Vol.:(0123456789) 1 3
School Mental Health
DOI 10.1007/s12310-017-9228-1
REVIEW PAPER
Promoting Resilience Through Trauma‑Focused Practices:
A Critical Review of School‑Based Implementation
Brittany N. Zakszeski
1
· Nina E. Ventresco
1
· Aliza R. Jafe
1
© Springer Science+Business Media, LLC 2017
Keywords Trauma-informed service delivery · Trauma-
focused practices · Trauma-sensitive schools · Multi-tiered
systems of support · School-based implementation
Introduction
Unfortunately, exposure to trauma is common in childhood
(e.g., Finkelhor, Turner, Shattuck, & Hamby, 2015) and
marked by potentially devastating efects. Children who
have experienced trauma are at increased risk of impair-
ments in not only emotional functioning but also behavio-
ral, social, and academic functioning (Perfect, Turley, Carl-
son, Yohanna, & Saint Gilles, 2016; Porche, Costello, &
Rosen-Reynoso, 2016). The range and cascade of negative
outcomes associated with children’s experience of chronic
trauma represent a signifcant public health concern and bar-
rier to school success (Overstreet & Mathews, 2011).
To promote the functioning and well-being of individu-
als who have experienced trauma and prevent (re)trauma-
tization, the Substance Abuse and Mental Health Services
Administration (SAMHSA) (2014) advocates use of a
trauma-informed approach to prevention and intervention.
This approach represents a variety of practices that involve
(a) realizing the efects of trauma on individuals, families,
groups, organizations, and communities; (b) recognizing the
signs and symptoms of trauma; (c) responding by integrating
knowledge about trauma into policies, procedures, and prac-
tices; and (d) actively resisting re-traumatization, and that
are characterized by the principles of safety; trustworthiness
and transparency; peer support; collaboration and mutual-
ity; empowerment, voice, and choice; and consideration of
cultural, historical, and gender issues (paraphrased from
pp. 9–10). SAMHSA has advocated that a trauma-informed
approach, involving trauma-focused (or trauma-specifc)
Abstract The current review sought to describe the imple-
mentation and evaluation of trauma-focused school practices
as represented in the published literature. Through a system-
atic literature search, we identifed 39 articles describing
trauma-focused practices implemented in school settings
with elementary populations and coded data regarding
these interventions’ characteristics as well as their imple-
mentation and evaluation procedures. Reviewed interven-
tions were most often implemented by external clinicians or
researchers with select populations in response to traumatic
events experienced by a community (e.g., natural disaster,
political violence). Additionally, interventions were most
frequently evaluated solely using rating scales assessing
psychopathological symptoms and without consideration
of important dimensions such as treatment integrity, fdel-
ity, and acceptability as well as outcome generalization and
maintenance. We call for coordinated practice and research
agendas focused on embedding trauma-focused practices
within integrated multi-tiered systems of supports; designing
culturally sensitive practices and training school personnel
to serve as intervention agents; and increasing the rigor and
broadening the methods, informants, and foci of screening
and intervention evaluation procedures in the direction of
leveraging multi-method, multi-informant, strengths-based
assessment.
Electronic supplementary material The online version of this
article (doi:10.1007/s12310-017-9228-1) contains supplementary
material, which is available to authorized users.
* Brittany N. Zakszeski
brk213@lehigh.edu
1
College of Education, Lehigh University, 111 Research
Drive, Iacocca Hall, Bethlehem, PA 18015, USA