Trauma-Informed Care in a School Setting: Occupational Therapy Interventions to Promote Emotional Regulation

PICO Question What trauma-informed occupational therapy interventions improve emotional regulation and participation in school-based tasks for students? Objectives Define trauma and note its prevalence among school-aged children Describe principles of Trauma-Informed Care and its importance in a school setting. Describe current research to determine best practice using a Trauma-Informed Care (TIC) approach in schools for OT practitioner

Policy Essay: Fostering the acceptance and inclusion of LGBTQ youth in the child welfare system: Considerations for advancing trauma informed responses for LGBTQ youth in care

LGBTQ youth are vulnerable to nearly all forms of childhood maltreatment and trauma and are disproportionately overrepresented in the child welfare system. Many LGBTQ youth in the child welfare system encounter a number of obstacles related to discrimination, rejection, placement instability, and further maltreatment. Despite recent insights and advances in the field of trauma informed care the trauma experiences of LGBTQ youth have largely gone unaddressed in major works and frameworks related to trauma informed care. The following article explores the unique trauma and maltreatment experiences of LGBTQ youth and provides considerations for enhancing and improving practice with LGBTQ youth through the implementation of recent insights in the field of trauma informed care

Developing and implementing trauma informed care principles: A pilot project

Background: Exposure to childhood trauma have lifelong consequences effecting the health and well-being of the individuals who experienced or witnessed the trauma. As healthcare providers, we must recognize patients who have been exposed to trauma and ensure that it is responded to appropriately. This approach is known as trauma informed care. Objective: The purpose of this quality improvement project was to increase knowledge, opinion, and self-rated competence related to trauma informed care through the use of an educational intervention. Application of trauma informed care into daily practice was monitored through semi-structured interviews with project participants. Methods: Registered nurses from the women’s and children’s division of a Magnet designated, community hospital in Virginia were invited to attend an instructor led class on the key aspects of trauma informed care. Training was developed using Substance Abuse and Mental Health Service Administration (SAMHSA) trauma informed care guidelines and facility data collected during a 2018 organizational assessment. Lewin’s change theory was the theoretical framework for the project. Results: Statistically significant changes in nurse’s knowledge, opinions, and competence in applying trauma informed care were noted after attending the trauma informed care educational session. Participants consistently reported the importance of recognizing the effects trauma may have on patients and their families. Accounts of positive nurse driven experiences after the application of trauma informed care principles were also self-reported during post-intervention interviews. Conclusion: This quality improvement project yielded positive results related to using education to increase knowledge, opinions, and competence in providing trauma informed care. After the intervention, participants were also able to apply trauma informed care to daily practice producing positive nurse-patient relationships. This project supports the need for further research in the relationship of the application of trauma informed care and patient outcomes. Key words: trauma informed care, pediatrics, educatio

Exploring What is Old and What is New about Trauma-informed Care: Implications for Child Welfare Practice.

Trauma-informed care is becoming increasing part of discourse in child welfare practice. This paper explores the current debates and offers some critical reflections relevant for trauma-informed care implementation in child welfare practice. Firstly, the paper discusses the lack of conceptual clarity of a shared understanding for both trauma and trauma-informed care posing challenges for implementation and assessing evidence. Then, it explores the proposed paradigm shift of trauma-informed care in a child welfare practice context. The paper then explores aspects of trauma-informed care that may support newer ways of understanding experiences and interventions. Then, explores aspects of trauma-informed care that may support re-emphasising and re-establishing well-established within child welfare practice. The need to bring critical thinking to applying trauma-informed care is stressed to ensure it is applied to support best child welfare practice. Furthermore, the paper highlights the need for systems level support to support the integration of trauma-informed care (the old and the new)

A Meta-analysis on the Effectiveness of Trauma-informed Practice

This study looked at past research on trauma informed practice to analyze its effectiveness.. There is sufficient research portraying the helpfulness of the trauma-informed approach; however, there is little research on whether it is effective as a theoretical intervention. The study looked at how different trauma-informed interventions have helped in diminishing the effect of trauma on different populations. The populations considered in the analysis include: women that have experienced domestic violence, children, individuals with Post-Traumatic Stress Disorder (PTSD), and youth that reside in neighborhoods with high levels of crime. Since trauma-informed care is currently considered a broad theoretical framework for practice, with this meta-analysis, we aim to establish it as a concrete evidence-based practice

The Knowledge and Utilization of Trauma-Informed Care by Educational and Mental Health Professionals Who Serve Children in a Texas City

The purpose of this qualitative descriptive study was to understand the knowledge and utilization of trauma-informed care by professionals serving children within schools, social service agencies, or child therapy in a middle-sized Texas city. Previous studies acknowledged the prevalence of trauma and the need for systemic trauma-informed care in communities. The theoretical framework used to guide this study was attachment theory due to the emphasis on securely attached relationships, which is consistent with trauma-informed care. Data collection methods included an online open-ended questionnaire and semistructured personal interviews. Data analysis was completed using reflexive thematic analysis to develop themes from participant responses. Seven themes emerged from the data to address the three research questions, which sought to understand participants’ knowledge and utilization of trauma-informed care and perceived gaps in knowledge. The resulting themes addressed the need for more education about trauma’s impacts, practical strategies, and systemic trauma-informed care. I concluded that there is a community-wide need for more trauma and trauma-informed care training and education. Keywords: trauma, trauma-informed care, attachment, education, systemic, collaboratio

EFFECTIVENESS OF STAFF TRAINING ON TRAUMA-INFORMED CARE

The connection between experiencing trauma and the development of substance use disorder is widely recognized. Although trauma is more prevalent among individuals with substance use disorders, healthcare professionals have limited access to training focused on trauma informed care. It is crucial for those working in addiction treatment to receive training and education on trauma informed care to understand the impact of trauma and its association with substance use disorders. This DNP project\u27s objective was to develop and evaluate an educational presentation for staff emphasizing the importance of trauma-informed care in the context of addiction. The effectiveness of this intervention was assessed using a pre-/post-intervention approach. Twelve employees at an inpatient substance use treatment facility participated in this project. The results revealed that participant knowledge and familiarity with trauma and trauma informed care increased after engaging with the material. An educational intervention effectively increased staff knowledge and familiarity with trauma-informed care. By increasing staff awareness on the impact of trauma and trauma-informed care the education may result in improved patient outcomes in addiction treatment. Additionally, a staff that is well-versed in trauma-informed care may create a more supportive and empowering environment for patients, leading to increased engagement in treatment and better overall satisfaction with the care they receive

Key themes for identifying trauma informed care best practices within secondary education

Trauma informed care is a growing trend present today in multiple organizations and institutions. There are a variety of methods, theories, and interventions currently being employed that directly relate to trauma and a trauma informed care approach. This study investigates those trauma and trauma informed care practices to better understand which work, under what conditions, and which ones do not. The information gathered will help to provide a foundation for a sustainable trauma informed care system and approach. This was a qualitative study utilizing interviews and questionnaires to reveal trauma informed care best practices. Five participants with varying degrees of expertise in Trauma Informed Care were chosen at random in order to investigate their best practices for implementing trauma informed care within a secondary education setting. When the interviews were concluded, the most common themes that a-rose were physical and psychological safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment, voice and choice, cultural and historical backgrounds, environmental effects, and governance and leadership. Practices that reflect those themes were reported to be the most effective for a trauma informed care approach by the participants. The themes that arose in this study generally reflected those laid out in the literature. There was a relation between the themes uncovered and the practices used. It appeared that the data was then analyzed to determine which specific practices are associated with each theme in order to get a better understanding of the way each is used in the classroom in order to gain the most benefit and success from a trauma informed care approach

Considerations when implementing trauma-informed care into male domestic violence offenders' intervention programs

Master's Project (M.Ed.) University of Alaska Fairbanks, 2016This project addresses significant factors to consider when implementing trauma-informed care in Batterer’ Intervention Programs. Literature addressing trauma informed care and domestic violence interventions is discussed to demonstrate how trauma-informed care might be used with male perpetrators of domestic violence. There is a gap in the literature describing how trauma-informed care is integrated with domestic violence perpetrators, and this gap is surprising due to extensive literature supporting a clear link between trauma history and violent criminality. A checklist was created using the best practices in trauma-informed approaches and is intended to be used by agencies in a clinical setting, including Batterer’ Intervention Programs seeking to integrate trauma-informed approaches when working with male batterers

A Two-Article Examination of the Integration of Trauma-informed Care with Adult Medical Care

ABSTRACT A Two-Article Examination oF the Integration of Trauma-informed Care with Adult Medical Care Author: Sharon Czabafy Dissertation Chair: Ram Cnaan, PhD The intersection of attachment theory and trauma theory provides information on how a person understands and communicates health symptoms and explains interactions in a relationship such as with a medical care provider. Extensive research exists regarding health effects and health behaviors related to the experience of trauma and attachment styles for adults, people 21-years-old and older and demonstrates the intersection of trauma, attachment styles, and health outcomes for adults. Additionally, numerous studies portray the spiraling costs of healthcare and identify the super-utilizers of health care. Super-utilizers are adults who have preventable and frequent visits to emergency rooms and or hospitalizations. Super utilizing patients have complex medical issues often exacerbated by mental illness and or substance use. The Adverse Childhood Experience (ACE) study demonstrates that people who had adverse childhood experiences have multiple medical problems as adults as well as mental health disorders and addictions, factors for super-utilizers. Weaving the cords of attachment and trauma theories with health outcomes suggest a trauma-informed approach to adult health care improve health care outcomes. Trauma-informed care acknowledges the impact of trauma and provides care with an awareness of those effects. Understanding the impact that trauma has on patients may assist care providers in offering a more efficient effective approach to service delivery. Recent research suggests integrating effective trauma-informed care programs, into mental health and addiction treatment is best practice. However, little research is available regarding trauma-informed adult physical health care. This two-article theoretical-conceptual dissertation seeks to address the gap in the literature by further investigating the benefits of providing adult, trauma-informed medical care. The first paper, in this dissertation, explores the intersection of attachment and trauma theories with health outcomes. The second article builds on the need for trauma-informed care and defines the tenets of a trauma-informed care framework with examples of a trauma-informed approach through composite case vignette