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.

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Critical Review of the LiteratureCan Borderline Personality Disorder be treated effectively in forensic settings? A systematic reviewBorderline Personality Disorder (BPD) is a common diagnosis in forensic settings. Certain features of BPD, such as impulsivity and emotional dysregulation, can create a vulnerability to impulsive acts. The condition is also associated with poor mental and physical health, making the treatment of BPD and its clinical features an important goal in forensic settings. This paper reviews evidence for the effectiveness of treating BPD and its symptoms using psychological approaches in forensic settings. A systematic search found 2913 papers, of which 13 met the inclusion criteria. The papers reported nine separate studies (six controlled) that implemented four distinct interventions, often adapted for particular forensic settings. Improvements in overall BPD symptomatology and specific BPD symptoms were reported for all types of intervention, although few differences in outcome between intervention and control groups were found. There were also reported improvements in BPD-related behaviours, but data on offending behaviour were absent. Heterogeneity in study quality and design makes it challenging to draw any firm conclusions about the effectiveness of any one form of treatment over another, nor about which treatment may best suit a particular setting. Further randomised controlled trials are needed to answer these questions. Service Improvement ProjectEvaluation of a brief educational intervention for clinical staff aimed at promoting trauma-informed approaches to careThere is growing evidence that trauma plays an important role in the aetiology of severe and enduring mental health problems. Yet staff can be reluctant to ask patients about trauma for reasons such as anxiety about harming patients and limited access to training. Where services have adopted trauma-informed approaches (TIAs) to mental health care (i.e., considering the ways in which trauma affects individuals when planning and delivering services), improved clinical outcomes have been observed. With this in mind, a new educational video was developed for mental health staff at an NHS trust. The video was intended to be (a) brief (10 minutes); (b) contemporary and engaging; and (c) accessible using computers, smartphones and tablets. Forty-one multidisciplinary staff viewed the video. Quantitative and qualitative evaluation indicated improvements in self-reported knowledge and confidence with regard to trauma, and a decrease in worries with regard to asking patients about such experiences. Participants found the video to be enjoyable, understandable and informative. Importantly, many indicated that it spurred them to further action, such as further training and asking patients about possible trauma. These findings indicate that a video of this type can offer an important ‘taster’ of trauma-related learning, constituting an important step towards embedding trauma-informed ways of working at a service. Main Research ProjectThe Role of Intrusive Imagery in Hoarding DisorderThe cardinal feature of Hoarding Disorder (HD) is persistent difficulty discarding possessions, with the resulting clutter compromising the intended use of living areas. Within the dominant cognitive-behavioural model of hoarding (Frost & Hartl, 1996), hoarding behaviours are positively and negatively reinforced in the context of certain object-related beliefs. Available treatments for HD have so far yielded modest outcomes, indicating a need for new approaches. Intrusive imagery has so far been neglected in HD research, despite the frequency of trauma in the histories of people with the condition. To address this, 27 individuals who met the DSM-5 criteria for HD and 28 community controls (CCs) were interviewed about their everyday experiences of mental imagery. Participants were also asked about the images they experienced during two recent real-life examples of actual or attempted discard of (1) an object of low subjective value; and (2) an object of high subjective value. Everyday imagery in the HD group commonly reflected themes of illness, death and reminiscence. Imagery in HD participants tended to carry negative emotional valence in comparison with CCs, and was associated with greater interference in everyday life and attempts to avoid the imagery. HD participants reported more negative experiences of intrusive imagery in comparison with CCs during recent episodes of discarding objects of low subjective value. However, HD participants experienced positive imagery when discarding, or trying to discard, high value objects. These findings indicate that although people with HD frequently report traumatic histories, this is not reflected in the everyday imagery that they experience. There is some evidence to suggest that the negative and positive memories experienced in relation to low and high value objects may aid our understanding of discarding and saving behaviour in HD. The theoretical and clinical implications of these findings are further discussed.

Fans of college sports embrace the idea of athletes playing sport and, in turn, receiving tuition scholarships that provide them an opportunity to trade athletic talent for a free education. A contradictory body of research using internal colonization theory posits that the trade of education for playing sports is not a fair exchange but is fraught with exploitation that continues to perpetuate subjugation. An accepted narrative in athletic competition is that the recruiting pipeline draws athletes from impoverished inner-city areas engaging young athletes who experience difficulties keeping up scholastically becoming academically resistant as they focus on their sport at the expense of their academics. Biopsychosocial and developmental neuroscience research recognizes outside social factors as variables that affect the development of the brain, thus influencing basic mechanical operations of specific brain structures. This dissertation breaks new ground by utilization of the 10-question Adverse Childhood Experiences (ACE) Inventory to explore a possible relationship between ACE scores and Academic Resistance (AR), ACE scores and Locus of Control, and ACE scores and Identity Foreclosure. Using the T-test to determine a relationship between 194 participants’ ACE scores and AR, the findings showed the probability of Type I error of 5%, to be that the AR of student athletes with an ACE score >=2, n=94, to be significantly higher than the AR of student athletes with an ACE

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Female survivors of intimate partner violence (IPV) in Nigeria endure harsh and traumatic experiences that affect their rights as women and their well-being. As the phenomenon of IPV persists in Nigeria, it is not only a family problem but a critical social and psychological problem. This study examined Nigerian female survivors’ hidden strength, agency, and resilience, rather than their powerlessness and vulnerability. Analysis of survey questionnaires, interviews, and secondary scholarship reveals that some Nigerian female survivors of IPV are able to cope whilst navigating stressful and traumatic experiences. The results also show that survivors’ ability to thrive and cope under stress not only results from individual traits and use of agency, but also from external support. This study infers sociocultural change and female empowerment. The results propose a need for interventions and further research on the development of the concept of resilience in female Nigerian survivors of IPV.