioral Therapy, Cognitive Behavioral Intervention for Trauma in Schools).