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Trauma-Informed Schools:
An Avenue for
Substance Abuse
Prevention and a
Shield from
Juvenile Delinquency
 TABLE OF CONTENTS

Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Develop standardized school process of screenings for ACES . . . . . . 6

Employ district-wide strategies to help students who

have experienced trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Community collaborations . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Review and reform policies concerning delinquency . . . . . . . . . . . 9

Enhance drug education to reflect best practices

and current research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

2 Trauma Informed Schools: An Avenue for Substance Abuse Prevention and a Shield from Juvenile Delinquency
EXECUTIVE SUMMARY

Trauma is directly connected to numerous adverse outcomes in school-aged youth.

Exposure to traumatic experiences, especially those occurring in childhood, has been

linked to substance use disorders (SUDs), including early initiation of drug use, and

dependence. There are also significant economic and societal costs of trauma: health

care expenditures, the costs of incarceration, future lost wages and opportunity,

etc. Schools are positioned to play a key role in prevention. This report serves as a

strategic toolkit for schools to address trauma in the student population. Traumatic

experiences and the interventions used to address trauma are vastly diverse.
RODUCTION

Trauma Informed Schools: An Avenue for Substance Abuse Prevention and a Shield from Juvenile Delinquency 3
 INTRODUCTION

Trauma is defined as “exposure to actual or threatened death, serious injury, or sexual violence” (Kilpatrick
et al., 2013). In a broader context, trauma can be described as an event that occurs that causes significant
stress on the experiencing individual’s cognitive or physical state of being. (Briere & Scott, 2013).
Traumatic experiences can include physical threats of injury or violence, but can also reference experiences
of emotional abuse or abandonment. Briere and Scott (2013) describes the application of this concept
as experiences that are temporarily overwhelming, cause extreme distress, or produce long-term
psychological symptoms for the experiencing individual.

The experiencing and witnessing of traumatic events is considered by many researchers to be an expected
life experience for most Americans. Copeland et al. (2007), found that 68% of children and adolescents in
their study had experienced a potentially traumatic event by the age of 16, and 50% had experienced more
than one event. In a similar study, Bell and Jenkins (1993) found that more than 60% of youth age 17 and
younger had been exposed to crime, violence, and abuse either directly or indirectly, and around half of all
children and adolescent experienced an assault in the last year. Finkelhor et al. (2013) found that nearly 14%
of children experienced repeated maltreatment by a caregiver in the past year and that more than 13% of
children reported being physically bullied, while 1 in 3 children reported being emotionally bullied.

Some consequences of exposure to trauma include truancy, violence,

Schools have a unique
academic decline (including higher attrition rates), and mental health
issues (Ford, Hartman, Hawke, & Chapman, 2008); each of which are opportunity to intervene
either correlated with or are risk factors for substance abuse. The effects and help students
of traumatic events can have significant consequences on substance use effectively handle the
initiation and prevalence rates for impacted youth. Individuals who have
emotional, mental, and
experienced significant traumatic events are four times more likely to
behavioral consequences
become an alcoholic, four times more likely to inject drugs, two and half
times more likely to smoke than those who have not (MHTCT, 2017). of trauma.

Schools have a unique opportunity to intervene and help students

effectively handle the emotional, mental, and behavioral consequences of trauma. High school dropouts are
more likely to have experienced trauma than their graduating peers and are generally considered at high-
risk for substance use disorders (SUDs). Also, not only are high school dropouts more likely to develop SUDs,
they are approximately six times more likely to be incarcerated than high school graduates (Khatiwada,
McLaughlin, Palma, & Sum, 2009). Additionally, Abram et al. (2004) found that trauma is more prevalent
among juvenile detainees than in community samples of youth. Appropriately addressing these concerns
in school settings could help prevent SUDs in students and subsequently juvenile delinquency. However,
due to a complicated intersection of political, social, and economic circumstances, current methods widely
implemented to address such behaviors are conventionally punitive in nature (Brent, 2016).

Some of the methods used to address trauma-associated behaviors which might have negative outcomes
on the lives of students are incentivized across the public school system. Given the dwindling economic

4 Trauma Informed Schools: An Avenue for Substance Abuse Prevention and a Shield from Juvenile Delinquency
resources allocated to public schools, coupled with the precarious nature of federal and state funding
allocation, Brent (2016) suggests that schools are willing to adopt harsher disciplinary policies and shift
priorities in order to ensure that schools remain funded. However, the financial consequences of failing
to adequately address trauma among school-aged youth include costs associated with rates of attrition
and incarceration (Khatiwada, McLaughlin, Palma, & Sum, 2009; Juvenile National Conference of State
Legislators, 2011).

To support youth, the Substance Abuse and Mental Health Services Administration (SAMHSA) recommends
incorporating a trauma-informed approach. SAMHSA defines a trauma-informed approach as “A program,
organization, or system that:

• Realizes the widespread impact of trauma and understands potential paths for recovery;
• Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the
system;
• Responds by fully integrating knowledge about trauma into policies, procedures, and practices; and
• Seeks to actively resist re-traumatization.”

RECOMMENDATIONS

Trauma Informed Schools: An Avenue for Substance Abuse Prevention and a Shield from Juvenile Delinquency 5
 Develop standardized school process of screenings for ACES

A common advocated practice is the universal screening for trauma exposure and traumatic stress
reactions. The first step in initiating and implementing trauma informed responsiveness in schools is to
perform universal Adverse Childhood Experiences (ACEs) screenings. A universal approach to screening for
ACEs can maximize the detection of students at risk for a wide range of adverse outcomes, thereby allowing
for schools to respond effectively and improve the outcomes of these students (Overstreer & Chafouleas,
2016). Information derived from universal screening can also help prevent re-traumatization of students.
Early identification of students struggling with trauma can help schools change the lens through which
trauma-exposed students are perceived (Overstreer & Chafouleas, 2016).

Screening the entire student body provides an avenue for school

Screening the entire student
administration to visualize the full scope of mental wellness in their
body provides an avenue
school, which has been shown to have a positive association with risk for
for school administration
physical health conditions, behavioral health challenges, and academic
to visualize the full scope
performance. There are a plethora of ACEs questionnaires, based on the
of mental wellness in their
Kaiser Permanente study, available online through organizations such
school…
as the Centers for Disease Control and Prevention (CDC) and the World
Health Organization (WHO). Schools can take the basic format, and
with the help of local mental health practitioners and other specialists, customize these tools to their unique
population. For optimal long-term impact, screening could be implemented with follow-up at the one year
mark or in conjunction with Youth Risk Behavior Survey collection (CDC or self-administration) after the initial
school-wide screening.

The approach the Santa Rosa Community Health’s Elsie

Allen Campus, located at the Elsie Allen High School,
used to utilize the mental health services provided to
youth illustrates the importance of ACEs screening
in improving health services. They incorporated an
ACEs based questionnaire into their appointments
with youth seeking services at their clinic. The Elsie
Allen Campus’s clinical staff designed a questionnaire
based on the ACEs study’s original questionnaire and
incorporated questions (such as a deportation question
for a predominantly Latino population) that addressed
the unique needs of the population they served (Health
& Medicine Policy Research Group and Illinois ACEs
Response Collaborative, 2017). The information garnered
from this questionnaire was used to inform their
approach to care and identify youth in need of further
mental health services (Radding, 2017).

6 Trauma Informed Schools: An Avenue for Substance Abuse Prevention and a Shield from Juvenile Delinquency
Employ district-wide strategies to help students who have experienced trauma

Trauma-informed approaches should exist at every level of education, from

the administration to the classroom. While specific strategies may vary, Enhanced training
interventions that keep students in classes and respond compassionately to for all staff who work
students with behavioral problems related to recent trauma are promising. in schools is a vital
School districts should consider strategies that notify teachers if there is investment.
knowledge of a traumatic event while maintaining student privacy. One
model for this is the Handle With Care program, a collaboration between
law enforcement and schools piloted in West Virginia. If a school-aged youth is involved in a potentially
traumatic experience (family drug arrests, domestic violence, etc.), a notification is made to the school with
the message to provide additional support to the student without revealing private information. This model
helps teachers confidentially interpret student behavior—outbursts, falling asleep, emotional distress, etc.—
and respond with patience. http://www.handlewithcarewv.org/

Enhanced training for all staff who work in schools is a vital investment. Training should include
terminology, causes, prevalence, and impact of trauma on the lives of youth. Trainings should be culturally
competent and respectful of students’ identities (ethnicity, national origin, religion, sexual orientation, etc.)
Staff should be made aware of available resources to help students who might be dealing with trauma (MO
DMHP, 2014). Schools should also recognize the vital resource already in place in the school community.

Peer support and mentoring programs show great promise to help students processing traumatic
experiences develop resiliency, a crucial ability to adapt and thrive through adversity. By sharing their own
lived experience and practical guidance, peers validate each others’ experiences, create strategies for self-
empowerment, build trust and support among students, and are valuable tools for healing. SAMHSA (https://
www.samhsa.gov/
recovery/peer-support-
social-inclusion) and the
Center for Evidence-
Based Mentoring
(https://www.rhodeslab.
org/) have numerous
mentoring models to
implement and have
established the value of
peer mentor programs.

Trauma Informed Schools: An Avenue for Substance Abuse Prevention and a Shield from Juvenile Delinquency 7
 Community collaborations

Effective trauma-informed interventions and prevention efforts are … community collaboration

most successful when they recognize the need for partnership –
begins with recognizing and
working collaboratively with parents, community organizations, and
youth. Schools should engage the community when developing debunking stigma around
programs, policies, and strategies for addressing trauma. In the 2004 mental wellness and trauma
handbook “SCHOOLS: School-based education for drug abuse
prevention”, the United Nations Office on Drugs and Crime suggests
involving the community throughout the spectrum of school-based prevention efforts such as policy review,
promotion, youth recruitment, and teacher training (p. 49). Well-equipped and trained educators can identify
a youth’s need for mental health and support services such as referral to therapy, after-school recreation,
mentoring (e.g., Big Brother, Big Sister), and life skill development. Well-connected educators and staff
are knowledgeable about issues facing students and resources available for the youth and their parents.
Reciprocal communication and involvement build support for school-based efforts for at-risk youth.

Furthermore, community collaboration begins with recognizing and debunking stigma around mental
wellness and trauma. Also, cultural competency is necessary to develop strong relationships between
schools and the community they serve. Integrating the insight and resources of community and faith-
based organizations is valuable to schools’ efforts as well. Federal agencies such as SAMHSA and the CDC
offer comprehensive ‘toolkits’ with resources for these organizations. Consistent messaging across social
groups will further entrench concepts of wellness in youth and expand the reach of trauma responsive
interventions.

8 Trauma Informed Schools: An Avenue for Substance Abuse Prevention and a Shield from Juvenile Delinquency
Review and reform policies concerning delinquency

A school environment can shield the effects of a challenging life and provide a safe and supportive haven
for children. It can also be a place that not only triggers traumatic reactions for children but also reinforces
some of the negative themes that have been learned over the course of a traumatized child’s development
(Tishelman et al., 2010).

Traditional strategies school staff use when addressing disruptive behavior that
A school focus only on hard-line consequences for misbehavior can worsen problems
environment can … with trauma victims and miss opportunities to more effectively intervene
provide a safe and (Maynard, Farina & Dell, 2017). It is critically important for schools to limit
supportive haven for harsh discipline or other policies such as “zero tolerance policies” that are
children. potentially traumatizing (Tishelman et al., 2010). The over-application of zero-
tolerance policies may lead to rigid and absolute disciplinary practices for even
minor offenses. These methods ignore the behavior’s broader context and contributory factors (Tishelman
et al., 2010). Also, stricter, authoritarian, and harsh discipline methods disproportionately affect poor and
minority students, as they are more likely to have experienced complex trauma as children and adolescents
(Espinosa et al., 2017; Sadhu, 2013). Youth impacted by trauma, who may be at-risk of being delinquent, may
engage in certain behaviors such as running away, school truancy, and unregulated disruptive behaviors
which could become barriers to their success in school and academics (Flocks, Calvin, Chriss & Prado-
Steiman, 2017). Zero tolerance policies therefore do not correct behaviors, instead they contribute to the
exacerbation of certain behaviors that trauma impacted youth exhibit. This approach increases the risk of
failing in school, being delinquent, and ending up in the juvenile justice system.

Vital reforms schools should implement include restorative

justice principles which provide opportunities to help youths
who have experienced trauma better understand the impact
of their actions on others and strive to learn new skills to
manage similar situations in the future (Pickens & Tschopp,
2017). Practicing restorative justice reduces disparities
in punishment and provides longer-term approaches to
correcting behavior. Analyses of these programs have found
they produce significant decreases in school fights, bullying,
discipline referrals, in-school suspensions, and increases in
attendance and academic progression towards graduation
(Fronius et al., 2016). One example of a program is the
Monarch Room (MR) intervention, an intervention designed
to provide an alternative to suspensions/expulsions that keeps
students in the classroom learning (West, Day, Somers &
Baroni, 2014).

Trauma Informed Schools: An Avenue for Substance Abuse Prevention and a Shield from Juvenile Delinquency 9
 Enhance drug education to reflect best practices and current research

Research shows a strong association between post-traumatic stress disorder … an integrated

(PTSD) and substance abuse (Brailsford & Myrick, 2010). To enhance trauma approach that
interventions and drug education in schools, an integrated approach that focuses focuses on
on empowering students is needed. According to McBride (2003), the goal of empowering
trauma interventions and substance abuse education programs within schools students is
is to focus more on behavior change rather than knowledge. An integrative needed.
approach involves using a collaborative decision-making process and basing
the curriculum of the program on the wants and needs of the students they are
reaching (Brailsford & Myrick, 2010). Using a trauma framework, it is possible to more clearly identify the role
and roots of drug education, as well as strengthen interventions (Cadiz et al., 2008)

ATION
EDUC
DRUG

10 Trauma Informed Schools: An Avenue for Substance Abuse Prevention and a Shield from Juvenile Delinquency
CONCLUSION

Children and adolescents’ response to trauma contribute to a myriad of social, emotional, and academic
difficulties that can interfere with students’ ability to learn at school. Trauma can diminish concentration,
memory, and the organizational and language abilities students need to succeed in school. These effects
of trauma on students cognitive ability can potentially lead to problems with academic performance,
challenging behavior in the classroom, and difficulty forming relationships. Schools can play a significant
role in addressing trauma and students’ needs by incorporating trauma-informed approaches to education.
Trauma-informed schools reflect a national movement to create educational environments that are
responsive to the needs of trauma-exposed youth. Trauma-informed schools respond to the needs of
trauma-exposed students by integrating and implementing effective practices, programs, and procedures
into all aspects of the organization and culture. While this report does not provide a comprehensive and
exhaustive list of trauma-informed recommendations, it does provide a valuable foundation for schools to
reform practices and implement changes that have strong evidence to meaningfully improve the lives of
students.

Trauma Informed Schools: An Avenue for Substance Abuse Prevention and a Shield from Juvenile Delinquency 11
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suicidal ideation, and substance abuse risk among juvenile justice-involved youth. Journal of Child &
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Flocks, J., Calvin, E., Chriss, S., & Prado-Steiman, M. (2017). The case for trauma-informed, gender-specific prevention/
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Trauma Informed Schools: An Avenue for Substance Abuse Prevention and a Shield from Juvenile Delinquency 13
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14 Trauma Informed Schools: An Avenue for Substance Abuse Prevention and a Shield from Juvenile Delinquency
 Childhood Trauma
and its Effects
Young children exposed to five or more significant adverse experiences in
the first three years of childhood face a 76% likelihood of having one or
more delays in their language, emotional or brain development.

What is trauma?
It can include
• Physical, sexual, and emotional abuse
• Community or school violence
• Witnessing or experiencing domestic violence
• Parent incarceration
• Natural disasters or terrorism
• Sudden or violent loss of loved one

26%
• Neglect of children in the United States will
• Serious illness or injury witness or experience a traumatic
event before they turn four.
School-age
children who have
As the number of traumatic events experienced during
experienced
trauma can develop childhood increases, the risk for the following health
Post-Traumatic Stress problems increase:
Disorder (PTSD) • Depression • Suicide attempts
• Alcoholism • Uncontrollable anger
3-15% 1-6%
girls boys • Drug abuse

People who
experience trauma are of youth in juvenile detention
centers have experienced
childhood trauma, and the majority

90% never received professional help or

support afterwards

4x
more likely to have
3x
more likely to
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an alcoholic use experience in Detained Youth. U.S. Department of Justice. Juvenile Justice Bulletin. Retrieved January 25,
disorder depression 2018 from https://www.ojjdp.gov/pubs/239603.pdf.

National Center for Mental Health Promotion and Youth Violence Prevention, “Childhood
Trauma and Its Effect on Healthy Development,” July 2012 (http://sshs.promoteprevent.org/
sites/default/files/trauma_brief_in_final.pdf)

Substance Abuse and Mental Health Services Administration, U.S. Department of Health and
Human Services (http://www.samhsa.gov/children/social_media_apr2011.asp)

4x
more likely to
1.5x
more likely to
Rumberger, R.W. & Losen, D.J. (2016) The High Cost of Harsh Discipline and Its Disparate Impact.
Civil Rights Project-Proyecto Derechos Civiles.

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PTSD. Retrieved January 25, 2018 from
inject drugs smoke https://www.ptsd.va.gov/public/family/ptsd-children-adolescents.asp.
 Recommendations
Academic institutions serving America’s youth should:
Universally implement
standardized screenings for
Adverse Childhood Experiences
(ACEs).

Employ evidence-based,
district-wide strategies to assist
students who have experienced
trauma.

Promote community
collaboration to address
adolescent trauma.
Enhance drug education to
reflect best practices and
current research.

Review disciplinary policies

and adopt approaches
that incorporate and adopt
disciplinary approached that are
trauma informed.

REFERENCES
National Center for Mental Health Promotion and Youth Violence Prevention, “Childhood Trauma and Its Effect on Healthy Development,” July 2012 (http://sshs.
promoteprevent.org/sites/default/files/trauma_brief_in_final.pdf)

Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services
(http://www.samhsa.gov/children/social_media_apr2011.asp)
 2016–2018 FELLOWS
Ashley Hudson-Stabin Allen Ramelb
Mental Health & Substance Abuse Services Alcohol and Drug Abuse Division of Hawaii State
Division of Alabama Department of Mental Health, Department of Health
Alabama Hawaii

Camille Richoux Sean Hardrick, Sr.

Division of Behavioral Health Services Arkansas Prevention Division of the Oklahoma Department of
Department of Human Services Mental Health and Substance Abuse Services
Arkansas Oklahoma

Meisje Scales Dane Minnick

Division of Substance Abuse and Mental Health of
Delaware Health and Social Services
Delaware
Khaela Dorman
Georgia Department of Behavioral Health and
Development Disabilities
Georgia
Audrey Benavente
Prevention & Training Branch (PEACE)
Guam Behavioral Health and Wellness Center
Guam
Division of Prevention, Housing, Technology &
Management Services of New York State Office of
Alcoholism and Substance Abuse Services
New York
Chino Amah-Mbah
Bureau of Prevention, Treatment, and
Recovery Division of Mental Health and
Substance Abuse Services
Wisconsin

Since 2006, the Substance Abuse and Mental Health Services Administration’s (SAMHSA)
Center for Substance Abuse Prevention (CSAP) Prevention Fellowship Program has worked
to build the nation’s prevention workforce through mentorship, hands-on work experience, training,
and certification.

SAMHSA/CSAP Prevention Fellowship Program

(240) 485-1700
preventionfellowship@seiservices.com
https://www.seiservices.com/samhsa/csap/preventionfellowship/