The Research Files Episode 57: Trauma informed practice in schools

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Hello, and thank you for downloading this Research Files podcast from Teacher magazine – I'm Jo Earp.

The topic for this episode is something we've had a lot of requests for – trauma informed education practices. Studies show that exposure to trauma in childhood is widespread. My guest today is Dr Emily Berger, an educational and developmental psychologist at Monash University here in Melbourne. We'll be talking about some of the terminology, the benefits of trauma informed practice in schools (for all students), and different approaches to creating trauma informed classrooms. There'll also be some specific advice relating to bushfire incidents, so keep listening.

Jo Earp: Emily, welcome to The Research Files. So let's start off with the terminology then – what do we mean by the term ‘childhood trauma'?

Emily Berger: There are various terms for childhood trauma – so, you might hear terms such as ‘developmental trauma', ‘complex trauma', or ‘Adverse Childhood Experiences' (ACEs) is another common term. Adverse Childhood Experiences have probably been studied the most in the research and they would refer to things such as child abuse and neglect, and also things such as household challenges. So, household challenges could be exposure to a parent with a mental illness, exposure to separation of family, or substance abuse in families; and then, as you mentioned before, in terms of the bushfires, it can include things such as exposure to bushfires.

Really, ‘trauma' is an event or an occurrence that can lead to psychological distress among young people – that can be short-term or it can be longer term, leading to intrusive thoughts about the event, or a perceived danger, that there's danger to themselves or to other people as a result of the event. And that's really what trauma is – it's an event that can impact people differently.

JE: You've mentioned there about some of the effects of the trauma. I'm thinking particularly the K-12 sphere – they manifest themselves in different ways according to different age groups or is it really just an individual thing?

EB: It can definitely be an individual thing. I think in terms of how it manifests though, you might see things such as regressive behaviours in the younger children – things such as clinginess, trouble sleeping, trouble eating, maybe bedwetting in the younger ones. Then, in the older ones, again the intrusive thoughts, ruminating thoughts, which I guess makes it really relevant for schools, particularly because that's where you can see trouble learning, trouble concentrating because a child's ‘fight or flight' stress response is in overactivation, meaning that their brain isn't processing information in the same way. So that's where you get the trouble concentrating, and this is why schools care so much about this issue.

JE: Is there a difference that you can pick up on between those who are experiencing childhood trauma – trauma – as opposed to just, you know, difficultly concentrating?

EB: It's interesting that you say that because it does require a bit of a specialist eye to see that. I think that [when we talk about trauma informed care and trauma informed practice in schools], what we ask for teachers to do is to be aware, to be aware that this may be an issue, this may be a concern. Of course, as you say, concentration issues can be for a range of different reasons. Psychologists (and I also work as a psychologist), it's our job to unpack that and communicate with teachers as best we can about what is going on for the child. But it's really, again, trauma informed practice is about teachers being aware and mindful of these impacts and that trauma may be one of the reasons.

JE: So, we're not expecting people, for people listening thinking ‘well, I've not got the background to specifically spot that', we're not expecting people to come up with a diagnosis, it's just like you say, being aware and then thinking about what support is available and the people that you can contact that are available.

EB: That's exactly right, it's having a different lens and looking at the ‘why' for the behaviour and just sort of speculating about why it might be, and then reaching out for support. If it's from a psychologist, a social worker, or someone else that you have, particularly at the school, to be able to give you that extra support and answers about the behaviour, and support for the family as well.

JE: Now, I mentioned in the intro that this is definitely a topic that we get a lot of requests for, and I've noticed that it's gained traction, if you like, over the last few years – trauma informed practice in schools, and the interest in that and the request for support in that area. Is that something that's been happening research-wise, has it been driven by that?

EB: Absolutely. I can't keep up in terms of the level of interest. Absolutely. It's probably about the last five to 10 years that it's really started to become of interest, and particularly there are different models out there which I can talk about, that have become more popular and that schools are implementing. We have had resources available, though, for the past almost 20 years – so, there's Calmer Classrooms resources, that's one example of a resource that have been available for almost 20 years now. But I would say the last five years particularly, research has really started to ramp up to the point that it's difficult to keep up with.

JE: Okay then, so, what are the benefits of adopting trauma-informed practice in schools?

EB: The benefits are wide ranging. Part of my research and my team that I work with at Monash University we're really looking at how trauma informed practice can be beneficial, under what circumstances in terms of for children, but also for teachers and school staff, but also for parents.

For example, a recent review that I did of trauma informed practice in schools revealed that for students particularly it helped in terms of lowering levels of post-traumatic stress disorder symptoms, depressive symptoms in students, helping in terms of their school attachments and connectedness, and school achievement as well. In terms of teachers, it definitely helps with their perceived levels of confidence and knowledge. Part of my research and what I found through the review (which I'm happy to share with you) is that we're not doing enough to understand how this works for teachers and school staff as well, of course because we're expecting them to deliver these approaches in schools.

And the last group I guess to talk about is parents and that's probably an area where we really don't know how it's working, how we can engage parents and families in a trauma informed approach within the school, being a part of the school community. Also, I'd like to say that parents can also be vulnerable themselves – so it's not just the children who come with a trauma history, it can also be parents who come with a trauma history, and it can be parents who struggle with attachments and relationships in schools. And that can have flow-on effects for the relationships that children can form in schools and the belonging that children feel in schools. So, I feel that parents and carers is another really important area that we, as researchers, with time and funding and research we can better understand that.

JE: Is trauma informed practice good practice for all students – not just those that have experienced trauma?

EB: Yes, look, that's definitely where I would like to see research moving. From a psychological perspective – if I can put my psychologists hat on ­– yes, absolutely. If we think about trauma informed practice, trauma informed practice is about an individualised approach, understanding each child. We know that a child who presents with trauma can look very similar to a child who presents with ADHD and concentration issues, as we've discussed before, or a child with autism spectrum disorder. So, they present with very similar symptoms and concerns, such as difficulty adjusting to changes in routine. So, the principle therefore is that presenting with the similar symptoms and having that individualised approach, therefore you can use a similar approach with all students. And that, to me, is a trauma informed approach.

Unfortunately, there hasn't been a lot in the research literature. Because it is still such as new area there hasn't been enough written about how we can actually use those approaches for different students. So, Berry Street, the Berry Street group for example, has written about trauma informed practice and adjusting it for children with intellectual disability. And I'm working at the moment on research around adjusting it for children with autism spectrum disorder, with the rationale in mind that they present with very similar symptoms and concerns – which is why it's hard for teachers to tease out what's going on – and so therefore we can use very similar approaches.

JE: I just want to take a break for a moment at this point and discuss an aside, which is as we're talking today of course the bushfires are still burning across Australia. Lives have been lost, communities, and ecosystems of course, have been devastated. I want to discuss specifically then, how teachers can support students, colleagues and themselves, during this period but also down the track. We've published an article on some of the resources that are available, and we'll put a link to that in this podcast, and you can just go to teachermagazine.com.au, search for the word ‘bushfire' and you'll find that in the archive. The reality of today's media, and social media coverage I guess, is that a lot more people and maybe younger people, are exposed to those kinds of images. Sometimes they are very confronting, there has been some very confronting and distressing images. How can adults respond to that? I've seen some advice about trying to shield children completely, for example, from media coverage, others saying that it's impossible to do, you need to be open and honest. What's your take on that?

EB: I think it's a really important topic and something worthwhile talking about today. I guess I have a few thoughts about it. Number one, it's about listening. Listening first and talking second as a parent, or as an adult when you're talking to young people and listening to young people about these issues. Listening out for anything that they say that makes you think that they're thinking about these issues, or particularly if they're ruminating about these issues, if they're constantly bringing up issues or comments related to say the bushfires, for example, or other adversities related to the bushfires.

Every child and student will have a different reaction. Research has found that children can have a reaction from being quite distressed, obviously, either immediately or sometime after as well – that's important to keep in mind, that it can be a delayed response. But also, research shows that children can actually be resilient to these sorts of events, and actually experience growth and flourishing following these sorts of events, because they learn about themselves and they learn about their competencies, and what they can do and what they can achieve.

When we're talking to children about these sorts of events, when they're seeing things, it is important to find a nice middle ground of being honest with them but also being hopeful about the response of emergency services, the community. Being realistic with them about what they can do to help – so, helping them [if they're wanting to help in some way], navigate a way that they can help. Again, being honest but also being hopeful that there are services out there and teams out there that are out there to support us, always remembering that the ruminating thoughts for a child might continue. So, always being on the lookout and being open, and opening up space and time to have these conversations as well is really important.

JE: On a high fire risk day, for example, where the school remains open, you may have some students concerned about that, and just to point out the support, I guess, and the systems in place. Is that right?

EB: Yeah, absolutely. So, again, it's that approach of being honest – kids are very perceptive, they know what's going on, particularly if they live in these high fire danger areas, they are very perceptive. We've done some work with children in our research and what they're saying is they want people to be open and transparent, they want space and time to be able to speak about their concerns. But at the same time we do need to be hopeful because we do find that children, particularly the younger children, can misinterpret either how much they can support other people and so they feel a lot of pressure themselves that they should be doing more. Or they can misinterpret the level of danger and so they can see a high fire warning day, for example, and misinterpret that as it's right on their back doorstep. So, we've got to, as adults, provide them with that balanced perspective in terms of the danger, and, again, what they could do to help.

JE: And the context as well. It just reminds me of something that was in the article that we did which I'd not really thought about, which was that a lot of younger children can misinterpret, say for example, when they see a replay of something on TV of a bushfire, they might think ‘oh, that's a new incident'. So, things as simple as that, isn't it?

EB: Absolutely. And seeing the news and thinking that these events are continuing and ongoing, yeah, absolutely.

JE: Okay. So, let's move on then to creating a trauma informed classroom. There are five principles, aren't there, of trauma informed care?

EB: Yeah, so, when I wrote the article that you're referring to, my aim was to look at some of the more, if I could say, ‘popular' models of trauma informed practice and pull them together in terms of, what are the commonalities between those approaches? So, I looked at the BRACE [Belonging, Routine, Attachment, Capacity and Emotions] Model, the ARC [Attachment, Regulation and Competency] Model and the Berry Street Education Model, in terms of trauma informed practice. And they were models that were represented as well in the recent review that I did of trauma informed practice approaches. And so pulling those together into, as you say, those five principles.

It's really worthwhile mentioning as well that there are other people working. I know there's a team in Western Australia as well, that they are working on 10 principles of trauma informed practice in schools. So, there's a lot of different ideas about how we label these areas or how we describe these areas. My aim through doing this research and through doing the article was to look across those three approaches and pull them together and say, ‘well, these are the commonalities'.

So, the five principles that were pulled together for the article were: family belonging, collaboration and engagement; school belonging, collaboration and engagement; focusing on emotions and emotion regulation; consistency in routine (and that's one that's been spoken about a lot in schools); and then, building choice and student empowerment.

JE: Coming up, we'll be finding out more about the principles of trauma informed care and those five principles with Dr Emily Berger, but first here's a quick message from our sponsor.

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JE: So, going through those five principles that you used in your article then, one by one. The first, you've talked about there, is family belonging, engagement and attachment. So, that collaboration of parents, educators and so on, to really create some consistency, if you like, for the student. And, that sense of safety is important isn't it. Different children will have different triggers, that provoke that ‘fight or flight response' but, what are some of the common ones?

EB: I've seen a range of things both through my research but also through working as a psychologist. It can be things such as a teacher raising their voice. It could be things such as a door being closed to the classroom, so students feeling that they don't have control over the situation – they can't escape. As you say, fight or flight is all about ‘I'm either going to stay here and fight or I'm going to flee, and is there something in my way that's stopping me from fleeing the situation?' So, teachers raising their voice, or a door being closed to the classroom.

It can be changes in routine – that's probably a really big one, and that's a part of the principles of course that we'll talk about – having consistency in the approach. Not only consistency across home and school, but also consistency in terms of how the teachers actually respond to students. Doing as you say you're going to do for these students. So, not changing the rules half way through for students, that's all about this approach of consistency and collaboration.

JE: The second important principle is being engaged with school, having a strong attachment there and sense of belonging. We've covered OECD research which suggests that, for some students, a sense of belonging indicates their educational success and it's also a good indicator of long-term health and wellbeing. Why is this important for those that have experienced trauma?

EB: I think it comes back to your point about safety and security. We can think about when we [as adults] feel out of control or we feel nervous about a situation, we'll want to control the situation. And it's exactly the same for students as well. So, having a connectedness with the school means that you can have some control as well. So, relationships and connections.

It's important to keep in mind though that relationships and connectedness take time with these students. And that's something I always try to remind teachers about – that to create a connection with students who have experienced trauma, because they do tend to sometimes have distrust of other people, and distrust of the school system, or distrust of teachers, that it does take time to develop those. And that's all through being consistent, doing as you say you're going to do, responding in a way that you know is going to be individualised and is going to work for that student.

JE: For secondary teachers, though I'm thinking they're seeing different students all the time aren't they, it's not like a primary teacher who may have one class and they can work with those students regularly. Are there are any, not instant tips because it's not as easy as that, but what kind of things should teachers be looking at then to build that connectedness?

EB: I think connectedness with parents and carers is really important. I think that, going back to that first principle of collaborating with parents and having a connection with parents and carers, teachers to parents and carers, is really important. That helps to build a sense of trust in the student, in the school, if parents are showing trust in the school then students will show trust and faith in the school. Also, having again that consistent approach across home and across school. Having parents support and show faith in teachers I think is really important, and that's helps the student then to have faith as well in what's happening at school.

It is very hard – teachers are dealing with students who come with a history that they don't necessarily have control over and they don't have control over the history of the children, let alone the parents as well, so it can be challenging to develop those connections with the parents, with the students. And that's what I always like to say to teachers, to develop goals with students and goals for students that are also achievable and meet the child where they're up to. And having those achievable goals allows the child and the teacher to experience success with the child. Through experiencing success, both the teacher and the child can then develop a more collaborative, positive relationship. Rather than a negative relationship and having it be negative. So, it is about goal setting and goal setting is about protecting the health, I guess, of the student but also helping the teacher to feel more positive about those interactions.

JE: So, number three then. This one is all about emotions isn't it?

EB: Yeah, absolutely. Because of the dysregulated flight or fight stress response of students who have experienced trauma, they can have dysregulated emotions, they can also have problems controlling their impulses as well. So, they're more impulsive and more likely to act on the impulse coming from what their fight or flight stress response is telling them to do – either stay there and fight, or to ‘flee' the situation, if I can put it that way.

A trauma informed practice approach is about working again collaboratively with the student, but building in individualised approaches within the school that can help a child to recognise their own emotions and triggers for themselves as well, when their emotions might get too high. Strategies within the school for them to deal those emotions. Do they need to have a red card and take five minutes outside of the classroom, do they need to go and walk around the school oval a couple of times just to help regulate themselves? Getting a child and having the teacher in touch with those emotions of the child and the triggers of the child is really important.

Also trauma informed practice – the approaches really recommend a child becoming aware of the emotions of other people, and how their behaviour and their emotions can impact on other people as well. And so, it's through that that a child can develop those emotion regulation skills.

JE: Really this kind of practice is something that we do with the students, rather than to the students. Getting them involved at every level.

The next principle then is something I think a lot of educators will be aware of – the importance of consistency. We've mentioned it a few times already today. So, predictable routines, things like that. Can you give a few examples of what teachers can do?

EB: You're absolutely right, I think that schools are great in terms of routines. It's why sometimes children can cope better at school than they can in the home setting, because school is much more routine. So, we know that routines are really helpful.

Routines can be classroom routines, in terms of ‘first we'll do this, then we'll do this, and then this will happen …' So, quite often, particularly in primary schools, they will have a chart in the primary school and it's a visual chart as well – so that can be helpful for some of the other children with some neurodiversity issues – and so they have a visual chart that the students can look at, at the beginning of the day, but also the teacher can refer back to.

Other approaches can be things such as precorrective statements – where a teacher can remind the students ‘when you enter a classroom, go and sit on the mat …' But also for those students (again, remembering this is an individualised approach), for those students who might struggle with that, to actually provide a precorrective statement ‘remember, we're going to go and sit on the mat …' So we'd specifically tell that student ‘remember, when you walk into the classroom, we're going to go and sit on the mat …'

We can also verbally tell children about their routines. So, I quite often use the language ‘first', ‘next', ‘then' and the ‘then' is always the thing that the child wants to do. So, sometimes children can become distressed because they're being asked to do something that they don't want to do and they actually would prefer to do another activity. So, we can also verbally say ‘well, first we're to do this, then we'll do this, and next …' and the next is the part that they really want to do. So the child knows that you've heard them, knows that it will happen, that they just need to go through these steps and that they'll get to the desired activity. And again, that comes back to that point about control as well. That the child has been heard and has some control and choice over the situation.

JE: There are three things there that have popped into my head just while you were speaking. The first one, going back to the difference between home and school routine. Is that in itself an issue then – the differences between … the first thing we talked about was collaborating with parents. So, getting them on board with what their normal routine is, or things in particular that happen at home that you may be able to link in with school. Is that something you should be thinking about as well?

EB: Absolutely. I think that schools and home environments, there's definitely a push and a need for how to communicate and how to communicate better around what's working at home, which might equally work at school. And then, equally, what's working at school might also work at home. Building up whatever approach it is, again, it's an individual basis, but building up whatever approach is that allows to have that communication between home and school, but also communication about what's working at home, because chances are it's going to work at school and it's worth a try.

JE: The second thing was – I'm trying to think about the ‘first, next, then' and being clear about what's coming up and not having any surprises, if you like. Is that the fear of not knowing then? Is that what's happening there?

EB: Yeah, absolutely that could be another trigger. Fear of not knowing what's happening, because that's really fear of being out of control of the situation. Yeah, absolutely.

JE: And the other thing was the consistency. I just want to go back to that again. You're saying, teachers can make clear this is what's going to happen. We all know that in the middle of lessons, or sometimes you overrun, we've all done it – I've done it when I've been teaching, you've said ‘we'll do this' and you end of not doing it because you've not got time, or you have a late change, or something happens in the classroom. What are the consequences then of not following through?

EB: I think that we can't foresee every possible consequence or, as you say, every change in routine. Schools are dynamic in terms of routines and what's happening at that time. For me, it's about teachers and schools understanding that there's been a change, there's been a shift and, again, identifying the kids that that might be an issue for. And implementing things, either just before that change or after that change, knowing that the child is going to need to enact their emotion regulation plan for example, if they have an emotion regulation plan of how they're going to regulate themselves. We actually need to put that into place either before that change, because we know there's going to be a change, or give the child that five minutes to regulate (five to 10 minutes to regulate) after there's been a change, and not expecting the child is going to be able to shift straight away and launch straight in, because the story has changed.

JE: So, not expecting everything to run smoothly and perfectly. We're not saying that. What we're saying is do everything you can to help support students when that happens. Let's move on then. The final principle is about empowering students and building on their strengths, really. And then also giving them a voice – which we've already mentioned – giving them some choice a