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Trauma-Informed Care and Wellness Centers

Prevalence and Impact of Trauma

Over the past 20 years, there has been a growing body of research concerning the prevalence and impact of trauma on people's lives. Much of this stemmed from a large study conducted by the Centers for Disease Control and Kaiser Permanente in Southern California between 1995 and 1997. In the study, more than 17,000 patients completed confidential surveys about things they experienced as children and their current health status and behaviors.

The study identified a set of common traumas, known as Adverse Childhood Experiences, or ACEs, and their direct relationship to health, social, and behavioral problems throughout a person's lifespan. ACEs include things like abuse, neglect, loss, domestic violence, anxiety, and bullying. Close to one quarter of Oregon's youth have one or more ACEs, and those living in poverty are likely to have multiple ACEs.

Because the body release cortisol when it is faced with a threat, and because cortisol can build up over time, the research also showed that even if the mind forgets a previous trauma, the body doesn't. As a result, students who have experienced multiple ACEs don't always have the ability to distinguish between real and perceived threats. This can translate to depression or anger in the classroom, even when it doesn't appear to the outside observer that there has been any trigger for those feelings. When students are feeling down or agitated, they are not able to learn. Not only that, but they may be receiving discipline for their behavior, which could serve to re-traumatize them.

For a fascinating exploration of ACEs and the impact of their manifestation in young people's lives, watch the documentary "Paper Tigers," by KPJR Films.
To see a helpful infographic about trauma-informed care, visit www.ukerusystems.com.

Addressing Increasing Effects

Over the past several years, we have seen an increase in the number of young students in our schools who are impacted by ACEs. We know that if we are not able to provide them with a safe and accessible learning environment in elementary school, they may fall behind and face greater risk of dropping out in the future.

Our Behavior Cadre, comprising trained behavioral specialists, care coordinators, mental health professionals, and special educators, has done a great job helping our schools respond to and support students' behavioral needs. However, we wanted to do something more systemic that would not only benefit students who may be impacted by ACEs, but would also provide a more productive learning environment for all students.

In the spring of 2016, the Office for School Performance contracted with Dr. Rick Robinson, an expert in neurodevelopmentally-sensitive, trauma-informed care, to provide professional development to our Behavior Cadre, counselors, and principals. Elementary principals also did a book study on "Fostering Resilient Learners," which deals with incorporating trauma-informed care in schools.

Principles of Care

The five main principles of providing trauma-informed care in the classroom are:

  • Safety. The classroom activities and settings ensure the physical and emotional safety of students.
  • Trustworthiness. The classroom activities and setting maximize trustworthiness by making the classroom tasks clear and consistent, by maintaining boundaries that are appropriate to the school.
  • Choice. The classroom activities and settings maximize student experiences of choice and control.
  • Collaboration. The classroom activities and settings maximize collaboration and sharing of power between students and staff.
  • Empowerment. The classroom activities and settings prioritize student empowerment and skill-building.

Implementing the Pilot Program

Through the course of the professional development and other training, we determined that a trauma-informed pilot program would be initiated at six of our elementary schools in the fall of 2016: Butternut Creek, Brookwood, Eastwood, Lincoln Street, Reedville, and Witch Hazel. These schools each agreed to do three things: 1) Dedicate a space in their building for a wellness room; 2) Bring on a full-time, trained staff member from the Behavior Cadre to oversee the space; and 3) Train all staff on how to effectively deliver trauma-informed care in their classrooms.

Each of the schools approached the incorporation of trauma-informed care a bit differently, but there were some common elements. Each classroom in the school was supposed to have a "peace corner" or "calm corner" where students could give themselves a little space and attempt to either regain the energy or the calming they needed to get to a place where they were feeling happy and able to access their learning.

Schools also created wellness centers. Students were taught to access the room for up to 15 minutes at a time when they were feeling agitated. They learned skills in this specially-designed space to de-escalate, put words to their feelings, and use sensory tools to self-regulate and then get back to their learning. It was an empowering experience that helped students build resiliency and coping skills, and increased their readiness and ability to learn.

The pilot program was very successful. Students at the schools where trauma-informed care and wellness centers were provided experienced fewer behavior incidents, less discipline, and greater attendance. Staff absenteeism at those schools was reduced as well!

Expanding the Program

Because of the pilot program's success, wellness centers were expanded and are now located in 15 elementary schools, 1 middle school, and 1 high school:

  • Brookwood Elementary School
  • Butternut Creek Elementary School
  • Eastwood Elementary School
  • Free Orchards Elementary School
  • L.C. Tobias Elementary School
  • Ladd Acres Elementary School
  • Lenox Elementary School
  • Lincoln Street Elementary School
  • McKinney Elementary School
  • Minter Bridge Elementary School
  • Mooberry Elementary School
  • Reedville Elementary School
  • Rosedale Elementary School
  • Witch Hazel Elementary School
  • W.L. Henry Elementary School
  • South Meadows Middle School
  • Century High School

The 2018-19 school year is not expected to bring another expansion; existing programs will strengthen their practices and the focus will be on training additional staff on the principles of trauma-informed care.