Monday, January 13, 2020

Trauma-Informed Schools: New Research Study Says “There’s No Research”


Schools “Hitch-Up” to Another Bandwagon that is Wasting Time and Delaying Recommended Scientifically-Proven Services (Part I)


[CLICK HERE for the Entire Blog Message]

Dear Colleagues,

Introduction

   While most educators know that they are supposed to implement “evidence-based” academic and behavioral practices in their schools (according to the Elementary and Secondary Education Act), most of our districts and schools still struggle mightily in this area.

   Some of the “challenges” here include the fact that many educators:
  • Do not know the differences across the terms “evidence-based,” “scientifically-based,” and “research-based;”
  • Do not know how to evaluate and discriminate between methodologically and statistically-analyzed “sound” research versus “passable” research versus “unsound” research;
  • Assume that “published” research—especially when in a national professional journal—much less in a national foundation’s technical report, an association newsletter or E-blast, or a popular press publication or newspaper is automatically “sound” research;
  • Assume that “published” research is “sound” because it was sponsored or advocated by a “trusted” source, a well-regarded “expert,” a social media “giant,” or an entity (for example, the U.S. Department of Education, one of its funded federal Technical Assistance Centers, a State Department of Education) that “would only disseminate sound research” (of course—I am being facetious here);
  • Overgeneralize the results of one or a small number of sound studies, while also not understanding that even “sound” research may not be relevant to their districts or schools—because the research does not apply to their settings or demographic conditions, students or staff, or the underlying root cause reasons for their circumstances;
  • Do not have the time or the within-district expertise to evaluate the quality of the research in identified and needed areas; and
  • Do not have the resources, training potential, staff or staff expertise, or funding to implement even sound research with the needed intensity, integrity, and sustainability.

   I am not trying to be disrespectful here. I understand these challenges— given the many schools I consult with across the country and internationally— all too well.

   But I still need to note that far too many districts and schools consciously, dismissively, or naïvely “jump on unsound, unproven, or ill-fitting educational bandwagons,” and adopt partially, poorly, or untested programs, practices, or interventions.

   All too often, they are then “surprised” when these programs do not succeed.

   Parenthetically, it is important to note that some vendors depend on some of the “challenges” above to sell their programs, curricula, or consulting services. 

   That is, they use their marketing, “sales pitches,” and testimonials to secure contracts—knowing that the district or a school does not have the expertise, resources, or time to do its own objective “due diligence” . . . and that, if the district or school did conduct its own competent and objective product evaluation, it would never purchase the program, curriculum, or consulting service.]
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   But, most critically, when districts and/or schools implement programs or curricula that are invalid, untested, or inappropriate to their students. . . and they are unsuccessful, there are real implications. 

   These include:
  • Time, money, and other resources are wasted.
  • Staff and student motivation and momentum are hindered.
  • Positive and needed student change or improvement is undermined, unrealized, or unraveled.
  • And, especially, staff and student trust is damaged, such that staff and student resistance to the next (possible most effective) program increases.
   At a surface level, the implementation of unsuccessful programs—that never should have been implemented in the first place—involves poor planning, decision-making, and needless waste.

   At a deeper level—not to be an alarmist—this represents educational malpractice. 

   If a doctor would not use an untested drug on his/her patients, how can a responsible educator rationalize the use of an untested (or poorly matched) program or curriculum in his/her district or school?

   At any level, one must question the validity of any district or school’s complaints about its lack of time, money, and other resources when it selects and implements invalid or untested programs that—predictably—are unsuccessful (or worse).
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Trauma-Informed Schools, SEL, Mindfulness, and Meditation Revisited

   Over the past few months, I have continued to monitor the research and practice of three areas that are beginning to be linked programmatically in the schools: 
  • Trauma-Informed or Trauma-Sensitive Care, or Trauma-Informed Systems
  • Social-Emotional Learning (SEL)
  • Mindfulness and Meditation
   In this two-part Blog Series, I will update you on the newest research-to-practice in these areas, while also citing past Blogs that have directly addressed these approaches. 

   This first Part I discusses a recent study that reviewed over 9,000 studies, published over the past ten years, investigating trauma-informed school programs.  Using objective, research-sensitive criteria, this study determined that none of the studies met their criteria for sound research. 

   We discuss this result in the context of the thousands of schools across this country that have potentially implemented invalid, unsound, or wasteful (as above) trauma-informed programs, and describe an evidence-based multi-tiered approach that responsibly addresses the needs of students impacted by trauma.  We also address the flawed national PBIS and SEL-CASEL frameworks, recommending that they not be used as the foundation of a more generic school-wide approach for these students.

   In Part II, we will discuss the relationship and inappropriate use of mindfulness and mediation with students experiencing trauma.  Here, we will describe the biological and neuropsychological underpinnings of trauma-related student emotionality, and how mindfulness and mediation will not change this emotionality—especially when it is classically conditioned (i.e., Pavlovian in nature).

   The theme across both Parts of this Series—and consistent with the Introduction above—is that:

Districts and schools need to know the Trauma-Informed Care, SEL, Mindfulness, and Meditation research-to-practice as all of these areas have significant flaws that should result in educators questioning their use in schools.

   Recognizing that districts and schools do not always have the time or expertise of evaluate the current research-to-practice, I hope that this two-part Series (and my previous Blogs on these topics) will help to close this gap.
_ _ _ _ _ _ _ _ _ _

Trauma-Informed Schools:  New Research Says There is No Research

   Over the past five years or more, the national discussion on the effects of trauma—especially relative to school-aged students—has increased exponentially.  Fueling this discussion is a screening tool that was developed in the mid-1990s, the Adverse Childhood Experiences (ACEs) scale, that we believe is being misinterpreted and misused.  The result has been the wasteful adoption by many schools “Trauma-Informed” programs and practices that are not providing the appropriate services, supports, and interventions to students.

   We discussed the ACEs in detail in a recent Blog stating:


Aren’t Schools with Positive, Safe Climates Already “Trauma Sensitive”?  Unmasking the ACEs, and Helping Students Manage their Emotions in School

The original ACE Study was conducted by the Kaiser Permanente Health Maintenance Organization (HMO) in Southern California from 1995 to 1997 with two waves of data collection.  As they were receiving physical exams, over 17,000 HMO members completed confidential surveys regarding their childhood experiences and their current health status and behaviors.  Significantly, beyond the fact that the sample was from a limited geographic area, the participants were primarily white and from the middle class.

Below are the actual ACE Study Questions.  Each “Yes” response received one point toward the “final score.”  As educators, please read these items relative to today’s students.  Think about how many of your students have experienced four or more of these events so far in their lives (more on that below).

While you were growing up, during your first 18 years of life:

1. Emotional Abuse. Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you?   or Act in a way that made you afraid that you might be physically hurt?

2. Physical Abuse. Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you?   or Ever hit you so hard that you had marks or were injured?

3. Sexual Abuse. Did an adult or person at least 5 years older than you ever…  Touch or fondle you or have you touch their body in a sexual way?   or Attempt or actually have oral, anal, or vaginal intercourse with you?

4. Emotional Neglect.  Did you often or very often feel that … No one in your family loved you or thought you were important or special?   or Your family didn’t look out for each other, feel close to each other, or support each other?

5. Physical Neglect. Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you?   or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

6. Parental Separation or Divorce. Were your parents ever separated or divorced?

7. Mother Treated Violently.  Was your mother or stepmother:  Often or very often pushed, grabbed, slapped, or had something thrown at her?   or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard?   or Ever repeatedly hit at least a few minutes or threatened with a gun or knife?

8. Household Substance Abuse.  Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?

9. Household Mental Illness. Was a household member depressed or mentally ill, or did a household member attempt suicide?

10. Incarcerated Household Member.  Did a household member go to prison?
_ _ _ _ _

The most critical concerns with the ACEs’ Questions are:

·        They do not discriminate between “finite” events (e.g., having a household member incarcerated) and events that can occur over time or in a repeated way;

·        Thus, they do not quantify many of the events (e.g., how long was the separation, how many times was your mother physically threatened);

·        They do not identify the age (or age range) when the child or adolescent experienced each event;

·        They do not ask for a rating of the intensity of each event (e.g., along a Mild-Moderate-Severe continuum);

·        They do not get a rating of the emotional impact of each event at the time that it occurred (e.g., along a None-Low-Mild-Moderate-Significant-Life Changing continuum); and

·        They do not get a rating of the current (assuming an event occurred in the past) and/or continuing emotional impact of each event.

   Given the absence of this critical contextual information, we do not really know the cumulative depth, breadth, intensity, or impact of an individual’s traumatic history.  Indeed, we may just simply know how many events an individual may have experienced.
_ _ _ _ _

New Research Study on the Trauma-Informed Research

   In July, 2019, Maynard, Farina, Dell, and Kelly published an article, “Effects of Trauma-Informed Approaches in Schools: A Systematic Review,” in the Campbell Systematic Reviews published by John Wiley & Sons.


   The goal of the study was to systematically and objectively review the empirical research in Trauma-Informed approaches in schools so that the research-based efficacy of the different approaches being implemented could be evaluated.

[CLICK HERE for the Entire Blog Message with the Full Description of this Article]

   Eventually, the authors did a comprehensive research review that identified 9,102 possible school-based, trauma-related articles that were published during the last ten years.  After removing duplicate articles from the review, they began to apply the criteria above to the remaining 7,173 studies— eventually excluding 7,106 studies.

   Of the remaining 67 studies:  All 67 were excluded.  49 did not use random controlled trials or quasi-experimental design methods; 12 did not examine the effects of a trauma-informed approach; and 5 examined only one aspect of a trauma-informed approach.

   Thus:  These authors determined that there were no school-based, trauma-informed research studies over the past ten years that were conducted using sound research methodologies such that the programs investigated could be objectively determined to be effective in addressing the trauma-related needs of school-aged students.

[CLICK HERE for the Entire Blog Message with the Authors’ Conclusions]
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Expanding on the Concerns with the Trauma-Sensitive/Informed School Movement

   As noted, we published two Blogs dedicated to this topic during 2019.

   If you CLICK on the date of the Blogs below, you will link directly to the Blog that is posted on my website (www.projectachieve.info/blog).


Aren’t Schools with Positive, Safe Climates Already “Trauma Sensitive?   Unmasking the ACEs, and Helping Students Manage their Emotions in School
_ _ _ _ _


The Traps and Trouble with “Trauma Sensitive” Schools:  Most Approaches Are Not Scientifically-Based, Field-Tested, Validated, or Multi-Tiered.  A National Education Talk Radio Interview (Free Link Included) Puts it All into Perspective
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   In those two Blogs devoted to this subject, we stated our beliefs that:
  • Some educators have become over-sensitized to this issue—for example, incorrectly attributing some students’ emotional or behavioral issues to “trauma” when they are due to other factors;
  • Some schools do not understand and are misusing the Adverse Childhood Experiences (ACEs) scale and research; and
  • Some districts—with all good intents—have adopted “trauma sensitive” programs and protocols that are either not needed or not advisable.
   Clearly, Maynard, Farina, Dell, and Kelly’s systematic review of the trauma-informed “research” demonstrates the validity of the third concern above.  Indeed, given the innumerable states and districts that have already adopted trauma sensitive or informed programs, protocols, and practices, Maynard’s review suggests that many of these implemented programs are NOT scientifically-based, have NOT been well field-tested, and are NOT validated using objective and methodologically-sound approaches.  In addition, some districts and schools are likely using approaches that are NOT directly applicable to their students and needs, and are NOT being implemented along a multi-tiered continuum.
_ _ _ _ _

   To support these statements, the August 17th Blog described in detail answers to the following questions:

Issue #1: Do Practitioners Understand the Original ACEs Research, Its Strengths, and Its Limitations to School-Based Practice?

Issue #2.  Are Schools Implementing Specialized “Trauma Sensitive” Programs When They Should be Implementing More Comprehensive (Pervasive and Preventative) Positive School Climate Practices?

Issue #3.  Do Schools (Have the Time to) Evaluate the Integrity and Utility of their Trauma Sensitive Programs Prior to Implementation, and How Many Schools Choose their Programs Due to Cost and Not Outcomes?

Issue #4.  Do Schools Understand the Science-to-Practice Components that Facilitate Students’ Emotional Self-Management—The Key Preventative “Skill” Needed by All Students?

[CLICK HERE for the Entire Blog Message that Comprehensive Answers these Four Questions]
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   The October 12th Blog updated the August discussion, and provided a link to a national radio broadcast interview that I did on this subject with Larry Jacobs, the host of Education Talk Radio—on October 4, 2019.

[CLICK HERE for this 28-minute Education Talk Radio Interview]
_ _ _ _ _

   Once again, please feel free to re-read the original Blogs to get a more detailed analysis of the Reports and summary discussed above.
_ _ _ _ _ _ _ _ _ _

Multi-Tiered Strategic/Intensive Interventions for Students with Significant Trauma Issues

   As noted above—and in our August 17th Blog, when districts and schools use comprehensive, systematically-implemented multi-tiered Positive Behavioral Support/Social-Emotional Learning (PBSS/SEL) systems that teach and motivate students to learn, master, and independently apply social, emotional, and behavioral self-management skills, they will automatically be addressing the emotionality that many students experience due to trauma.

   But the evidence-based PBSS/SEL system that we advocate is not grounded by either the flawed national PBIS framework or the flawed national SEL-CASEL framework. 

   The PBSS/SEL system that we advocate is grounded by individual, group, and organizational principles of psychology and well-established research-to-practice.  This system has been integrated into the Project ACHIEVE model that was designated as an evidence-based program in 2000 by the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA; www.projectachieve.info).

   We have discussed this issues before.  Please note two previous Blogs that described and analyzed the flaws in both the PBIS and CASEL-SEL frameworks:


The Year in Review (Part II): Schools’ Pursuit of Effective School Discipline, Classroom Management, and Student Self-Management Strategies
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Analyzing Your School Discipline Data and Your SEL (PBIS or School Discipline) Program: Students’ Discipline Problems are Increasing Nationally Despite Widespread SEL/PBIS Use (Part I)
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   And, please note two additional earlier Blogs that described the evidence-based components of an effective, valid, and multi-tiered science-to-practice PBSS/SEL system that has been implemented nationwide for over 35 years:


Redesigning Multi-Tiered Services in Schools: Redefining the Tiers and the Differences between Services and Interventions
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Solving the Disproportionate School Discipline Referral Dilemma: When will Districts and Schools Commit to the Long-term Solutions? There are No Silver Bullets—Only Science to Preparation to Implementation to Evaluation to Celebration (Part III)
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   But—as noted in Maynard, Farina, Dell, and Kelly’s systematic review of the trauma-informed research—a multi-tiered system needs to have services, supports, strategies, and interventions to address the strategic or intensive needs of students who experience frequent and/or high levels of emotionality due to trauma.

   To accomplish this, a sound multi-tiered system needs to have:
  • Data-based problem-solving and functional assessment processes that determine the root causes of a student’s emotionality.  These assessment processes validate that the student’s emotionality is triggered by past or present traumatic events, and not by the many other emotional triggers that are not trauma-related (see the section immediately above); and
  • Evidence- or research-based services, supports, strategies, and/or interventions that are linked to the root cause analyses and that have a high probability of student-centered success.

   For students who need small group or individual intervention—due to their social, emotional, behavioral, or mental health challenges, the school’s mental health and related service professionals (e.g., school psychologists, counselors, and social workers) need to be directly involved.  This is because some of these students need more clinical intervention, and these mental health professionals are the best-trained and skilled people to deliver them.

[CLICK HERE for the Entire Blog Message that Identifies Ten Strategic or Intensive Clinical Interventions that can be used with Students affected by Trauma, and Descriptions of the following four trauma-focused therapeutic approaches:
  • Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
  •  Cognitive-Behavioral Intervention for Trauma in Schools (CBITS)
  •  Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS)
  • Trauma Systems Therapy (TST)]
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Summary

   This two-part Blog Series is dedicated to helping districts, schools, educators, and mental health practitioners understand the research to-practice limitations of specific trauma-informed programs, as well as those built on the SEL-CASEL and PBIS frameworks.  This discussion will include mindfulness and meditation programs and approaches—again, within a trauma-treatment context.

   In this first Part I, we summarized a recent study that reviewed over 9,000 studies, published over the past ten years, investigating trauma-informed school programs.  Using objective, research-sensitive criteria, this study determined that none of the studies met their criteria for sound research. 

   We then discussed this result in the context of the thousands of schools across this country that have potentially implemented invalid, unsound, or wasteful (as above) trauma-informed programs, and describe an evidence-based multi-tiered approach that responsibly addresses the needs of students impacted by trauma.  We also addressed the flawed national PBIS and SEL-CASEL frameworks, recommending that they not be used as the foundation of a more generic school-wide approach for these students.

   In Part II, we will discuss the relationship and inappropriate use of mindfulness and mediation with students experiencing trauma.  Here, we will describe the biological and neuropsychological underpinnings of trauma-related student emotionality, and how mindfulness and mediation will not change this emotionality—especially when it is classically conditioned (i.e., Pavlovian in nature).

   The theme across both Parts of this Series—and consistent with the Introduction above—is that:

Districts and schools need to know the Trauma-Informed Care, SEL, Mindfulness, and Meditation research-to-practice as all of these areas have significant flaws that should result in educators questioning their use in schools.

   Recognizing that districts and schools do not always have the time or expertise of evaluate the current research-to-practice, we hope that this two-part Series (and my previous Blogs on these topics) will help them to choose effective, multi-tiered approaches to address the social, emotional, and behavioral needs of students impacted both by trauma and by other emotionally-triggering situations, circumstances, and/or conditions. 

  We also hope to encourage districts and schools that have already adopted and implemented trauma-informed or sensitive programs to objectively and comprehensively evaluate their research, practice, and student-centered outcomes— especially with students who have strategic or intensive clinical needs. 

   Virtually all of the research-to-practice discussion in this Blog suggests that these districts and schools may be wasting money, time, and other resources using programs that (a) are invalid, unsound, or unproven; and (b) will not “mature” over time to produce the results that they are not demonstrating right now.
_ _ _ _ _

   Now that the New Year has passed and we (as educators) are “back in session” (I am flying right now to a full week consultation in the Northeast), I want to remind everyone that:
  • There is still at least five months left in the school year, and that there is still time to start a new academic and/or social, emotional, or behavioral initiative to benefit your students; and
  • Most districts are fully into their strategic planning mode for the next school year.

   Relative to both areas, I am fully prepared to help you “add value” to the great things that you are already doing, or to evaluate your current initiatives— especially those that are not producing the results that you desired.

   I am currently working with over ten different districts—from inner city to extremely rural.  While most of my consultations are long-term (from three to five years), I usually start most of them by completing a “Plan for Planning” process that includes (a) a strategic Current Status and Needs Assessment in the area of desire or concern; (b) a Resource and Outcomes Analysis; and (c) an Action Plan that provides a one to three year change or value-added process that includes resources and training, components and content, implementation timelines and actions, short- and long-term outcomes, and formative and summative evaluations needed.

   In most cases, my consultations start with a free, one-hour telephone conversation with a district or school leadership team where we clarify needs and goals, generate and answer critical questions, and decide— mutually—if we are a good match.

   I encourage you to contact me to set up this free conversation.  As noted above, it is not too late to (re)start a new, focused initiative right now, or to begin planning for the 2020 to 2021 school year.

Best,

Howie

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