Trauma
TRAUMA - CINDY HOANG
THE PREVALENCE OF INFORMATION
TRAUMA AMONG YOUTH The mental health field has long recognized the negative
consequences associated with a range of traumatic events,
The National Survey of Children's Exposure to
including physical assault, sexual assault, natural or man-made
Violence conducted in 2011 indicated that 41.2%
disasters, accidents, and medical incidents (American
of children had been victims of physical assault
Psychiatric Association [APA], 2013). The shockingly high
within the last year, with 10.1% of these incidents
prevalence of exposure to violence among America's children
causing physical injury and 6.2% of the incidents
and adolescents highlights the importance to school
including the use of a weapon
psychologists of understanding the effects of violence and
effective intervention strategies.
During the same time period, 5.6% of children and
adolescents were victimized sexually, with rates
reaching as high as 22.8% among adolescent
females. In addition to threats in the community,
13.8% were subjected to neglect or physical,
sexual, or emotional abuse by a caregiver
INCREASED RISK FACTORS:
The Impact of Trauma on School Functioning
Rates of exposure to community violence are Traumatic exposure at home, school, or in the community has been
especially high among children living in urban, associated not only with PTSD, but also higher rates of separation anxiety,
low-income, predominantly racial/ethnic social anxiety, depression, suicidal ideation, and oppositional and
minority communities. aggressive behavior
Rates of exposure to violence are also higher
among adolescents from racial and ethnic Trauma also has a negative impact on academic functioning with higher
minority backgrounds symptoms of traumatic stress predicting poorer reading, math, and science
Children from high-income African American and achievement scores among elementary students
Hispanic households were exposed to more
violence than teenagers from low-income Additionally, traumatic symptoms are associated with a three-fold increase
Caucasian households in odds of having an Individualized Education Program for learning or
Children who are recent immigrants are at behavior problems
especially high risk for a history of victimization
or exposure to violence Despite the serious consequences of trauma and other
mental health concerns, the majority of
youth with mental health concerns lacks access to
treatment, and those that receive treatment
often receive ineffective care
The importance of school mental health services has led
to calls for expansion of services that rely on
partnerships between schools, families, and community
agencies to provide evidence-based and data-driven
prevention and intervention programs in schools
CSP 512
Fact Sheet
Trauma
TRAUMA - CINDY HOANG
IMPLEMENTATION FEATURES WITHIN A
Trauma Exposure Measures MULTITIERED FRAMEWORK
- Perhaps the most well-known measure of trauma Effective implementation is described as including four
exposure is the ACE Questionnaire, a retrospective foundations that interact to enable ongoing monitoring, data-
survey initially designed for adults. based decision making, and self-enhancement
- Child and adolescent-focused, rating-scale-based
screeners for trauma exposure that may be
amenable to school-based administration include
the brief screening adaptation of the Childhood
Trauma Questionnaire for adolescents and
adults
- The Traumatic Events Screening Inventory for
Children (TESI-C; National Center for PTSD, 2011)
is an interview-based screener for traumatic
exposure in children; although its administration
format and requirements (i.e., relevant mental
health licensure) may limit its efficient use with
large populations of students in school settings,
gated screening procedures (e.g., those starting These four elements include: outcomes, practices, data, and systems. The
with adult nomination) may make this instrument elements work together to inform decisions within a multitiered framework
more amenable to school-based use. of service delivery designed to meet the needs of all students.
THE FOUR ‘‘R’S’’
The four ‘‘R’s’’ include
(a) realization about trauma and its effects,
(b) recognition of the signs of trauma,
The Role of Schools (c) response that appropriately embraces trauma understanding across tiers
of service delivery, and
Schools may address the negative academic, (d) resist practices that could inadvertently re-traumatize.
behavioral, and psychological impact of trauma
on their students by adopting a trauma-informed Trauma-Focused Cognitive Behavioral Therapy
approach. The trauma-informed approach is not
an intervention; rather, it is a way of providing Trauma-focused cognitive–behavioral therapy (TF-CBT) is an evidence-
services to children and families that facilitates based treatment that has been used successfully with youth and families
the improved functioning of those negatively who experience ongoing traumas.
affected by trauma.
TF-CBT was developed to address the multiple negative impacts of
Because students from racial/ethnic minority and traumatic life events for youth aged 5–17 years old and their parents or
low socioeconomic backgrounds may primary caregivers (when available).
disproportionately experience some potentially
traumatic events, provision of trauma-informed This treatment has several components including: Psychoeducation,
care in schools may minimize disparities in Relaxation, Cognitive Coping, Trauma Narrative and Processing (i.e.,
academic, behavioral, and psychosocial outcomes gradual exposure), In-Vivo Exposure, Conjoint Parent–Child Sessions and
related to the experience of trauma. Enhancing Safety Skills.
CSP 512
Fact Sheet
