No description available.

Telehealth services can address many barriers to traditional office-based mental health services. Few studies have assessed youth and caregiver perceptions of and satisfaction with trauma-focused interventions delivered via telemental health. The present study reports data collected using the Telehealth Satisfaction Questionnaire (TSQ), which was developed to measure child and caregiver satisfaction with services, comfort with the telehealth equipment, and barriers to traditional office-based services. Thirteen clinicians delivered home- and school-based Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) via videoconferencing on tablets and computers to 60 child patients (71.7% Latinx, 18.3% Black, and 10.0% non-Hispanic White). Patients and caregivers completed the TSQ at treatment discharge via telephone, videoconferencing, or in-person interviews. There was a high level of satisfaction among patients and caregivers receiving TF-CBT via telemental health. Furthermore, most youth and caregivers felt comfortable using the telehealth equipment from the outset of therapy, and all participants who were not initially comfortable using the equipment reported feeling more comfortable over time. The most common barriers to traditional office-based services were caregiver work schedule (57.7%), distance to mental health clinic (55.8%), and lack of transportation (44.2%). Patients and caregivers expressed a preference for telemental health services if given the option between receiving therapy via videoconferencing versus going to an office-based clinic. Findings indicated telemental health treatment addressed barriers that would have otherwise prevented families from accessing office-based services. The TSQ can be used to help clinics and providers assess patient and caregiver satisfaction with telehealth services in various settings. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

acase@tulane.edu / Although the theoretical basis supporting the use of trauma-informed approaches in schools is promising, evidence for mechanisms of facilitating their acceptability among teachers is limited. Findings from implementation science indicate that foundational professional development training during pre-implementation activities can generate teacher support for a new approach, which is essential to successful formal implementation. Theoretical models point toward enhanced teacher knowledge of the approach as a predictor of such support. The current study examined whether foundational professional development training increased teacher knowledge of a new school-wide initiative, trauma-informed approaches, and evaluated that knowledge growth as a predictor of teacher perceptions of acceptability for trauma-informed approaches. Feasibility and system fit, two domains of perceived social validity of trauma-informed approaches, were assessed as potential moderators of the association between knowledge growth and acceptability. Although the training significantly increased teachers’ knowledge of trauma-informed approaches, knowledge growth did not predict acceptability ratings. Feasibility and knowledge growth did not interact to predict acceptability ratings. However, individuals providing higher ratings of system fit demonstrated a positive relationship between knowledge growth and acceptability. When system fit ratings were lower, knowledge growth predicted lower acceptability ratings. Findings provide partial support for foundational professional development training as a pre-implementation tool and identify factors that influence pre-implementation acceptability of trauma-informed approaches among teachers. / 1 / Elizabeth McIntyre

Despite trauma being widespread through the U.S. population and being associated with a multitude of negative life outcomes, trauma is not systematically being detected or considered during treatment or other service administration. To minimize the risk of re-traumatization and attempt to ameliorate the effects of past trauma, trauma informed care (TIC) is being implemented. TIC is an approach that attempts to educate individuals, particularly service providers, about the impact of trauma, as well as how to most effectively provide care for an individual who has experienced trauma. When implementing TIC trainings, it is important to establish a need for the trainings by determining if service providers are already knowledgeable about TIC and do not need training, and it is important to monitor service provider’s familiarity throughout the trainings to determine if the trainings are being effective. To determine if there is a need for the trainings, an initial survey was conducted to determine how familiar service providers were with TIC. In order to assess if the TIC training is educating service providers, we assessed the familiarity of service providers with trauma informed care. In order to monitor this familiarity, a survey was e-mailed from October 2015 to October 2018 every six months to service providers who were then instructed to complete the survey and forward it to anyone they thought may be interested in completing it. In the survey, they were asked to indicate how familiar they are with TIC: not familiar, somewhat familiar, or familiar. While these surveys were being distributed, TIC trainings were being held for the organizations in which the service providers were employed. In October 2015, at the start of TIC trainings, only 44.8% of survey providers reported being familiar with TIC while 20% reported not being familiar with TIC at all (n = 105). In October 2018, after TIC training had been implemented, 93.8% of service providers reported being familiar with TIC and 0.0% reported not being familiar with TIC at all (n = 64). These results indicate that there was a need for TIC training in these organizations due to the lack of familiarity the service providers reported at the first survey, and the TIC training may be contributing to the education of service providers which may be leading to more effective care being administered.

No description available.

This qualitative action research concentrates on examining the best practices for teachers in trauma-informed practices by producing an implementation guide to train the trainer. The theoretical framework utilized to help inform the development of this research was Bronfenbrenner’s ecological systems theory (1989) in relation to human development for identifying the emerging best practices with being trauma informed. The scope of this research focuses on low-socioeconomic status (SES) urban youth, so cultural sensitivity is naturally always a component of a complete train-the-trainer, trauma-informed teaching program. I identified the emerging best practices in two ways: (a) by gathering and summarizing supporting sources of literature and (b) by holding collaborative conversations with acknowledged experts in culturally competent trauma-informed training. The findings revealed six components essential to prepare the trainer on trauma-informed education training. First, culturally responsive pedagogy and culturally responsive teaching were identified to aid in bridging the gap in providing support. Social capital based upon lived experiences of students was recognized by acknowledging their needs through appropriate modeling of positive attitudes and behavior while increasing confidence in student learning using inclusive resources demonstrated throughout academic content. Next, the key principles of brain science were acknowledged showing a relationship between impact of trauma and learning affects such as: processing, decoding, self-regulation, and impulse control. Then, mental health was addressed to show there is an impact of negative interactions and disciplinary actions, according to Bronfenbrenner’s (1979) ecological systems theory. Attitude and language were acknowledged as both verbal and non-verbal and having an impact on instructional behavior, which influences student climate in learning and behavior. Lastly, the equity and accountability components were identified to require teachers to move away from implicit bias issues by creating more cultural-normative behavior through designing more restorative practices while building partnerships with students and families alike. The result of this action research provided a set of emerging best practices embedded in the implementation guide to support the trainer in training educators on how to teach trauma-impacted youth in California’s culturally diverse public-school classrooms.

acase@tulane.edu / The current study examined the impact of a professional development training in trauma-informed approaches on teacher attitudes. The current study had two main purposes: first, to determine whether two components of attitudes, perception of the problem and self-efficacy, became more trauma-informed among teachers following a professional development training; and second, to investigate whether that change in attitudes was linked to initial levels of familiarity with trauma-informed approaches and/or years of experience. Teachers from 6 schools that are part of the New Orleans Trauma-Informed Schools Learning Collaborative participated in the study (N = 163; 68.7% female, 58.9% White). Teachers filled out demographic information and completed the ARTIC scale (Baker, Brown, Wilcox, Overstreet & Arora, 2015) both before and after training. A paired-samples t-test revealed that perception of a problem and self-efficacy among teachers did become significantly more aligned with trauma-informed approaches following the training. However, contrary to the hypothesis, familiarity and years of experience did not moderate perception of a problem or self-efficacy. Regardless, these results have important implications for the trauma-informed schools movement as they show that PD trainings can positively impact teacher attitudes, potentially increasing teacher motivation to carry out trauma-informed practices in the classroom. / 1 / Juliana Vanderburg

No description available.

Trauma-informed care (TIC) incorporates evidence about the prevalence and impact of early trauma on behavior across the lifespan. TIC is a person-centered response that focuses on improving client functioning by viewing and responding to maladaptive behavior in the context of traumatic experiences. TIC is grounded in the Adverse Childhood Experiences (ACE) study, a collaborative research project between the Centers for Disease Control and Prevention and Kaiser Permanente (Centers for Disease Control and Prevention, 2013a). The ACE study began in 1997 to collect information (n=17,337) via a 10-item survey about adverse childhood experiences related to abuse (emotional, physical, and sexual), neglect (emotional and physical), and household dysfunction (domestic violence, divorce, death of a parent, or the presence of a substance-abusing, mentally ill, or incarcerated member in the household). The ACE score reflects the total number of adverse experiences endorsed by that individual. Dozens of publications analyzing ACE data have revealed staggering evidence of the pervasive and enduring nature of early trauma. Findings are clear and consistent, demonstrating that as the number of early adverse experiences increases, the risk for myriad health, mental health, and behavioral problems in adulthood also increases in a robust and cumulative fashion (Centers for Disease Control and Prevention, 2013b). For example, as ACE scores increase, so does the likelihood of alcohol and drug abuse, smoking, chronic obstructive pulmonary disease, depression, suicide attempts, fetal death, obesity, heart disease, liver disease, intimate partner violence, early initiation of sexual activity, multiple sexual partners, sexually transmitted diseases, and unintended pregnancies. Furthermore, childhood adversity is associated with adult criminality, including sexual offending; sex offenders report significantly higher ACE scores than the general population (Reavis, Looman, Franco, & Rojas, 2013). Reavis et al. (2013) opined that it is therefore unsurprising that offense-specific models of sex offender treatment have produced mixed results in terms of effectiveness, and suggested that treatment programs should more strongly emphasize the role of early trauma on self-regulation and attachment. This 90-minute workshop will first provide an overview of the principles of trauma informed care. Participants will learn about the various ways that early trauma lays the groundwork for a range of interpersonal problems and maladaptive coping skills stemming from longstanding relational deficits and distorted cognitive schema about oneself and others. Then, workshop participants will learn to incorporate an interpersonal process approach to sex offender treatment, which combines elements of developmental, family systems, and cognitive models to conceptualize adult client behavior in the context of childhood trauma (Teyber & McClure, 2011). Participants will learn how to establish a nonthreatening sex offender treatment environment that facilitates trust, emotional safety, and intimacy. Participants will learn to utilize immediacy interventions to create corrective experiences; when clinicians respond effectively to relational themes and patterns as they present themselves in individual and group therapy, client skills can be enhanced, practiced, and reinforced. This workshop will reflect the conference theme of "Shouldering Responsibility: Making Society Safer" by introducing an innovative model and framework for promoting change. TIC recognizes the role of traumatic events in the development of high-risk behavior and values the subjectivity of trauma as a central function in the healing process. By exploring and understanding maladaptive and abusive behavior through the lens of early trauma, clinicians can help sex offender clients learn and generalize new skills, enhance their interpersonal relationships, and improve their general well-being (Teyber & McClure, 2011). This type of personal growth would be expected to mitigate future potential to reoffend as the client incorporates more healthy and successful strategies for relating to others and meeting emotional needs.

Fostering a Trauma Informed Mindset in the Criminal Justice System Lauren Ledford, Mary Jo Oliver M.S., Meredith Jordan, Chloe Salyer, Adam Walker, Andrea D. Clements Ph.D. The presence of early childhood adversity and trauma is disproportionately high in individuals involved with the criminal justice system compared to the non-criminally involved population. Childhood adversity and trauma is consistently linked to many adverse lifelong outcomes such as increased mortality, increased risk of mental illness, and increased risk of substance use disorder. In order to respond to this increased risk, empathy and community-wide interventions have emerged as effective means of responding and resisting re-traumatization. Community and empathy-based training of law enforcement officials may assist in understanding trauma and combatting its effects as they are often some of the first people to come in contact with individuals experiencing the effects of childhood adversity and trauma. This study sought to evaluate the effectiveness of Trauma-Informed Care (TIC) training for police officers in their ability to have knowledge of, believe to be relevant, understand, feel confident implementing, and apply TIC principles. We hypothesized knowledge, relevance, understanding, implementation confidence, and application of TIC would all increase from pre-assessment to post-assessment. As part of an initiative to increase TIC awareness and implementation, 64 police officers participated in a one-day training that began with a pre-survey and ended with a post-survey. Both surveys contained measures concerning TIC knowledge, relevance, understanding, implementation confidence, and application. The post survey also included an additional measure regarding training quality satisfaction. The sample consisted primarily of White (N = 44), middle-aged males (M = 42.27, SD = 8.588). There was a significant difference between TIC knowledge t(56) = -4.593, p<.001, d = 1.096, TIC relevance t(56) = -2.488, p = .016, d = .912, TIC understanding t(56) = -8.611, p <.001, d = 2.932, and implementation confidence t(56)= -5.942, p <.001, d = 1.326 from the pre to post assessment. However, there was not a significant difference between TIC application t(56) = -1.826, p = .073, d = .585 from pre to post assessment. The consistently significant increase in TIC scores indicate that a TIC training is an effective means of improving officer perception of trauma and willingness to implement TIC practices.