1.6 Trauma informed practice
In the previous sections, we learned that a traumatic experience involves a threat to one’s physical or emotional wellbeing, and elicits intense feelings of helplessness, terror, and lack of control (American Psychiatric Association, 2000). Traumatic experiences can significantly alter a person’s perception of themselves, their environment, and the people around them. As traumatic experiences accumulate, responses become more intense and have a greater impact on functioning. Ongoing exposure to traumatic stress can impact all areas of people’s lives, including biological, cognitive, and emotional functioning; social interactions, relationships and identity formation. Because people who have experienced multiple traumas do not relate to the world in the same way as those who have not had these experiences, they require services and responses that are sensitive to their experiences and needs.
Meeting the needs of trauma survivors requires that programs become ‘trauma informed’ (Harris & Fallot, 2001). Harris and Fallot (2001) describe a trauma informed service system as a one who’s mission is altered by knowledge of trauma and the impact it has on the lives of the consumers. This means looking at all aspects of programming through a trauma lens, constantly keeping in mind how traumatic experiences impact consumers. Programs that are informed by an understanding of trauma respond best to consumer needs and avoid engaging in re-traumatising practices.
PRINCIPLES OF TRAUMA INFORMED PRACTICE
The principles of trauma informed care were identified on the basis of knowledge about trauma and its impact, findings of the Co-Occurring Disorders and Violence Project (Moses, Reed, Mazelis, & D’Ambrosio, 2003), literature on therapeutic communities (Campling, 2001), and the work of Maxine Harris and Roger Fallot (Fallot & Harris, 2002; Harris & Fallot, 2001;) and Sandra Bloom (Bloom, 2004). Principles of trauma informed practice include:
- Understanding trauma and its impact: understanding traumatic stress and how it impacts people and recognising that many behaviours and responses that may be seem ineffective and unhealthy in the present, represent adaptive responses to past traumatic experiences.
- Promoting safety: establishing a safe physical and emotional environment where basic needs are met, safety measures are in place, and provider responses are consistent, predictable, and respectful.
- Ensuring cultural competence: understanding how cultural context influences one’s perception of and response to traumatic events and the recovery process; respecting diversity within the program, providing opportunities for students to engage in cultural rituals, and using interventions respectful of and specific to cultural backgrounds.
- Supporting student control, choice and autonomy: helping students regain a sense of control over their daily lives and build competencies that will strengthen their sense of autonomy; keeping consumers well-informed about all aspects of the system, outlining clear expectations, providing opportunities for students to make daily decisions and participate in the creation of personal goals, and maintaining awareness and respect for basic human rights and freedoms.
- Sharing power and responsibility: promoting democracy and equalisation of the power differentials across the program; sharing power and decision-making across all levels of an organisation, whether related to daily decisions or in the review and creation of policies and procedures.
- Integrating care: maintaining a holistic view of consumers and their process of healing and facilitating communication within and among service providers and systems.
- Healing happens in relationships: believing that establishing safe, authentic and positive relationships can be corrective and restorative to survivors of trauma.
- Recovery is possible: understanding that recovery is possible for everyone regardless of how vulnerable they may appear. Instilling hope by providing opportunities for consumer and former consumer involvement at all levels of the system, facilitating peer support, focusing on strength and resiliency, and establishing future-oriented goals.
TRAUMA INFORMED PRACTICE IN SCHOOLS
In summary, the connection between student disengagement and underachievement and trauma underscores the need for specific programming for these students. The following realities highlight the need for trauma informed practice in schools.
Trauma can impact school performance, as evidenced by:
- Lower academic achievement and grades
- Higher rate of school absences
- Increased drop-out
- More suspensions and expulsions
- Decreased reading ability
- Trauma can impair learning
- Single exposure to traumatic events may cause jumpiness, intrusive thoughts, interrupted sleep and nightmares, anger and moodiness, and/or social withdrawal—any of which can interfere with concentration and memory.
- Chronic exposure to traumatic events, especially during a child’s early years, can adversely affect attention, memory, and cognition, reduce a child’s ability to focus, organise, and process information, interfere with effective problem solving and/or planning. This may result in overwhelming feelings of frustration and anxiety.
Traumatised children may experience physical and emotional distress.
- Physical symptoms like headaches and stomach aches
- Poor control of emotions
- Inconsistent academic performance
- Unpredictable and/or impulsive behaviour
- Over or under-reacting to bells, physical contact, doors slamming, sirens, lighting, sudden movements
- Intense reactions to reminders of their traumatic event
- Thinking others are violating their personal space, i.e., “What are you looking at?”
- Blowing up when being corrected or told what to do by an authority figure
- Fighting when criticised or teased by others
- Resisting transition and/or change
Once schools understand the educational impacts of trauma, they can become safe, supportive environments where students make the positive connections with adults and peers they might otherwise push away, calm their emotions so they can focus and behave appropriately, and feel confident enough to advance their learning. In other words, schools can make trauma sensitivity a regular part of how the school is run. Trauma sensitivity will look different at each school. However, a shared definition of what it means to be a trauma-sensitive school can bring educators, parents, and policymakers together around a common vision. We define the core attributes of a trauma informed school to include the following:
- A shared understanding among all staff—educators, administrators, counsellors, school nurses, cafeteria workers, custodians, bus drivers, athletic coaches, advisors to extracurricular activities, and paraprofessionals—that adverse experiences in the lives of children are more common than many of us ever imagined, that trauma can impact learning, behaviour, and relationships at school, and that a ‘whole school’ approach to trauma sensitivity is needed.
- The school supports all children to feel safe physically, socially, emotionally, and academically. Children’s traumatic responses, and the associated difficulties they can face at school, are often rooted in real or perceived threats to their safety that undermine a sense of wellbeing in fundamental ways. Therefore, the first step in helping students succeed in school, despite their traumatic experiences, is to help them feel safe—in the classroom, on the playground, in the hallway, in the cafeteria, on the bus, in the gym, on the walk to and from school. This includes not only physical safety but also social and emotional safety, as well as the sense of academic safety needed in order to take risks to advance one’s learning in the classroom.
- The school addresses students’ need in holistic ways, taking into account their relationships, self-regulation, academic competence, and physical and emotional wellbeing. The impacts of trauma can be pervasive and take many forms, and the way in which a child who has experienced traumatic events presents themselves may mask—rather than reveal—their difficulties. A broader more holistic lens is needed to understand the needs that underlie a child’s presentation. Researchers tell us that if we bolster children in four key domains— relationships with teachers and peers; the ability to self-regulate behaviours, emotions, and attention; success in academic and non-academic areas; and physical and emotional health and well-being—we maximise their opportunities to overcome all kinds of adversity in order to succeed at school. A trauma informed school recognises the inextricable link that exists among these domains and has a structure in place that supports staff to address students’ needs holistically in all four areas.
- The school explicitly connects students to the school community and provides multiple opportunities to practice newly developing skills. The loss of a sense of safety resulting from traumatic events can cause a child to disconnect from those around him or her. Typically, children who have experienced traumatic events are looking to those at school to restore their feeling of security and to help reconnect them with the school community. Schools can meet this need if they foster a culture of acceptance and tolerance where all students are welcomed and taught to respect the needs of others. Individual support services and policies that do not pull children away from their peers and trusted adults, but rather assist children to be full members of the classroom and school community, are also essential.
- The school embraces teamwork and staff share responsibility for all students. Expecting individual educators to address trauma’s challenges alone on a case-by-case basis, or to reinvent the wheel every time a new adversity presents itself, is not only inefficient, but it can cause educators to feel overwhelmed. A trauma informed school moves away from the typical paradigm in which classroom teachers have primary responsibility for their respective students to one based on shared responsibility requiring teamwork and ongoing, effective communication throughout the school. In a trauma-sensitive school, educators make the switch from asking “what can I do to fix this child?” to “what can we do as a community to support all children to help them feel safe and participate fully in our school community?” Trauma informed schools help staff—as well as those outside the school who work with staff—feel part of a strong and supportive professional community.
- Leadership and staff anticipate and adapt to the ever-changing needs of students. In a trauma informed school, educators and administrators take the time to learn about changes in the local community so that they can anticipate new challenges before they arise. They do their best to plan ahead for changes in staffing and policies that are all too common in schools. Trauma informed schools also try to adapt to all of these challenges flexibly and proactively so that the equilibrium of the school is not disrupted by inevitable shifts and changes.
Interview with Erik Gordon on being a trauma-informed teacher [51 min 46 sec]
Listen to this interview with Erik Gordon – a science teacher from Washington, US who works at Lincoln High School: https://www.tipbs.com/blog/48-on-being-a-trauma-informed-teacher-with-erik-gordon
How childhood trauma affects health across the lifespan [6 min 37 sec]
Watch this TED Talk by Nadine Burke Harris. A transcript and Closed Captions are also available within the video: https://youtu.be/95ovIJ3dsNk
Reflection Questions
- Name the five common types of child maltreatment.
- How does child trauma impact development and learning?
- Explain three principles of trauma informed practice.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.
Bloom, S. L. (2004). Neither liberty nor safety: the impact of trauma on individuals, institutions, and societies. Part I. Psychotherapy and Politics International, 2, 78-98.
Campling, P. (2001). Therapeutic communities. Access Advances in Psychiatric Treatment, 7(5), 365-372.
Fallot, R. D., & Harris, M. (2002). The Trauma Recovery and Empowerment Model (TREM): Conceptual and practical issues in a group intervention for women. Community Mental Health Journal, 38(6), 475–485.
Harris, M., & Fallot, R. D. (2001) Designing trauma-informed addiction services. New Directions for Mental Health Services, 57-73.
Moses, D. J., Reed, B. G., Mazelis, R., & D’Ambrosio, B. (2003). Creating Trauma Services for Women with Co-Occurring Disorders: Experiences from the SAMHSA Women with Alcohol, Drug Abuse, and Mental Health Disorders who have Histories of Violence Study. Delmar, NY: Policy Research Associates.