1. Supporting Children and Families Under
Stress: Resilient and Trauma-Informed
Schools
Audra Langley, Ph.D.
UCLA Semel Institute for Neuroscience & Human Behavior
NCTSN Trauma Services Adaptation Center for
Resiliency, Hope, and Wellness in Schools
ALangley@mednet.ucla.edu

2. Prevalence of Exposure to
Traumatic Events among
Youth
 More and more youth are experiencing
traumatic events
– Family and interpersonal violence
– Community violence
– Accidents
– Natural and technological disasters
– Terrorism
– Medical Trauma

3. A Startling Number of Students
Are Exposed to Violence
2% Direct assault 6% No violence
• The
No violence
27% Violence not
involving Gun or knife
Witness violence
a weapon
48% 40%
Direct assault 54%
& witness
23%
National Survey of Adolescents LA Unified School District
1995 6th-Grade Students, 2004

4. Distress from Trauma Has
Negative Effects on Students in
the Classroom
• Classroom performance declines due to…
– Inability to concentrate
– Flashbacks and preoccupation with the trauma
– Avoidance of school and other places
• Other behavioral and emotional problems develop that can impede
learning and interpersonal relations
– Substance abuse
– Aggression
– Depression

5. Why Schools: Access and
Decreasing Disparities in Care
 Most youth with mental health needs do not seek
treatment
 Many internalizing disorders in children go
undetected
 Of youth who do receive intervention, 75% access
through schools
 Schools are ideal settings for detection and
intervention with traumatized children
– Trauma affects school performance
– Barriers to access are partially removed
 Disparities: Low SES and ethnic minority children

6. Partnering with Schools and
Communities is critical
– Establishing and maintaining
stakeholder relationships
 Why child mental health is important to them
 Education: Training, Products, and access
to community-informed
Interventions/Services
 Learn their language and speak it
– Partnering is an iterative process:
 Needs assessment
 Listening and incorporating input

7. Gaining support from school
community
 Liaison with teachers and administration
– Find ideal time for education and intervention
– Present education about trauma
 Students and Trauma DVD
 Trauma Awareness Powerpoint Slides
 Child Trauma Toolkit for Educators
 Outreach to parents
– Depending on community and school issues,
consider working with parent leaders to engage
parents in process
– Develop parent component depending on needs
of parents

8. Trauma impacts learning and
academic outcomes
 Decreased IQ and reading ability (Delaney-Black et
al., 2003)
 Lower grade-point average (Hurt et al., 2001)
 More days of school absence (Hurt et al., 2001)
 Decreased rates of high school graduation
(Grogger, 1997)
 Increased expulsions and suspensions (LAUSD
Survey)
 DVD

9. Use a “Trauma Lens” to better understand a
child’s behavior.
A shift in perspective from:
“What is wrong with this
child?”
to
“What has this child been
through?”
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12. Trauma narrative picture

16. We have to ask “what they have
been through”
 Children may have never been given the
opportunity to tell their story
 Identify those in need—not only the ones
who are already on educator radars
– High Risk Students/Schools
– Grade Level or Universal Screening

17. We Must Equip Schools and Families
to Support Children’s Recovery Efforts
Provide concrete information to
parents and educators on what
they can do to support youth
under stress or recovering from
traumatic events

18. How does distress from trauma affect students in
the classroom?
 Academic, social and behavioral problems:
 Failing to understand directions
 Overreacting: comments from teachers & peers, bells, physical contact, doors
slamming, lighting, sudden movement
 Difficulty with authority, redirection, or criticism
 Misreading context
 Failing to connect cause and effect
 Clinginess and worry about safety
 Somatic Complaints
 Incomplete school work or decreased school performance
 Absenteeism
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19. What can I do to support my students?
 Maximize the child’s sense of safety. Accept no bullying or
teasing.
 Give youth consistency and choices Predictable routines, clear
expectations, consistent rules, and immediate feedback.
 Understand that youth process their experiences through
their interactions with others (Know this is a way to cope with
trauma).
 Express positive thoughts for the future.
 Help youth to cope with day to day problems.
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20. As a parent, you are in the best position to help your child
after a stressful event
Como padres, ustedes están en la mejor posición para
ayudar a su hijo/a después de un evento estresante
 Listen
 Protect
 Connect
 Escuchar
 Proteger
 Conectar
http://www.ready.gov/sites/default/files/documents/files/PFA_SchoolCrisis.pdf
http://www.cphd.ucla.edu/pdfs/PFA_Ready%20Parent_Final_8.5x11.pdf

21. AND We Must Increase School-
Based Mental Health Services
•Access to state of the art
interventions to address
students’ mental health needs.
•School employed clinicians
•Agencies collocating in schools

22. What interventions exist?
Thorough review of the literature reveals at least 30
programs designed for schools
“How Schools Can Help Students Recover from Traumatic
Experiences”
http://www.rand.org/pubs/technical_reports/TR413.html
Only 7 have been evaluated in any kind of controlled
trial
– All use cognitive-behavioral skills
 Psycho-education; Relaxation; Affect regulation; Cognitive coping;
Trauma narrative; In vivo mastery of trauma reminders; Enhancing
safety
– Some also use experiential activities

23. Cognitive Behavioral Intervention
for Trauma in Schools (CBITS)
For Children
• 10 group-therapy sessions for trauma
symptoms
• 1-3 individual sessions for exposure to
trauma memory and treatment planning
For Parents
For Teachers
• 2-4 group sessions to…
• In-service to educate about…
− Educate about trauma
– How trauma can affect students
− Provide parenting support
– How to detect signs of trauma
• Family outreach and liaison
– How to support traumatized for other social services
students in the classroom

24. CBITS
• Based on current evidence and practice guidelines
• Easy-to-follow treatment manual with handouts for
students
• Short training (two days maximum)
• Developed in schools with multicultural youth to be feasible in the
school setting
• CBITS has the flexibility to meet the needs of students and families
from diverse backgrounds
– Urban, suburban, rural, Native American
– Recent immigrants and refugees
– in multiple languages

25. Other Group Interventions used in
schools
• TARGET-Trauma Affect Regulation: Guide for Education and
Therapy
• Uses “FREEDOM” steps: Focus, recognize triggers, emotion self-
check, evaluate thoughts, define goals, options, make a
contribution
• Some evidence
• SPARCS-Structured Psychotherapy for Adolescents Responding
to Chronic Stress
•Uses mindfulness, problem-solving, meaning-making, relationships
and communication, distress tolerance, psycho-education
• Not yet well tested

26. Summary
 Trauma lens, Identification, Educator and
Parent Support for Recovery, MH
interventions= Trauma Informed School
 Trauma Informed Schools lay the foundation
for resiliency, hope, and wellness among
students
 Resilient, hopeful, well students are better
able to learn

27. Thank you for your time, attention,
…and what you
do each and
every day.
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