Skip to main content

Creating Trauma-Informed Schools for Rural Appalachia: The Partnerships Program for Enhancing Resiliency, Confidence and Workforce Development in Early Childhood Education


Poverty lack of resources and pervasive adversity threaten the healthy social and emotional development of many children living in rural Appalachia. Despite these traumatic stressors, however, Appalachian residents have proven surprisingly resilient and responsive to intervention. This article describes the twin efforts of the Partnerships Program for Early Childhood Mental Health and Project LAUNCH, a community-university-state initiative, to transform school systems by establishing enduring partnerships within and across schools and agencies, pooling and disseminating critical resources, and strengthening the skills, confidence and capacity of the early childhood education workforce. This article describes the three-tiered framework of services implemented at the schools, with special emphasis on its trauma-informed training for educators combined with trauma-specific mental health interventions delivered on site. Despite a modest sample size, results indicate significant pre-improvement/post-improvement in teacher confidence and hopefulness in positively impacting challenging child behaviors; a decrease in the negative attributes of the preschool learning environment; and increased teacher ratings of child resilience as measured by the Devereux Early Child Assessment. Program limitations and future directions for creating trauma-informed Appalachian schools are discussed.

This is a preview of subscription content, access via your institution.

Fig. 1


  • Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C. H., Perry, B. D., et al. (2006). The enduring effects of abuse and related adverse experiences in childhood. European Archives of Psychiatry and Clinical Neuroscience, 256(3), 174–186.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bracken, B. A. (1987). Limitations of preschool instruments and standards for minimal levels of technical adequacy. Journal of Psychoeducational Assessment, 5, 313–326.

    Article  Google Scholar 

  • Brennan, E., Bradley, J., Allen, M., & Perry, D. (2008). The evidence base for early childhood mental health consultation in early childhood settings: Research synthesis addressing staff outcomes. Early Education and Development, 19(6), 982–1022. doi:10.1080/10409280801975834.

    Article  Google Scholar 

  • Briggs-Gowan, M., Carter, A., Clark, R., Augustyn, M., McCarthy, K., & Ford, J. (2010). Exposure to potentially traumatic events in early childhood: Differential links to emergent psychopathology. Journal of Child Psychology and Psychiatry and Allied Disciplines, 51(10), 1132–1140. doi:10.1111/j.1469-7610.2010.02256.x.

    Article  Google Scholar 

  • Buss, K., Warren, J., & Horton, E. (2015). Trauma and treatment in early childhood: A review of the historical and emerging literature for counselors. The Professional Counselor Digest, 8(2), 6–8.

    Google Scholar 

  • Chandler, L. (1981). The source of stress inventory. Psychology in Schools, 18(2), 164–168.

    Article  Google Scholar 

  • Cohen, E., & Kaufman, R.  (2000).  Early childhood mental health consultation,  DHHS Pub. No. CMHC-SVP0151.  Rockville, MD:  Center for Mental Health Services, Substance Abuse and Mental Health Administration.

  • Cole, S., O’Brien, J., Gadd, M., Ristuccia, J., Wallace, D., & Gregory, M. (2013). Helping traumatized children learn: Supportive school environments for children traumatized by family violence. Boston, MA: Massachusetts Advocates for Children Trauma and Learning Policy Initiative.

    Google Scholar 

  • Geller, S., & Lynch, K. (1999). Teacher opinion survey. Richmond: Virginia Commonwealth University Intellectual Property Foundation and Wingspan LLC.

    Google Scholar 

  • Gilliam, W. (2008). Preschool mental health climate scale. Unpublished survey. Harvard University.

  • Harvey, M. R. (1996). An ecological view of psychological trauma. Journal of Traumatic Stress, 9(1), 3–22.

    Article  PubMed  Google Scholar 

  • Hepburn, K., Kaufman, R., Perry, D., Allen, M., Brennan, E., & Green, B. (2007). Early childhood mental health consultation: An evaluation tool kit. Washington, DC: Georgetown University, Technical Assistance Center for Children’s Mental Health; Johns Hopkins University, Women’s and Children’s Health Policy Center; and Portland State University, OR, Research and Training Center on Family Support and Children’s Mental Health.

  • Kanner, A., Coyne, J., Schaefer, C., & Lazarus, R. (1981). Comparison of two modes of stress management: Daily hassles and uplifts versus major life events. Journal of Behavioral Medicine, 4(1), 1–37.

    Article  PubMed  Google Scholar 

  • Kaufman, R., Perry, D., Irvine, M., Duran, F., Hepburn, K., & Anthony, B. (2012). Creating practice-based principles for effective early childhood mental health consultation services. Washington, DC: Georgetown University.

    Google Scholar 

  • Kids Count Data Center (2015).

  • LeBuffe, P., & Naglieri, J. (1999). Devereux early childhood assessment: User’s guide. Lewisville, NC: Kaplan Press.

    Google Scholar 

  • Ohio Department of Education (2014). School report cards.

  • Ohio Department of Health (2014). County health profiles.

  • Ohio Department of Jobs and Family Service (2013). Appalachian counties profile statistical and demographic data.

  • Ohio School Boards (2015).

  • Perry, B. (2004).  Maltreatment and the developing child:  How early childhood experience shapes child and culture.  Inagural lecture for the Margaret McCain Lecture Series, September 23, 2004.  Printed Copy.

  • Perry, D., Allen, M., & Brennan, E. (2010). The evidence base for mental health consultation in early childhood settings: A research synthesis addressing children’s behavioral outcomes. Early Education and Development, 21(6), 795–824. doi:10.1080/10409280903475444.

    Article  Google Scholar 

  • Phillips, D. A., & Shonkoff, J. P. (Eds.). (2000). From neurons to neighborhoods: The science of early childhood development. Washington, DC: National Academies Press.

    Google Scholar 

  • Robert Wood Johnson (2014). County Health Rankings & Roadmaps.

  • Simpson, J. S., Jivanjee, P., Koroloff, N., Doerfler, A., & Garcia, M. (2001). Promising practices in early childhood mental health. Systems of care: Promising practices in children’s mental health, 2000 Series, Volume III. Washington, DC: Center for Effective Collaboration and Practice, American Institutes of Research. Retrieved from

  • Substance Abuse and Mental Health Services Administration. (2014a). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.

  • Substance Abuse and Mental Health Services Administration. (2014b). Trauma-Informed Care in Behavioral Health Services. Treatment Improvement Protocol (TIP) Series 57. HHS Publication No. (SMA) 13-4801. Rockville, MD: Substance Abuse and Mental Health Services Administration.

  • United States Census Bureau (2014).

  • Wolpow, R., Johnson, M., Hertel, R., & Kincaid, S. (2011). The heart of learning and teaching: Compassion, resiliency, and academic success. Washington State Office of Superintendent of Public Instruction (OSPI) Compassionate Schools. Olympia, WA.

  • Work, W., Cowen, E., Parker, G., & Wyman, P. (1990). Stress resilient children in an urban setting. Journal of Primary Prevention, 11(1), 3–17.

    Article  PubMed  Google Scholar 

  • Zhang, Z., Infante, A., Meit, M., English, N., Dunn, M., & Bowen, K. (2008). An analysis of mental health and substance abuse disparities & access to treatment services in the Appalachian Region. Final Report presented to the Appalachian Regional Commission. Appalachian Regional Commission and National Opinion Center.

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Sherry Shamblin.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shamblin, S., Graham, D. & Bianco, J.A. Creating Trauma-Informed Schools for Rural Appalachia: The Partnerships Program for Enhancing Resiliency, Confidence and Workforce Development in Early Childhood Education. School Mental Health 8, 189–200 (2016).

Download citation

  • Published:

  • Issue Date:

  • DOI: