trauma-informed schools part 2: trauma sensitive practices · pdf file trauma-informed schools...

Trauma-Informed Schools Part 2: Trauma Sensitive Practices

Dr. Briana Woods-Jaeger

Assistant Professor

Rollins School of Public Health

Licensed Clinical Psychologist

Briana Woods-Jaeger, PhD, MS

Rollins School of Public Health, Emory University

Southeast Region MHTTC

Disclaimer: The opinions expressed herein are the views of the presenters and do not reflect the official

position of the Department of Health and Human Services (DHHS), SAMHSA. No official support or

endorsement of DHHS, SAMHSA, for the opinions described in this document is intended or should be

inferred.

Objectives Describe approaches to implement

trauma-informed practices in schools

Provide examples of trauma-informed programs and practices

Discuss staff wellness as a foundation for trauma-informed

schools

Describe staff wellness tools and resources

1

2

3

4

School Mental Health Interventions

4

Multi-Tiered Approach

Universal: target whole

school or classrooms

• Least intrusive, lowest cost

• Greatest chance of adoption

• Can be easier than other approaches

• Need buy in from administrative leaders and

all school staff

Fazel et al., 2014

School Mental Health Interventions

5

Multi-Tiered Approach

Selective: targeted to

population subgroups,

address risk factors

within higher risk

groups

• Promote awareness of alternative coping

strategies

• Reduce development of some problem

behaviors

• Can be delivered in classrooms or small

groups for students at high risk

• Strong evidence for students with risk factors

and for students with anxiety or depressive

disorders

Fazel et al., 2014

School Mental Health Interventions

6

Multi-Tiered Approach

Indicated: overlap

conceptually with

mental health

treatments; can

include services

delivered by staff

employed by

community-based

agencies

• Generally show stronger outcomes for clinical

impairment than universal or selective

interventions

• Community-partnered mental health services

• Consultation in mainstream schools by mental

health specialists

• Some schools provide onsite individual, family

and group treatment

• Intensive treatment can take place during the

school day – more efficient for students and

parents

Fazel et al., 2014

Core Areas of a Trauma-Informed School

1. Identifying and Assessing Traumatic Stress

2. Addressing and Treating Traumatic Stress

3. Trauma Education and Awareness

4. Partnerships with Students and Families

5. Creating a Trauma-Informed Learning Environment

6. Cultural Responsiveness

7. Emergency Management/Crisis Response

8. Staff Self-Care and Secondary Traumatic Stress

9. School Discipline Policies and Practices

10. Cross System Collaboration and Community Partnerships

NCTSN, 2017

Barriers to Becoming and Sustaining a Trauma-Informed School

• Limited staffing and funding to screen for trauma

• Lack of availability of appropriate tools and resources

• Limited capacity of schools to follow-up with students identified as needing services

• District-level leadership changes

• Workforce instability

• Shifting school and district priorities

Overstreet & Chafouleas, 2016

Poll Question: “What are barriers you have

faced in becoming a trauma-informed school?”

Facilitators to Becoming and Sustaining a Trauma-Informed School

• Use of familiar frameworks (e.g., MTSS) to align trauma-informed

approaches with existing educational practices

• Building from effective school-based mental health models and practices

• Use of naturalistic resources (i.e., teachers, peers) within schools to

implement and sustain supports

• Peer-selected key opinion leader (KOLs) teachers to promote new

strategies

• Inclusion of integrated models

• Strengthening the active involvement of parents

Atkins et al., 2008; Atkins et al., 2010; Overstreet & Chafouleas, 2016

Examples of Trauma-Informed Programs & Practices in Schools

MTSS Approach to TIS

Brymer et al., 2012; CBITS, n.d.

Trauma-Informed Training

• Increase staff knowledge about prevalence and effects of trauma

• Increase staff’s ability to recognize signs and symptoms of trauma

• Improve staff skills in appropriately responding to students exhibiting trauma symptoms

• Effectively address student behavior

• Make appropriate referrals

• Recognize and address secondary traumatic stress and burnout • Staff Wellness*

Maynard et al. 2019

Psychological First Aid for Schools (PFA-S)

• Designed to reduce the initial distress caused by emergencies and to foster short- and long-term adaptive functioning and coping

• Identifies individuals who may need additional services and links them to such services as needed

• Potential to mitigate the development of mental health problems or long-term difficulties in recovery

Brymer et al., 2012

PFA Core Actions Goal: To initiate contacts or to respond to contacts by students and staff in a non-intrusive, compassionate, and helpful manner

Contact and Engagement

Goal: To enhance immediate and ongoing safety, and provide physical and emotional comfort Safety and Comfort

Goal: To calm and orient emotionally overwhelmed or disoriented students and staff Stabilization (if needed)

Goal: To identify immediate needs and concerns, gather additional information, and tailor Psychological First Aid for Schools interventions to meet these needs

Information Gathering:

Current Needs and Concerns

Goal: To offer practical help to students and staff in addressing immediate needs and concerns Practical Assistance

Goal: To help establish brief or ongoing contacts with primary support persons or other sources of support, including family, friends, teachers, and other school and/or community resources

Connection with

Social Supports

Goal: To provide information about stress reactions and coping to reduce distress and promote adaptive functioning

Information on Coping

Goal: To link students and staff with available services needed at the time or in the future

Linkage with

Collaborative Services

Brymer et al., 2012

PFA-S Resources

Schools can find training resources including the PFA-S Field Operations Guide, https://www.nctsn.org/resources/all-nctsn- resources.

• PFA-S Field Operations Guide: provides guidance on responding to

disaster, violence, or terrorism events using the Psychological First Aid

intervention.

• PFA-S Webinar: describes the fundamentals of Psychological First Aid

for Schools. This webinar offers information on how PFA-S helps to

reduce the distress that school communities can experience after a

disaster or violent event.

PFA Example Intervention: Link

Communication Skills

Stress Screener

Referral to Resources

Link in Schools Video

Link in Schools Pilot Data: Depressive & PTSD Symptoms

1 Repeated measures ANOVA model controls for student race, grade and sex, flood versus other disaster and correlation within schools

*P

Hospital-based Link Study

Children who received LINK

had significantly improved

child behaviors compared to

children who received

educational materials:

Peer relationships

problems (p=.0240)

Conduct problems (p=

.0368)

UI Children’s Hospital

Blank Children’s Hospital

Children’s Minnesota

Children’s Mercy, Kansas City

Link in Schools Process

summer/early fall summer/early fall fall & spring end of year

Trauma Informed

Care training

delivered to all

school staff

Implement Link Program:

At-risk youth (identified using existing

school systems) receive one-on-one

Link session

End-of-year Link

de-briefing

On-going Link

mentoring

Specialists

receive Link

training

Cognitive Behavioral Intervention for Trauma in Schools (CBITS)

• School-based, group and individual intervention; used with students 5th-12th grade

• Evidence-based intervention program developed for diverse youth exposed to trauma

• Reduce symptoms of post- traumatic stress disorder (PTSD), depression, and behavioral problems

• Improves functioning, grades and attendance, peer and parent support and coping skills

21 CBITS, n.d.

Program Components

10 g