Intimate partner violence (IPV), substance use, and HIV are syndemic and have compounding risks that contribute to the collective physical and mental health burden among women in the United States. These syndemic factors may contribute to the significant gender-related disparities in substance use disorder (SUD) treatment. IPV is a source of stress and trauma for women, with known interactions with SUD; however, SUD services generally lack trauma-informed treatment modalities to address IPV-related health impacts. The goal of this dissertation was to improve the understanding of the associations between IPV, substance use behaviors, and SUD treatment utilization, and to inform the response to women’s needs related to IPV experiences and substance use within healthcare settings. We employed a mixed-methods approach to understand the interplay of IPV with subsequent substance use behaviors and utilization of SUD services, along with identifying differences by HIV status. We used quantitative methods to evaluate the association of specific forms of IPV (psychological, physical, and sexual) with subsequent substance use (Chapter 2) and SUD service utilization (Chapter 3), and qualitative methods to explore women’s perspectives on how IPV experiences influenced their substance use behaviors and SUD treatment and recovery (Chapter 4). The study in Chapter 2 found that incident IPV experiences were associated with increased risk of subsequent substance use, with physical IPV being more consistently associated than other IPV forms. The study in Chapter 3 found recent IPV experiences to be associated with increased SUD service utilization, whereas lifetime IPV experiences were associated with decreased utilization. Both quantitative studies highlight the complex relationship between IPV and substance use and SUD service utilization. This relationship varies by IPV form, with the syndemic interaction of IPV and HIV exacerbating adverse outcomes. In Chapter 4, qualitative findings explained mechanisms of IPV’s contribution to substance use behaviors and impediment of SUD service engagement and recovery. The interviews also highlighted the value of mental health and IPV supportive services, along with SUD treatment, for a successful SUD recovery. Overall, the findings of this dissertation emphasize the importance of using a trauma-informed approach to address IPV to facilitate women’s SUD recovery. / 2026-05-16T00:00:00Z

This practicum project is an investigation into the design of a second-stage house and the role that interior design can play in creating a healing environment based on a trauma-informed approach. Approaching the design with a knowledge of the trauma of domestic abuse, the effects of this trauma, and the recovery process was central to the project. Through a process of literature review, four key themes in recovery of domestic abuse were found. The key themes of safety, empowerment, social support and psychological healing became the design guidelines for the project. Using these four guidelines as a foundation, concepts in environmental psychology were explored. The concepts of privacy, territory and restorative design were chosen for their relevance to the design guidelines. Through an exploration of these design concepts in conjunction with the four themes of recovery, a trauma-informed second-stage housing design called River Tree is proposed.

This practicum project is an investigation into the design of a second-stage house and the role that interior design can play in creating a healing environment based on a trauma-informed approach. Approaching the design with a knowledge of the trauma of domestic abuse, the effects of this trauma, and the recovery process was central to the project. Through a process of literature review, four key themes in recovery of domestic abuse were found. The key themes of safety, empowerment, social support and psychological healing became the design guidelines for the project. Using these four guidelines as a foundation, concepts in environmental psychology were explored. The concepts of privacy, territory and restorative design were chosen for their relevance to the design guidelines. Through an exploration of these design concepts in conjunction with the four themes of recovery, a trauma-informed second-stage housing design called River Tree is proposed.

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Through perspectives from neuroscience, transpersonal psychology, and transcendentalist philosophy, the art of yoga is proposed as a supporting modality for healing through complex trauma. Personal narrative and original paintings further speak to a process of coming back Home. Where trauma strips one of self, yoga breeds connection back to Self. Yoga is union of individual consciousness with universal consciousness. Yogic philosophy invites one into a space of grey, somewhere between object and subject, physical and spiritual, tangible and ineffable. It is there one comes to find healing by sitting back as a pure observer. In the journey of trauma uncovery, one comes to meet an embodied sense of safety that prevails across levels of body, mind, and soul. The stars begin to shine once again in the universe held within.

California is experiencing a massive teacher shortage, and urban schools are disproportionately affected by it negatively. Retention efforts to date have not included strategies to address Compassion Fatigue (burnout and secondary trauma) teachers experience when working with traumatized students at urban schools. This dissertation explores whether Compassion Fatigue is an unaddressed reason for teacher attrition at urban schools. A mixed method practical action research approach using the Professional Quality of Life Scale Version Five (ProQOL 5) and qualitative interviews, portions of which were turned into illustrative vignettes drove the exploration. Approximately 114 teachers completed the ProQOL 5. Statistical analysis of the ProQOL 5 results showed that female teachers experience more compassion fatigue than male teachers; compassion fatigue is more acute with beginning teachers than with veteran teachers; and that teachers working at high-poverty schools experience statistically significant differences in compassion satisfaction and fatigue than teachers at low poverty schools. Correlation tests revealed statistically significant relationships between compassion fatigue and the school’s racial demographics even when controlling for the socioeconomically disadvantaged status of the school and teacher ethnicity. Linear regression models showed that the percentage of African American students in the school is a statistically significant predictor of compassion fatigue. Qualitative interview analysis showed that secondary trauma from students is not the only trauma teachers are experiencing, and that school climate and conditions matter when attempting to retain teachers. In the final phase of the action research, a policy brief was developed through a collaborative and iterative process, based both on the findings and engagement with stakeholders. If California is serious about producing and retaining high-quality teachers at all urban schools,’ efforts to mitigate compassion fatigue should be undertaken immediately.

Through this study, I aim to increase understanding of how young moms experience, perceive, make meaning, and conceptualize positive support within the context of service provision (education, residential services, legal services, healthcare etc.). More broadly, I aim to illuminate ways that societal notions of vulnerability and autonomy may be shifted to offer improved quality of support to young mothers and other marginalized communities. Such a shift would counter paternalistic attitudes that have historically influenced how “support” has been imposed on young mothers. Although a full transformation would take time, we may begin to undertake the necessary work of reimagining support, gradually shifting towards the goal of building capabilities toward relational autonomy. 25 moms from diverse socio-economic backgrounds in Ontario, Canada, between the ages of 16-25 years, participated in creating visual art images and/or verbally sharing what support meant to them. I engaged in a relational approach to interaction and dialogue, centering a praxis of reflexivity and ethical treatment of everyone involved in the interview process. Guided by a critical feminist framework that included intersectionality, maternal theory, and vulnerability theory, I engaged in a feminist phenomenological approach to the analysis of transcripts and co-constructed visual analysis of imagery with the moms. Study findings reveal how service provision contexts are shaped by traditional ways of understanding vulnerability and autonomy as a binary and in opposition to one another, with an overvaluation of invulnerability. Yet young moms describe that they understand positive support as a combination of both responses to the effects of exposure to sources of vulnerability and as efforts to build autonomy in relationships with service providers, infrastructure, and broader communities of care. In addition, young moms describe positive qualities of service design and delivery, such as being non-judgemental, reliable, and sensitive, with attuned and caring interactions. The combination of these qualities can facilitate a process of internalization of positive attitudes, culminating in the development of an identity as a confident caregiver. / Dissertation / Doctor of Philosophy (PhD) / Through this critical feminist arts-based study, I aim to increase understanding of how young moms make meaning of the concept of positive support within the context of service provision. 25 moms in Ontario, Canada, between the ages of 16-25 years, participated in creating visual art images and/or verbally sharing what support meant to them. I engaged in a relational approach to interviewing, and a feminist phenomenological approach to the analysis of transcripts and visual analysis of imagery. Study findings reveal how service provision contexts are shaped by traditional ways of understanding the concepts of vulnerability and autonomy as a binary and in opposition to one another. Yet young moms asserted that effective forms of positive support must be designed and delivered as a combination of both a response to the effects of exposure to sources of vulnerability and as efforts made to build autonomy in-connection to others and the world(s) around us.

Abstract Adverse Childhood Experiences and Trauma-Informed Schools: Restorative Practices for Social and Emotional Behavior Issues in Education by Heather Easterling The purpose of this study was to determine whether factors in school climate and culture and the educator's role in evaluating adverse childhood experiences (ACEs), trauma-informed situations, and disruptive classroom behaviors, enable a school to generate interventions needed to help students succeed. This qualitative study evaluated the ACEs and the relationships traumatic incidents had on disruptive classroom behaviors that teachers experienced with students. Although there is emerging research regarding ACEs and trauma-informed schools, there are multiple factors that facilitate the relationship between ACEs and disruptive classroom experiences. Data collection strategies included the use of interview procedures and document review. This evidence was gathered from teachers who provided their experiences with disruptive classroom behaviors and their experiences with behavior intervention programs such as RTI2B (Response to Instruction and Intervention for Behavior) and trauma-informed practices. Analysis of data occurred in three phases: (a) categorization based on emergent themes from the interviews, (b) constructing the explanation in narrative form, and (c) re-examination of the collected data concerning discipline referrals, school climate surveys, and attendance surveys. This research study provided insight into experiences teachers had with disruptive classroom behaviors. The experiences showed implementation of trauma-informed practices, a positive behavior program, and the need for a support system for teachers to be able to better reach students who have experienced ACEs that are related to disruptive classroom behaviors. The results revealed that there were direct factors that determined that the relationship between ACEs and trauma were consistent with disruptive classroom behaviors.

Problematic substance use is a pressing global health problem, and dissemination and implementation of accurate health information regarding prevention, treatment, and recovery are vital. In many nations, especially the US, many people are involved in religious groups or faith communities, and this offers a potential route to positively affect health through health information dissemination in communities that may have limited health resources. Health information related to addiction will be used as the backdrop issue for this discussion, but many health arenas could be substituted. This article evaluates the utility of commonly used health communication theories for communicating health information about addiction in religious settings and identifies their shortcomings. A lack of trusting, equally contributing, bidirectional collaboration among representatives of the clinical/scientific community and religious/faith communities in the development and dissemination of health information is identified as a potential impediment to effectiveness. The Substance Abuse and Mental Health Services Administration's (SAMHSA) tenets of trauma-informed practice, although developed for one-on-one use with those who have experienced trauma or adversity, are presented as a much more broadly applicable framework to improve communication between groups such as organizations or communities. As an example, we focus on health communication within, with, and through religious groups and particularly within churches.

There is a growing body of research documenting the impact of traumatic stress on child development, which has resulted in a call to action for trauma-informed practices as a priority, yet implementation within schools and training for educators is lacking (American Academy of Physicians, https://www.aap.org/en-us/Documents/ttb_aces_consequences.pdf, 2014). Understanding teachers’ perceptions regarding current levels of knowledge, self-efficacy, and trauma-informed training can help guide future professional development experiences for both pre-service and practicing teachers. This study investigated the knowledge, self-efficacy, and training of trauma-informed practices as self-reported by primary educators, serving in grades kindergarten through third-grade, within two regions of Tennessee and Virginia. The Primary Early Childhood Educators Trauma-Informed Care Survey for Knowledge, Confidence, and Relationship Building (PECE-TICKCR) scale was adapted from the TIC-DS scale (Goodwin-Glick in Impact of trauma-informed care professional development of school personnel perceptions of knowledge, disposition, and behaviours towards traumatised students, Graduate College of Bowling Green State University, 2017), validated, and created for the purpose of this study. The sample consisted of 218 primary educators who completed an online survey regarding personal knowledge, self-efficacy, and training experiences of trauma-informed practices. Correlations revealed a statistical significance between the Knowledge of Trauma factor and the Confidence in Providing Trauma-Informed Strategies factor. There was also a statistical significance between the Knowledge of Trauma factor and the Confidence in Creating Supportive relationships factor and between the Confidence in Providing Trauma-Informed Strategies factor and the Confidence in Creating Supportive Relationships factor. The findings indicated that teachers need more knowledge regarding community resources for families and students but feel confident in providing supportive relationships. Teachers also are interested in more training events related to strategies to use when working with students exposed to trauma. Implications for teacher preparation programs and professional development training for practicing teachers is discussed.