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.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
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.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.
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.
Baweja, S., Santiago, C. D., Vona, P., Pears, G., Langley, A., & Kataoka, S. (2016). Improving implementation of a school-based program for traumatized students: Identifying factors that promote teacher support and collaboration. School Mental Health, 8, 120–131.
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.
Briesch, A. M., Chafouleas, S. M., Neugebauer, S. R., & Riley-Tillman, T. C. (2013). Assessing influences on intervention use: Revision of the usage rating profile-intervention. Journal of School Psychology, 51, 81–96. https://doi.org/10.1016/j.jsp.2012.08.006.
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.
Burke, N. J., Hellman, J. L., Scott, B. G., Weems, C. F., & Carrion, V. G. (2011). The impact of adverse childhood experiences on an urban pediatric population. Child Abuse and Neglect, 35, 408–413. https://doi.org/10.1016/j.chiabu.2011.02.006.
Chafouleas, S., Johnson, A., Overstreet, S., & Santos, N. (2016). Toward a blueprint for trauma-informed service delivery in schools. School Mental Health, 8, 144–162.
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.
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.
Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2006). Treating trauma and traumatic grief in children. New York: Guilford Press.
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.
Copeland, W. E., Keeler, G., Angold, A., & Costello, E. J. (2007). Traumatic events and posttraumatic stress in childhood. Archives of General Psychiatry, 64, 577–584.
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.
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.
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.
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.
Eckenrode, J., Laird, M., & Doris, J. (1993). School performance and disciplinary problems among abused and neglected children. Developmental Psychology, 29, 53–62.
Eckenrode, J., Rowe, E., Laird, M., & Brathwaite, J. (1995). Mobility as a mediator of the effects of child maltreatment on academic performance. Child Development, 66, 1130–1142.
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.
Fantuzzo, J. W., Perlman, S. M., & Dobbins, E. K. (2011). Types and timing of child maltreatment and early school success: A population-based investigation. Children and Youth Services Review, 33, 1404–1411. https://doi.org/10.1016/j.childyouth.2011.04.010.
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.
Figley, C. R., & Kleber, R. (1995). Beyond the “victim”: Secondary traumatic stress. In R. Kleber, C. R. Figley, & B. P. R. Gersons (Eds.), Beyond trauma: Cultural and societal dynamics (pp. 75–709). NY: Plenum.
Fitzgerald, M. M., & Cohen, J. A. (2012). Trauma-focused cognitive behavior therapy for school psychologists. Journal of Applied School Psychology, 28(3), 294–315. https://doi.org/10.1080/15377903.2012.696037.
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.
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.
Hurt, H., Malmud, E., Brodsky, N. L., & Giannetta, J. (2001). Exposure to violence: Psychological and academic correlates in child witnesses. Archives of Pediatrics and Adolescent Medicine, 155, 1351–1356. https://doi.org/10.1001/archpedi.155.12.1351.
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.
Jaycox, L. H., Kataoka, S. H., Stein, B. D., Langley, A. K., & Wong, M. (2012). Cognitive behavioral intervention for trauma in schools. Journal of Applied School Psychology, 28, 239–255. https://doi.org/10.1097/CHI.0b013e3181799f19.
Jaycox, L. H., Langley, A. K., Stein, B. D., Wong, M., Sharma, P., Scott, M., et al. (2009). Support for students exposed to trauma: A pilot study. School Mental Health, 1, 49–60.
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.
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.
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.
Langley, A., Nadeem, E., Kataoka, S., Stein, B. D., & Jaycox, L. H. (2010). Evidence-based mental health programs in schools: Barriers and facilitators of successful implementation. School Mental Health, 2, 105–113.
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.
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.
Mathews, T., Dempsey, M., & Overstreet, S. (2009). Effects of exposure to community violence on school functioning: The mediating role of posttraumatic stress symptoms. Behaviour Research and Therapy, 47, 586–591. https://doi.org/10.1016/j.brat.2009.04.001.
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.
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.
Nadeem, E., & Ringle, V. A. (2016). De-adoption of an evidence-based trauma intervention in schools: A retrospective report from an urban school district. School Mental Health, 8, 132–143.
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.
Nooner, K., Linares, O., Batinjane, J., Kramer, R., Silva, R., & Cloitre, M. (2012). Factors related to posttraumatic stress disorder in adolescence. Trauma, Violence, & Abuse, 13, 153–166.
Overstreet, S., & Chafouleas, S. M. (2016). Introduction to the special issue. School Mental Heath, 8, 1–6.
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.
Porche, M. V., Costello, D. M., & Rosen-Reynoso, M. (2016). Adverse family experiences, child mental health, and educational outcomes for a national sample of students. School Mental Health. https://doi.org/10.1007/s12310-016-9174-3.
Rolfsnes, E. S., & Idsoe, T. (2011). School-based intervention programs for PTSD symptoms: A review and meta-analysis. Journal of Traumatic Stress, 24, 155–165. https://doi.org/10.1002/jts.20622.
Saigh, P. A., Mroueh, M., & Bremner, J. D. (1997). Scholastic impairments among traumatized adolescents. Behaviour Research and Therapy, 35, 429–436. https://doi.org/10.1016/S0005-7967(96)00111-8.
Shonk, S. M., & Cicchetti, D. (2001). Maltreatment, competency deficits, and risk for academic and behavioral maladjustment. Developmental Psychology, 37, 3–17. https://doi.org/10.1097//0212-16220.127.116.11.
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.
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.
Wodarski, J. S., Kurtz, P. D., Gaudin, J. M., & Howing, P. T. (1990). Maltreatment and the school-age child: Major academic, socioemotional, and adaptive outcomes. Social Work, 35(6), 506–513. https://doi.org/10.1093/sw/35.6.506.
Woodbridge, M. W., Sumi, W. C., Thornton, S. P., Fabrikant, N., Rouspil, K. M., Langley, A. K., et al. (2016). Screening for trauma in early adolescence: Findings from a diverse school district. School Mental Health, 8, 89–105. https://doi.org/10.1007/s12310-015-9169-5.
Conflict of interest
The authors declare that they have no conflict of interest.
About this article
Cite this article
Chafouleas, S.M., Koriakin, T.A., Roundfield, K.D. et al. Addressing Childhood Trauma in School Settings: A Framework for Evidence-Based Practice. School Mental Health 11, 40–53 (2019). https://doi.org/10.1007/s12310-018-9256-5
- Childhood trauma
- School mental health