Why Schools Can't Become Trauma-Sensitive Unless They Simultaneously Address Bullying, Exposure to Violence, Persistent Academic Failure, and Other Student Mental Health Issues
I hope you are doing well as
we move into Fall and the end of the first quarter of the year.
Today’s message will carry
somewhat of a “mixed message.” I am
going to discuss trauma, its impact on students in schools, and the importance
of implementing approaches that help these students to succeed in school.
At the same time, I am going to
emphasize that many of the approaches needed for these students are no
different than other (or the same) students who have experienced significant,
negative home or life events; teasing or bullying; persistent academic failure
and frustration; social rejection, aggression, or isolation; or acute or
chronic exposure to violence.
Finally, I am issuing a
warning that an increased emphasis on “Trauma-Sensitive Schools” and
“Trauma-Informed Practices” by the federal government and some of its funded
national Technical Assistance centers has already created yet another “cottage
industry” of companies, consultants, and “specialized trainings” in this area.
My concerns are rooted in my
attendance at the National School-Based Mental Health Conference last month in
Pittsburgh. I have attended (and
presented at) these conferences for at least a decade, and it was notable that-
- at the 2013 Conference- - there were virtually no conference sessions
on trauma-sensitive or –informed practices.
And yet, suddenly, at last month’s Conference, there were ten or more
sessions discussing this topic.
Again, I am not saying
that this is not an important topic and/or mental health/behavioral
concern. However, I am cautioning
that many of these sessions were recommending “trauma-specific” treatments or
programs that have not been field-tested or validated in schools or with large
numbers of students. And yet, here they
are being advocated for at a major national conference.
Critically, virtually all of
these “trauma-sensitive or -informed” trainings:
* Are not needed at the Tier 1/Prevention or
even Tier 2/Strategic Intervention levels of social, emotional, and behavioral
support if a school has a sound school-wide program in this area- - one that
focuses on students’ social competency and self-management skills.
* Have not (once again) been field-tested nor demonstrated
their short- or long-term success or their unique need in actually
helping students to cope with significant levels of trauma (especially in the
absence of other mental health supports).
* Add yet another specialized responsibility to
our teachers’ “plates” that they are unprepared to fully address, and that they
should not need to address- - once again, if the school had sound Tier
I/Positive Behavioral Support System approaches in place.
_ _ _ _ _
The Bottom Line is that:
* We need to prepare and support all teachers
in how to create positive, differentiated, and success-oriented classrooms that
teach students the academic and social, emotional, and behavioral skills
that they need to be successful.
* These latter skills need to focus on teaching
students to demonstrate and apply interpersonal, social problem-solving,
conflict prevention and resolution, and emotional coping skills. As taught, these skills need to be embedded
into the academic activities where students need to collaborate and work
together, and into students’ social and interpersonal individual and group
activities and interactions.
* These skills need to be explicitly applied to
the areas of behavioral health, bullying prevention, truancy and dropout
prevention and reduction, PBIS and positive approaches to discipline, and
social and emotional learning.
* Schools and districts need to have skilled
mental health specialists (typically school psychologists and clinical social
workers) who know the cognitive-behavioral and emotional coping interventions
to help those students who need more intensive social-behavioral services and
supports.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _
How Did this All Start
?
The most-recent focus on
trauma began when a series of studies were published in the late 2000s that
related to the
Adverse Childhood Experiences (ACE) Study, research that originated with the Centers
for Disease Control and Prevention (CDC; www.cdc.gov), and Kaiser Permanente's
Health Appraisal Clinic in San Diego. In
one of the largest investigations ever conducted to assess the relationship between
ten specific childhood experiences and their later-life health and well-being,
information was collected from patients who were undergoing comprehensive
physical examinations at more than 17,000 health maintenance organizations.
The ten home or family experiences covered
the first 18 years of the respondents’ lives (the survey does not
discriminate when the events occurred), and the experiences were rated “Yes” or
“No” relative to whether they ever occurred- - even once. The experiences involved (a) parental or
adult emotional abuse or physical threats, physical aggression, sexual
touching, sexual penetration; (b) parental drug abuse, separation or divorce,
mental illness, or incarceration; and (c) times where the respondent did not
feel loved or supported or protected, did not have clean clothes or
supervision, or did not have medical care when needed.
According to the CDC’s website, “the ACE
Study suggests that certain experiences are major risk factors for the
leading causes of illness and death as well as poor quality of life in the
United States. It is critical to understand how some of the worst health and
social problems in our nation can arise as a consequence of adverse childhood
experiences. Realizing these connections
is likely to improve efforts towards prevention and recovery.”
Comment. Without minimizing the real impacts of these
individual and cumulative life events, and acknowledging the burgeoning
research in this area, it is important to recognize that:
*
Most of the research in this area is correlational- - these ten
home and family life events during childhood or adolescent do not necessarily cause
adults to have health and/or social problems.
All we know is that adults with these problems, retrospectively, had a
higher number of the ACE events.
Moreover, we cannot
generalize the results of data from thousands of adults to predict the impact
of these events on a single adult- - or even a single child or adolescent.
* For
an individual student, the intensity of the ten events may be more
predictive of the cited adult problems than the number of the events. Study participants did not rate the intensity
of the events- - they only reported, from their perspectives, whether the
events occurred or did not occur.
* For
an individual student, the age when the one or more events occurred, and
their emotional coping skills and/or the presence of external support systems
may be more predictive of the impact of the events than their actual number.
* As
noted above, there are other home, community, and school events (e.g.,
bullying, exposure to violence, the impact of a disability) that were not
on the ACE that may be as predictive to adults’ (and students’) health and
social status.
_ _ _ _ _
The Bottom Line is that schools need
to:
* Routinely
screen all students for social, emotional, and/or behavioral
concerns. However, we need to recognize
that the best screeners are classroom teachers who have positive
relationships with their students, are tuned in to them as individuals, and are
able to recognize when they are struggling in these areas.
*
Have early intervention teams (e.g., Student Assistance Teams, Student
Services Teams) who include the best academic and behavioral professionals in
or available to the school- - who then work with the school staff,
parents/guardians, and the student him/herself to determine the “root causes”
underlying the social, emotional, and/or behavioral concerns.
*
Have professionals skilled in social, emotional, and behavioral
interventions, and (when needed) additional mental health response systems so
that the services, supports, strategies, and/or programs needed to address the
underlying causes of a student’s challenges can be successfully addressed.
Significantly, this
“system” may involve school-based or school-linked community mental health
professionals- - especially when the school does not have the depth of
expertise needed, or when the student needs intensive supports at that level.
_ _ _ _ _ _ _ _ _ _ _ _ _ _
Where Has This Gone ?
Somewhat parallel to the ACE research has
been work published in 2005 and then 2013 by the Massachusetts Advocates for
Children (MAC). Focusing first on the
policies needed to “Help Traumatized Children Learn,” and then to create
“Trauma-Sensitive Schools,” the MAC’s work has become embedded in legislative
action in Massachusetts that established (FY2014) a Safe and Supportive Schools
Grant Program. The grant money is to
help schools to create and implement plans to help establish “Safe and
Supportive School Environments.”
Significantly, the legislative act defined a
“Safe and Supportive School Environment” as:
“A safe, positive, healthy and inclusive whole-school learning
environment that (i) enables students to develop positive relationships with
adults and peers, regulate their emotions and behavior, achieve academic and
non-academic success in school and maintain physical and psychological health
and well-being; and (ii) integrates services and aligns initiatives that
promote students’ behavioral health, including social and emotional learning,
bullying prevention, trauma sensitivity, dropout prevention, truancy reduction,
children’s mental health, the education of foster care and homeless youth, the
inclusion of students with disabilities, positive behavioral approaches that
reduce suspensions and expulsions and other similar initiatives.”
In the 2013 document, the MAC
emphasized the importance of aligning all of the initiatives above
together because “the same legal and policy conditions necessary for trauma
sensitivity are also necessary for a wide range of other important education
reform initiatives.”
_ _ _ _ _ _ _
Summary and Conclusions
Many of the social, emotional,
and behavioral reactions, responses, and needs that students have when they
experience significant, negative home or life events; teasing or bullying;
persistent academic failure and frustration; social rejection, aggression, or
isolation; or acute or chronic exposure to violence coexist. Significantly, then, it makes no sense (nor
is it realistic relative to teachers, time, and training) to implement
separate, discrete prevention and early response programs for what appear to be
somewhat different situations.
We know that there are five
components needed in a (Tier I) prevention and early intervention approach to
supporting all students- - especially those students experiencing the life and
social circumstances above. These are:
* Positive school and classroom climates and
relationships
* Identifying and teaching core, needed
interpersonal, conflict prevention and resolution, social problem-solving, and
emotional coping skills
* Establishing a behavioral accountability
system and holding students accountable to using their social, emotional, and
behavioral skills
* Maintaining consistency throughout the
process
* Applying the process to all settings, while
encouraging the different student peer groups in a school to become full
partners in supporting the process
Beyond this, schools and
districts need a continuum of services, supports, strategies, and programs that
provide interventions and mental health supports to students (and families) in greater
need.
We have got to work together-
- effectively and efficiently- - in order to establish these system, school,
staff, and student approaches. We should
not be swayed by companies, consultants, or
specialized training approaches that have not been field-tested or validated in schools or with large numbers of students, and that take our attention away from the “common core” of components that help create truly safe and support school environments.
specialized training approaches that have not been field-tested or validated in schools or with large numbers of students, and that take our attention away from the “common core” of components that help create truly safe and support school environments.
I hope that some of the ideas above resonate with you. Please accept my best wishes as you continue
to provide the services and supports that all of your students need. Have a
GREAT week !!!
Best,
Howie
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