Knowledge, Skills, and Self-reflection: Linking Trauma Training Content to Trauma-Informed Attitudes and Stress in Preschool Teachers and Staff

This article has been updated

Abstract

Increasingly, preschools are integrating trauma-informed interventions, which often include components of training, to improve practices and promote the well-being of children who have experienced trauma. Similar interventions have been linked to positive outcomes for older children; however, there is limited research that examines whether or how training on trauma specifically contributes to child and staff well-being within early childhood settings such as preschools. The current study examines the relationship between trauma-informed training content, trauma-informed attitudes, and stress in a sample of 111 preschool staff (49% lead teachers, 20% assistant teachers, and 27% other staff such as administrators and classroom aides). This study examined the unique influence of training related to trauma-informed skills (e.g., screening for trauma, responding to challenging trauma-related behaviors) and trauma-informed self-reflection (e.g., the impact of a child’s trauma on staff) on trauma-related attitudes and stress (including general stress and child-related stress) in a sample of teachers and staff with prior training on trauma-informed knowledge (e.g., definitions of trauma). Compared to those with only knowledge training, teachers and staff with self-reflection (β = .22, SE = .09, p = .014) and self + skills training (β = .50, SE = .13, p < .001) had stronger trauma-informed attitudes than those with only knowledge training. Direct pathways from training content and trauma-informed attitudes to general stress were not significant. Pathway from trauma-informed attitudes to child-related stress (β = − .51, SE = .12, p ≤ .001) and the indirect pathway from self-reflection training (β = − .11, p = .015) self + skill training (β = − .25, p < .001) to child-related stress through trauma-informed attitudes were significant. The findings of this study suggest that all trauma-informed training is not equal; training that focuses on self-reflection, such as the role of vicarious trauma, may be particularly important as part of a trauma-informed school approach. Trauma-informed attitudes are also an important mechanism through which trauma-informed interventions may influence staff well-being in preschool settings.

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

Fig. 1

Change history

  • 04 November 2020

    On page 6 the text “[XX UNIVERSITY] Institutional” included for blinded review was replaced with “University of Utah”.

References

  1. Aikens, N., Tarullo, L., Hulsey, L., Ross, C., West, J., Xue, Y., & Mathematica Policy Institute. (2010). A year in head start: Children, families and programs. Retrieved from: https://www.acf.hhs.gov/opre/resource/a-year-in-head-start-children-families-and-programs.

  2. Alisic, E., Bus, M., Dulack, W., Pennings, L., & Splinter, J. (2012). Teachers’ experiences supporting children after traumatic exposure. Journal of Traumatic Stress, 25(1), 98–101.

    Article  Google Scholar 

  3. Alvarez, A. (2020). Seeing race in the research on youth trauma and education: A critical review. Review of Educational Research. https://doi.org/10.3102/0034654320938131.

    Article  Google Scholar 

  4. Arapovic-Johansson, B., Wåhlin, C., Kwak, L., Björklund, C., & Jensen, I. (2017). Work-related stress assessed by a text message single-item stress question. Occupational Medicine, 67(8), 601–608.

    Article  Google Scholar 

  5. Baker, C. N., Brown, S. M., Wilcox, P. D., Overstreet, S., & Arora, P. (2016). Development and psychometric evaluation of the Attitudes Related to Trauma-Informed Care (ARTIC) Scale. School Mental Health, 8(1), 61–76.

    Article  Google Scholar 

  6. Bartlett, J. D., & Smith, S. (2019). The role of early care and education in addressing early childhood trauma. American Journal of Community Psychology, 64(3–4), 359–372.

    Article  Google Scholar 

  7. Bertram, R. M., Blase, K. A., & Fixsen, D. L. (2015). Improving programs and outcomes: Implementation frameworks and organization change. Research on Social Work Practice, 25(4), 477–487.

    Article  Google Scholar 

  8. Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., et al. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230–241.

    Google Scholar 

  9. Briggs-Gowan, M. J., Ford, J. D., Fraleigh, L., McCarthy, K., & Carter, A. S. (2010). Prevalence of exposure to potentially traumatic events in a healthy birth cohort of very young children in the northeastern United States. Journal of Traumatic Stress, 23(6), 725–733.

    Article  Google Scholar 

  10. Brunsek, A., Perlman, M., McMullen, E., Falenchuk, O., Fletcher, B., Nocita, G., ... Shah, P. S. (2020). A meta-analysis and systematic review of the associations between professional development of early childhood educators and children’s outcomes. Early Childhood Research Quarterly, 53, 217–248. https://doi.org/10.1016/j.ecresq.2020.03.003.

    Article  Google Scholar 

  11. Chafouleas, S. M., Johnson, A. H., Overstreet, S., & Santos, N. M. (2016). Toward a blueprint for trauma-informed service delivery in schools. School Mental Health, 8(1), 144–162.

    Article  Google Scholar 

  12. Curbow, B., Sprall, K., Ungaretti, A., McDonnell, K., & Breckler, S. (2001). Development of the child care worker job stress inventory. Early Chilhdood Research Quarterly, 15(4), 515–536.

    Article  Google Scholar 

  13. Dorado, J. S., Martinez, M., McArthur, L. E., & Leibovitz, T. (2016). Healthy Environments and Response to Trauma in Schools (HEARTS): A whole-school, multi-level, prevention and intervention program for creating trauma-informed, safe and supportive schools. School Mental Health, 8(1), 163–176.

    Article  Google Scholar 

  14. Elo, A.-L., Leppänen, A., & Jahkola, A. (2003). Validity of a single-item measure of stress symptoms. Scandinavian Journal of Work, Environment & Health, 29(6), 444–451.

    Article  Google Scholar 

  15. Fantuzzo, J. W., & Fusco, R. A. (2007). Children’s direct exposure to types of domestic violence crime: A population-based investigation. Journal of Family Violence, 22(7), 543–552.

    Article  Google Scholar 

  16. Friedman-Krauss, A. H., Raver, C. C., Neuspiel, J. M., & Kinsel, J. (2014). Child behavior problems, teacher executive functions, and teacher stress in Head Start classrooms. Early Education and Development, 25(5), 681–702.

    Article  Google Scholar 

  17. Gilliam, W. S., & Reyes, C. R. (2018). Teacher decision factors that lead to preschool expulsion. Infants & Young Children, 31(2), 93–108.

    Article  Google Scholar 

  18. Glasgow, R. E., Harden, S. M., Gaglio, B., Rabin, B., Smith, M. L., Grenndolyn, C. P., et al. (2019). RE-AIM planning and evaluation framework: Adapting to new science and practice with a 20-year review. Frontiers in Public Health, 7(64), 1–9.

    Google Scholar 

  19. Gomez, R. E., Kagan, S. L., & Fox, E. A. (2015). Professional development of the early childhood education teaching workforce in the United States: An overview. Professional Development in Education, 41(2), 169–186.

    Article  Google Scholar 

  20. Hall-Kenyon, K. M., Bullough, R. V., MacKay, K. L., & Marshall, E. E. (2014). Preschool teacher well-being: A review of the literature. Early Childhood Education Journal, 42(3), 153–162. https://doi.org/10.1007/s10643-013-0595-4.

    Article  Google Scholar 

  21. Harding, J. F., Connors, M. C., Krauss, A. F., Aikens, N., Malone, L., & Tarullo, L. (2019). Head Start teachers’ professional development, well-being, attitudes, and practices: Understanding changes over time and predictive associations. American Journal of Community Psychology, 63(3–4), 324–337.

    Article  Google Scholar 

  22. Holmes, C., Levy, M., Smith, A., Pinne, S., & Neese, P. (2015). A model for creating a supportive trauma-informed culture for children in preschool settings. Journal of Child and Family Studies, 24, 1650–1659. https://doi.org/10.1007/s10826-014-9968-6.

    Article  PubMed  Google Scholar 

  23. Hubel, G. S., Davies, F., Goodrum, N. M., Schmarder, K. M., Schnake, K., & Moreland, A. D. (2020). Adverse childhood experiences among early care and education teachers: Prevalence and associations with observed quality of classroom social and emotional climate. Children and Youth Services Review, 111(February), 104877.

    Article  Google Scholar 

  24. Jennings, P. A., Doyle, S., Oh, Y., Rasheed, D., Frank, J. L., & Brown, J. L. (2019). Long-term impacts of the CARE program on teachers’ self-reported social and emotional competence and well-being. Journal of School Psychology, 76(April), 186–202.

    Article  Google Scholar 

  25. Jennings, P. A., & Greenberg, M. T. (2009). The prosocial classroom: Teacher social and emotional competence in relation to student and classroom outcomes. Review of Educational Research, 79(1), 491–525.

    Article  Google Scholar 

  26. Jimenez, M. E., Wade, R., Lin, Y., Morrow, L. M., & Reichman, N. E. (2016). Adverse experiences in early childhood and kindergarten outcomes. Pediatrics, 137(2), 1–11.

    Article  Google Scholar 

  27. Kenny, D. A. (2015). Mediation. Retrieved from https://davidakenny.net/cm/mediate.htm.

  28. Lawson, H. A., Caringi, J. C., Gottfried, R., Bride, B. E., & Hydon, S. P. (2019). Need for trauma literacy. Harvard Educational Review, 89(3), 421–448.

    Article  Google Scholar 

  29. Lorentson, M. (2017). Connecticut’s Early Childhood Trauma Collaborative Trauma Training Needs Assessment Report. https://www.ct-aimh.org/wp-content/uploads/2018/07/2018CTAIMHTraumaTrainingNeedsAssessmentfullreportfinal.pd

  30. Loomis, A. M. (2018). The role of preschool as a point of intervention and prevention for trauma-exposed children: Recommendations for practice, policy, and research. Topics in Early Childhood Special Education, 38(3), 134–145. https://doi.org/10.1177/0271121418789254.

    Article  Google Scholar 

  31. Loomis, A. M. (2020). Effects of household and environmental adversity on indices of self-regulation for Latino and African American preschool children: Closing the school readiness gap. Early Education and Development. https://doi.org/10.1080/10409289.2020.1745513.

    Article  Google Scholar 

  32. Loomis, A. M., & Mogro-Wilson, C. (2019). Effects of cumulative adversity on preschool self-regulation and student-teacher relationships in a highly dense Hispanic community: A pilot study. Infants & Young Children, 32(2), 107–122. https://doi.org/10.1097/IYC.0000000000000139.

    Article  Google Scholar 

  33. Maxwell, K. L., McWilliam, R. A., Hemmeter, M. L., Ault, M. J., & Schuster, J. W. (2001). Predictors of developmentally appropriate classroom practices in kindergarten through third grade. Early Childhood Research Quarterly, 16(4), 431–452.

    Article  Google Scholar 

  34. McEwen, B. S. (2008). Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediators. European Journal of Pharmacology, 583(2–3), 174–185. https://doi.org/10.1016/j.ejphar.2007.11.071.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Mendelson, T. S., Tandon, D., O’Brennan, L., Leaf, P. J., & Ialongo, N. S. (2015). Brief report: Moving prevention into schools: The impact of a trauma-informed school-based intervention. Journal of Adolescence, 43, 142–147. https://doi.org/10.1016/j.adolescence.2015.05.017.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Merrick, J. S., Narayan, A. J., DePasquale, C. E., & Masten, A. S. (2019). Benevolent childhood experiences (BCEs) in homeless parents: A validation and replication study. Journal of Family Psychology, 33(4), 493–498.

    Article  Google Scholar 

  37. Narayan, A. J., Rivera, L. M., Bernstein, R. E., Harris, W. W., & Lieberman, A. F. (2018). Positive childhood experiences predict less psychopathology and stress in pregnant women with childhood adversity: A pilot study of the benevolent childhood experiences (BCEs) scale. Child Abuse and Neglect, 78(2017), 19–30.

    Article  Google Scholar 

  38. Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation Science, 10(1), 1–13.

    Article  Google Scholar 

  39. Overstreet, S., & Chafouleas, S. M. (2016). Trauma-informed schools: Introduction to the special issue. School Mental Health, 8(1), 1–6.

    Article  Google Scholar 

  40. Preacher, K. J., & Kelley, K. (2011). Effect size measures for mediation models: Quantitative strategies for communicating indirect effects. Psychological Methods, 16, 93–115.

    Article  Google Scholar 

  41. Purtle, J. (2018). Systematic review of evaluations of trauma-informed organizational interventions that include staff trainings. Trauma, Violence, and Abuse. https://doi.org/10.1177/1524838018791304.

    Article  PubMed  Google Scholar 

  42. Smith, S., & Lawrence, S. (2019). Early care and education teacher well-being: Associations with children’s experience, outcomes, and workplace conditions. March, 17. https://www.nccp.org/publications/pdf/text_1224.pd.

  43. Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. Rockville, MD: Substance Abuse and Mental Health Services Administration.

  44. Thomas, M. S., Crosby, S., & Vanderhaar, J. (2019). Trauma-informed practices in schools across two decades: An interdisciplinary review of research. Review of Research in Education, 43(1), 422–452.

    Article  Google Scholar 

  45. U.S. Department of Health & Human Services Administration for Children and Families Administration on Children Youth and Families Children’s Bureau. (2018). Child maltreatment 2016. https://doi.org/10.1097/MOP.0000000000000362

  46. U.S. Department of Health & Human Services Administration for Children and Families. (2020, March 11). FY 2020 Head start funding increase. Retrieved from: https://eclkc.ohs.acf.hhs.gov/sites/default/files/pi/downloads/acf-pi-hs-20-02.pdf.

  47. U.S. Department of Health & Human Services Administration for Children and Families. (2015, September 8). State policies to promote social-emotional and behavioral health of young children in child care settings in partnership with families. Retrieved from: https://www.acf.hhs.gov/sites/default/files/occ/ccdf_acf_im_2015_01.pdf.

  48. Whitaker, R. C., Dearth-Wesley, T., & Gooze, R. A. (2015). Workplace stress and the quality of teacher-children relationships in Head Start. Early Childhood Research Quarterly, 30, 57–69. https://doi.org/10.1016/j.ecresq.2014.08.008.

    Article  Google Scholar 

  49. Whitaker, R. C., Dearth-Wesley, T., Gooze, R. A., Becker, B. D., Gallagher, K. C., & McEwen, B. S. (2014). Adverse childhood experiences, dispositional mindfulness, and adult health. Preventive Medicine, 67, 147–153. https://doi.org/10.1016/j.ypmed.2014.07.029.

    Article  PubMed  Google Scholar 

  50. Whitaker, R. C., Herman, A. N., Dearth-Wesley, T., Smith, H. G., Burnim, S. B., Myers, E. L., et al. (2019). Effect of a trauma-awareness course on teachers’ perceptions of conflict With preschool-aged children from low-income urban households: A cluster randomized clinical trial. JAMA Network Open, 2(4), e193193.

    Article  Google Scholar 

  51. Zakszeski, B. N., Ventresco, N. E., & Jaffe, A. R. (2017). Promoting resilience through trauma-focused practices: A critical review of school-based implementation. School Mental Health, 9(4), 310–321.

    Article  Google Scholar 

  52. Zeng, S., Corr, C. P., Grady, C. O., & Guan, Y. (2019). Adverse childhood experiences and preschool suspension expulsion: A population study. Child Abuse & Neglect. https://doi.org/10.1016/j.chiabu.2019.104149.

    Article  Google Scholar 

  53. Zinsser, K. M., Zulauf, C. A., Nair Das, V., & Callie Silver, H. (2017). Utilizing social-emotional learning supports to address teacher stress and preschool expulsion. Journal of Applied Developmental Psychology. https://doi.org/10.1016/j.appdev.2017.11.006.

    Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Alysse M. Loomis.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Loomis, A.M., Felt, F. Knowledge, Skills, and Self-reflection: Linking Trauma Training Content to Trauma-Informed Attitudes and Stress in Preschool Teachers and Staff. School Mental Health 13, 101–113 (2021). https://doi.org/10.1007/s12310-020-09394-7

Download citation

Keywords

  • Early care and education
  • Adverse childhood experiences
  • Professional development
  • Trauma-informed attitudes