A Structural Trauma-Informed Approach to Emotional and Behavioral Disorders

Background: Emotional and behavioral disorders (EBD) is a federally recognized disability category in K-12 schools. Despite federal mandates meant to support students with disabilities, one in three students identified with EBD drop out of school, and 60.5% of these students have contact with the criminal justice system within four years of leaving secondary school (OSERS, 2021). These outcomes disproportionately harm students of color, who are subject to harsher and more frequent disciplinary referrals, suspensions, and expulsions, and who are more likely to be classified with EBD than their White counterparts (Bal et al., 2019; OSERS, 2021; Losen et al., 2014).

This study explored how theoretical perspectives influence interventions and supports related to EBD. A scoping review was utilized to answer: 1. What theoretical and conceptual frameworks have been applied in empirical studies focused on EBD? 2. How do these frameworks impact the approaches to intervention and practice for EBD?

Methods: A systematic search was conducted across 3 databases (Academic Search Complete, ERIC, APAPsycInfo) using keywords focused on: emotional and behavioral disorders, school, and theory. Results yielded 1,213 articles. Two independent reviewers reviewed studies for inclusion criteria: 1) questions or purposes focused on EBD and 2) explicitly stated a theoretical framework. Data were extracted through a full-text review, identifying the theoretical framework, study design, settings and participants, methods, and major findings of each study. The PRISMA-ScR protocol was utilized to ensure rigor and reviewers came to consensus on final articles included (n=24).

Results: Results revealed the following themes: (1) Theoretical and Conceptual Frameworks. The dominant paradigm approached EBD through a medical model of disability (n=15), positioning behavioral needs within an individual context. Theoretical frameworks within a social model of disability were utilized less often (n=9) and examined systems or intersectional concerns related to EBD. (2) Impact of Frameworks on Intervention and Practice. Behavioral approaches focused on modifying student behaviors, while ecological and systems theories contextualized the student within family, community, and school environments and examined how structural failures to support students with EBD harmed students.

Implications: Based on these findings, a conceptual framework was developed to explain how: (1) educational systems have produced disabling environments for students with emotional and behavioral needs, and (2) practitioners can deliver liberatory mental health services that are structural trauma-informed. The following structural trauma-informed practices are outlined: (1) historically and culturally responsive school-wide supports; (2) individualized supports grounded in best practices of mental health care; and (3) transformative justice practices to address racial disproportionality in EBD. Framing EBD through a structural trauma lens allows for analysis and interventions that may help prevent negative outcomes. This has important implications for social workers, educators, and researchers, as it facilitates a shift toward addressing systemic factors that influence EBD, moving beyond dominant approaches that focus on individual behavior.This extends beyond school settings and is relevant to approaching emotional and behavioral disorders among youth and adolescents more broadly. It underscores the importance of examining ecological contexts to develop more comprehensive and effective interventions for youth.