Addressing Childhood Trauma in School Settings: A Framework for Evidence-Based Practice
Supporting evidence and intervention resources for addressing childhood trauma are growing, with schools indicated as a potentially critical system for service delivery. Multiple points for prevention and intervention efforts in schools are possible, but in this manuscript, we review evidence on trauma-specific interventions targeted to students exhibiting negative symptoms. Trauma-specific interventions with evidence and utility for school-based delivery are highlighted, along with key considerations in selection. In addition, we discuss the potential to maximize the impact of trauma-specific interventions for individual students when delivered as part of a school-wide trauma-informed approach that incorporates system-level prevention and intervention strategies. Future directions for research on trauma-specific interventions and trauma-informed approaches in school settings are discussed.
KeywordsChildhood trauma Trauma-specific School mental health Trauma-informed
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
- Amaya-Jackson, L., Reynolds, V., Murray, M. C., McCarthy, G., Nelson, A., Cherney, M. S., et al. (2003). Cognitive-behavioral treatment for pediatric posttraumatic stress disorder: Protocol and application in school and community settings. Cognitive and Behavioral Practice, 10, 204–213. https://doi.org/10.1016/S1077-7229(03)80032-9.CrossRefGoogle Scholar
- Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D., et al. (2006). The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience, 256, 174–186. https://doi.org/10.1007/s00406-005-0624-4.CrossRefPubMedGoogle Scholar
- Blaustein, M. (2013). Childhood trauma and a framework for intervention. In E. Rossen & R. Hull (Eds.), Supporting and educating traumatized students: A guide for school-based professionals (pp. 3–21). New York, NY: Oxford University Press.Google Scholar
- Brock, S. E., Reeves, M. A. L., & Nickerson, A. B. (2014). Best practices in school crisis intervention. In P. Harrison & A. Grimes (Eds.), Best practices in school psychology: System level services (6th ed., pp. 211–230). Bethesda, MD: National Association of School Psychologists.Google Scholar
- Chorpita, B. F., & Weisz, J. R. (2009). Modular approach to therapy for children with anxiety, depression, trauma, or conduct problems (MATCH-ADTC). Satellite Beach, FL: PracticeWise, LLC.Google Scholar
- Chorpita, B. F., Weisz, J. R., Daleiden, E. L., Schoenwald, S. K., Palinkas, L. A., Miranda, J., et al. (2013). Long-term outcomes for the Child Steps randomized effectiveness trial: A comparison of modular and standard treatment designs with usual care. Journal of Consulting and Clinical Psychology, 81(6), 999–1009. https://doi.org/10.1037/a0034200.CrossRefPubMedGoogle Scholar
- Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2006). Treating trauma and traumatic grief in children. New York: Guilford Press.Google Scholar
- Cole, S. F., Eisner, A., Gregory, M., & Ristuccia, J. (2013). Creating and advocating for trauma-sensitive schools. Massachusetts Advocates for Children. Retrieved from http://www.traumasensitiveschools.com.
- De Bellis, M. D., Hooper, S. R., Spratt, E. G., & Woolley, D. P. (2009). Neuropsychological findings in childhood neglect and their relationships to pediatric PTSD. Journal of the International Neuropsychological Society, 15, 868–878. https://doi.org/10.1017/S1355617709990464.CrossRefPubMedCentralGoogle Scholar
- De Bellis, M. D., Woolley, D. P., & Hooper, S. R. (2013). Neuropsychological findings in pediatric maltreatment: Relationship of PTSD, dissociative symptoms, and abuse/neglect indices to neurocognitive outcomes. Child Maltreatment, 18, 171–183. https://doi.org/10.1177/1077559513497420.CrossRefPubMedPubMedCentralGoogle Scholar
- Dorado, J., Martinez, M., McArthur, L., & Leibovitz, T. (2016). Health environments and response to trauma in schools (HEARTS): A school based, multi-level comprehensive prevention and intervention program for creating trauma-informed, safe, and supportive schools. School Mental Health, 8, 163–176.CrossRefGoogle Scholar
- Dorsey, S., Mclaughlin, K. A., Kerns, S. E. U., Harrison, J. P., Lambert, H. K., Briggs, E. C., et al. (2017). Evidence base update for psychosocial treatments for children and adolescents exposed to traumatic events. Journal of Clinical Child & Adolescent Psychology, 46, 303–330. https://doi.org/10.1080/15374416.2016.1220309.CrossRefGoogle Scholar
- Eklund, K., Rossen, E., Koriakin, T., & Chafouleas, S. M. (in press). A systematic review of trauma screening measures for children and adolescents. School Psychology Quarterly.Google Scholar
- Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14, 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8.CrossRefPubMedGoogle Scholar
- Gonzalez, A., Monzon, N., Solis, D., Jaycox, L., & Langley, A. K. (2016). Trauma exposure in elementary school children: Description of screening procedures, prevalence of exposure, and posttraumatic stress symptoms. School Mental Health. https://doi.org/10.1007/s12310-015-9167-7.PubMedGoogle Scholar
- Goodkind, J. R., LaNoue, M. D., & Milford, J. (2010). Adaptation and implementation of cognitive behavioral intervention for trauma in schools with American Indian youth. Journal of Clinical Child and Adolescent Psychology, 39, 858–872. https://doi.org/10.1080/15374416.2010.517166.CrossRefPubMedPubMedCentralGoogle Scholar
- Jaycox, L. H., Cohen, J. A., Mannarino, A. P., Walker, D. W., Langley, A. K., Gegenheimer, K. L., et al. (2010). Children’s mental health care following Hurricane Katrina: A field trial of trauma-focused psychotherapies. Journal of Traumatic Stress, 23, 223–231. https://doi.org/10.1002/jts.20518.PubMedPubMedCentralGoogle Scholar
- Jaycox, L. H., Morse, L. K., Tanielian, T., & Stein, B. D. (2006). How schools can help students recover from traumatic experiences: A toolkit for supporting long-term recovery. Retrieved from http://www.rand.org/content/dam/rand/pubs/technical_reports/2006/RAND_TR413.pdf.
- Kataoka, S., Jaycox, L. H., Wong, M., Nadeem, E., Langley, A., Tang, L., et al. (2011). Effects on school outcomes in low-income minority youth: Preliminary findings from a community-partnered study of a school trauma intervention. Ethnic Disparities, 21(S1), 71–77.Google Scholar
- Kataoka, S. H., Stein, B. D., Jaycox, L. H., Wong, M., Escudero, P., Tu, W., et al. (2003). A school-based mental health program for traumatized Latino immigrant children. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 311–318. https://doi.org/10.1097/00004583-200303000-00011.CrossRefPubMedGoogle Scholar
- Langley, A. K., Gonzalez, A., Sugar, C. A., Solis, D., & Jaycox, L. (2015). Bounce back: Effectiveness of an elementary school-based intervention for multicultural children exposed to traumatic events. Journal of Consulting and Clinical Psychology, 83(5), 853–865. https://doi.org/10.1037/ccp0000051.CrossRefPubMedPubMedCentralGoogle Scholar
- Lansford, J. E., Dodge, K. A., Pettit, G. S., Bates, J. E., Crozier, J., & Kaplow, J. (2002). A 12-year prospective study of the long-term effects of early child physical maltreatment on psychological, behavioral, and academic problems in adolescence. Archives of Pediatrics and Adolescent Medicine, 156, 824–830. https://doi.org/10.1001/archpedi.156.8.824.CrossRefPubMedPubMedCentralGoogle Scholar
- March, J. S., Amaya-Jackson, L., Murray, M. C., & Schulte, A. (1998). Cognitive-behavioral psychotherapy for children and adolescents with posttraumatic stress disorder after a single-incident stressor. Journal of the American Academy of Child and Adolescent Psychiatry, 37(6), 585–593. https://doi.org/10.1097/00004583-199806000-00008.CrossRefPubMedGoogle Scholar
- Morsette, A., Swaney, G., Stolle, D., Schuldberg, D., van den Pol, R., & Young, M. (2009). Cognitive behavioral intervention for trauma in schools (CBITS): School-based treatment on a rural American Indian reservation. Journal of Behavior Therapy and Experimental Psychiatry, 40, 169–178. https://doi.org/10.1016/j.jbtep.2008.07.006.CrossRefPubMedGoogle Scholar
- Morsette, A., van den Pol, R., Schuldberg, D., Swaney, G., & Stolle, D. (2012). Cognitive behavioral treatment for trauma symptoms in American Indian youth: Preliminary findings and issues in evidence-based practice and reservation culture. Advances in School Mental Health Promotion, 5, 51–62. https://doi.org/10.1080/1754730X.2012.664865.CrossRefGoogle Scholar
- National Child Traumatic Stress Network. (2015). National child traumatic stress network position statement: Prerequisite clinical competences for implementing effective, trauma-informed interventions. Retrieved from http://www.nctsn.org/sites/all/modules/pubdlcnt/pubdlcnt.php?file=http://nctsn.org/sites/default/files/assets/pdfs/nctsn_position_statement_on_clinical_competency.pdf&nid=1771.
- National Child Traumatic Stress Network. (2016). National child traumatic stress network empirically supported treatments and promising practices. Retrieved from http://www.nctsn.org/resources/topics/treatments-that-work/promising-practices.
- Perfect, M. M., Turley, M. R., Carlson, J. S., Yohanna, J., & Saint Gilles, M. P. (2016). School-related outcomes of traumatic event exposure and traumatic stress symptoms in students: A systematic review of research from 1990 to 2015. School Mental Health, 8, 7–43. https://doi.org/10.1007/s12310-016-9175-2.CrossRefGoogle Scholar
- Stein, B. D., Jaycox, L. H., Kataoka, S. H., Wong, M., Tu, W., Elliott, M. N., et al. (2003). A mental health intervention for schoolchildren exposed to violence: A randomized controlled trial. Journal of the American Medical Association, 290, 603–611. https://doi.org/10.1001/jama.290.5.603.CrossRefPubMedGoogle Scholar
- Stevens, J. E. (2012). Lincoln High School in Walla Walla, WA tries new approach to school discipline—Suspensions drop 85%. ACEs Too High. Retrieved from http://acestoohigh.com/2012/04/23/Iincoln-high-schooI-in-waIla-walia-wa-tries-new-approach-toschool-discipline-expulsions-drop-85/.
- Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach (HHS Publication No. 14-4884). Retrieved from http://store.samhsa.gov/shin/content/SMA14-4884/SMA14-4884.pdf.
- Weisz, J. R., Chorpita, B. F., Palinkas, L. A., Schoenwald, S. K., Miranda, J., Bearman, S. K., et al. (2012). Testing standard and modular designs for psychotherapy treating depression, anxiety, and conduct problems in youth: A randomized effectiveness trial. Archives of General Psychiatry, 69, 274–282. https://doi.org/10.1001/archgenpsychiatry.2011.147.CrossRefPubMedGoogle Scholar