TABLE 2.

Empirical evidence for trauma-informed approaches in schools since 2019.

Component: Subcomponent	First author (year)	Method/focus	Findings
Identified as whole-school approach	Avery et al. (2022)	Quantitative six-month evaluation of a trauma-informed schoolwide approach created in Australia, as it contributed to teachers' perceptions and attitudes to being trauma responsive. Staff in three Catholic schools completed a school culture pre-assessment, pre- and post-survey using Attitudes Toward Trauma-Informed Care (ARTIC) Scale, and participated in interviews, focus groups and class observations.	Two schools showed no change on their subscale or total ARTIC scores pre- and post-evaluation; their initial scores were high. The remaining school showed a statistically significant increase on one scale and a significant decrease on another scale. In individual interviews and focus groups, school staff reported increased knowledge and understanding of trauma, improved perceptions of and responses to student and staff behaviours, reflected on the importance of school leadership, and made suggestions for intervention implementation.
Identified as whole-school approach	Jones, E. L. (2023)	Case study of three non-mainstream schools in the UK implementing attachment- and trauma-training and approaches. Semi-structured interviews were conducted with three staff members and 11 students completed an in-school activity soliciting their views.	Staff reported on their current individual approaches to attachment and trauma, including a motto that ‘every day is a new day;’ praising students for positive actions; being consistent so to be construed as a trustworthy adult working in a routine, structured way; and taking a nurturing approach that reassures students, seeks to understand them and makes them feel seen. Staff also implemented interventions, including school-based counselling, a safe place outside classrooms to reset, emotion-coaching and restorative conversations. Relationships among staff and between staff and students were also highlighted. Perceived benefits of the approaches included improved student achievement, behaviour, wellbeing and communication skills.
Relationships	Luthar (2020)	Qualitative study. 10 former and current teachers who indicated experience in trauma-informed schools were asked about challenges they faced and possible solutions.	Identified challenges included compassion fatigue, feelings of inadequacy, threats of physical violence, standardised testing and professional evaluation standards. Proposed solutions included increased mental health capacity in schools, additional training about mental health, new policies to improve mental health (e.g. mandatory social–emotional learning). Researchers concluded that teachers would benefit from ongoing relational support.
Relationships	Post et al. (2020)	Qualitative findings from three-year evaluation of child–teacher relationship training on teachers' stress, perception of children, social justice attitudes, and ability to demonstrate relevant skills in the classrooms of one elementary school. Four pre-school teachers completed semi-structured interviews.	Teachers reported that training lowered their stress levels and helped them build stronger relationships with students in the high poverty school.
Understanding & Commitment: Training	Anderson et al. (2022)	Mixed method study of trauma-informed professional development for six teachers and one other school staff member. Participants completed Professional Quality of Life Scale before and after; submitted bi-weekly reflection journal entries; and participated in a focus group.	Participants reported a change in their teaching approach based on better understanding of children's adversity and social–emotional needs. There were significant differences pre- and post-test in reported compassion satisfaction and secondary traumatic stress on the ProQOL.
Understanding & Commitment: Training	Garcia et al. (2023)	Quantitative pre-post survey design. 205 responses from school staff including mental health counsellors/social workers, teachers, administrators and other personnel. Evaluation of trauma-informed practices (TIPs) learning collaborative. Assessed implementation of TIPs using the Trauma Sensitive Schools Checklist against a question about leadership engagement in the collaborative.	Senior leadership awareness of the training was central to adoption of trauma-informed practices. Schools with engaged leaders demonstrated statistically significant increases in trauma-informed practices. Schools with disengaged leaders showed no significant change.
Understanding & Commitment: Training	MacLochlainn et al. (2022)	Quasi-experimental, waitlist control group, pre-post test design to evaluate a trauma-informed professional development training. Compared trauma-informed attitudes and compassion fatigue of 216 school personnel (n = 98 intervention, n = 118 control group) utilising the ARTIC and Pro-QoL scales.	The intervention group showed a significant positive increase in attitudes related to trauma-informed care immediately before (Time 1) and after the two-day training (Time 2), which remained in a six-month follow-up (Time 3). The same group showed a significant decrease in burnout and secondary traumatic stress from Time 1 to Time 3, but no change in compassion satisfaction. Whereas burnout scores decreased in the intervention group, the control group experienced significant increases in burnout over the same period. The intervention group also showed significantly positive increases in ARTIC scores between Times 1 & 3 while the control group had no change. The intervention group also showed positive increases in work self-efficacy and reactions vs. no change in the control group.
Understanding & Commitment: Training	McIntyre et al. (2019)	Quantitative pre-post assessment design; evaluation of two-day foundational professional development intervention as relates to increases in knowledge and acceptance of trauma-informed approaches; 183 teachers sampled.	Teachers demonstrated significant increased knowledge after training. Perceptions of their school's fit to trauma-informed approaches influenced acceptability. If system fit was strong, acceptability increased and vice versa.
Understanding & Commitment: Training	Orapallo et al. (2021)	Quantitative valuation of 20-hour trauma training. Longitudinal pre-post design, one year. 2418 staff and teachers across 42 preschools and elementary schools.	Respondents were able to demonstrate the knowledge covered in training. Attitudes toward trauma-informed care were significantly more favourable across all seven subscales and the overall ARTIC score at post test.
Understanding & commitment: Training	Wojciak et al. (2022)	Qualitative evaluation of a train-the-trainer trauma programme for educators. Two non-overlapping populations participated in data collection: trainers through focus groups and participants through a survey.	Trainers (principals, school counsellors and teachers) reported feeling empowered to adopt a new approach and focus on relationship-building with students. They reported no longer taking student behaviours personally and engaging in more self-reflection. Trainers reported fewer disciplinary incidents and office referrals and a calmer environment in the school. Training recipients (other school staff) reported greater awareness of trauma and its impact on learning. Recipients then advocated for more responsive support for students. They expressed both frustration with the training and changes as well as recognition of positive benefits of a trauma-informed approach.
Understanding & Commitment: Training & Practice changes	Stokes (2022)	Mixed method case study of one school implementing a trauma-informed instructional model in Victoria, Australia. Model consisted of 1) whole-school participation in trauma-informed positive education training, and 2) integration of trauma-informed practices, including non-punitive behaviour management. Researchers used one student and one staff survey, and then performed 32 interviews with leadership (n = 4), teachers (n = 6), educational support staff (n = 2) and students in years 7–12 (n = 20).	Respondents reported greater understanding and empathy for students' situations. School staff reported increased collective influence in several areas between 2019 and 2021. They believed the implementation of new classroom strategies to better manage student behaviours resulted in fewer disruptions and a calmer learning environment. Schoolwide, staff reported that behaviour management changed from punitive to restorative. Students reported increases in appropriate classroom behaviour and effective teaching time and staff reported better teacher-student relationships and that their time use was more effective. Students also reported increases in their connectedness to school, confidence, self-regulation and goal-setting, expectations for success and teachers' concern. Staff agreed, reporting increases in staff trust of students and students' interpersonal relationships.
Understanding & commitment: Training & Screening	von der Embse et al. (2019)	Study presents initial findings of a K-8 school demonstration project to integrate mental health supports and trauma-informed approaches with MTSS at Tier 1 & Tier 2. Teachers received training about trauma, classroom management and how to use screening tools, then six teachers were given ongoing coaching in classroom management. Teachers screened students during each quarter of two school years using the Social, Academic and Emotional Behaviour Risk Screener (SAEBRS) tool.	Participating teachers reported lower office discipline referrals (ODRs) compared to their peers and over time, going from an average of 1.2 ODRs per day to 0.2/day. Students exhibited a decline in risk, based on SAEBRS screening.
Understanding & commitment: Training, Practice changes; Relationships	Wall (2021)	Qualitative case study of educators' perspectives of trauma-informed approaches in an elementary school. Three types of regular professional development were implemented, including training about the effects of trauma, implementation of a school-wide social emotional learning programme, and a relationship-building skills programme that included self-care and mindfulness. Data gathered over three years included classroom observation; meeting and special event attendance; interviews with teachers, parents and administrators; a parent focus group; and publicly available school data.	Staff implemented trauma-informed approaches that included restorative (‘conversation over consequence’) practices in lieu of punitive ones. Classroom adaptations included more student support and empowerment through breaks, snacks, flexible seating, sensory-soothing methods and allowing students more choice. Teachers adapted their instruction to include class routines and consistency and emphasise growth over meeting goals. The school also encouraged development of positive student–student, student-teacher-staff and teacher-teacher relationships as well as supporting and empowering parents. Since implementation of the above approaches, students' scores on standardised tests have improved and there have been fewer class disruptions, improved self-regulation and more efficient de-escalation when incidents occur.
Understanding & Commitment: Training, Screening; Equity focus	Somers, (2022)	Case study of K-8 charter school in a Midwestern urban area. Case study included semi-structured interviews with staff and analysis of school data, including time management of counsellors, disciplinary data, professional learning records and staff surveys. Interventions included ACEs screening; teacher professional development; increased mental health staffing; creation of a mental health services centre providing SEL and character education; an equity team that reviewed school policies, retention and discipline data, and made suggestions to enhance equity; and an advisory council. Results compared pre-intervention and after three years of intervention.	School counsellors increased time serving students to 87.3%. Students were given SEL support as an alternative to in-school suspension. Out-of-school suspensions dropped from 360/year to 85/year. Vast majority of teachers and staff reported that training made school a better place to work, increased job satisfaction, and improved their confidence in handling SEL and student behavioural issues. Discipline referrals decreased by 26%.