Nhận thức của nhân viên trường học về chương trình định hướng chấn thương trong việc cải thiện kiến thức và môi trường

Philadelphia College of Osteopathic Medicine DigitalCommons@PCOM PCOM Psychology Dissertations Student Dissertations, Theses and Papers 2018 School Staff Perceptions of a Trauma Informed Program on Improving Knowledge, Competence, and School Climate Elizabeth Mikolajczyk Philadelphia College of Osteopathic Medicine Follow this and additional works at: https://digitalcommons.edu/psychology_dissertations Part of the Psychology Commons Recommended Citation Mikolajczyk, Elizabeth, "School Staff Perceptions of a Trauma Informed Program on Improving Knowledge, Competence, and School Climate" (2018). PCOM Psychology Dissertations.edu/psychology_dissertations/473 This Dissertation is brought to you for free and open access by the Student Dissertations, Theses and Papers at DigitalCommons@PCOM. It has been accepted for inclusion in PCOM Psychology Dissertations by an authorized administrator of DigitalCommons@PCOM. For more information, please contact library@pcom.

Philadelphia College of Osteopathic Medicine Department of Psychology SCHOOL STAFF PERCEPTIONS OF A TRAUMA INFORMED PROGRAM ON IMPROVING KNOWLEDGE, COMPETENCE, AND SCHOOL CLIMATE By Elizabeth Mikolajczyk Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Psychology May 2018 PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE DEPARTMENT OF PSYCHOLOGY Dissertation Approval This is to certify that the thesis presented to us by ______________________________ on the ______ day of __________________, 20___, in partial fulfillment of the requirements for the degree of Doctor of Psychology, has been examined and is acceptable in both scholarship and literary quality. Committee Members’ Signatures: ______________________________, Chairperson ______________________________ ______________________________ ______________________________, Chair, Department of Psychology iii Acknowledgements It has been a winding road to get me here, finally, with a career I love and the knowledge that I am far stronger than I ever thought I was. It would not have been possible without the support of some amazing people, and for your support and guidance, I will be eternally grateful. To my dissertation committee, your knowledge, guidance and enthusiasm was, and continues to be, an inspiration to me.

Thank you for investing your time and energy in helping me to complete my dissertation. Terri Erbacher, your passion for exploring frontiers to better help our students was contagious. You taught me to drive forward, keeping the end in focus. Virginia Salzer, thank you for sharing your knowledge of statistics and the research process.

Harry Gill, I am eternally grateful, not only for your commitment to supporting me in completing the dissertation, but without your friendship, encouragement and humor, I am not sure I ever would have finished. I hope that one day I will be able to pay it forward. To my mentors and friends, Dr. Doug DiRaddo, Dr.

Laura Donnelly, and Stacey Falls, your supervision and mentorship has been a powerful example and an inspiration to me. Thank you for your patience and empathy when supervision became more therapeutic than instructional. Your guidance and advice has helped to shape me into the professional I am today, and I can’t thank you enough. To Kerri Flatau, my partner in crime throughout this project, thank you for your insights, motivation, and team work.

You kept me on point and accountable. Thank you for your patience during those rough moments. This project would not have been what it was without you. iv To my son Rory, thank you for the hugs and smiles that brought me through this graduate experience.

After researching the subject of trauma for hours, sometimes the only thing I needed was a hug from my son. You happily obliged and gave me a “Good job, Mom, keep it up.” You may never know how much that meant to me. And finally, to my husband James, whose unwavering support to me and my dreams allowed me to find a career I love. You listened to me talk about challenges and difficulties throughout the last seven years and dealt with half my attention and twice the housework.

This degree is as much yours as it is mine. v Abstract This study sought to examine school staff perceptions of knowledge, competence, school climate and program effectiveness during and after participation in a trauma informed care professional development. The majority of the sample consisted of special areas (art, music, library) teachers and paraprofessionals from all district schools, which consisted of three elementary schools, one middle school and one high school in in a school district located in Southeast Pennsylvania approximately 20 miles from a major metropolitan city. Most of the participants were female.

Participants completed a pretest survey and an identical survey following each phase. Questions on the survey pertained to each of the research questions exploring whether school staff felt they were knowledgeable about trauma and its prevalence, whether they felt they were competent to work with students who have a trauma history, whether they perceived their school culture and climate as being supportive in becoming trauma informed, and if they believed the TIPS program was effective and useful. It was hypothesized that the participants would respond positively in each case, perceiving themselves to have learned about trauma, gained competence in dealing with traumatized students, positively perceive the school culture and climate as supportive in their endeavor to become trauma informed, and would rate the TIPS program as effective and useful. Although none of the hypotheses was supported, each of the hypotheses illustrated an increase from pretest to posttest, however slight.

Also, it is important to view these results with caution and considering several limitations. Clinical implications and directions for future research are discussed. vi Table of Contents Acknowledgements. vv Table of Contents.

vii List of Figures. viiii List of Tables. ix Chapter 1: Introduction. 1 Statement of the Problem.

1 Purpose of the Study. 4 Chapter 2: Review of the Literature. 37 Measures and Materials. 48 vii Hypothesis Number 4.

52 Summary of the Findings. 72 viii List of Figures Figure 1. Score Means for Each Research Question Across Staff Perceptions of Knowledge, Competence, Culture, and Program Effectiveness………………………50 ix List of Tables Table 1. Staff Perceptions of Own Knowledge Base of Trauma……………………….

Staff Perceptions of Own Competence…………………………………………47 Table 3. Staff Perceptions of School Culture……………………………………………48 Table 4. Staff Perceptions of the Effectiveness of the TIPS Program………………….48 Chapter 1: Introduction Introduction In California, a homeless high school student felt he had nowhere else to go after being kicked out of his home, so he slept on the roof of his school. When administration found out, instead of supporting him and connecting him with services, they threatened him with legal action if he was caught trespassing again (Peter P.

vs Compton Unified School District, 2015). This is one example of how many school districts are ill- informed regarding how to handle students with a history of trauma. In the following paragraphs it will become clear that the prevalence of childhood trauma is far greater than was previously thought. Children are more likely to access mental health services through their schools or their primary health care providers, making schools a crucial participant in screening and treatment.

Thus, it is critical that educators become familiar with the symptoms and impact of traumatic stress and help to create supportive environments for all students (Simonich, et al. It is crucial that school staff are given the tools to work with traumatized students. One does not need to have experience in therapy to help students with trauma histories. One simply needs to provide a safe environment, connections, and to be supportive and guiding in emotion and impulse management.

Trauma prevention is always the goal, but for students who have already experienced trauma, the manner in which school staff respond can potentially impact these students, positively or negatively (Bath, 2008). Statement of the Problem Although children have always endured trauma, the true prevalence of childhood trauma has been severely underestimated in the past. In his book, The Body SCHOOL STAFF PERCEPTIONS OF A TRAUMA INFORMED PROGRAM 2 Keeps the Score, Bessel Van der Kolk, a leading trauma expert, explained how a widely used psychiatric textbook from the 1970’s asserted that incest was extremely rare; occurring about only once in every million women (2014). At that time there were approximately one hundred million women living in the United States.

Given that figure, approximately only 100 women nationwide should have had a history of trauma from incest; therefore, Dr. Van der Kolk was quite surprised when nearly half, forty-seven of them, showed up in his office seeking treatment. The lack of accurate information continued for decades. Fortunately, in the mid- 1990s, Dr.

Vincent Felitti of Kaiser Permanente, in conjunction with Dr. Robert Anda of The Center for Disease Control (CDC) sent the clients of Kaiser Permanente a questionnaire about adverse childhood experiences. In 1998, they published a study based on the survey data, which indicated increased exposures to childhood trauma could predict a dramatic increase in 7 of 10 of the leading causes of death in this country. This seminal study was called, the Adverse Childhood Experiences Study (ACES) (Felitti et al.

Although trauma is not a new concept, it had previously been viewed as limited to a small population, as Dr. Van der Kolk observed, and relegated to mental health and social services. With the publication of the ACES data, trauma began receiving attention as a medical issue. Since then, numerous studies have been published worldwide that examine the effects of trauma throughout the lifespan and examine the crossover among physical, neurological, cognitive, emotional and psychosocial effects.

In response to the information from ACES, Dr. Robert Block, the former president of the American Academy of Pediatrics said in a testimony to the Senate, “Based on this study, SCHOOL STAFF PERCEPTIONS OF A TRAUMA INFORMED PROGRAM 3 childhood trauma, including abuse and neglect, may be the leading cause of poor health among adults in the United States” (2011). This information begged the question concerning what kind of effects these experiences have on children, in their everyday life and in school, and how those with direct contact with children, such as therapists or school staff, could and should alleviate the symptoms and prevent the negative lasting effects. This has led to a steady stream of research into what is known as “trauma informed care” (Hodas, 2007).

Although trauma informed care (TIC) is still in its infancy, the volume of research has increased dramatically over the last two decades. With more research being published daily, an increasing number of state departments of education and also school districts are recognizing the severity of the problem, understanding the importance of early identification and intervention, and are making efforts to include trauma competency as part of their staff trainings. The San Francisco Unified School District adopted a Safe and Supportive Schools Policy in 2014 (San Francisco Unified School District, 2014). In 2005, Massachusetts Advocates for Children, in partnership with Lesley University’s Center for Special Education, published Helping Traumatized Children Learn (Cole, et al.

This flexible framework has been utilized throughout Massachusetts and the country as a model for building trauma sensitive schools. For instance, Ferguson, Missouri used Helping Traumatized Children Learn as a model for their Forward Through Ferguson: A Path Toward Racial Equity Report (Ferguson Commission, 2015). Even though trauma has been examined for decades, trauma informed care (TIC), particularly as it pertains to application in schools is relatively new. Multiple theoretical SCHOOL STAFF PERCEPTIONS OF A TRAUMA INFORMED PROGRAM 4 frameworks have been designed to help create more trauma sensitive and informed schools and districts such as Helping Traumatized Children Learn (Cole et al., 2005) and the subsequent Creating and Advocating for Trauma-Sensitive Schools (Cole, et al., 2013), as well as The Heart of Teaching and Learning (Wolpow, Johnson, Hertel, & Kincaid, 2009) and Attachment, Self-Regulation, and Competency (Kinniburgh, Blaustein, Spinazzola & Van der Kolk, 2005).

There are a limited yet increasing number of books in publication to provide guidance regarding how to apply these frameworks in schools, such as Supporting and Educating Traumatized Students (Rossen & Hull, 2012) and Lost at School by Ross Greene (2008). Resources with information regarding the application of trauma knowledge in the classroom are very difficult to find.