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.

Romantic breakups are common life experiences that often lead to psychological distress, such as symptoms of depression and anxiety and, for certain individuals, post-traumatic stress symptoms. Given the influence of relationships in our lives, it is unsurprising how distressing such a loss can be. Despite relational distress being a common presenting problem, limited research exists examining how to mitigate distress experienced following a romantic breakup best effectively. Furthermore, although previous research has indicated that individuals following romantic breakups can experience symptoms of post-traumatic stress, limited analytical attention has been given to how trauma-focused therapeutic interventions could be used in the treatment of this distress. Considering these gaps, this research study sought to add to the literature by (a) providing a theoretical framework for conceptualizing romantic breakups as small “t” traumas, thus benefiting from trauma-informed treatment approaches, and (b) by utilizing a small n experimental design to examine the influence of the trauma-informed treatment approach, group Eye Movement Desensitization and Reprocessing (GTEP) on mitigating psychological distress following romantic breakups in college students. The results of this study, though limited, are twofold. First, the results indicated that individuals may indeed experience post-traumatic stress symptoms following breakups. Secondly, GTEP may positively influence post-traumatic stress symptoms related to experiencing a romantic breakup.

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

Childhood trauma, often referred to as America’s hidden crisis, significantly impacts the learning and behavior of students with disabilities (SWD), in particular. SWD who experience or witness trauma face challenges related to discipline, academic achievement, absenteeism, and social and emotional well-being. According to the National Survey on Children’s Health (2021), 16.3% of children served under the Individuals with Disabilities Education Act have encountered two or more adverse childhood experiences by age 18, with over half of the states surpassing the national average. Addressing this urgent concern is difficult due to a shortage of qualified service providers, such as nurses, psychologists, and mental health specialists, and other limitations like lack of resources and funding. However, research indicates schools can implement trauma-informed practices to provide the necessary support for SWD to thrive. This research study explored how an urban school district utilized Advocacy Centers and coaches in elementary schools to support vulnerable students in overcoming trauma and achieving success in their learning environments. Specifically, this qualitative, focused ethnography case study investigated best practices in trauma-informed care provided by four advocacy coaches supporting trauma-impacted SWD in Title I elementary schools in the southeastern United States. The study incorporated participant questionnaires, classroom observations, field notes, semi-structured interviews, and examination of classroom artifacts. Two key themes emerged: (a) building strong relationships with students and (b) promising trauma-informed practices for classrooms. Results of the data analysis indicated that educators must first establish strong, authentic relationships with SWD before being able to effectively integrate trauma-informed practices into their classrooms. Recommendations and implications for future research are presented.

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.