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.

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

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This dissertation explores Trauma-Informed Care (TIC) from the perspective of school-based occupational therapists (SB-OTs) to support students who may be negatively affected by adverse childhood experiences (ACEs). TIC focuses on creating an interpersonal culture of safety and respect and is becoming more well known in healthcare and education. Using the Nominal Group Technique (NGT), experienced SB-OTs from across the US participated in focus groups to identify priorities for delivery of TIC in school-based practice. Additionally, the 5 NGT focus groups (n=24) identified facilitators and barriers to effective TIC in schools. Drawing from these findings, the Pediatric Remediation Outcomes: Trauma-Informed Principles (PRO-TIP) program is proposed. PRO-TIP centers on refining fine motor skills through school-based occupations, guided by occupational therapy (OT) theory, and caters to educators and SB-OTs. The program is designed to support students, educators, SB-OTs, and improve the wider workplace culture. By offering fundamental priorities on TIC aspects, this dissertation serves as a valuable resource for entry-level occupational therapists (OTs), researchers, school staff, and administrators seeking to embrace a trauma-informed approach. The framework for the PRO-TIP program emerges as a practical, evidence-based tool designed to be further developed and piloted in elementary-school settings. With original research and a novel program design, this dissertation began with the end in mind: to help young, misunderstood learners with trauma related behaviors change their life trajectory for the better. / Temple University. College of Public Health / Health and Rehabilitation Sciences

Growing evidence of the health risks associated with adverse childhood experiences (ACEs) has prompted public health and community initiatives to promote awareness, detection, and responses that are trauma informed. Nationwide programs to integrate trauma-informed care into education, health care, and child serving agencies, have thus far led to the proposal and advancement of trauma-informed policies and practices in many communities. While Mississippi agencies include trauma-specific intervention and training, statewide ACEs initiatives and relevant data are still limited. This project aimed to contribute to the larger goal of a statewide trauma-informed paradigm shift, by increasing ACEs awareness and developing recommendations for the integration of such research into programs aimed at serving vulnerable populations. Sixty-one child-serving professionals participated in adversity and resilience training (ART), a 3-hour workshop addressing childhood adversity, traumatic stress, resilience, and secondary traumatization. Outcomes measured were changes in trauma knowledge, trauma informed attitudes, attributions regarding difficult child-behaviors, and secondary trauma knowledge and self-care. Participants also provided ratings on a training evaluation survey. There were significant changes in trauma knowledge (F(1,22) = 6.418, p = .000, ηρ2 = .226) and trauma-informed attitudes (F(1,22) = 11.014, p = .003, ηρ2 = .334) between pre- and post-training. Training evaluations were generally positive (M = 4.61, SD = 0.13, on a 1 to 5 Likert scale). The current study contributes to the research an evaluation of a training intervention that offers feasible strategies for scalable training and assessment of outcomes.

Thesis advisor: V. Paul Poteat / Intimate partner violence (IPV) occurs in LGBTQ (lesbian, gay, bisexual, transgender, queer) relationships at rates equal to or even higher than cisgender heterosexual relationships (Walters, Chen, & Breidig, 2013). The health consequences of IPV are well documented (Kwako et al., 2011). Trauma-informed care (TIC) is one service approach receiving increasing support for use with IPV survivors (Warshaw, Lyon, Phillips, & Hooper, 2014). Nevertheless, there is little research exploring the association between TIC and health among LGBTQ IPV survivors. Immobilization is prevalent for IPV survivors for whom fight or flight may increase risk of violence during traumatic situations (van der Kolk, 1989). TIC might be well-positioned to counter these immobilizing effects in effort to facilitate mobilization and better health for IPV survivors. The relationship between TIC and health through mobilizing mechanisms has not yet been tested. This study examined several mobilizing mechanisms as mediating the relationship between TIC and health including: 1) lower social withdrawal; 2) lower shame; 3) greater emotion regulation; and, 4) greater empowerment. Among 227 LGBTQ adults, structural equation modeling analyses tested the relationship between TIC and health, and the mediating effects of lower social withdrawal and shame, and greater emotion regulation and empowerment on the relationship between TIC and health. Results indicated that the direct effects of TIC on mental and physical health were not significant. Indirect effects of TIC on mental and physical health through the set of mobilizing mechanisms were not significant. However, TIC did predict greater empowerment and emotion regulation and lower social withdrawal. Lower social withdrawal and lower shame also predicted better mental health, while lower shame and emotion regulation predicted better physical health. Practitioners need to uncover additional services and resources beyond TIC that could improve health among LGBTQ IPV survivors. Research should continue to examine the potential effects of TIC in addition to how it is applied in the context of evidence-based treatment programs that are adapted for sexual and gender minorities. / Thesis (PhD) — Boston College, 2018. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental and Educational Psychology.

Trauma has been found to be highly prevalent and associated with many negative health and social outcomes (i.e., heart disease, higher suicide risk, high-risk behaviors) in the general population. Despite these associations, trauma detection is relatively rare in service-providing organizations. Trauma-informed care (TIC) is a proposed solution that encourages trauma detection, understanding the symptoms associated with trauma, and treating trauma while actively avoiding re-traumatization to the service user. Although research about TIC efficacy has been fairly limited, there are some promising potential benefits of the practice to the client, provider, and the population as a whole. For this study, we looked at service providers’ reported familiarity with TIC and implementation of TIC in their organization across seven timepoints. We found familiarity increased more than implementation, and we discuss potential reasons that may cause this discrepancy.

Homelessness is a growing concern in the United States Virgin Islands (USVI) especially since 2 major hurricanes in 2017 devastated the islands. The impact trauma has on reoccurring homelessness in the USVI is unknown. Failure to understand the impact trauma may pose on persons who are homeless could hinder stable housing and perpetuate reoccurring homelessness. The purpose of this cross-sectional study was to examine the predictive relationship between trauma and reoccurring homelessness in persons who are homeless living in the USVI. The theoretical framework for this study was Psychological Trauma Theory. Participants were homeless adult persons (N=73) who were surveyed using the Trauma History Questionnaire and the Residential Timeline Follow-Back. A multiple regression analysis was used to examine the prediction of trauma on reoccurring homelessness, while controlling for demographic variables. The results indicated trauma was not statistically predictive on duration of homelessness and housing stability though when gender and education were controlled, there was significance in predicting service utilization with an adjusted R of (.19) of the variance and a value of (p > .000). Homeless males were more likely to utilize services than females though both homeless males and females with a high school education or higher were less likely to use services. The outcomes of this study have social change implications including counselor educators, counselors, and community stakeholders collaborating to facilitate trauma-informed care and design gender specific programs to increase service utilization among the homeless.

Studies have shown that using trauma-informed strategies in the classroom positively effect students learning and academic success. However, studies have proven that educators’ lack exposure to trauma-informed care area. The purpose of the study was to 1). Investigate educators’ knowledge and uses of trauma-informed strategies in their classrooms and 2.) develop a resource of trauma-informed strategies for educators to better serve students with trauma and Adverse Childhood Experiences (ACEs). A research design of surveying elementary teachers from a Northeast Indiana public school. The survey was administered to twenty-six elementary teachers in both the general and special education setting. Twenty participants completed the survey. The survey questions were both open and closed ended questions that gathered educators understanding of trauma and trauma-informed strategies in the classroom. Twenty educators completed the survey. Results suggested that educators lack trauma-informed Professional Development while all educators have a high percent of students with trauma within their classrooms. Results also suggested that educators may not have a good understanding of what trauma-informed strategies are or how to implement them in their classroom.

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