Trauma-informed schools

Evidence Rating  
Evidence rating: Some Evidence

Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.

Health Factors  
Decision Makers
Date last updated

Trauma-informed schools include trauma-informed strategies and education for all students (tier 1), supplemental supports for some students (tier 2), and intensive interventions for students who suffer from trauma exposure (tier 3). These multi-component interventions typically include revisions to disciplinary policies, social-emotional instruction, school-wide culturally appropriate education about trauma, parent/caregiver education and engagement, data monitoring and routine screening, and individualized intensive support (e.g., cognitive behavior therapy or wrap around services) for students who exhibit symptoms of trauma. Trauma-informed schools often develop community partnerships to support these efforts and collaborate across child services to coordinate care1, 2, 3. The 2015 National Survey of Children Exposed to Violence indicates that nearly 60% of children have been exposed to trauma in the past year; more than 1 in 10 children reported 5 or more exposures4.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Increased understanding of trauma

  • Increased use of trauma-informed practices

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

  • Increased resilient recovery

  • Improved social emotional skills

  • Improved student attendance

  • Improved youth behavior

  • Increased high school completion

What does the research say about effectiveness?

There is some evidence that trauma-informed school-wide interventions increase understanding of trauma and use of multi-component trauma-informed practices among school staff and teachers5, 6, 7. Additional evidence is needed to confirm effects, especially on student outcomes.

Trauma-informed school-wide interventions may increase student resilient recovery7, coping skills6, ability to pay attention8, and attendance5. Such interventions are also associated with increased high school completion rates9, improved classroom behavior, and improved emotional and physical safety for students in urban, suburban, and rural areas1, 10. Trauma-informed school-wide programs may also enhance bullying prevention efforts, and address the social-emotional and mental health needs of vulnerable students11. Over the long term, trauma-informed interventions are associated with decreased office discipline referrals (ODRs), physical aggression incidents, and out-of-school suspensions5, 9.

School-based social and emotional instruction, common in trauma-informed schools, increases academic achievement12 and prosocial behavior, and improves mental health outcomes13. School-wide Positive Behavioral Interventions and Supports (SWPBIS), another common component, improves students’ behavior14, 15, and individual and group cognitive behavior therapy (CBT) has been shown to decrease symptoms of post-traumatic stress disorder (PTSD) and depression16, 17.

Researchers suggest that schools provide information and training to all levels of staff to help them recognize behaviors that may be reactions to trauma, as well as how to assist and refer students to support services18. Schools characterized by strong relationships between school staff and mental health professionals19 and a clear commitment to changing the school climate and culture through trauma-informed approaches18 appear to have greater effects than schools that do not.

Trauma-informed schools may reduce disparities in educational outcomes between students from families with lower incomes and/or minority backgrounds and students from families with higher incomes. Trauma-informed practices should be culturally sensitive and introduced carefully to build teacher investment and avoid defensive reactions to the suggested changes20

How could this strategy impact health disparities? This strategy is rated likely to decrease disparities.
Implementation Examples

States can establish systematic frameworks to support trauma-informed schools, as in the Washington State Compassionate Schools Initiative and Massachusetts’ Flexible Framework Helping Traumatized Students Learn. In 2004, the Massachusetts state legislature also established a grant program for schools that implement trauma-informed practices21, 22. Several state departments of education include resources to address trauma, such as Illinois, Iowa, Massachusetts, and Wisconsin 3, 2324, 25.

The Jamestown School District in Jamestown, California encourages all adults working with children to use trauma-informed practices and provides information to assist administrators, teachers, staff, parents, and law enforcement26. The Menominee Indian Tribe of Wisconsin has adopted trauma-informed schools and trauma-informed care practices throughout the community27.

School preparation programs can also use comprehensive trauma-informed practices. For example, Trauma Smart is used in Head Start preschool programs in 26 counties across Missouri28.

Implementation Resources

PACEs-TIC toolkits - PACEs Connection. Positive & adverse childhood experiences (PACEs): Trauma-informed care (TIC) toolkits.

CPI-TIC resources - Crisis Prevention Institute (CPI). The top 10 recommended trauma-informed care (TIC) online resources.

AIR-TIC - American Institutes for Research (AIR). Trauma-informed care (TIC).

AIR-SSL SCI Resources - American Institutes for Research (AIR). Safe supportive learning (SSL): School climate improvement (SCI) resource package.

Center-TIS - Center for Resiliency, Hope, and Wellness in Schools. Promoting trauma-informed school (TIS) systems that provide prevention and early intervention strategies that create supportive and nurturing school environments.

WI DPI-Resources for schools - Wisconsin Department of Public Instruction (WI DPI). Resources for schools to help students affected by trauma learn.

WA OSPI-Heart of learning 2009 - State of Washington, Office of Superintendent of Public Instruction (WA OSPI). The heart of learning: Compassion, resiliency, and academic success. 2009.

Layne 2011 - Layne CM, Ippen CG, Strand V, et al. The Core Curriculum on Childhood Trauma: A tool for training a trauma-informed workforce. Psychological Trauma: Theory, Research, Practice, and Policy. 2011;3(3):243-252.


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1 Phifer 2016 - Phifer LW, Hull R. Helping students heal: Observations of trauma-informed practices in the schools. School Mental Health. 2016;8(1):201-205.

2 McInerney 2014 - McInerney M, McKlindon A. Unlocking the door to learning: Trauma-informed classrooms & transformational schools. Education Law Center. 2014.

3 WI DPI-TSS - Wisconsin Department of Public Instruction (WI DPI). Mental health and trauma sensitive schools (TSS): Wisconsin’s Trauma Sensitive Schools Initiative.

4 OJJDP-Exposure to violence 2015 - Office of Juvenile Justice and Delinquency Prevention (OJJDP). Children's exposure to violence, crime, and abuse: An update. Juvenile Justice Bulletin. 2015.

5 Dorado 2016 - Dorado JS, Martinez M, McArthur LE, Leibovitz T. Healthy Environments and Response to Trauma in Schools (HEARTS): A whole-school, multi-level, prevention and intervention program for creating trauma-informed, safe and supportive schools. School Mental Health. 2016;8(1):163-176.

6 Perry 2016 - Perry DL, Daniels ML. Implementing trauma-informed practices in the school setting: A pilot study. School Mental Health. 2016;8(1):177-188.

7 Shamblin 2016 - Shamblin S, Graham D, Bianco JA. Creating trauma-informed schools for rural Appalachia: The Partnerships Program for enhancing resiliency, confidence and workforce development in early childhood education. School Mental Health. 2016;8(1):189-200.

8 Holmes 2015 - Holmes C, Levy M, Smith A, Pinne S, Neese P. A model for creating a supportive trauma-informed culture for children in preschool settings. Journal of Child and Family Studies. 2015;24(6):1650-1659.

9 Mathematica-Verbitsky-Savitz 2016 - Verbitsky-Savitz N, Hargreaves MB, Penoyer S, et al. Preventing and mitigating the effect of ACEs by building community capacity and resilience: APPI cross-site evaluation findings. Washington, D.C.: Mathematica Policy Research (MPR); 2016.

10 Walkley 2013 - Walkley M, Cox TL. Building trauma-informed schools and communities. Children & Schools. 2013;35(2):123-126.

11 Blitz 2015 - Blitz LV, Lee Y. Trauma-informed methods to enhance school-based bullying prevention initiatives: An emerging model. Journal of Aggression, Maltreatment & Trauma. 2015;24(1):20-40.

12 Weare 2011 - Weare K, Nind M. Mental health promotion and problem prevention in schools: What does the evidence say? Health Promotion International. 2011;26(Suppl 1):i29-69.

13 Durlak 2011 - Durlak JA, Weissberg RP, Dymnicki AB, Taylor RD, Schellinger KB. The impact of enhancing students’ social and emotional learning: A meta-analysis of school-based universal interventions. Child Development. 2011;82(1):405-32.

14 Bradshaw 2012 - Bradshaw CP, Waasdorp TE, Leaf PJ. Effects of school-wide positive behavioral interventions and supports on child behavior problems. Pediatrics. 2012;130(5):e1136-e1145.

15 Flannery 2014 - Flannery KB, Fenning P, Kato MM, McIntosh K. Effects of school-wide positive behavioral interventions and supports and fidelity of implementation on problem behavior in high schools. School Psychology Quarterly. 2014;29(2):111-124.

16 Leenarts 2013 - Leenarts LEW, Diehle J, Doreleijers TAH, Jansma EP, Lindauer RJL. Evidence-based treatments for children with trauma-related psychopathology as a result of childhood maltreatment: A systematic review. European Child & Adolescent Psychiatry. 2013;22(5):269-283.

17 Wethington 2008 - Wethington HR, Hahn RA, Fuqua-Whitley DS, et al. The effectiveness of interventions to reduce psychological harm from traumatic events among children and adolescents: A systematic review. American Journal of Preventive Medicine. 2008;35(3):287-313.

18 Wiest-Stevenson 2016 - Wiest-Stevenson C, Lee C. Trauma-informed schools. Journal of Evidence-Informed Social Work. 2016;13(5):498-503.

19 Crosby 2015 - Crosby SD. An ecological perspective on emerging trauma-informed teaching practices. Children & Schools. 2015;37(4):223-230.

20 Blitz 2016 - Blitz LV, Anderson EM, Saastamoinen M. Assessing perceptions of culture and trauma in an elementary school: Informing a model for culturally responsive trauma-informed schools. The Urban Review. 2016;48(4):520-542.

21 WA OSPI-Heart of learning 2009 - State of Washington, Office of Superintendent of Public Instruction (WA OSPI). The heart of learning: Compassion, resiliency, and academic success. 2009.

22 MAC-TLPI - Massachusetts Advocates for Children (MAC), Harvard Law School. Trauma and Learning Policy Initiative (TLPI).

23 IL SBE-Trauma - Illinois State Board of Education (IL SBE). Climate & culture: Trauma.

24 IA DOE-Trauma - Iowa Department of Education (IA DOE). Trauma-informed or trauma-sensitive schools: Resources and information.

25 MA DOE-TSS - Massachusetts Department of Elementary and Secondary Education (MA DOE). Trauma-sensitive schools (TSS).

26 Jamestown-Trauma - Jamestown School District. Trauma informed practices: Helping children heal through trauma-informed parenting and other informational links. Jamestown, California.

27 Menominee-TIC - Menominee Indian Tribe of Wisconsin. Menominee community ACE/TIC initiatives.

28 Trauma Smart - Trauma Smart. Trauma Smart: A program of Crittenton Children's Center.