Applied and Translational Research on Trauma-Responsive Practices and Programs

Acute and chronic exposure to adversity and trauma has been linked to later dysfunction, disorder, and disease. Children and adults who endure recurring and extremely stressful interpersonal conditions such as abuse and neglect and domestic violence often bear significant social-emotional, cognitive, and behavioral consequences. Other risks within the home such as substance abuse and mental health problems may compound the costs of interpersonal trauma, although not all need be present for children to suffer irreparable harm. Environmental risks associated with poverty and neighborhood disadvantage also undermine development functioning, and may add to the hardship of children and families living in those environments.

As research on adversity and trauma has expanded, so too has the body of evidence demonstrating that the negative impacts of trauma are lessened, and possibly reversed, when systems that serve children and families provide them adequate safety, care, and resources. How systems respond is dependent on what providers within these systems understand about the causes and effects of trauma, as well as how they apply this knowledge to their work. Progress along these lines has been advanced by the advent of trauma-informed care, which is a philosophy and approach that prepares systems and organizations to recognize and respond to trauma. However, the field lacks consensus around how trauma-informed care should be translated into practice. Recent attempts have been made to identify the implementation drivers of trauma-informed care as well as its practice elements such as screening, assessment, and referral. The field also has been aided by efforts to distinguish trauma-informed and trauma-focused approaches, referring to treatments that aim to ameliorate posttraumatic symptoms and facilitate healing. Furthermore, there is growing recognition that, even in systems where professionals may not address trauma directly, understanding the signs and symptoms of trauma may still be of benefit. These trauma-sensitive contexts include many education, health care, and social service systems and settings.

This roundtable discussion will highlight examples of applied and translational research on trauma-focused, trauma-informed, and trauma-sensitive approaches that aim to prevent trauma or mitigate its effects. One example that will be discussed is the Trauma and Recovery Project, a five-year initiative that aims to increase the availability, accessibility, and coordination of trauma-focused services for families in the child welfare system. In addition, we will illustrate ways in which both selective and universal home visiting programs can implement trauma-informed practices, including a novel trauma screening, brief intervention and referral to treatment model (T-SBIRT). We also will highlight an implementation project that is applying the T-SBIRT model in workforce development settings with low-income adults. Finally, we will discuss the theory and operational strategies that comprise a trauma-sensitive, school-based intervention approach, providing case examples to illustrate how this approach can change the culture and climate of schools to be more attuned and responsive to the needs of children who have experienced trauma.