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

In this groundbreaking Master's thesis, Rameesha Qazi explores the critical realm of survivor care policies and toolkits within the NGO space, driven by her own experience of sexual violence during my work abroad. Rooted in a survivor-centered and trauma-informed framework, my analysis encompasses an evaluation of policies from organizations and essential toolkits, revealing striking gaps in addressing systemic barriers, recognizing trauma's nuanced impact, and supporting diverse coping strategies. A unique contribution to the field and in recognizing contextual variations in survivor needs, I introduce a country guide as a practical tool for NGOs to enhance their survivor care policies, providing a roadmap for how to address gaps in support. Furthermore, extending the focus beyond policies, I scrutinize toolkits from prominent organizations and propose recommendations, emphasizing the crucial need to engage survivors, provide comprehensive support, and amplify survivor voices. The thesis not only underscores the urgency for trauma-informed, survivor-led approaches but also challenges prevailing norms in the development sector. It aims to reshape the discourse around sexual exploitation and abuse, advocating for tangible, sustainable change in policies and toolkits to ensure the safety, support, and empowerment of survivors within the NGO space. This research stands as a testament to the imperative role of survivor voices in shaping effective, adequate, and sustainable solutions for combating sexual violence within the development sector.

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.

The decision to drop out of high school can affect a person's life in many ways, as lifetime earnings, employment options, overall health, and the probability of incarceration are all negatively influenced when students drop out of school. The purpose of this qualitative case study was to investigate the perceptions of faculty, staff, parents, and high school graduates regarding factors leading to the high graduation rates of students in a dropout prevention program during the 2017–2018 and 2018–2019 school years. A total of 15 one-on-one interviews were conducted to collect data around participants' perceptions of how the application process; onboarding and orientation program; academic progress monitoring and interventions; and social, emotional, and mental health supports contributed to the program's high graduation rate. Data were reviewed, analyzed, and coded, resulting in emerging themes across the data set. Themes were then synthesized and aggregated into four findings. Findings indicated the advisor role and the student–advisor relationship, staff training in trauma-informed practices, staff collaboration, and providing a flexible and responsive program structure were factors influencing the high graduation rate of students in this dropout prevention program. These findings were used to develop four corresponding implications for district and school leaders to create and maintain structures where students are supported by at least one trusted adult, provide meaningful and consistent trauma-informed professional learning, create an environment where staff collaboration around student needs is a priority, and provide flexible schedules and options for students to positively affect student graduation from alternative educational settings. / Doctor of Education / The decision to drop out of high school can affect a person's life in many ways, as lifetime earnings, employment options, overall health, and the probability of incarceration are all negatively influenced when students drop out of school. The purpose of this qualitative case study was to investigate the perceptions of faculty, staff, parents, and high school graduates regarding factors leading to the high graduation rates of students in a dropout prevention program during the 2017–2018 and 2018–2019 school years. A total of 15 one-on-one interviews were conducted to collect data around participants' perceptions of how the application process; onboarding and orientation program; academic progress monitoring and interventions; and social, emotional, and mental health supports contributed to the program's high graduation rate. Data were reviewed, analyzed, and coded, resulting in emerging themes across the data set. Themes were then synthesized and aggregated into four findings. Findings indicated the advisor role and the student–advisor relationship, staff training in trauma-informed practices, staff collaboration, and providing a flexible and responsive program structure were factors influencing the high graduation rate of students in this dropout prevention program. These findings were used to develop four corresponding implications for district and school leaders to create and maintain structures where students are supported by at least one trusted adult, provide meaningful and consistent trauma-informed professional learning, create an environment where staff collaboration around student needs is a priority, and provide flexible schedules and options for students to positively affect student graduation from alternative educational settings.

No description available.

This study utilized a correlational research design to investigate the relationships that may exist between teacher empathy, attitudes, and levels of self-efficacy. In particular, the study was designed to (a) determine whether attitudes towards trauma-informed care mediated the relationship between teacher empathy and teacher self-efficacy related to classroom management and (b) uncover what teachers find most challenging in their efforts to support students experiencing trauma. An online survey, completed by 146 American teachers, included items from three established measures: the Empathy Scale for Teachers (Wang et al., 2022); the Underlying Causes of Problem Behaviors and Symptoms subscale of the Attitudes Related to Trauma- Informed Care (ARTIC-35) (Baker et al., 2016); and the Classroom Management subscale of the Teacher Sense of Self-Efficacy scale (Tschannen-Moran & Woolfolk Hoy, 2001). Multiple regression was used to analyze the quantitative data and thematic analysis was used to uncover themes from responses to an open-ended item on the survey. The following six themes emerged from the thematic analysis of descriptions provided by teachers of the biggest challenge they face in their efforts to support students experiencing trauma: The most common response involved difficulty recognizing and responding to trauma. This study found higher levels of teacher empathy to be associated with more positiveteacher attitude towards trauma informed care, as measured by the underlying causes of problem behaviors and symptoms subscale of the ARTIC-35. Additionally, these positive attitudes (consistent with trauma-informed care) were associated with more efficacious feelings in teachers regarding their classroom management. The results indicate that attitude towards trauma-informed care serves as an indirect-only mediator to explain the impact of empathy on level of teacher self-efficacy related to classroom management. Although caution is urged when drawing causal conclusions from correlational studies, the results highlight the potential importance of cultivating teacher empathy so trauma-informed practices can flourish in creating positive, safe classroom environments that increase learning opportunities for all students while possibly reducing departures from the teaching profession.

This study examined school staff’s trauma-informed practices and experiences in an urban alternative high school that serves former high school dropouts, many of whom have experienced trauma. In light of the growing concern about trauma among students and the interest in trauma-informed education, this study offers a significant contribution by analyzing educators’ meaning-making, highlighting both what their practices look like “on the ground,” and identifying the consequences. Framed by Contemporary Trauma Theory as well as the concept of educational trauma (Sullivan, 2004), this study used ethnographic methods to examine the practices school staff used to create a schooling environment that was responsive to the needs of students with trauma histories. Observations and interviews were conducted with a total of 8 staff and 27 students over the course of one school year. The findings indicate that staff members’ trauma-informed practices centered on building relationships and using those relationships as a knowledge base in order to decipher and respond to negative student behavior. Together, these practices overlap with defining features of trauma-informed schools outlined in the literature. Staff practices had both positive and negative impacts on the school community. / Urban Education

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.