Incorporating Trauma into
PBIS & Teacher Management
Chris Dunning, Ph.D.
Professor Emerita
University of Wisconsin-Milwaukee
cdunning@uwm.edu
Trauma and Learning
Who could
be the trauma
student here?
Children who do not
feel safe live in a
state of emergency.
Their energy is
consumed by crisis,
making it
impossible for them
to focus on
learning.
From “Too Scared to Learn”
by Jenny Horsman, 2000
ANSWER:
Either
Implications for Learning
“Traumatized children often spend so
much time in the lower level brain in a
state of fear that they consistently
focus on non-verbal vs. verbal cues.”
Children who have
experienced trauma also experience:
More school nurse visits/School absences
Referral to school speech pathologist/support
services
More Disciplinary Actions/Suspension from school
More aggressive or non-attentive in school
Difficulties with peers, teachers, and staff
Lower performance and grade point averages
Higher drop-out rates
•
“The school setting can be a battleground in which
traumatized children’s assumptions of the world as a
dangerous place sabotage their ability to develop
constructive relationships with nurturing adults.
Unfortunately, many traumatized children adopt
behavioral coping mechanisms that frustrate educators
and evoke exasperated reprisals, reactions that both
strengthen expectations of confrontation and danger and
reinforce a negative self-image.
• Traumatized children’s behavior can be perplexing.
Prompted by internal states not fully understood by the
children themselves and unobservable by teachers,
traumatized children can be ambivalent, unpredictable
and demanding. But it is critical to underscore that
traumatized children’s most demanding behavior often
originates in feelings of vulnerability.”
(Helping Traumatized Children Learn, p. 32-33)
Trauma-Informed Educator
Practice
The trauma-informed educator:
• Understands the impact of trauma on a
child’s behavior, development,
relationships, and survival strategies
• Can integrate that understanding into
planning for the child and learning
• Understands his or her role in responding
to child traumatic stress
5
What Can an Educator Do?
• Recognize that exposure to trauma occurs to
many children, not just those in protective or
foster care.
• Recognize the signs and symptoms of child
traumatic stress and how they vary in
different age groups.
• Recognize that children’s “bad” behavior is
sometimes an adaptation to trauma.
• Understand the impact of trauma on different
developmental domains.
6
What Can an Educator Do?
• Understand the impact of trauma and PTSD on learning.
• Understand the cumulative effect of trauma.
• Gather and document psychosocial information regarding
all traumas in the child’s life to make better-informed
decisions.
• Lessen the risk of system-induced secondary trauma by
serving as a protective and stress-reducing buffer for
children:
– Develop trust with children through listening, frequent
contacts, and honesty in order to mitigate previous traumatic
stress.
– Understand that schools would do well to be proactive about
trauma rather than reactive.
Trauma-Informed Educator
• Offers interventions that increase self worth,
• Forms strong relationships to enhance sense of
trust,
• Emphasizes the relationship consequences of
behaviors,
• Build up avenues for achievement and hope,
• Helps child learn both emotion management
skills and relationship skills,
• Teaches how to calm biology to increase ability
to think.
Essential Elements of TraumaInformed education
1. Maximize the child’s sense of safety.
2. Assist children in reducing inappropriate
hyperarousal and/or dissociation.
3. Address the impact of trauma and subsequent
changes in the child’s behavior, learning,
development, and relationships.
4. Utilize comprehensive assessment of the
child’s trauma experiences and their impact on
the child’s development and behavior to guide
services.
9
5. Coordinate services with other agencies.
Maximizing Safety: Understanding
Children’s Responses
• Children who have experienced trauma often
exhibit extremely challenging behaviors and
reactions.
• When we label these behaviors as “good” or
“bad,” we forget that children’s behavior is
reflective of their experience.
• Many of the most challenging behaviors are
strategies that in the past may have helped the
child survive in the presence of abusive or
neglectful caregivers.
10
Maintaining safety
• Behavior management based on selfregulation rather than compliance
– Conflict resolution
– Problem-solving
– Compromise
• Create positive peer culture
– Reduce or prevent isolation/bullying
– Increase social competence
• Understand child’s need for containment
• Providing positive behavioral supports
– Identify triggers that set child off
– Consistency and structure
– Involve child, especially feedback
PBIS
• Assumes that approximately 80% of students
can and will behave well if
– 1) there are clear behavioral expectations
– 2) they are taught how to behave in effective and
ongoing manners.
“Insights from Trauma-Informed Care help us to
understand that it is just as important, if not more so,
to focus on students’ emotional responses as their
behavioral responses. Behavior may often
communicate a student’s emotional need.”
White and Dibble (2012) Wisconsin DPI
Using Positive Behavioral Interventions
& Supports (PBIS) to Help Schools Become More Trauma-Sensitive
Paradigm Shift
• Understanding that trauma is not a cognitive
experience, but a sensory one, dictates
strategies that immediately restore, to victims, a
sense of safety and renewed sense of
empowerment/control in the face of fear and
uncertainty generated by the incident.
• Reduction of the arousal level is critical to the
restoration of pre-trauma cognitive processes,
learning functions, behavior and performance.
Trauma and School
• Trauma can trigger (arouse) the activation of the
autonomic nervous system to ready itself to resist or
solve the real or perceived threat presented by
exposure to an incident such as…..
• If the response (arousal) is not discharged or
deactivated, the sustained arousal state can lead to
sustained cognitive and behavioral dysfunction.
• Trauma being a sensory experience, arousal is
experienced as an absence of the “sense of safety”
and as a “sense of powerlessness.”
• Aggressiveness, over reactive responses and
exaggerated withdrawal are survival behaviors –
attempts to feel safe, in control.
What This Tells Us
• As long as a student is not feeling safe and in
control, this aroused state makes it difficult to
process verbal information, attend, focus, retain
and recall.
• Intervention designed to deactivate the arousal
state and return the student to a sense of safety
and a sense of power or control, helps to restore
previous cognitive and behavioral patterns.
• The most immediate, short-term and long-term
intervention, therefore, must be designed to
restore that sense of safety and control.
Why use the PBIS Triangle
for Traumatized Students?
Hierarchy of Brain Function
Bruce Perry M.D., Ph.D. 1997
In the brain of someone who has experienced a variety of emotional,
behavioral and cognitive stimuli, a “top heavy” ratio develops.
In this ratio, the brain matures to moderate the more primitive
instincts of the midbrain/brainstem.
Bruce Perry M.D., Ph.D. 1997
When key experiences (Which develop the cortical/limbic part of the brain)
are absent or minimal, the “higher” to “lower” brain ratio is impaired.
In this case, the ability of the brain to moderate impulsive, reactive
responses and to work through frustration is diminished significantly.
Bruce Perry M.D., Ph.D. 1997
Children raised in environments characterized by domestic
violence, physical abuse or other persistent trauma will develop an
excessively active midbrain/brainstem. This results in an overly
active and reactive stress response and a predisposition to
aggression and impulsiveness.
Bruce Perry M.D., Ph.D. 1997
When the developing brain is both deprived of sensory stimuli and
experiences traumatic stress, the brainstem/ midbrain to cortical/limbic
ratio is profoundly altered.
Bruce Perry M.D., Ph.D. 1997
The Child’s Brain
Differences due to Psychological Trauma
Memory
Normally coordinated and cohesive
Explicit Memory
Left Brain
Implicit Memory
Right Brain
• Facts
• Details
• Who, what,
where, when,
how
• Tied to
Language
• Emotional Memory
• Senses-smells,
sounds, etc.
• Tied to Fight, Flight,
Freeze Response
Memory and Traumatic Stress
Trauma
Uncouples
Integration of
Memory
I feel a
certain way
and I don’t
know why!!
Fight/Flight/Freeze
• Overdevelopment of regions of the brain
involved in anxiety and fear responses
And
• Underdevelopment of regions of the
brain involved in complex thought and
those necessary for learning.
Implications for Learning
• Traumatized children often spend so much time
in the lower level brain in a state of persisting
fear that they consistently focus on non-verbal
vs. verbal cues
• May be very intelligent but can’t learn
easily→must do verbal learning when calm
• •Learning needs to be more experience-based
⇒ → when traumatized children are stressed
they are reactive/reflexive vs. accessing
cognitive solutions
Implications for Behavior
• During early development, these
traumatized children spent so much time
in a low-level state of fear that they were
focused primarily on non-verbal cues.
• Once out of such an environment, it is still
difficult for the child's brain to interpret
(relearn) these innocent looks and touches
as benign.
These children are often labeled as
learning disabled.
• Difficulties with cognitive organization contribute to a
more primitive, less mature style of problem solving -with violence often being employed as a "tool.“
• A traumatized child -- in a persistent state of arousal -can sit in a classroom and not learn.
• The brain of this child has different areas activated -different parts of the brain controlling his functioning.
• The capacity to internalize new verbal cognitive
information depends upon having portions of the frontal
and related cortical areas activated, which in turn
requires a state of attentive calm.
• This is a state that the traumatized child rarely achieves.
Conduct Disorders
Behavior is the language of trauma.
Most children lack the language skills
needed to describe how they are
suffering, so they use behavior to
express themselves.
Most behaviors used by children to
express themselves are considered
“negative” behaviors.
Cortical Modulation Is AgeRelated
• The capacity to moderate frustration,
impulsivity, aggression, and violent behavior is
age-related.
• With sufficient motor, sensory, emotional,
cognitive, and social experiences during
infancy and childhood, the mature brain
develops (in a use-dependent fashion) a
mature, humane capacity to
– tolerate frustration
– contain impulsivity
– channel aggressive urges.
Outcome
• When a child is threatened, he or she is likely to
act in an "immature" fashion.
• Regression, a retreat to a less-mature style of
functioning and behavior, is commonly observed
in all of us when we are physically ill, sleepdeprived, hungry, fatigued, or threatened.
• When we regress -- in response to a real or
perceived threat -- our behavior is mediated
(primarily) by less-complex brain areas.
Baseline State of Arousal
 If a child has been raised in an environment of persistent
threat, the child will have an altered baseline such that
the internal state of calm is rarely obtained.
 The traumatized child will have a "sensitized" alarm
response, over-reading verbal and non-verbal cues as
threatening.
 Increased reactivity will result in dramatic changes in
behavior in the face of seemingly minor provocative
cues.
 Over-reading of threat will lead to a "fight or flight"
reaction and impulsive violence.
 The child will view his violent actions as defensive.
Change in “thermostat”
• Children exposed to significant threat will "re-set" their
baseline state of arousal such that even when no
external threats or demands are present, they will be in a
physiological state of persistent alarm.
• As external stressors are introduced (e.g., a complicated
task at school, a disagreement with a peer) the
traumatized child will be more "reactive."
• Even a relatively small stressor can instigate a state of
fear or terror.
• The cognition and behavior of the child will reflect his or
her state of arousal.
The Threat Recurs: Chronic
Hyperarousal
 Traumatic Reenactment
 Damages meaning, conscience, view of self and
others
 Disrupted attachment – failed trust, failed
relationships
 Problems with authority figures
 Difficulties resolving conflicts
 Inability to grieve
 Addiction to stress
 Resistance to change
 Deterioration, alienation
Affective or Physiological
Dysregulation
• Impaired developmental achievement
related to arousal regulation:
Mood
Bodily Functions
Diminished awareness of emotional
and behavioral states
Difficulty describing emotional or
bodily states
Students who have experienced
complex trauma• Developmentally adverse interpersonal
trauma for over one year, and exposure
was before the age of 18.
• Subjective experiencing of:
Rage
Betrayal
Shame
Humiliation
Interconnected Framework for
School Mental Health
Development of an Interconnected
Systems Framework for School
Mental Health
February, 2012
Susan Barrett and Lucille Eber,
National PBIS Center Partners;
and Mark Weist,
University of South Carolina
University of Maryland,
Center for School Mental Health)
Trauma-Sensitive School PBIS Model
Tier 1
Trauma-Sensitive School PBIS Model
Tier 1
School policies, culture
& climate
Behavior management
Instructional practices
& approaches
Modeling
Classroom consultation
TRAUMA SENSITIVE
SCHOOL
Trauma Proofing
Curriculum
Compassionate
School
Emotionally Safe
School
PFA-Psychological
First Aid
The Whole Learner
Intellectual
(Problem solving /
creativity)
Physical
(Stamina)
Emotional
(Resiliency /
empathy)
All components are interdependent
What’s “New” In The Context
Of What’s “Old”?
• A trauma-sensitive school environment is
characterized by respect and supports capable of
“taking over” when the student’s coping skills fail.
– Operationalization
•
•
•
•
•
RtI
PBIS
Crisis/Disaster/Active Shooter Interventions
Violence Prevention/Bullying Programs
Character Education/Emotional Intelligence/Service
Learning
• Stress Management/Yoga
• Restorative Discipline/Justice
How We Become:
Office of the Superintendant of Public Instruction
State of Washington
Ten Strategies of a
Compassionate School
1. Focus on culture and climate in the school and community.
2. Train and support all staff regarding trauma and learning.
3. Encourage and sustain open and regular communication for
all.
4. Develop a strengths based approach in working with students
and peers.
5. Ensure discipline policies are both compassionate and
effective (Restorative Practices).
6. Weave compassionate strategies into school improvement
planning.
7. Provide tiered support for all students based on what they
need.
8. Create flexible accommodations for diverse learners.
9. Provide access, voice, and ownership for staff, students and
community.
10. Identify vulnerable students and outcomes and strategies
Domains of Compassionate
Instruction
• Domain 1: Safety, Connection, and
Assurance
• Domain 2 : Emotional and Behavioral
Self-Regulation
• Domain 3: Competencies of Personal
Agency, Social Skills, and Academic
Skills
The Six Principles
1)
2)
3)
4)
5)
6)
Always Empower, Never Dis-empower
Provide Unconditional Positive Regard
Maintain High Expectations
Check Assumptions, Observe, Question
Be a Relationship Coach
Provide Opportunities for Helpful
Participation
Another Curriculum for
Traumatized Children
Connecting
1 Safety
2 Engaging
3 Trusting
Processing
4 Managing the self
5 Managing feelings
6 Taking responsibility
Adapting
7 Developing social awareness
8 Developing reflectivity
9 Developing reciprocity
(Cairns, K. & Stanway, S., 2004.)
Step I - Safety First
􀂄􀂄 Stay aware of the terror
􀂄􀂄 Provide and sustain a relaxing environment
􀂄􀂄 Use self appropriately to deal with a terrified student:
voice, gestures, expression
􀂄􀂄 Use group work skills to create sense of safety
􀂄􀂄 Bring relaxation into the awareness of the child
and encourage practice
􀂄􀂄 Discourage dependence on high stimulus
activities
• (Cairns, K. & Stanway, S., 2004.)
Step II - Engaging
􀂄􀂄 Provide appropriate environmental stimulation for
adults and students
􀂄􀂄 Learning about the effects of trauma is part of
good classroom management
􀂄􀂄 Stories and metaphors are powerful tools for
teaching about overwhelming events
􀂄􀂄 Encourage expression of experience and
development of emotional intelligence
􀂄􀂄 Bring dissociation into awareness, develop sense of
protector self and observer self
Step III - Trusting and Feeling
􀂄􀂄 Accept the level of trust the student has to offer
􀂄􀂄 Encourage open discussion of issues of trust
􀂄􀂄 Encourage the student to express inner states in
words, even though they will find this difficult
􀂄􀂄 Notice non-verbal signals of feelings and help student
to recognize and name what is happening
􀂄􀂄 Identify self-transcending as well as self-assertive
emotions
Step IV - Managing the Self
􀂄􀂄 Discuss and practice relaxation and soothing
activities with the student
􀂄􀂄 Avoid asking ‘why did you do that?’ Instead invite
reflection linking inner state with actions
􀂄􀂄 Encourage the student to be interested in their own
inner state with regard to their behavior
􀂄􀂄 Comment on small indicators of self-regulation
􀂄􀂄 Encourage students to build on growing capacity
for self-management
Procedures or Situations That May Trigger
Prior Experiences of Trauma Include:
􀂄Lack of controlpowerlessness
􀂄Threat or use of physical
force
􀂄Observing threats, assaults,
others engaged in self-harm
􀂄Isolation
􀂄Being in a locked room or
space
􀂄Physical restraints –or even
wristbands
􀂄Interacting with authority
figures
􀂄Interacting with men, in
general
􀂄Lack of privacy
􀂄Removal of clothing –strip
searches, medical exams
􀂄Being touched –pat downs
􀂄Being watched 􀂄Loud noises
􀂄Fear based on lack of
information
􀂄Darkness Intrusive or
personal questions
Step V - Managing Feelings
􀂄􀂄 Expect and contain disturbed behavior
􀂄􀂄 Encourage student to feel more in control space, time, activities
􀂄􀂄 Limit choices, restrict choice-making to less
stressful situations and celebrate
successes
􀂄􀂄 Encourage student to recognize and
celebrate learning from mistakes
Step VI - Taking Responsibility
􀂄􀂄 Recognize the power of traumatic identity and
expect resistance to changing identity
􀂄􀂄 Provide choices about how they see
themselves
􀂄􀂄 Allow student to let go of excessive or
inappropriate responsibilities
􀂄􀂄 Encourage student to allow adults to be in
control appropriately
􀂄􀂄 Celebrate any evidence of the student taking
appropriate responsibility for behavior
VII - Developing Social Awareness
􀂄􀂄 Encourage friendships and social interaction
􀂄􀂄 Identify and rehearse social situations
requiring self-control in the student
􀂄􀂄 Encourage the student to broaden the range of
their social connections and to be interested
in people generally
􀂄􀂄 Promote activities motivating social
accountability such as sport, drama, music
VIII - Developing Reflectivity
􀂄􀂄 Promote self-esteem; catch them doing
something good
􀂄􀂄 Provide and comment on role models of
centered people who are comfortable in their own
lives
􀂄􀂄 Encourage the use of tools for reflection such as
keeping a diary
􀂄􀂄 Help students deal with feedback from a range of social
situations
􀂄􀂄 Be creative about ways to help the student
become fearlessly reflective
IX - Developing Reciprocity
• Provide and invite reflection on wide range of
aesthetic experiences
• Share thoughts and feelings
• Apologize when we hurt the student
• Encourage the student to reflect on our
experience
as well as their own
• Invite the child to take our position - ‘What do
you think I should do about this?’ in response to
student’s behavior
• Accept that we are a problem for the child
Trauma-Sensitive School PBIS Model
Tier 2
Tier 2
Trauma assessment
screening
DERS
CPTSRI
CANS
CROPS/PROPS
Sensory Regulation
Experiential Therapies
Group Trauma
Interventions
TARGET
SPARCS
SSET
Difficulties in Emotional Regulation
Scale (DERS) (Gratz, K.L.)
• The DERS is a brief, 36-item, self-report questionnaire
designed to assess multiple aspects of emotion dysregulation.
• The measure yields a total score as well as scores on six
scales derived through factor analysis:
1. Non-acceptance of emotional responses
(NONACCEPTANCE)
2. Difficulties engaging in goal directed behavior (GOALS)
3. Impulse control difficulties (IMPULSE)
4. Lack of emotional awareness (AWARENESS)
5. Limited access to emotion regulation strategies
(STRATEGIES)
6. Lack of emotional clarity (CLARITY)
Nearly all empirically validated treatments for child trauma seek to
make changes in the domain of emotion regulation, but there are
few measures that assess this domain.
Group Interventions
• Support for Students Exposed to Trauma (SSET)
Toolkit to manage stress and trauma:
From National Child Traumatic Stress Network
•
Structured Psychotherapy for Adolescents Responding to Chronic
Stress (SPARCS)
– For traumatized adolescents continually living with ongoing stress
– Six domains of functioning to cope more effectively, make better
choices, and cultivate supportive relationships
Goals:
• to help traumatized adolescents make better choices for their lives
• to cultivate healthier relationships
• to activate meaning making
• to rouse mindful action
• to teach tools for coping with current and future stressors
• to promote healing
TARGET
• Trauma Adaptive Recovery Group Education and Therapy
(TARGET)
• Objective: developed to help trauma survivors understand how
trauma changes the body and brain’s normal stress response
into a survival-oriented “alarm” reaction that can lead to
posttraumatic stress disorder (PTSD).
• TARGET provides a practical skill-set that can be used by
trauma survivors and family members to de-escalate and
regulate extreme emotion states, to manage intrusive trauma
memories, and to restore the capacity for information processing
and autobiographical memory.
• TARGET teaches a sequence of seven (7) skills described as
the FREEDOM steps.
• For ages 11-17
Trauma-Sensitive School PBIS Model
Tier 3
Power and Control Strategies that are
NOT Beneficial to a Traumatized
Student
• Threats
• Bribes
• Control over bodily functions, like prohibiting
children from using the bathroom
• Random enforcement of petty rules
• Humiliation or degradation
• Isolation
• Corporal punishment
Tier 3
Evidence-Based Trauma
Interventions for Schools
www.nctsn.org
Individual Trauma
Interventions
TF-CBT
CBITS (Child Behavioral
Intervention for
Trauma
in Schools
Sensory ExperiencingSE
ADBT-SP (Adapted
Dialectical Behavioral
Therapy)
Life Skills/Life Story
SITCAP
http://www.nctsn.org/resources/topics/treatments-that-work/promising-practices
Resources
• Bluestein, J. (2001) Creating Emotionally Safe Schools: A guide for
educators and parents. HCI
• Cairns, K. & Stanway, S., Learn the child - helping looked after children
to learn: A good practice guide for social workers, carers and
teachers. London, England: BAAF
• Coles, S. et al (2005) Helping Traumatized Children Learn: Supportive
School Environments for Children Traumatized by Violence.
Boston: Massachusetts Advocates for Children / The Hale and Dorr
Legal Services Center of Harvard Law School
• Craig, S. (2006) Reaching and Teaching Children Who Hurt: Strategies
or your classroom. Paul Brookes Pub.
• Hart, S. and V. Hodson (2004) The Compassionate Classroom:
Relationship based teaching and Learning Puddledancer Press
• Jaycox, L. et al.(2006) How Schools Can Help Students Recover from
Traumatic Experiences: A Tool-Kit for Supporting Long-Term
Recovery, RAND Corporation (TR-413), RAND Corp.
• Jaycox, L. (2003) CBITS: Cognitive-Behavioral Intervention for Trauma
in Schools, Sopris West
Resources cont.
• Levine, P. (2007) Trauma Through A Child’s Eyes: Awakening
the ordinary miracle of healing infancy to adolescence.
Berkley, CA: North Atlantic Books
• Levine, P. and M. Kline (2008) Trauma-Proofing Your Kids.
Berkley, CA: North Atlantic Books.
• Morrow, G. (1987) The Compassionate School: Educating
abused and traumatized children. New York: Prentice-Hall.
• Wolpow, R. et al. Compassionate Schools: The heart of Learning
and Teaching. Seattle: Office of the Superintendant of Public
Instruction State of Washington