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Caused by
Racial trauma can result from major experiences of racism such as hate crimes, or it can be the result of an accumulation of many small occurrences, such as everyday discrimination and microaggressions.

SEL Responses

Identity representation in books

When reading a story to the class, discuss how characters might think or feel.

Assigning responsibilities and tasks to each student builds a sense of self-worth.

Starting the day with an affirmation can set the tone for a positive learning environment as it encourages positive self-talk and promotes a growth mindset.

Teaching mindfulness activities such as breathing can be done in conjunction with “brain breaks” in between lessons.

Journal exercises help students identify and express their feelings or opinions, and group discussions can promote healthy and respectful disagreements.

Social-Emotional Learning Circles help promote community discussions and respectful, reflective listening.

Sources:

https://www.apa.org/pubs/highlights/spotlight/issue-128

https://resilienteducator.com/classroom-resources/trauma-informed-teaching-tips/

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Many ethnic and racial groups experience higher rates of posttraumatic stress disorder (PTSD) as compared to White Americans. One explanation for this is the experience of racism, which can itself be traumatic.

When traumatization is due to experiences of racism it is sometimes called racial trauma. Racial trauma can result from major experiences of racism such as workplace discrimination or hate crimes, or it can be the result of an accumulation of many small occurrences, such as everyday discrimination and microaggressions.

An article by Williams and colleagues, published in Practice Innovations, aims to provide a context for understanding how racism can lead to a diagnosis of PTSD according to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Racial trauma may merit a DSM-5 diagnosis of PTSD when there is an identifiable index trauma (Criterion A), re-experiencing of the trauma (Criterion B), avoidance of trauma reminders (Criterion C), negative mood/cognitions (Criterion D), and hyperarousal (Criterion E). However, all symptoms of PTSD may be present due to racial trauma, even if a Criterion A event cannot be identified.

The DSM-5 limits what is defined as a traumatic experience to direct exposure to physical and sexual violence up to and including actual death, repeated exposure to traumatic information in a work setting, and indirect exposure by way of receiving news of a traumatic event involving a close friend or loved one.

This may preclude a PTSD diagnosis, even if all symptoms are present. However, if the nature of the trauma does not meet DSM-5 criteria, PTSD may still be diagnosed based the ICD-10 criteria (International Classification of Diseases), because it does not explicitly restrict the types of traumas that may result in a diagnosis of PTSD.

Sometimes bona fide Criterion A events are missed by mental health service providers because they are unaware of the impact of discrimination, fail to recognize experiences of racism as traumatic, or fail to inquire about experiences of racism at all. For example, being bullied at school for being "different," racial profiling by police, and workplace racial harassment can all be DSM-5 Criterion A events, but these are rarely included in conventional checklists and batteries for trauma.

Further, assessing discriminatory distress in patients of color during a clinical encounter may be uncomfortable for therapists who have not had practice discussing racial issues. Many White people are socialized to demonstrate non-racist values by not talking about race. However, this approach leaves such clinicians ill-equipped to have conversations about race with their clients of color, and so it is even less likely they will be able engage in productive conversations surrounding traumatic experiences of racism.

One solution to this problem is the UConn Racial/Ethnic Stress & Trauma Survey (UnRESTS), a clinician administered semi-structured interview designed for clients who are part of stigmatized racial and ethnic groups.

In terms of the structure of the UnRESTS, it collects information about a client's racial and ethnic group and ethnic identity, and then guides the clinician in asking about experiences surrounding explicit and obvious racism, racism experienced by loved ones, being vicariously impacted by racist experiences that were learned about, and experiences with subtle forms of racism or microaggressions.

The end of the UnRESTS is a checklist designed to determine if symptoms are present in each of the critical areas delineated by the DSM-5 as indicative of PTSD. The UnRESTS is also available in Spanish.

The UnRESTS is useful to clinicians as an aid to uncovering racial trauma, developing a culturally-informed case conceptualization, and including experiences of racism into the diagnosis of PTSD when warranted.

Three case examples are provided in the article that describe the impact of racial stress and trauma and the role of the UnRESTS in understanding their experiences.

Citation

Williams, M. T., Metzger, I. W., Leins, C., & DeLapp, C. (2018). Assessing racial trauma within a DSM-5 framework: The UConn Racial/Ethnic Stress & Trauma Survey. Practice Innovations, 3(4), 242-260. http://dx.doi.org/10.1037/pri0000076
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Note: This article is in the Clinical Psychology topic area. View more articles in the Clinical Psychology topic area.

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Many ethnic and racial groups experience higher rates of posttraumatic stress disorder (PTSD) as compared to White Americans. One explanation for this is the experience of racism, which can itself be traumatic. When traumatization is due to experiences of racism it is sometimes called racial trauma.

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Psychologists can provide evidence-based interventions to help you cope with traumatic stress or acute stress disorder.

One is Psychological First Aid (PFA), originally designed to help children, adolescents, adults, and families in the aftermath of a disaster or terrorism. It’s now used to help people who have experienced any type of trauma. PFA is based on the idea that distress is normal after a traumatic event. Rather than treat that stress like a disorder, the focus of this approach is to provide support and assistance and share information about stress reactions and coping strategies. Mental health providers and disaster response workers provide PFA in the days and weeks after a trauma, in diverse settings including hospitals, housing shelters, community settings, and even over telephone crisis hotlines. The goal of PFA is to reduce distress and improve coping and functioning, both short-term and long-term.
Another evidence-based treatment is cognitive behavioral therapy, or CBT, which is successfully used to treat many psychological disorders, including traumatic stress. CBT is a psychological treatment that helps people learn to change unhelpful thinking and behavioral patterns. The World Health Organization recommends trauma-focused CBT to treat symptoms of acute traumatic stress in adults. Some research also suggests that people who receive trauma-focused CBT may be less likely to develop chronic PTSD.

In addition, a variety of treatments have been developed to help children and adolescents who have been exposed to trauma or adverse childhood events such as neglect or abuse. Many of these therapies are family-based and include the child’s parents or caregivers in the treatment process.

Sources: How to cope with traumatic stress (apa.org)

Giacomo Nicolosi

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Caused by physical injuries of sudden accident and severity which require immediate medical attention.

Symptoms:

Flashbacks or intrusive thoughts about the traumatic accident.

Intense physical or emotional reactions to reminders of the accident.

Nightmares

Avoiding people, places, activities or sensations that remind you of the accident.

Responses:

Immediate interventions

Staying connected to friends and other important people

Being able to talk about the traumatic accident and your reactions to it with supportive people

Having supporters who avoid reacting in unhelpful ways when told about the acident.

Returning to your routine, such as going to work or school, doing chores and maintaining a sleep schedule.

Sources:

https://www.healthline.com/health/traumatic-events

https://www.edutopia.org/article/are-you-risk-secondary-traumatic-stress

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Caused by a death or event where a child has "ongoing difficulties that interfere with everyday life and make it difficult to recall positive memories of their loved ones."

Symptoms

Decreased academic performance

Depression

Anxiety

Avoidance and numbing

Intrusive memories about the death

Lack of sleep

Decreased concentration

Lower grades

Fear of safety

Headaches

Irritability

Anger

Reminder triggers

Responses

Effective Interventions

Child Therapy

Trauma-Focused Cognitive Behavioral Therapy

Normalize expressed feelings

Be sensitive

Peer support groups

Maintain normal routines

Provide opportunities to talk and ask questions

Listen and acknowledge feelings

Be brief and patient

Sources

https://www.nasponline.org/resources-and-publications/resources-and-podcasts/school-climate-safety-and-crisis/mental-health-resources/addressing-grief/addressing-grief-tips-for-teachers-and-administrators

https://www.nctsn.org/what-is-child-trauma/trauma-types/traumatic-grief

-Alex M.

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Caused by a pain, injury, serious illness, medical procedures and frightening treatment experiences.

Symptoms:

Hypervigilance

Avoidance behavior

Anxiety

Intrusive memories

Intense emotions

Emotional numbing

Exaggerated startle response

Exhaustion (not wanting to go to school or falling asleep in school)

Confusionin class

Sadness

Responses:

Medical healthcare

Mental healthcare

Counseling

Interventions

Sources:

https://www.chop.edu/conditions-diseases/trauma-and-stressor-related-disorders-children

https://istss.org/public-resources/friday-fast-facts/fast-facts-medical-trauma#:~:text=Medical%20trauma%20is%20emotional%20and,be%20difficult%2C%20uncomfortable%20or%20frightening.

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Caused by "deliberate and unsolicited action that occurs with the intent of inflicting social, emotional, physical, and/or psychological harm to someone." Also includes cyberbullying.

Symptoms

Depression

Anxiety

Anger

Frustration

Poor self esteem

Loneliness or Isolation

Missing classes or school

Poor academic performance

Suicidal or homicidal thoughts

Self-injury

Eating or sleeping changes

Responses

Stop the bullying immediately

Investigate/refer investigation

Refer to school rules regarding bullying

Support the bullied child

Offer guidance to peers

Impose immediate consequences

Notify colleagues and parents

Follow-up and intervene as necessary

Sources

https://www.nctsn.org/what-is-child-trauma/trauma-types/bullying

https://www.learningforjustice.org/professional-development/bullying-guidelines-for-teachers

-Alex M.

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Trauma From Adverse Childhood Experiences (ACE)

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Trauma From Adverse Childhood Experiences (ACE)

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Caused by physical and emotional abuse, neglect, caregiver mental illness, racism, community violence and household violence.

Symptoms include

- Heart disease and diabetes
- Poor academic performance
- Substance abuse later in life

Responses

- therapeutic sessions with mental
health professionals
- meditation
- physical exercise
- spending time in
nature
- ideal approach is to reduce sources of stress from people's lives

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Caused by experiences of traumatic experiences of another person.  Sometimes known as compassion fatigue, the toll of tending to someone's painful experiences can create very real symptoms in caregivers, including teachers.

Symptoms include

Increased anxiety and concern about safety

Intrusive negative thoughts and images related to students' traumatic stories

Fatigue and physical complaints

Feelings of numbness or detachment from students and peers

Diminished concentration and difficulty with decision making

Desire to physically or emotionally withdraw from others

Feelings of professional inadequacy

Who Is Most At Risk?

Educators with previous or unresolved trauma exposure

Female educators

Highly empathetic educators

New or inexperienced educators, with a lack of training

Educators working with unsupportive administrations

Educators working in communities that have experienced communal trauma, including high levels of poverty, high levels of crime, generational/historical trauma, tragic events, and natural disasters

Responses

1. Listen: Create a safe space for teachers to share their stories with one another.

2. Protect: Preserve that teacher's confidentiality and work to keep them safe from their stressors.

3. Connect: Connect with the teacher's experience and use that to help provide them with resources for stress management.

4. Model: Develop systems and plans for stress management.

5. Teach: Using these steps, help one another in your teacher capacities, continue to learn more about STS, and share your experiences.

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Karen Baicker

A 4th grade teacher named Sarah from New Orleans recently spoke about the trauma her students and families are facing, and the ways it frequently spills into her classroom. "This year already, I've had a student whose parent was killed, and others whose parents are in and out of jail. I've had to confiscate a weapon. Some of my kids are homeless." She does her best to help her students, including greeting them at the door with hugs and helping them get counseling. But at the end of the day, as she tries to fall asleep, she finds herself worrying about the difficulties her kids may be facing at that very moment.

Today, over half of all children in the United States suffer from some kind of trauma. Whether trauma stems from a student's home life or results from a community tragedy, teachers recognize that helping children cope with outside challenges is part and parcel with helping them learn. However, far less known-and even less supported-is the impact that student trauma has on educators like Sarah.

What Is Secondary Traumatic Stress?

Secondary traumatic stress (STS) is the emotional distress that arises when someone vicariously experiences the traumatic experiences of another individual. Sometimes known as compassion fatigue, the toll of tending to someone's painful experiences can create very real symptoms in caregivers, including teachers.

Other fields, including nursing and law enforcement, have long identified the toll that interacting with victims of trauma can take on caring professionals. In these sectors, awareness of the impact has led to systems for recognizing, processing, and treating the professionals impacted by STS. However, despite schools making great strides implementing a trauma-informed approach to caring for students, the emotional distress that educators experience when working with traumatized students is still widely overlooked.

What Are the Symptoms of STS?

One reason STS goes unrecognized is that it can mirror the emotional burnout many teachers experience. Teachers who find themselves drained from their days in class may chalk it up to the rigors of lesson-planning, standardized tests, behavioral challenges, and other quotidian demands of the classroom.

Some of the common symptoms of STS include

Increased anxiety and concern about safety

Intrusive negative thoughts and images related to students' traumatic stories

Fatigue and physical complaints

Feelings of numbness or detachment from students and peers

Diminished concentration and difficulty with decision making

Desire to physically or emotionally withdraw from others

Feelings of professional inadequacy

Who Is Most At Risk?

Knowing that you are helping others can provide an emotional lift. Compassion satisfaction is the condition of feeling rewarded or motivated by helping those experiencing trauma. Teachers who are drawn to the field of education tend to be empathetic to begin with, and thus are predisposed to compassion satisfaction. Yet being prone to compassion satisfaction is itself a risk factor for STS.

Teachers who work in areas of high poverty or high trauma will typically experience a greater exposure to STS, but trauma exists across all socioeconomic groups. According to the National Child Traumatic Stress Network (NCTSN), risk appears to be greater among

Educators with previous or unresolved trauma exposure

Female educators

Highly empathetic educators

New or inexperienced educators, with a lack of training

Educators working with unsupportive administrations

Educators working in communities that have experienced communal trauma, including high levels of poverty, high levels of crime, generational/historical trauma, tragic events, and natural disasters

How Can STS Be Treated?

Steve Hydon is a clinical professor at the University of Southern California and a leading researcher bringing knowledge from the field of social work into education. Hydon suggests the first step in treating STS is to build understanding and awareness of STS.

Hydon worked with the U.S. Department of Education to develop psychological first aid resources for educators rebuilding in New Orleans after Hurricane Katrina. Administrators looking to implement a district- or school-wide approach to STS can look to this five-step program:

1. Listen: Create a safe space for teachers to share their stories with one another.

2. Protect: Preserve that teacher's confidentiality and work to keep them safe from their stressors.

3. Connect: Connect with the teacher's experience and use that to help provide them with resources for stress management.

4. Model: Develop systems and plans for stress management.

5. Teach: Using these steps, help one another in your teacher capacities, continue to learn more about STS, and share your experiences.

A number of other approaches have been found to provide support: regularly scheduled meetings where educators can come together to discuss workplace stress and partake in counseling services; STS training programs; faculty appreciation events; and other stress-relieving social activities.

Experts also recommend that teachers manage the effects of STS in their personal lives by engaging with family and friends, reconnecting with hobbies, practicing mindfulness techniques, and prioritizing self-care. It is also crucial to establish personal, professional, and emotional boundaries between work and home.

Trauma and the Power of Story

Many educators also advocate for the healing power of stories in coping with both primary and secondary trauma. The Yale Child Study Center - Scholastic Collaborative for Child & Family Resilience is currently researching ways that literacy, and the ability to craft and reshape one's personal narrative, can provide a buffer for children facing adversity and build resilience for teachers. Through literature, people can learn that others have experienced and coped with similar adversity.

In the latest Scholastic Kids & Family Reading Report, over half of the students surveyed said they have turned to books to help them through difficult times.

Trauma experts caution that asking victims to retell a traumatic incident, especially in the near aftermath, has the risk of retraumatizing the victim. However, when implemented thoughtfully, storytelling allows the narrator not just the power to retell, but to rewrite their experiences. Working together through traumatic circumstances offers students and teachers alike the chance to reclaim and reframe those events in ways that offer hope and healing.

To learn more about support for STS, please visit the National Child Traumatic Stress Network or the crisis hotlines.

Karen Baicker is the executive director of the Yale Child Study Center - Scholastic Collaborative for Child & Family Resilience, as well as the publisher for Family and Community Engagement (FACE) at Scholastic. She develops innovative programs and services that reach communities most in need.

More on This Topic: Proactively Addressing Teachers' Cost of Caring

ASCD Express, Vol. 15, No. 13. Copyright 2020 by ASCD. All rights reserved. Visit www.ascd.org/ascdexpress.

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The Impact of Secondary Trauma on Educators

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Karen Baicker A 4th grade teacher named Sarah from New Orleans recently spoke about the trauma her students and families are facing, and the ways it frequently spills into her classroom. "This year already, I've had a student whose parent was killed, and others whose parents are in and out of jail.

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Caused by natural disasters such as floods, storms, bushfires, earthquakes.....etc

Symptoms include
• Asking lots of questions about the event or future
• Avoiding talking about what has happened
• Wanting to help others who have been affected
• Crying, feeling down
• Bad dreams or nightmares about different things
• Being more clingy and having fears of separation from loved ones, homes, pets
• Trouble getting to sleep, waking from sleep, occasionally sleepwalking
• Physical reactions (eg, fast beating heart, upset stomach, headaches)
• Feeling grumpy and losing temper
• Trouble concentrating
• Difficulty with schoolwork
• Agitation
• Difficulty interacting with peers and adults
• Playing, drawing and re-enacting parts of the trauma
• Difficulties with everyday functioning (eg, not completing homework,
forgetting to pack bags, bring swim gear)
• Feeling shocked
• Grief and sadness about loss of a loved one, pet or possessions

Teachers' Responses
- Monitor symptoms over time
- Maintain routines
- Talk about the traumatic event
- Set clear and firm limits/expectations of behaviour
- Use a ‘buddy’ or ‘support’ system
- Safe ‘relaxation’ spaces
- Provide choices – regain control
- Anticipate difficult times and plan ahead
- Prepare children and adolescents for situations which may
trigger reactions
- Focus on strengths and positives
- Teach self-care