Slow Down: What We Don’t Know (Yet) About Trauma-Informed Approaches in Schools
Editor’s note: here at SSWN, we strive to bring you open-access research when we can, and this time I’m excited to bring you some just-published work that I was able to be part of, along with social work researchers at Saint Louis University. It’s part of the Campbell Collaboration, a long-running global organization that supports evidence synthesis to promote “better evidence for a better world.” Along with a team led by Campbell Collaboration Social Welfare Coordinating Group Co-Chair Dr. Brandy Maynard , we conducted a systematic review of the literature around trauma-informed approaches in schools. Our review, “Effects of trauma‐informed approaches in schools: A systematic review,” published today in the Campbell Systematic Reviews Journal (all 15 volumes are open-access and can be found here) is an extensive review of published and unpublished literature on trauma-informed care in schools. As you’ll see from the review, while there is undeniably some evidence for specific treatments for individual students dealing with trauma, thus far there haven’t been any rigorous evaluations of trauma-informed approaches for a whole school population, and as we write in our conclusion:
“From this review, it seems like the most prudent thing for school leaders, policymakers, and school mental health professionals to do would be proceed with caution in their embrace of a trauma‐informed approach as an overarching framework and conduct rigorous evaluation of this approach. We simply do not have the evidence (yet) to know if this works, and indeed, we do not know if using a trauma‐informed approach could actually have unintended negative consequences for traumatized youth and school communities. We also do not have evidence of other potential costs in implementing this approach in schools, whether they be financial, academic, or other opportunity costs, and whether benefits outweigh the costs of implementing and maintaining this approach in schools. “Maynard BR, Farina A, Dell NA,Kelly MS. Effects of trauma‐informed approaches in schools:A systematic review.Campbell Systematic Reviews. 2019;e1018.https://doi.org/10.1002/cl2.101818
What follows below is the “Plain-language Summary” of our “empty review” below, where we weren’t able to find any rigorous evaluations to date of trauma-informed approaches in schools. I welcome your feedback on this review, and we will be devoting substantial time here at SSWN over the rest of the year to looking at trauma interventions in schools, as well as using the tools of evidence synthesis to better understand what “works” in school mental health.
One final note: if you want lots more training in how to be evidence-informed in your school mental health practice, all within the context of a caring and dynamic professional learning community, apply for the Fall 2019 cohort of our Loyola School Mental Health Advanced Practice Program (SMHAPP) certificate, a 15-credit, 2-year, 99% online experience where you can learn more about EBP, data-driven decision-making, and strength-based practice. More info on the SMHAPP is here .
1.1 The review in brief
Despite growing support and increased rate of which trauma‐informed approaches are being promoted and implemented in schools, evidence to support this approach is lacking.
1.2 What is this review about?
Exposure to different types of trauma have been associated with varying types and complexity of adverse outcomes, including adverse effects on cognitive functioning, attention, memory, academic performance, and school‐related behaviors. Given the growing research on trauma and increased knowledge about the prevalence, consequences and costs associated with trauma, there have been increased efforts at the local, state and federal levels to make systems “trauma‐informed” (Lang, Campbell, & Vanerploeg, 2015). While the intent of creating trauma‐informed approaches in schools is a noble one, relatively little is known about the benefits, costs, and how trauma‐informed approaches are being defined and evaluated (Berliner & Kolko, 2016). Adopting a trauma‐informed approach in a complex system such as a school building or district is a time consuming and potentially costly endeavor and thus it is important to assess the effects of this approach to inform policy and practice.
This aim of this review was to assess trauma‐informed approaches in schools on trauma symptoms/mental health, academic performance, behavior, and socioemotional functioning. Trauma‐informed approaches include programs, organizations, or systems that realize the impact of trauma, recognize the symptoms of trauma, respond by integrating knowledge about trauma policies and practices, and seeks to reduce retraumatization. At least two of the three key elements of a trauma‐informed approach must have been present: Workforce development, trauma‐focused services, and organizational environment and practices, which differ from trauma‐specific interventions designed to treat or otherwise address the impact/symptoms of trauma and facilitate healing.
What is the aim of this review?
This Campbell systematic review sought to examine the effects trauma‐informed schools on trauma symptoms/mental health, academic performance, behavior, and socioemotional functioning. Although we conducted a comprehensive search to find studies testing trauma‐informed approaches in schools, no studies met the inclusion criteria.
1.3 What are the main findings of this review?
No studies met criteria for this review, indicating that there is a lack of evidence of trauma‐informed approaches in schools.
1.4 What do the findings of this review mean?
Despite widespread support and growing adoption of trauma‐informed approaches in schools across the globe, we found no studies to provide good evidence to suggest that this approach is effective in achieving the stated goals. Given the degree to which trauma‐informed approaches are being adopted in schools across the US and other countries, it is important that the effects of these programs be assessed.
One final note: in the spirit of open-access publishing, a pdf of the full review can also be downloaded from this link.