Collective Trauma and Building a Trauma-Informed Culture: Interventions

Editor's note: This text-based course is an edited transcript of the webinar, Collective Trauma and Building a Trauma-Informed Culture: Interventions, presented by Nadia Tourinho, MSW, LICSW, LCSW-C.

This is the final part of a four-part series titled Collective Trauma and Building a Trauma-Informed Culture. 

Learning Outcomes

After this course, participants will be able to:

• Describe how to use effective trauma-informed care techniques when working with parents, children, and staff.
• Identify how to look beyond children's behavior and actively listen to the message children communicate with their behaviors.
• Identify techniques nonclinical staff must develop to provide effective trauma-informed care in the workplace.
• Explain necessary strategies educators must incorporate in the classroom to create a trauma-informed sensitive environment.

As I mentioned in part three, you'll hear me refer to staff, clients, and providers. When I say clients, I refer to children, parents, and families. When I talk about providers and professionals, it includes teachers, social workers, psychologists, and anyone working with clients. Let's start with a case example of what non-trauma-informed looks like and what we don't want to do when we're out in practice. This is the case of Mary.

Mary is a 25-year-old mother of three who reaches out for help for her depression and marital stress. She is asked to complete seven different forms in the first meeting without understanding their purpose. The questions seem very private and personal, and she is worried about lying but also feels uncomfortable sharing details of the previous sexual and physical abuse she experienced as a child. She answers more questions when she meets the therapist, who is male, as he explains that he is there to complete her intake but will not be her actual therapist. He explains that it is a low-cost clinic, so she may not choose her counselor.

Two weeks later, she meets with another new person, and they ask her the same questions repeatedly. At the end of the 2nd meeting, she is given a diagnosis and asked to sign a treatment plan that the counselor made based on her disorder and the goals they believe she needs to work on. She is told she needs to see a psychiatrist because she is too severely ill to be seen without also taking medications. She is told she must meet with the doctor and do what he tells her otherwise, she could be discharged for non-compliance.

Mary leaves feeling bad about herself. The doctor again asks her in great detail about her trauma history and sends her home with two medications he thinks she needs. She goes home and never returns to the clinic.

Let's think about what is wrong with this example. First, Mary never had the opportunity to choose her treatment. It was just given to her. Second, sharing all the personal information when filling out the paperwork can be very off-putting for someone who has experienced trauma. Similarly, many teachers send home a questionnaire at the beginning of the school year. There may be questions parents might feel uncomfortable answering.

Teachers can turn that into more trauma-informed care by calling parents to introduce themselves and let them know the questionnaire will be sent home. Parents need to know that if they don't feel comfortable answering some questions, they don't have to. This is a way for the teacher to get to know the parents and the child since they'll be working together for the whole school year. Another option is to do a Zoom meeting with parents to establish a connection. Teachers often only meet with parents when the child is in trouble, or it's parent-teacher night. If we're trying to be trauma-informed, you want to start that relationship early on and not just send paperwork home without letting parents know why.

With these two examples, we see how important it is to remember how people may feel about writing their trauma on paper and being asked about it repeatedly. Not only are we re-traumatizing the person by asking them three times to state what is going on with them, but we also don't necessarily need to know all the details about how people have been traumatized and what happened to them. We treat symptoms and look at behavior to understand and be truly trauma-informed.

Interventions

Interventions are strategies or techniques to help modify behaviors that interfere with a person's well-being. We can help to plan a safe, effective, and appropriate intervention strategy, help clients and family members constructively express themselves and prepare them for potential outcomes and consequences. Interventions can be used by nonclinical staff, teachers, school professionals, clinicians, and therapists. We all play a part in a trauma-informed care environment. As I mentioned in part three, trauma-informed care starts with the nonclinical staff. Research shows that the quality of interactions with nonclinical staff can affect a person's feeling of safety. Survivors' interactions with administrative staff and assistants set the tone for the provider-patient relationship. Thus, training staff to understand and utilize trauma-informed care approaches and amend practices to assist survivors better.

Appointments and Phone Calls

When someone calls a provider's office to make an appointment or the school to get support, it is of utmost importance that the person answering the phone be trained in trauma-informed care. It is common for the person answering the phone to ask why they need an appointment or the nature of their appointment. It's appropriate to ask that because they want to ensure they're scheduling with the right person and can relay why this person is coming in. In a magical world, that is completely fine. However, as seen in the previous example, if someone has experienced trauma, that can be very off-putting.

When I call my primary care physician and am asked that question, sometimes I do feel uncomfortable stating the nature of why I am going there. Now I have to explain it to this person on the phone, then the nurse when I get called back, then again with the doctor. I have wondered why I have to say something three times and how the person on the phone will be able to help me with my concern. Sometimes I have felt like I can't get an appointment if I don't share.  

This also can occur when a parent calls the school to talk to the principal or director. If the person answering the phone asks why you want to talk to them, the parent may not feel comfortable saying the real reason, whether it's to discuss something that has happened at home, the child's behavior, a need for an IEP, or anything else. If the parent has experienced trauma, they may feel uncomfortable sharing that with the person on the phone.

However, experts indicate that a preferable approach is for receptionists to ask whether their appointment was for a discussion or an exam. If further details are required, the person should be allowed to talk to clinical staff rather than being forced to disclose information to nonclinical staff. Giving this option gives the person some control they may not have had in the past.

Changing Appointments

When changes in appointments or delays might occur, staff should develop effective communication with the person. Emergencies do happen, and appointments need to be changed. When the need to change an appointment is determined, that change should be made immediately and not at the last minute. Remember that many survivors endured trauma where uncertainty and waiting were a feature. Taking time to reach out to the client yourself to cancel the appointment, rather than have someone else call, helps to build the relationship with the client.

Strict Policies 

For patients who do not cancel their appointment within 24 hours or parents who show up late to school, strict provisions may not be realistic for someone who has experienced trauma. Often just getting to an appointment or getting to the school can be difficult for someone who has experienced trauma. Be aware that even leaving the house may be triggering and difficult. For example, at my center, we have a policy that asks that clients try to give us at least a 24-hour notice if they must cancel. However, I also have a statement saying we know emergencies happen, and we understand you may not be able to keep an appointment. If that happens, we ask them to give us a call, and we'll be more than happy to reschedule that appointment.

I don't penalize people for not showing up for their appointments because then they're getting penalized and feel bad about it. At that point, we're not helping. We're making someone even feel worse about not being able to attend an appointment. Whether it's a therapy appointment or a school appointment, we need to encourage people to want to come and talk to us. Another thing to remember is that if a person cancels their appointment, the provider should follow up, not the nonclinical staff. This provides another opportunity to build rapport with the parent.

Here's a story about a client I had who had experienced trauma. We had a challenging session, and I was concerned about her well-being. I told her I would give her a call tomorrow and check in on her. She started crying, and I sat there quietly waiting. After she was done crying, she lifted her head and looked at me, and said, "I'm crying because no one has ever cared enough to call me and check up on me." Making that call, whether a clinician or a teacher, can be extremely meaningful for this person. At the same time, if the person is having a difficult time, you do not want to leave that in the hands of a nonclinical staff because they're not trained.

Greeting and Check-In 

Guiding Principles of Trauma-Informed Care 

The guiding principles of trauma-informed care are:

• Safety
• Trustworthiness and transparency
• Peer support and mutual self-help
• Collaboration and mutuality
• Empowerment, voice, and choice
• Cultural, historical, and gender issues

I've said this before, but the first step in having trauma-informed care is establishing safety. Remember, your classroom or space can be that child's safe haven because maybe at home, they don't feel safe and are witnessing domestic violence. Be transparent and straightforward, so children and families can trust you. Peer support is vital because we are all social creatures, and we need to be able to develop our emotional support within our peer group.

Collaboration between all working with the child and family is vital to helping a child succeed. When I was a social worker at a school, I would go into the classroom and observe a child on my caseload. Then I would work with the teacher on how we could help the child better manage some of his symptoms. Sometimes I could see when the child would be triggered and how he would respond. I also observed what the teachers were doing and if anything contributed to the child's behavior. Often we may accidentally make things worse by telling someone to calm down. I have found that when people say calm down, it escalates the kids even more. We need to empower children to do certain things and have their own voice because maybe elsewhere, they don't have a voice or get to make choices. Provide children opportunities to make age-appropriate choices. Be culturally sensitive and address gender issues.

Note that these elements of trauma-informed care are not merely a one-time task to be checked off of a list. Instead, a true trauma-informed approach is a series of ongoing, deliberate interactions that put the child as an individual at the forefront and not the exhibited behavior. All of these principles need to be implemented daily to be a true trauma-informed environment.

Best Practices for the Classroom 

Recognize the Signs of Trauma

Signs of trauma include difficulty focusing and struggling with creating and maintaining friendships. Some may be overly tired and/or have poor self-regulation. Other signs include excessive absences, changes in school performance, and withdrawal from activities or other people.

Provide Consistency and Structure

Children thrive with consistency and structure, so daily schedules should be structured and contain elements of academics, entertainment or play, and physical exercise or movement. While doing research, I found that the more obvious things are, the better a child will be able to succeed, especially when they have experienced some exposure to trauma. In the classroom, a schedule can lay out what the day will look like. Depending on the child's age, you can use pictures with your schedule to help them follow what is going on. As the day progresses, take down the image of the activity or task that was just completed. This is a great visual tool for the schedule. Weave in aspects of self-regulation skill building during the day as well.

Utilize Social-Emotional Learning

When we utilize social-emotional learning and teach social skills, we bring self-awareness, self-control, social awareness, and interpersonal skills to children. We can teach great techniques to children, but if they never put them into practice, they're not going to develop the social-emotional skills they need to grow well and be stable adults.

Use Restorative Practices Over Zero-Tolerance Policies

Zero-tolerance policies are ineffective and harmful. They focus on the offense and are rooted in punishment. The child or teen is punished for committing an infraction with detention, suspension, or expulsion. It removes the student from the classroom environment but does not consider the student as an individual and what might have led to the misbehavior. Remember, a trauma-informed environment focuses more on why the person is acting this way to help them, not just focusing on the behavior itself and stopping it.

Implement a Trauma-Informed Pedagogy 

Trauma-Informed Teaching

Trauma-informed teaching starts with understanding how trauma can impact learning and behavior. With this approach, educators think about what a student's behavior may be telling them. They reflect on their teaching practices to find ways to better support students who may be experiencing trauma. Here are some things we can do.

• Be mindful of your own emotions. Identifying and managing your feelings is the first step in helping students manage theirs.
• Expect that students will overreact sometimes. Provide the space and time they need to calm down. Let them know this is a normal response to trauma.
• Give students opportunities to talk or write about their experiences. Understanding the reasons behind a student's behavior can help you respond with empathy.
• Remind yourself that behavior is a form of communication. Try not to take it personally.
• Communicate with families about what you're seeing. They might have ideas you could try in class. Or they might ask you for ideas on how to help at home.
• Make sure your teaching is culturally responsive and doesn't exacerbate traumatic experiences students may have had. 
• Teach and model social and emotional skills, including positive behavior strategies.
• Ask the school counselor or other mental health specialist for recommendations and support. For behavior issues, a functional behavioral assessment can help identify what is causing the behavior and how to help.

Remember, everyone can get triggered, including teachers and therapists. Be aware of your own emotions so you can help the child to manage their emotions. Remember to try not to take a child's behavior personally. It's likely not an attack on you and has nothing to do with you. Many times, young children don't know how to express what's going on, so they act out. A child who was acting fine and all of a sudden becomes highly destructive, or vice versa, is a red flag. Teachers have to be very observant and pick up on certain things. It's not only the kids that misbehave that you have to observe; you also have to be able to observe the kids that might be a little bit too quiet because that can also be an indicator. Remember that if a student is acting this way, maybe it is something I need to explore. If you are a teacher, you likely don't have clinical skills, and if you are a therapist, you likely don't have teaching skills. However, by communicating with each other and using effective clinical skills, you can work together to help children.

Trauma Screening Tools

Professionals may administer trauma screening in several ways depending on the age and developmental stage of the child and the child's relationship with the caregiver and other collateral informants in their life. It is difficult to screen very young children for trauma symptoms. Instead, a professional may screen for exposure to traumatic events and social and emotional difficulties, such as attachment difficulties or mood dysregulation. As the child ages, it may be more appropriate to screen specifically for trauma symptoms. For example, if you're working with a child that is three years old, they might not be able to communicate with you fully, and the screening tools might not be helpful. However, children can be screened to see if they're easily attached to people or easily dysregulated. The therapist or social worker usually completes these screenings.

Providers using a screening tool should consider factors such as the child's age, language skills, and cognitive capabilities. This includes the child's developmental level. Another consideration is whether the child is among the populations for which the tool has been validated and normed. In addition, keep in mind any other factors that might affect the reliability and validity of the tool for the child.

Child-Completed Tool (Self-Report)

Child-completed tools are appropriate for children, typically ages eight and above, who can read and complete the questions. These measures allow the child to verbalize their responses aloud or in writing. If you are working with a developmentally delayed child, you might read the questions and have the child answer them aloud if they are unable to read and/or write. 

Caregiver-Completed Tool 

For infants, toddlers, young children (ages 0-8), or children with developmental delays, it is more appropriate to have a caregiver complete the trauma screening by providing written responses to the items or through an interview by the provider.

Provider-Completed 

The caseworker, clinician, or another professional can administer certain tools while reviewing and integrating available information on a child (e.g., court reports, interviews with caregivers and teachers, other questionnaires, and behavioral observations). These tools can be useful in consolidating a range of information in one place to be readily accessible.

When parents, teachers, and social workers collaborate and work together to support the child, it's more likely they will have improved outcomes. If you are in a school setting where a school counselor is administering these screenings, some information may be shared with the teaching staff if a release of information has been signed. 

Interventions for Social Workers in Early Childhood

Let's talk about some interventions for social workers in early childhood. There is the Bounce Back program, trauma-focused cognitive behavior therapy (TF-CBT, and modified grounding techniques. Even though these interventions are listed for social workers, the grounding techniques that we're going to go over can also be used by teachers or others as long as you know how to properly implement them. 

Bounce Back

Bounce Back is a cognitive-behavioral, skills-based, group intervention aimed at relieving symptoms of child traumatic stress, anxiety, depression, and functional impairment among elementary school children (ages 5-11) who have been exposed to traumatic events. Bounce Back is used most commonly for children who have experienced or witnessed community, family, or school violence, or who have been involved in natural disasters, accidents, physical abuse, neglect, or traumatic separation from a loved one due to death, incarceration, deportation, or child welfare detainment. There are 10 group sessions where children learn and practice feelings identification, relaxation, courage thoughts, problem-solving and conflict resolution, and build positive activities and social support. This can also be implemented in the classroom to reinforce what children are learning with the therapist or school counselor and let them know other children may be experiencing similar situations and feelings. It also includes 2-3 individual sessions in which children complete a trauma narrative to process their traumatic memory and grief and share it with a parent/caregiver. Between sessions, children practice the skills they have learned. Bounce Back also includes materials for parent education sessions. When I used this program I also met with the children individually and involved the parents and teachers.

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) 

Trauma-Focused Cognitive Behavioral Therapy is an evidence-based treatment program intended to help children and their families deal with the aftermath of a traumatic experience. The TF-CBT approach is applied in a safe and stable environment to encourage clients to share their feelings and aims to help those who have experienced trauma learn how to manage difficult emotions in a healthier way. You must be trained in this program to use it, and it is only for clinicians. There are no parts of it or interventions you can use without being trained. However, if the social worker, therapist, or school counselor is trained in TF-CBT and can work with you in helping to regulate the child, that would be beneficial.

Modified Grounding Techniques

Grounding techniques help control the symptoms of trauma by turning attention away from thoughts, memories, or worries and refocusing on the present moment. When you're doing grounding techniques with smaller children, you want to make sure you do it with them because they might need a little more help. Some of these grounding techniques can be implemented by anyone that is not clinical staff. It just has to be implemented correctly. Some of these can be used for small children, adolescents, and adults. 

5-4-3-2-1 Technique. My favorite grounding technique is the 5-4-3-2-1 technique. Using the 5-4-3-2-1 technique will purposefully take in the details of the person's surroundings using each of their senses. Encourage those using it to strive to notice small details that their mind would usually tune out, such as distant sounds or the texture of an ordinary object. It serves as a way for people to be aware of their surroundings and, at the same time, ground themselves.

• What are five things you can see? Look for small details such as a pattern on the ceiling, the way light reflects off a surface, or an object you never noticed. Young children can point to things they see.
• What are four things you can feel? Notice the sensation of clothing on your body, the sun on your skin, or the feeling of the chair you are sitting in. Pick up an object and examine its weight, texture, and other physical qualities. You can have objects on the table for children to feel.
• What are three things you can hear? Pay special attention to the sounds your mind has tuned out, such as a ticking clock, distant traffic, or trees blowing in the wind.
• What are two things you can smell? Try to notice smells in the air around you, like an air freshener or freshly mowed grass. You may also look around for something with a scent, such as a flower or an unlit candle.
• What is one thing you can taste? Carry gum, candy, or small snacks for this step. Pop one in your mouth and focus your attention closely on the flavors. For young children, make sure the object to taste is not a choking hazard.

Body Awareness. The body awareness technique will bring the person into the here and the now by directing their focus to sensations in the body. Pay special attention to the physical sensations created by each step. I have used this technique in a second-grade classroom where I had a couple of clients who had some level of trauma, but I didn't want to leave the other kids out, so we did it all together. Luckily the teacher was already teaching the students how to breathe deep. For the grounding techniques to be effective, you want to ensure that the kids can do all the activities below.

• Take five long, deep breaths through your nose, and exhale through puckered lips.
• Place both feet flat on the floor. Wiggle your toes. Curl and uncurl your toes several times. Spend a moment noticing the sensations in your feet.
• Stomp your feet on the ground several times. Pay attention to the sensations in your feet and legs as you make contact with the ground.
• Clench your hands into fists, then release the tension. Repeat this ten times.
• Press your palms together. Press them harder and hold this pose for 15 seconds. Pay attention to the feeling of tension in your hands and arms.
• Rub your palms together briskly. Notice the sound and the feeling of warmth.
• Reach your hands over your head like you're trying to reach the sky. Stretch like this for 5 seconds. Bring your arms down and let them relax at your sides.
• Take five more deep breaths and notice the feeling of calm in your body. 

This technique is beneficial because if someone feels they're having a flashback, they can do this to stay in the here and the now. Many kids find this silly and do not realize how relaxed they are once they get to the bottom of the list. You will need to talk preschool-age children through the activities and model for them.

Mental Exercises. Use mental exercises to take their mind off uncomfortable thoughts and feelings. They are discreet and easy to use at nearly any time or place. Experiment to see which works best for you. A few of these would be things preschool children could do with prompts. For older children and adolescents, you can place this list of activities in a quiet area for them to access. 

The main point of grounding techniques is to get the person out of their uncomfortable thoughts and feelings at that moment.  

Interventions for Early Childhood Teachers and Staff 

Educators must work closely with families to ensure children receive the necessary help and support. Here are some ways to work with families and outside specialists such as therapists, social workers, or counselors. Engage and include families in the program or school in caring, nonjudgmental ways—hold regularly scheduled meetings, invite them to the classroom to volunteer, and correspond through email and telephone. Use these opportunities with families to deepen your connection by learning more about their home lives and offering space for them to ask questions about the program. If a child is working with an outside specialist (such as a trauma specialist or a child therapist), ask for the family's permission to invite the specialist to the classroom so you can collaborate to better support the child. Work with specialists and families to create Individualized Family Service Plans, Individualized Education Programs, or Individual Support Plans that support children's positive behaviors, development, and learning and promote caregiver responsiveness).

Suggestions for Helping Children Who Have Experienced Trauma

Keep in mind that not all strategies work for all children. Create and maintain consistent daily routines for the classroom. Tell children when something out of the ordinary is going to happen. Offer children developmentally appropriate choices. Anticipate difficult periods and transitions during the day after and offer extra support during those times. Use techniques to support children's self-regulation. Understand that children make sense of their experiences by reenacting them in play or through interactions with peers and adults. Be nurturing and affectionate but also sensitive to children's triggers. That doesn't necessarily mean there should be touch because, for some children, a touch might not be helpful to them. After all, it might be a trigger. Use positive guidance to help all children.

Worry Eater. Figure 1 shows a picture of the worry doll that I use for children who might not be able to convey how exactly they feel. Older children can write down their worries, unzip the doll, and feed them to the worry doll. Younger children who can't do that can talk to the worry doll instead. I like to explain to children that the worry doll is there to help them through their worries and will eat up all their worries. I make playful noises like it's eating the worry, and then we're able to talk about that worry.

A worry doll helps get children to begin expressing how they're feeling. Many children and adults keep things within themselves. That's how outbursts happen. Sometimes I'll model with the worry doll and tell it, "I feel worried when..." Some children enjoy drawing and can draw their worries. Then you can ask them what's happening in the picture and see if they can tell you more about it. Encourage children to talk about their feelings and encourage them to use statements such as, "I feel worried when..." When you speak with a child about their worries, think about the following prompts.

• What do you look like when you're worried and when you're calm?
• What can you do to stop worrying?
• What is something you are worried about?

Figure 1. Worry eater doll.

Deep Breathing. Deep breathing is one of my favorite activities because when you take a deep breath and do it properly, it releases a chemical in your brain that helps relax you. However, deep breathing must be done correctly, or it can have the opposite effect. Sometimes people, especially young children, don't know how to take a deep breath. You can use bubbles, a stuffed animal, pretend flowers and candles to help teach children how to breathe deeply.

Blowing gently to create bubbles is an excellent way to be playful and breathe deeply. Children have to blow carefully and slowly to make the bubbles. Watch for children who get frustrated because they're blowing too hard and can't get the bubbles to come out. To use a stuffed animal, have the child lie down on their back and put a stuffed animal on their belly. Have them breathe in and move the stuffed animal up, then breathe out and bring it back down. This helps teach children to use their bellies to take big deep breaths. Another technique is to imagine smelling a flower. Have children breathe in through their nose to smell it and breathe out through their mouth. An alternative is to imagine a birthday cake with a candle on it. Take in a deep breath through the nose and then exhale through the mouth to blow out the candle. All of these techniques can be used at home with parents as well.

Additional Interventions

Here are some other interventions that can be used by clinical staff. Cognitive Behavioral Therapy (CBT) is a form of psychotherapy used to treat many psychiatric problems, including depression, anxiety, and PTSD. Child-parent psychotherapy (CPP) is a relationship-based treatment that integrates modalities derived from psychodynamic, attachment, trauma, cognitive-behavioral, and social learning theories.

The child-parent relationship targets the child's improvement in the emotional, cognitive, and social domains of functioning. The interventions focus on promoting affect regulation in the child and the parent, changing maladaptive behaviors in the child, the mother, and their interaction, supporting and encouraging developmentally appropriate interactions and activities, and assisting the child and the mother in creating a joint trauma narrative.

Skills training in affective and interpersonal regulation/narrative story-telling (STAIR/NST) is a two-module treatment focused on reducing symptoms of PTSD and other trauma-related symptoms (including depression and dissociation) and on building and enhancing specific social and emotional competencies that are frequently disturbed in youths who have experienced multiple traumas and/or sustained trauma. This intervention might also be used to prevent the development of traumatic stress symptoms when implemented after exposure to a traumatic event.

Trauma and grief component therapy (TGCT) is a group treatment program for traumatically bereaved older school-aged children and adolescents. The target population includes youths affected by community violence, school violence, gang violence, war/ethnic cleansing, and natural and man-made disasters. Cognitive behavioral intervention for trauma in schools (CBITS) is a skills-based, group intervention for children exposed to trauma who are typically between the ages of 10 and 15 years. It may be appropriate not only for intervening early after exposure to a traumatic event but also for treating traumatic stress symptoms. 

It's important to note that you need to be trained in all of these interventions to use them. They are good recommendations to present to a school principal and counselor or therapist to bring into the school.

Resources

• https://www.therapistaid.com/
• https://www.mylemarks.com/store/c36/FREE_DOWNLOADS.html
• https://www.psychologytools.com/downloads/cbt-worksheets-and-therapy-resources/
• https://www.theraplatform.com/therapy-resources
• https://www.briankonik.com/worksheets/
• Workbook
  • https://tfcbt.org/wp-content/uploads/2014/07/Your-Very-Own-TF-CBT-Workbook-Final.pdf

References

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Peterson, S. (2018, March 27). Trauma screening. The National Child Traumatic Stress Network. Retrieved March 8, 2022, from https://www.nctsn.org/treatments-and-practices/screening-and-assessments/trauma-screening  

Psychology Today. (n.d.). Therapeutic intervention. Retrieved March 8, 2022, from https://www.psychologytoday.com/us/therapy-types/therapeutic-intervention

Statman-Weil, K. (2015). Creating trauma-sensitive classrooms. Young Children (70)2.

Health as a Human Right. (2020, November 16). Trauma informed care – nonclinical staff encounters. Retrieved March 8, 2022, from https://healthasahumanright.wordpress.com/2018/09/12/trauma-informed-care-non-clinical-staff-encounters/  

Trauma-informed teaching tips for classroom & online educators: Resilient educator. ResilientEducator.com. (2021, June 8). Retrieved March 8, 2022, from https://resilienteducator.com/classroom-resources/trauma-informed-teaching-tips/