Trauma-Informed Programs Based in Schools: Linking Concepts to Practices and Assessing the Evidence

Background and Purpose: When children experience stress and adversity in their homes and communities, schools become a critically important context in which to intervene and foster their resilience. Changing practices within schools so that vulnerable and traumatized children are better understood and more compassionately served is a goal shared by many school professionals, yet schools remain poorly equipped to address the needs of these children. Any number of school-based interventions have the potential to benefit children at high risk for academic difficulties and mental health disorders, although questions remain as to which programs are most effective, scalable, and sustainable. Questions also remain about which programs best serve diverse populations, promote equity in the access to services, and have potential to reach the largest number of children in need, including those who do not outwardly manifest symptoms of traumatic stress. In this review, we take stock of existing programs used in schools to address the social, emotional, and academic needs of children with trauma histories and provide recommendations for future programming and evaluation efforts.

Methods: We conducted a systematic literature review to examine the characteristics of trauma-informed programs used in school settings. Databases used in the review include ERIC, PsycINFO, Pubmed, and Google Scholar. Selected articles (1) provided details of a trauma-informed school-based intervention and (2) included research and evaluation findings relevant to the assessment of program efficacy. Trauma-informed interventions that were not based in schools, such as those conducted in community agencies or mental health clinics, were excluded. Additionally, interventions in schools that were strictly limited to trauma screenings were also excluded. Interventions were grouped as (1) individual and group-based; (2) classroom-based; and (3) school-wide interventions.

Results: In total, 36 articles were reviewed and summarized. Half (n=18) of the programs detailed in these articles were individual and group-based interventions, which are considered Tiers 2 and 3 programs in the Response to Intervention (RTI) framework. Most programs were structured cognitive-behavioral interventions (TF-CBT, CBITS), which serve children with extensive trauma histories. Several programs are cultural adaptations of the original TF-CBT and CBITS models. Evaluations of many programs included single case studies, although more rigorous quasi-experimental and experimental designs were also sometimes used.

Conclusions and Implications: Findings highlight the promise of school-based approaches to lessen trauma symptoms and improve functioning in children who have been exposed to acute and more chronic forms of adversity. However, notable gaps in research evidence remain. Additionally, the potential of school-wide models of trauma-informed care has not been fully realized, despite a compelling rationale for their use. Further attention should be given to developing and evaluating trauma-informed programs, including comprehensive school-wide intervention to bolster support for students with subclinical symptoms at-risk for school failure.