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Education at OHSU
Trauma informed educational practices, the trauma informed educational practices mission.
Our mission is to transform healthcare education by building a community of educators and scholars engaged in implementing and evaluating equity-centered trauma informed educational practice (TIEP). TIEP grounds nursing in an equitable, inclusive, and culturally responsive pedagogical approach using the six guiding principles of Trauma Informed Care .
This page was last updated Thursday, November 30, 2023
What is trauma informed education?
"Trauma informed educational practices is a mindset, an acceptance of diversity, including background, knowledge, skills, and life experiences, and an understanding that some of those life experiences may be varied and include trauma" (Najjar, 2023; Najjar et al., 2022 ) . Adverse childhood experiences like poverty, neglect, and exposure to violence, including discrimination and racism, can induce overwhelming stress. Chronic stress and trauma can impact the brain’s cognitive and memory centers, derailing learning and triggering behaviors such as fight, flight, freeze, or fawn .
Beginning to understand trauma, recognizing it, and responding to it requires a mindset shift focused on providing a structure to support students, faculty, and staff in creating a learning environment free of discrimination and trauma, which fosters resilience. Trauma informed educational practices can be seen as restorative of former and current trauma and/or preparation for the future by building resilience.
The profound antidote to addressing trauma is human relationships, and if these relationships are positive, they can buffer the effects of stress and trauma. We have the power to decide whether we want our systems and institutions to be a place of trauma and re-trauma or a place of healing.
REFERENCE: Najjar, R., Jacobs, S., Keeney, S., Vidal, G., & Noone, J. (2022). Reflections on the Process of Implementing Trauma-Informed Education Lunch and Learns. Nurse Educator, Publish Ahead of Print. https://doi.org/10.1097/NNE.0000000000001338
REFERENCE: Najjar, R. (2023, January 25). Trauma-informed approach provides framework for achieving health equity. Campaign for Action. https://campaignforaction.org/trauma-informed-approach-provides-framework/
Why are trauma informed practices needed in healthcare education?
Achieving health equity requires a collective effort across and within healthcare disciplines. The 2020-2030 Future of Nursing report outlined the role of nurse educators and the learning environment in addressing social determinants of health, equity, and education. If unaddressed these determinants can undermine our ability to achieve health equity.
Using a trauma informed approach allows us to examine the influences of historic and systemic racism and discrimination that lead to inequities in the classroom. Students are exposed to racism and discrimination in and outside of the classroom which can be compounded by intergenerational poverty and trauma. A trauma informed approach provides us a framework and centers equity as we adjust to changes to our individual and systemic practices, pedagogy, and policies.
What are the steps we need to take?
- Build a trauma informed lens: this is a journey, not a destination.
- It is not enough to offer students remediation courses; what is required is a transformation in teaching and grading practices. This requires that we begin to accept that our practices are inequitable and work to change our practices, pedagogy, and policies.
- Embed safety and trust in all our work: this requires that we build positive relationships with students to facilitate learning and mitigate stress and the impact of current or past trauma. Keep in mind as educators that fear of failure, anxiety, and self-doubt reduce cognitive and learning abilities.
- Focus on culturally responsive practices: this requires that we are aware of and acknowledge historical and oppressive systems that have disproportionally affected racial, ethnic, and other systemically excluded groups. Our curriculum should be multicultural with positive cultural representations and provide evidence of the resilience of communities. Failing to honor and value students’ backgrounds and experiences in the classroom is another form of violence and can lead to trauma or re-trauma.
Where can we start?
This online platform provides information in various forms, including articles, books, podcasts, videos, and websites. A great resource and a collaborative partner for this work is Trauma Informed Oregon (TIO) . TIO is a non-profit organization that has helped to train healthcare providers in trauma informed care and serves as a resource for trauma informed efforts across the state. A strong focus for trauma informed efforts is wellness, and TIO dedicates a webpage with multiple resources on this concept of wellness. We encourage you to learn more about viewing wellness through a trauma informed lens.
Click the following tabs to explore and learn more about trauma informed educational practices.
The development of this online platform was funded by the OHSU Racial Equity and Inclusion grant opportunity through the OHSU Center for Diversity and Inclusion in partnership with the OHSU Office of Educational Improvement and Innovation.
We aim to strengthen healthcare education by supporting faculty and staff with the desire to implement or evaluate trauma informed educational practices. Please contact us if you would like more information about faculty and staff training or changes in your institution.
Rana Halabi Najjar, Ph.D., RN, CPNP
Associate Professor
OHSU School of Nursing – Monmouth
Pronouns: she, her, هي
Francis Alicia Rojina, M.P.H.
Student Inclusion & Success Coordinator
OHSU School of Nursing – Klamath Falls
Pronouns: she, her, ella
Our Research/Scholarship Interest Group (RIG/SIG) aims to transform healthcare education by building a community of educators and scholars using and evaluating Trauma Informed Educational Practices (TIEP). Individually, we are working on ways to expand our TI practices and pedagogical approaches. Collectively, we explore ways to support and share ideas on implementing TI in the educational environment. If you are interested in attending our educational sessions or collaborating on scholarship and research, please contact us.
RIG/SIG Principle Investigator
RIG/SIG Co-Investigator
Doria K. Thiele, PhD, CNM, IBCLC
Assistant Professor of Clinical Nursing
Pronouns: she/her
Echo recording of presentation on 'Trauma Informed Pedagogy in Healthcare'
Equity-centered trauma informed approach.
The following diagram describes the Equity-Centered Trauma Informed Approach to educational practice. The diagram illustrates the four phases of developing a trauma informed lens, which is centered on equity and justice. Remember, this is a journey, not a destination. The ongoing process of developing a trauma informed lens should be reflected in practice, pedagogy, and policy at OHSU to ensure safety, trust, peer support, collaboration, empowerment, and cultural responsiveness among the OHSU community. It takes all these components to light the way toward becoming a trauma informed space.
Article List
- Bridges and barriers: Educational mobility of Hispanic nurses
- Closing the Social-Class Achievement Gap: A Difference-Education Intervention Improves First-Generation Students’ Academic Performance and All Students’ College Transition
- Critical race Theory as a lens for Exploring inclusion and Equity in Nursing Education. Journal of Theory Construction & Testing
- Fostering academic success of Mexican Americans in a BSN program: An educational imperative
- Inequitable Opportunities: How Current Education Systems and Policies Undermine the Chances for Student Persistence and Success in College
- “It All Depends”: How Minority Nursing Students Experience Belonging During Clinical Experiences: Nursing Education Perspectives
- Seeking inclusion excellence: Understanding racial microaggressions as experienced by underrepresented medical and nursing students
- Shifting teacher practice in trauma-affected classrooms: Practice pedagogy strategies within a trauma-informed positive education model
- Trauma-Informed Practices in Schools Across Two Decades: An Interdisciplinary Review of Research
- Types of Trauma, Posttraumatic Stress Disorder, and Academic Performance in a Population of University Students
- Why Do You Work with Struggling Students? Teacher Perceptions of Meaningful Work in Trauma-Impacted Classrooms
- Adrift in a Pandemic: Survey of 3,089 Students Finds Uncertainty About Returning to College
- Collaborating to Solve Basic Needs Insecurity on College Campuses
- Leveraging the Neuroscience of Now by Mays Imad
- Equity-Centered Trauma-Informed Education
by Alex Shevrin Venet
In this book, Venet shares a systems approach to resorting to justice and equity in the classrooms, schools, and communities. The book has five parts: bring equity to the center, adopt a universal approach, rethink your role as an educator, move from mindset to systems change, and change the world from the inside your classroom. Venet writes candidly about how our educational systems are inequitable, and cause trauma or re-trauma. Informative concepts and content include:
- Principles of Equity-Centered Trauma-Informed Education
- Developing our lens (practice), transforming our classrooms (pedagogy), and shifting the larger systems (policy)
- Adopt a Universal Approach using the four proactive priorities (predictability, flexibility, connection, and empowerment)
- Tools to examine current practices
- Examine the curriculum, disrupt harmful narratives
- Activism and action as healing
The author includes many resources and references that are valuable to educators and administrators interested in advancing social justice and equity in education.
Venet AS. Equity-Centered Trauma-Informed Education . First edition. W.W. Norton & Company; 2021.
Training for Change: Transforming Systems to Be Trauma-Informed, Culturally Responsive, and Neuroscientifically Focused
by Dr. Alisha Moreland-Capuia
Training for Change provides an overview of the neurobiology of fear, brain development, trauma, substance use, bias, racism, and environmental factors that impact healthy brain development. Dr. Alisha Moreland-Capuia shares case studies to elucidate the concepts and provide recommendations to facilitate a trauma informed approach to changing systems. The book includes 12 chapters on topics such as:
- Developing brain and trauma
- Intersection of fear, trauma, aggression, and a path to healing
- Labeling theory: the power of words and implicit bias
- Restorative justice
- Change and hope of systems change
A must-read for any organization moving on the path to being trauma informed.
Moreland-Capuia A. Training for Change: Transforming Systems to Be Trauma-Informed, Culturally Responsive, and Neuroscientifically Focused . Springer Nature Switzerland; 2019.
- Teaching in Higher Ed: Trauma-Informed Teaching and Learning, with Mays Imad [Audio Podcast]
- Tea for Teaching: Trauma-informed Pedagogy [Audio podcast]
- NPR: Uncovering The 'Unspoken Traumas' Of Native American Boarding Schools [Audio podcast]
- NPR: Want To Dismantle Racism In Science? Start In The Classroom [Audio podcast]
Resource Guides
- Crisis Prevention Institute: Trauma-Informed Care for Educator
- Education Northwest: Trauma-Informed Practices for Postsecondary Education: A Guide
- Substance Abuse and Mental Health Services Administration : SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach
- The National Child Traumatic Stress Network: Addressing race and trauma in the classroom
- Cult of Pedagogy
- National League for Nursing - Taking Initiative Aim: Structural Racism, Diversity, Equity, Inclusion, Implicit Bias, and Social Justice
- OHSU Anti-Racist resources
- OHSU Foster Respectful and Equitable Education (FREE)
- National Museum of the American Indian by the Smithsonian: Native Knowledge 360
- Trauma Informed Oregon
- Trauma Informed Positive Behaviour Support
- Trauma Informed Teaching & Learning
Self-Care & Regulation
- Self-care resources for educators
A guide on how to do the 4-7-8 breathing exercise (scroll down for a video on this)
Mindful Breaks & Practices
Grounding Exercises
For these grounding exercises, walk students through the exercises after you watch the videos. You can have students stand facing the walls in the room so they can’t see each other. It helps them be uninhibited in their movements.
Standards of Practice for Trauma Informed Care in Educational Settings
Guidelines were developed by Trauma Informed Oregon through the Defending Childhood Initiative to provide educational institutions guidance in implementing trauma informed educational practice. We encourage institutional implementation starting with the development of a strategic plan based on the needs of students, faculty, and staff within the institutions. The language in this document focuses on K-12 programs, but can be adapted for any educational institution.
The Standards of Practice for Trauma Informed Care in Educational Settings Tool
Trauma Informed Care Screening Tool
Trauma Informed Oregon has also developed a screening tool that outlines ways an organization may advance in sequential movement from trauma aware (phase 1) to trauma informed (phase 4).
Using the Trauma Informed Care Screening Tool
Scholarship & Research
Dr. doria thiele.
Dr. Doria Thiele has been a nurse educator since 2008 and has taught across several programs. In recent years, Doria’s teaching has been in the Doctor of Nursing Practice program, which includes six nurse practitioner specialties. Doria’s research focuses on student perceptions of different trauma informed teaching strategies. This includes surveying students regarding belonging, stress, resilience, discrimination, and about specific trauma informed strategies they have experienced. Doria’s research goals are to better understand what is important to students in regard to trauma informed teaching strategies, and to improve experiences for all students, but most importantly students who come from historically excluded groups.
Dr. Rana Najjar
Dr. Rana Najjar has been teaching in the undergraduate and graduate programs in the School of Nursing since 2008. Her research and scholarship focus on bias, discrimination, and equitable and inclusive practices in healthcare education. She is the principal investigator for a mixed-methods study examining applicants’ experiences of bias during the admission process. Rana is a leader in Trauma Informed Education Practices (TIEP), collaborating with OHSU to design, implement, and evaluate faculty/staff training on TIEP. Rana has led book clubs and other initiatives with various nursing academic institutions to raise awareness of the impact of inequities on nursing education and build a community of trauma informed educators.
Publications
- Najjar, R. H. (2024). Equitable grading practices. In J. Noone & P. M. Gubrud-Howe (Eds.), Best practices in teaching nursing (1st ed., chp. 14). National League for Nursing
- Najjar, R., (2023, January 25). Trauma-informed approach provides framework for achieving health equity. Campaign for Action. https://campaignforaction.org/trauma-informed-approach-provides-framework/
- Najjar, R., Jacobs, S., Keeney, S., Vidal, G., & Noone, J. (2022). Reflections on the process of implementing trauma-informed education lunch and learns. Nurse Educator. Advanced online publication . https://doi.org/10.1097/NNE.0000000000001338
- Najjar, R., Noone, J., Reifenstein, K. (2022). Supporting an Inclusive Environment Through Correct Name Pronunciation. Nurse Educator. https://doi.org/10.1097/NNE.0000000000001285
- Noone, J., & Najjar, R.H. (2021). Minimizing Unconscious Bias in Admission to Nursing School. Journal of Nursing Education , 60(6), 317-323. https://doi.org/10.3928/01484834-20210520-03
- Research Interest Group: Evaluating Trauma Informed Education Practices in an Online Nursing Course (PI: Thiele)
- Facilitators & Barriers to Implementing Trauma Informed Educational Practice Training (PI: Najjar)
- Improving DNP Student Experiences Using Growth Mindset and Trauma Informed Techniques (PI: Thiele )
- Experiences of Bias in Nursing School Admissions (PI: Najjar)
- Research Interest Group: Incorporating Trauma Informed Teaching into Doctor of Nursing Practice Courses (PI: Najjar, Co-PI: Thiele)
- Building a Trauma Informed Education Resource Center: A DEI OHSU collaborative (PI: Najjar, Completed).
Podcasts/Webinars
- Correct Name Pronunciation: Supporting an Inclusive Environment
- Reflections on the process of implementing trauma informed education lunch and learns (Coming Soon!)
- Trauma Informed Education Lunch and Learns
Conference Presentations
- Najjar, R.H. Trauma-Informed Pedagogy: A Just, Equitable, and Inclusive Practice. Podium Presentation at the Western Institute of Nursing Conference, April 2023, Tucson, AZ.
- Najjar, R.H. Trauma-Informed Educational Practices. The American University of Beirut Nursing Research Day Conference. May 2022. Virtual Presentation
- Najjar, R.H., Noone, J., & Thiele, D. (2022). Trauma-Informed Educational Practices (TIEP): An Equitable and Inclusive Approach to Nursing Education. Podium Presentation (Professor Rounds) at the National League for Nurses Conference, September, 2022, Las Vegas, NV.
- Najjar, R.H., Equity-Centered Trauma-Informed Education. Poster and Podium presentation at the AACN Diversity Leadership Institute, June 2022, Virtual.
- Najjar, R.H., Noone, J., & Thiele, D. Using Trauma-Informed Educational Practices: An Equitable and Inclusive Approach to Nursing Education. Poster Presentation at AACN Diversity Symposium Conference, November 2021, Virtual.
- Thiele, D.K., Najjar, R.H., & Goranflo, R. Incorporating Trauma-Informed Education Practices into the Doctor of Nursing Practice Program. Poster presentation at the OHSU Education Symposium, May 2022, Portland, OR.
- Najjar, R.H. Trauma-Informed Approaches Center, Equity, Inclusion, and Culturally Responsive Pedagogy. Webinar for International Network for Doctoral Education in Nursing, November 2023, Virtual.
Work Highlighted
- Western Institute of Nursing
- American Organization for Nursing Leadership
Invited Lectures
- Najjar, R.H, & Ackerman-Barger, K. Achieving Health Equity by Leveraging Equity-Centered Trauma – Informed Educational Practice. Podium Presentation. Western Institute of Nursing. April 2023.
- Najjar, R.H. Equity-Centered Trauma-Informed Approaches in Healthcare Education. University of Washington, Office for Nursing Research: Nurse-Led Community Engaged Scholarship on Social Determinants of Health. November 2022.
- Najjar, R.H. Equity-Centered Trauma-Informed Education. The University of California Davis: Growing as a Community Education Webcast. September 2022.
- Najjar, R.H. Equity-Centered Trauma-Informed Educational Practices. The University of California Davis. Faculty Development Workshop. September 2022.
- Garcia, E., Hassmiller, S.B., Myler, A., Najjar, R.H., & Shirley, J. Trauma-Informed Inclusive Educational Practices. Panel Discussion with Audience Q & A at the Oregon Consortium for Nursing Education Conference, May, 2022, Bend, OR.
- Najjar, R.H. Equity-Centered Trauma-Informed Education. Digital Lecture Series for OHSU Nursing @ Noon, January 2022.
TIEP Training
- Najjar, R.H, Fry-Bowers, E., & Downs, A. Bookclub on Equity-Centered Trauma-Informed Educational Practices. An OHSU, University of San Francisco, & University of Portland Collaborative. February 2023 – April 2023
- Najjar, R.H & Ackerman-Barger, P. Bookclub on Equity-Centered Trauma-Informed Educational Practices. An OHSU & UC Davis Collaborative. October 2022 – March 2023
- Najjar, R.H & Garcia, E. Equity-Centered Trauma-Informed Educational Practices. OHSU RN/BS Program. Faculty Development sessions. September 2022.
- Najjar, R.H. Equity-Centered Trauma-Informed Education. The University of California Davis: Learning Culture Committee. September 2022.
Upcoming Events
Forum session: february 14th from 12-1 pm.
This is open to all internal and external to OHSU, please fill out the following form to receive the link for the session: https://ohsu.ca1.qualtrics.com/jfe/form/SV_4PdWmzRnBCamLno
Past Events
2022-2023 book club: discussing equity-centered trauma-informed education.
A joint collaborative activity between OHSU School of Nursing and the Betty Irene Moore School of Nursing. The book club discussions will focus on the book, Equity-Centered Trauma-Informed Education , by Alex Shervin Venet. Learn more about the author and book by visiting https://unconditionallearning.org .
Book Club Session Dates:
- October 17th
- November 14th
- February 13th
- March 20th (with special guest, author Alex Venet)
All sessions will be held via Zoom from 12:00 - 1:30 pm (PST). More information about registration to come in September 2022.
- Our Mission
Understanding Trauma-Informed Education
The principal of an internationally recognized trauma-informed school explains what this form of education is—and what it isn’t.
ACEs (adverse childhood experiences) have made their way into the mainstream over the past couple of years, even showing up in a segment that Oprah did for 60 Minutes . And because ACEs have a profound effect on children, the concept has been taken up in the world of education. Approaching education with an understanding of the physiological, social, emotional, and academic impacts of trauma and adversity on our students is driving changes in our systems.
However, these changes are not coming without misconceptions. As the principal of Fall-Hamilton Elementary , an internationally recognized trauma-informed school, I’ve encountered many misconceptions about trauma-informed education over the past five years. As educators move toward understanding the impact of trauma, including ACEs, and how creating and maintaining positive relationships can serve as a buffer to the negative impacts of trauma, it’s vitally important to understand what trauma-informed education is and is not.
6 Misconceptions About Trauma-Informed Education
1. Trauma-Informed education is solely about a student’s ACE score: The ACE study conducted by Kaiser Permanente and the CDC is credited with increasing public awareness of the potential negative health outcomes of adults based on their adverse childhood experiences.
That increased awareness is good, but trauma-informed education is not solely concerned with students’ ACE score. We should use the ACE study as a catalyst to look deeper into understanding the broad scope of adversity that children are experiencing but that the study did not include. Trauma-informed education includes examining the influence and impact on students in our schools of factors such as racism (explicit, implicit, and systematic; and microaggressions) as well as poverty, peer victimization, community violence, and bullying .
2. Educators must know a student’s ACE score to successfully intervene: It is not imperative to know a child’s ACE score or specific traumatic experience to provide effective interventions. Being trauma-informed is a mindset with which educators approach all children.
Research indicates that strong, stable, and nurturing relationships foster a feeling of belonging that is essential for all students but is absolutely imperative for healing with students who have experienced trauma. Karen Treisman, a clinical psychology specialist, says, “ Every interaction is an intervention .” As educators, we must understand the impact of daily positive interactions and affirmations for our students.
3. Trauma-informed education is about fixing kids: Our kids are not broken, but our systems are. Operating in a trauma-informed way does not fix children; it is aimed at fixing broken and unjust systems and structures that alienate and discard students who are marginalized.
If we view our trauma-informed approach as fixing kids, that creates a deficit mindset. Many kids are doing the best they can in the moment. We must meet all students where they are while supporting them with strong, stable, and nurturing relationships.
4. Trauma-informed educators don’t give students consequences for inappropriate behavior: There needs to be a clear understanding of the difference between consequences and punishment. Consequences by definition are designed to teach, while punishment relates to personal suffering.
It’s important to set clear boundaries and expectations and then to support students into success. When students do not meet expectations or disregard boundaries, it is imperative to teach and reteach the expectations through consistent consequences .
5. Sometimes you have to escalate a confrontation with a student to calm them down: Co-regulation is the idea of keeping calm in order to help calm a student who is experiencing anger, frustration, or fear. A dysregulated adult cannot regulate a dysregulated child. Raising our level of intensity is not a strategy that works.
We should instead use strategies that honor the student’s emotions and need for space while also getting their systems to calm in a safe way. This can be accomplished through first making sure that we really are calm and then by validating the student’s experiences and emotions in order to get to the root of what is causing those emotions.
This doesn’t mean excusing any poor choices the student may have made—it means ensuring that they’re in a state where they can understand and accept any consequences, which is necessary if they are to learn from the experience.
6. I’m a teacher, not a therapist—this isn’t my job: As educators explore the complexities of being trauma-informed, we need to remember that trauma-informed work is a journey and not a destination. It doesn’t mean that teachers need to do the work of professional therapists. Our part in helping students with trauma is focusing on relationships, just as we do with all of our students. The strong, stable, and nurturing relationships that we build with our students and families can serve as a conduit for healing and increasing resilience.
Becoming trauma-informed in our daily practice is truly a process of learning and adjustment, but it is a worthwhile process.
Because differences are our greatest strength
What is trauma-informed teaching?
By Trynia Kaufman, MS
Expert reviewed by Jerome Schultz, PhD
At a glance
Trauma-informed teaching considers how trauma impacts learning and behavior.
Trauma can slow down or completely stop our ability to learn.
Kids experiencing trauma are more likely to fall behind in class or get in trouble for behavior issues.
Imagine you’re being chased by a tiger. Your heart races as you feel a surge of adrenaline preparing your body to fight, flight, or freeze. Now imagine that right after escaping the tiger, you have to learn how to multiply fractions. You would likely find this task near impossible, even if you usually find math easy.
Trauma-informed teaching starts with an understanding of how trauma can impact learning and behavior. With this approach, educators think about what student behavior may be telling them. And they reflect on their teaching practices to find ways to better support students who may be experiencing trauma.
Trauma can slow down or completely stop our ability to learn. When our bodies sense a threat, energy rushes toward brain regions specialized in averting danger. This is essential for keeping us alive. But it also means that energy shifts away from the brain regions that help us learn.
When students are experiencing trauma, they might be more distracted or take longer to complete tasks. They may be more irritable or jumpy. And they’re more likely to fall behind in class or get in trouble for behavior issues.
Dive deeper
What is trauma.
Trauma is a physiological and psychological response to any deeply upsetting or threatening situation. These situations can range from child abuse or neglect to a serious car wreck. Ongoing adversity such as discrimination, bullying, poverty, or community violence can also cause trauma.
Most kids will recover from a traumatic event after a few weeks or months. But repeated trauma or chronic adversity can put the brain on high alert, looking for the next threat. This is called hypervigilance. It can cause kids to overreact to seemingly neutral events, like a teacher asking them to turn in an assignment.
Keep in mind that kids can respond in different ways to the same experience. The coronavirus crisis is a perfect example of this. Some kids may be traumatized by the experience, while others may not be.
Learn more about trauma and the coronavirus pandemic .
Trauma and learning and thinking differences
Researchers agree that trauma negatively impacts learning and attention. But can trauma cause lifelong challenges like learning disabilities and ADHD, or vice versa? That’s unclear. What we do know is that accurate identification is essential to providing appropriate treatments.
Students who have experienced trauma are more likely to be referred to special education. Trauma might sometimes be misidentified as ADHD since the symptoms have a lot of overlap. Hyperactivity, restlessness, disorganization, and trouble focusing can be signs of either trauma or ADHD.
Referring students for an evaluation can help identify the underlying issue. But it’s important to find an evaluator who has experience with ADHD and trauma if both are a potential concern.
Families: Learn more about evaluations .
Signs of trauma in school
When teachers know a student has experienced trauma, they’re better prepared to support the student’s educational and emotional needs. But often, students won’t say anything. So how can teachers know if students don’t tell them?
The first step is to take note of any change in behavior, since it could be a signal that something is going on. A normally outgoing student may become more reserved. A student who is typically organized may suddenly be missing assignments.
Keep in mind that if the trauma happened or started in previous years, teachers might see these behavioral issues within the first few weeks of school. Students whose severe or ongoing trauma goes unnoticed may even have a reputation for having behavior issues.
Potential signs of trauma:
Overreactions to everyday challenges
Negative outbursts or aggression
Frequent stomachaches or headaches
Appearing very sad
Inappropriate social interactions
Trouble with executive functions like focus, organization, and self-regulation
Falling behind with classwork
Many of these behaviors could also be caused by other issues. Students might have a medical condition, anxiety, or learning and thinking differences.
Educators: Learn how to use compassionate curiosity to help uncover what might be causing certain behaviors.
How to use trauma-informed teaching
Teachers know the importance of building positive relationships with students and their families. These relationships are even more important for students who are experiencing trauma.
Trauma-informed teaching can help show students that teachers care. It can help teachers provide support. And it can help students recover after a traumatic event.
What does trauma-informed teaching look like? Making simple changes to class structure and interactions with students can have a huge impact on those who are experiencing trauma. Here are strategies for educators to try:
Be mindful of your own emotions. Identifying and managing your feelings is the first step in helping students manage theirs.
Expect that students will overreact sometimes. Provide the space and time they need to calm down. Let them know this is a normal response to trauma.
Give students opportunities to talk or write about their experiences. Understanding the reasons behind a student’s behavior can help you respond with empathy.
Remind yourself that behavior is a form of communication. Try not to take it personally.
Communicate with families about what you’re seeing. They might have ideas you could try in class. Or they might ask you for ideas on how to help at home.
Make sure your teaching is culturally responsive and doesn’t exacerbate traumatic experiences students may have had.
Teach and model social and emotional skills, including positive behavior strategies.
Ask the school counselor or other mental health specialist for recommendations and support. For behavior issues, a functional behavioral assessment can help identify what is causing the behavior and how to help.
Educators: Learn more about understanding behavior as a form of communication and using positive behavior strategies .
More trauma-informed resources for educators
Learning more about trauma-informed teaching strategies can help teachers support students. Explore these resources:
ASCD Educational Leadership: Trauma-Informed Teaching Strategies
Child Mind Institute: How Trauma Affects Kids in School
Learning for Justice: A Trauma-Informed Approach to Teaching Through Coronavirus
The National Child Traumatic Stress Network: Child Trauma Toolkit for Educators
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Trauma-Informed Care Professional Development Certificate
Developed in partnership with the iu center for rural engagement, iu school of public health-bloomington, and the iu school of social work.
Trauma-informed care (TIC) is an approach for organizations and individuals to adopt that emerged from an understanding of the prevalence and pervasive impact of trauma across the human experience. Grounded in principles of safety, trustworthiness, choice, collaboration, and empowerment, TIC is focused on reducing further risk of harm to people who have experienced trauma and promoting their healing and growth.
This TIC training, available through Public Health & YOU , provides:
- a foundational curriculum focused on understanding trauma and the basics of TIC;
- modules to explore and apply TIC within specialized populations, including youth, Veterans, people with intellectual/developmental disabilities, and justice-involved individuals.
About the training
- free-of-charge
- entirely online*
- provides 6 continuing education units (CEUs) free-of-charge**
- includes content from 17 academics, practitioners, and community members
*only requires a valid email address to create an account ** CEUs offered through the IU School of Public Health-Bloomington and IU School of Social Work
For additional information, see the Frequently Asked Questions section below.
Visit IU's Expand portal to register for free.
Frequently asked questions, what is the cost of registration.
The training is offered at no cost to you. This training is for personal or professional development only (continuing education) and does not offer academic credit.
How long is the training?
This training includes four modules. The first module, Foundations of Trauma-Informed Care, takes approximately four hours. It is required for all learners and establishes a baseline understanding of TIC, including its background, principles, and application.
Following completion of the Foundations module, you can select one or all of the following population-specific modules, which take approximately two hours each to complete: Youth, Veterans, people with Intellectual and Developmental Disabilities (IDD), and justice-involved individuals. These modules provide additional information regarding the specific populations to further your understanding of TIC.
How do I register?
You can access the training through expand.iu.edu . If you are new to the site, you will be prompted to create an account using a valid email address. Following verification of your email address, you will be able to register for any Public Health & YOU course, including the Trauma-Informed Care training.
Who should take this training?
This training is intended for anyone interested in learning about trauma and trauma-informed care.
What are the requirements or prerequisites?
This course does not require you to have any previous training or advanced education. The only requirement is that you have a valid email address in order to access the training.
Does this certificate offer continuing education credits?
A certificate of completion is available following completion of the training for continuing education purposes. CHES category 1 credits and Social Work CEUs are also available.
To receive CEU certification, you must enroll in and complete the course, score 80% or higher on the Knowledge Checks, and follow the directions to download your certificate from the Expand Dashboard.
Center for Rural Engagement resources and social media channels
- Faculty and Staff Portal
What is Trauma-Informed Care?
Trauma-informed care shifts the focus from “What’s wrong with you?” to “What happened to you?” A trauma-informed approach to care acknowledges that health care organizations and care teams need to have a complete picture of a patient’s life situation — past and present — in order to provide effective health care services with a healing orientation. Adopting trauma-informed practices can potentially improve patient engagement, treatment adherence, and health outcomes, as well as provider and staff wellness. It can also help reduce avoidable care and excess costs for both the health care and social service sectors.
Video: What is Trauma-Informed Care?
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- Realize the widespread impact of trauma and understand paths for recovery;
- Recognize the signs and symptoms of trauma in patients, families, and staff;
- Integrate knowledge about trauma into policies, procedures, and practices; and
- Actively avoid re-traumatization.
A comprehensive approach to trauma-informed care must be adopted at both the clinical and organizational levels. Too frequently, providers and health systems attempt to implement trauma-informed care at the clinical level without the proper supports necessary for broad organizational culture change. This can lead to uneven, and often unsustainable, shifts in day-to-day operations. This narrow clinical focus also fails to recognize how non-clinical staff, such as front desk workers and security personnel, often have significant interactions with patients and can be critical to ensuring that patients feel safe.
What are the principles of trauma-informed care?
Following are recognized core principles of a trauma-informed approach to care that are necessary to transform a health care setting:
Throughout the organization, patients and staff feel physically and psychologically safe
Trustworthiness + Transparency
Peer support, collaboration, empowerment, humility + responsiveness.
(Adapted from the Substance Abuse and Mental Health Services Administration’s “Guiding Principles of Trauma-Informed Care.” )
What are the benefits of providing trauma-informed care?
There are a number of benefits to using a trauma-informed approach, not only for patients but also for providers and staff. Many patients with trauma have difficulty maintaining healthy, open relationships with a health care provider. For patients, trauma-informed care offers the opportunity to engage more fully in their health care, develop a trusting relationship with their provider, and improve long-term health outcomes. Trauma-informed care can also help reduce burnout among health care providers, potentially reducing staff turnover.
Trauma-informed care can help improve patient outcomes
How can health care providers help patients address trauma?
Individuals can build trauma-informed health care organizations that create safe, caring, inclusive environments for all patients. There are a number of trauma-informed strategies that organizations can adopt to help people overcome the effects of trauma, ranging from organizational changes in the culture and atmosphere of a health care setting to full adoption of practices to address trauma at the clinical level.
What are the steps to becoming a trauma-informed organization?
There are many ways to become a trauma-informed organization and the process does not have to be a burden to adopt. Foundational steps organizations can take to move toward fully adopting a trauma-informed approach to care include:
- Building awareness and generating buy-in for a trauma-informed approach;
- Supporting a culture of staff wellness;
- Hiring a workforce that embodies the values of trauma-informed care; and
- Creating a safe physical, social, and emotional environment.
For more details, see a brief on Laying the Groundwork for Trauma-Informed Care .
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