Trauma-Informed Care in Schools: What We Know (And Still Don’t Know), And Why That Matters for Marginalized Youth In K-12
This year on SSWN (and our sister social media platform SSWNetwork) we’re going to delve into a complicated and we believe necessary conversation about trauma-informed care (TIC), racial inequity, and evidence-based practice (EBP). These three concepts, themselves worthy of extensive study and exploration, are coming together in dynamic and powerful ways as school clinicians, researchers, and K-12 schools reckon with how to do trauma-informed care in school contexts.
I was honored to have the chance to start working out my own ideas on these topics as part of session I led November 8th at the 24th Advancing School Mental Health Conference, organized by the National Center for School Mental Health, held this year in Austin, Texas. I am grateful to the capacity crowd that came and responded to these ideas with their own challenges and questions, and I welcomed the chance to continue our conversation that day in the halls and since via e-mail. Overwhelmingly, the people I spoke to said that the TIC “movement” has to start to fully reckon with issues of structural racism and implementation challenges if it’s going to help schools become more responsive to trauma.
This will be the first of what I hope will be many articles that I and other SSWN authors write this year on TIC, EBP, and Racial Inequity in schools, and I thought I would start things off by sharing my presentation slides as well as some key points from the session.
From the conference program description: This presentation will pose a number of difficult and important questions regarding Trauma-Informed Care (TIC) in K-12 schools, framed by this overarching question: what do we REALLY know about TIC in schools, particularly TIC in marginalized school communities? Using ideas from implementation science and race and equity frameworks, participants will reflect on how to ensure that the important work of TIC is carried out in rigorous and culturally-responsive ways, without it becoming yet another educational trend that fades away.
Key Points from the session:
- Focus was on the EBP for Trauma-Informed Care at a Tier 1 and whole-school level;
- Much of the EBP for TIC in schools is at a Tier 2 & 3 level (e.g. CBITS) but is often conflated with the notion that there is EBP for TIC at a whole-school level;
- Our 2019 empty systematic review (led by SLU SSW Associate Professor Brandy Maynard and available here and here) found no rigorous evaluations of TIC at a Tier 1 and/or whole-school level, even after screening over 7,000 studies over a 10-year period (through late 2017);
- The Trauma-Responsive Schools Implementation Assessment (TRS-IA) is a useful tool to evaluate how well your school is doing in implementing TIC best practices (though when I ran it on my twins’ middle school a lot of the practices weren’t happening yet);
- The combination of limited empirical support for school-based TIC at Tier 1 is concerning, and reflects a possible reality that TIC has spread and been adopted without considering the EBP and other possible unintended consequences of implementing TIC;
- An emerging racial inequity lens (highlighted by the recent NYT “1619 Project” special issue and Gorski’s Equity Literacy work) indicates the need for districts to recognize the need to adopt both a trauma-informed and racial inequity-informed lens that is infused into all of their work, including making time to prioritize dismantling racial inequity and other facets of white supremacy in individual schools and districts while engaging in rigorous evaluation of the TIC programs themselves.
It was great to present on these initial ideas, and I look forward to extending them as well as hearing from other voices from the TIC movement in K-12 education this coming year on SSWN and SSWNetwork. As we wrote in our empty review:
This empty review comes at an admittedly early stage in American schools’ embrace of the trauma‐informed approach. Many innovations in education start with a great deal of excitement and moral fervor that is often not matched by rigorous evaluation of the interventions or curriculum being implemented (Walker, 2004). The trauma‐informed approach appears to be no exception…In just a short period of time, the trauma‐informed approach has already begun to “spread” into American K‐12 education at a rapid clip, and appears to also be being largely “adopted” in many schools. This rapid spread and adoption has the potential to quickly become another example of an education trend that falters without evidence to sustain it (Dearing et al., 2015).