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A narrative examination of using school-based trauma-informed practices Lemon, Rosalynn Michelle 2020

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   `     A NARRATIVE EXAMINATION OF USING SCHOOL-BASED TRAUMA-INFORMED PRACTICES by ROSALYNN MICHELLE LEMON M.A. University of British Columbia, 2014 B.A. University of British Columbia, 2008  A DISSERTATION SUBMITTED IN PARTIAL FULFILLMENT OF  THE REQUIREMENTS FOR THE DEGREE OF   DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Counselling Psychology) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) March 2020    Ó Rosalynn Michelle Lemon, 2020     ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the dissertation entitled:  A Narrative Examination of School-Based Trauma-Informed Practices   submitted by    Rosalynn Michelle Lemon in the partial fulfillment of the requirements for the degree of    Doctor of Philosophy  in    Counselling Psychology    Examining Committee  Dr. Marla Buchanan, Professor, Counselling Psychology, UBC Supervisor  Dr. William Borgen, Professor, Counselling Psychology, UBC Supervisory Committee Member  Dr. Alanaise Goodwill, Assistant Professor, Counselling Psychology, SFU Supervisory Committee Member  Dr. Ishu Ishiyama, Associate Professor, Counselling Psychology, UBC University Examiner  Dr. Dónal O’Donoghue, Professor, Department of Curriculum and Pedagogy, UBC   University Examiner      iii Abstract In Canada, the current rate of natural disasters, the influx of immigrant and refugee children from war-torn countries, and the prevalence of complex traumatic experiences in childhood highlight that it is time to examine our preparation within schools to address trauma.  However, there is a scarcity of empirical knowledge regarding effective practices for supporting Canadian students who have experienced trauma.  The present study involved in-depth narrative interviews with seven school counselling professionals who identified using trauma-informed practices in their schools.  Thematic content analysis was conducted on participant interviews to examine their stories of engaging with and implementing trauma-informed practices.  Six key themes were identified in the analyses of the participants’ narratives: Defining Trauma-Informed Practices, Experiences in Training and Learning About Trauma-Informed Practices, Trauma-Informed Practices: A Movement, Engaging in Trauma-Informed Work in Schools, How Trauma-Informed Practices Support, and The Future of Trauma-Informed Practices.  These themes are presented and discussed in terms of their implications for trauma-informed practices research and practice.      iv Lay Summary In Canada, the current rate of natural disasters, the influx of immigrant and refugee children from war-torn countries, and the prevalence of complex traumatic experiences in childhood highlight that it is time to examine our preparation within schools to address trauma.  However, Canadian research regarding the most effective ways to support students who have experienced adverse life experiences is limited.  The present study examined the stories of seven school counselling professionals who identified using trauma-informed practices in their schools.  Trauma-informed practices are an approach to counselling and education where school professionals strive to be knowledgeable about trauma, with the goal of creating an environment that prioritizes safety, choice, control and empowerment (Poole & Greaves, 2012).  The participants’ interviews were analyzed for key points and commonalities across their stories of using trauma-informed practices.  The findings are discussed in terms of the key themes and their implications for trauma-informed practices research and practice.     v Preface This dissertation is original, independent work by the author, R. Record-Lemon. This research was covered by UBC Ethics Certificate number H17-01642.    The narrative literature review discussed on pages 7-8 of Chapter 1 has been published [Record-Lemon, R. M., & Buchanan, M. J. (2017). Trauma-informed practices in schools: a narrative literature review. Canadian Journal of Counselling and Psychotherapy/Revue canadienne de counseling et de psychothérapie, 51, 286-305. Retrieved from https://cjc-rcc.ucalgary.ca/article/view/61156].  I conducted the narrative review data collection and analysis under the supervision of Dr. M. Buchanan.  Dr. M. Buchanan and I co-wrote the manuscript.       vi Table of Contents Abstract ........................................................................................................................................ iii Lay Summary ................................................................................................................................ iv Preface ............................................................................................................................................ v Table of Contents .......................................................................................................................... vi Acknowledgements .................................................................................................................... viii Chapter 1 Introduction ................................................................................................................. 1 Research Problem ........................................................................................................................ 1 Trauma-Informed Practices in Schools ....................................................................................... 2 Rationale ...................................................................................................................................... 4 Research Purpose and Question .................................................................................................. 8 Narrative Inquiry as an Approach to Investigating Trauma-Informed Practices ........................ 9 Significance of the Research ..................................................................................................... 10 Chapter 2 Literature Review ...................................................................................................... 12 Trauma in Childhood ................................................................................................................. 13 Theoretical Understandings on the Impacts of Trauma on Children and Youth ....................... 22 Conceptualizing Trauma-Informed Practices in Schools .......................................................... 35 Implementing Trauma-Informed Practices in Schools .............................................................. 42 Chapter 3 Methods ...................................................................................................................... 56 Social Constructionism .............................................................................................................. 56 Main Tenets of Social Constructionism .................................................................................... 57 Narrative Inquiry ....................................................................................................................... 58 Appropriateness of the Method ................................................................................................. 63 Description of the Participants .................................................................................................. 65 Recruitment Procedures ............................................................................................................. 67 Informed Consent ...................................................................................................................... 69 Study Procedures ....................................................................................................................... 69 Issues of Trustworthiness .......................................................................................................... 75 Delimitations ............................................................................................................................. 81 Ethical and Diversity Considerations ........................................................................................ 82 Chapter 4 Findings ...................................................................................................................... 83 Part I: Individual Narrative Accounts ...................................................................................... 84 Participant One - Linda ............................................................................................................. 84 Participant Two – Barbara ......................................................................................................... 86   vii Participant Three – Ann ............................................................................................................. 88 Participant Four – Diana ............................................................................................................ 90 Participant Five – Jill ................................................................................................................. 92 Participant Six – Mary ............................................................................................................... 94 Participant Seven – Sarah .......................................................................................................... 96 Part II: Composite Narrative ..................................................................................................... 99 Composite Narrative – Jane ....................................................................................................... 99 Part III: Key Themes ................................................................................................................ 103 Theme 1: Defining Trauma-Informed Practices ...................................................................... 103 Theme 2: Experiences in Training and Learning About Trauma-Informed Practices ............ 108 Theme 3: Trauma-Informed Practices - A Movement ............................................................ 113 Theme 4: How Trauma-Informed Practices Support the Students, the School Professionals, and the School Environment ................................................................................................... 118 Theme 5: Engaging in Trauma-Informed Work in Schools .................................................... 122 Theme 6: The Future of Trauma-Informed Practices .............................................................. 127 Summary of the Findings ........................................................................................................ 134 Chapter 5 Discussion and Conclusions .................................................................................... 135 Discussion of the Findings in the Context of Trauma-Informed Practices Literature ............. 136 Implications for Future Research ............................................................................................ 145 Recommendations for Practice ................................................................................................ 147 Strengths and Limitations ........................................................................................................ 153 Concluding Remarks ............................................................................................................... 154 References .................................................................................................................................. 156 Appendix A: Letter of Recruitment ......................................................................................... 184 Appendix B: Telephone Screen ................................................................................................ 186 Appendix C: Informed Consent Form .................................................................................... 188 Appendix D: Narrative Interview Protocol ............................................................................. 192 Appendix E: Transcription Key ............................................................................................... 194     viii Acknowledgements A special acknowledgement to the seven school counselling professionals who participated in this study.  Thank you for sharing your rich and inspiring stories of the innovative trauma-informed work you are doing within your schools and in the field     I wish to offer my acknowledgement and appreciation to the faculty, staff, and my fellow students in the UBC Counselling Psychology Program.  I offer my sincerest gratitude to my committee Dr. Marla Buchanan, Dr. Alanaise Goodwill, and Dr. William Borgen.  Marla, your mentorship, expertise and genuine care for your students have been invaluable throughout each and every stage of my program and research.  Thank you for sharing in my passion for school-based trauma-informed practices and for being a constant advocate for this work.  Bill, thank you for bringing your engaging contributions and school expertise to the research process.  Alanaise, thank you for your ongoing encouragement and thoughtful attention to the value of story in this research.  To my wonderful cohort, the Wolf Pack, it has been invaluable going through this winding PhD journey with the comradery of such a compassionate, encouraging, and inspiring group of women.  Special thanks are owed to my parents, family, and friends for their love and support every step of the way.  To my husband Peter Lemon, you have truly been my rock throughout these many, many years of graduate school.  Thank you for your constant love, support, encouragement, and much needed humor in this process.        1 Chapter 1 Introduction Research Problem  A significant number of school-aged children have been affected by traumatic events.  The results of the 2014 Canadian General Social Survey indicated that approximately one-third of Canadians have experienced childhood traumatic experiences such as physical abuse, sexual abuse, and/or witnessing violence in the home (Statistics Canada, 2019).  These traumatic experiences can have a considerable impact on a child’s health, mental wellness, and academic success (Gonzalez et al., 2016; Wright, 2014).  Previous research has suggested that schools can play a vital role in supporting students who have experienced traumatic events and many authors concur that there is a need for a formalized system of evidence-based trauma-informed practices in schools (e.g., Dorado, Martinez, McArthur, & Leibovitz, 2016; Mendelson, Tandon, O'Brennan, Leaf, & Ialongo, 2015).  However, trauma-informed practices are not yet widespread across Canadian schools and the current Canadian empirical literature base concerning trauma-informed practices is limited.  Furthermore, school professionals may encounter challenges in supporting students who have experienced trauma due to factors such as reported lack of knowledge and skills, lack of training and professional development, lack of experience, and lack of role clarity (Alisic, 2012; Alisic et al., 2012; Gubi et al., 2019).  The purpose of the present study was to obtain detailed accounts of experiences using trauma-informed practices in Canadian schools through examining the narratives of school counselling professionals who identified using a trauma-informed approach in their work in schools.    2 Trauma-Informed Practices in Schools Professionals using trauma-informed practices strive to engage in all aspects of counselling and education with an understanding of trauma and how it may impact students, families, and school staff (Gubi et al., 2019; Thomas, Crosby, & Vanderhaar, 2019).  The goal of this approach is to create an environment that prioritizes safety, choice, control, and empowerment (Poole & Greaves, 2012).  According to Dorado et al. (2016), trauma-informed practices offers an alternative paradigm to traditional behaviour-based approaches of understanding and intervening with student challenges, mental health concerns, and problem behaviours.  The primary focus of trauma-informed practices is not necessarily specific treatments for posttraumatic stress symptoms (Harris & Fallot, 2001).  Rather, trauma-informed practice is an overarching framework for supporting students that can include a range of services from whole-system initiatives to trauma-specific supports and services such as trauma assessment, psychoeducational programs, and specific trauma interventions implemented in schools (e.g., Jaycox et al., 2009; Rolfsnes & Idsoe, 2011; Woodbridge et al., 2016).  Many trauma-informed approaches advocate for a whole-school/system approach to establishing trauma-informed schools (Panlillio, 2019).  Therefore, trauma-informed practices often include a focus on educating and empowering school stakeholders (e.g., students, families, school personnel) by advocating for system-wide safety and wellness, and through promoting collaboration and shifts in thinking at an organizational, systems, and community level about the impact of traumatic events on children and youth (Kataoka et al., 2018; Phifer & Hull, 2016).  This involves recognizing and responding to the impacts of trauma not only among the students but also recognizing   3 that many school stakeholders including educators, school counselling professionals, school staff, and families/caregivers may also be affected by traumatic stress (Panlilio, 2019).  There is a range of traumatic events and adverse childhood experiences that school-aged children may experience.  The National Child Traumatic Stress Network, Schools Committee. (2017) note that common traumatic events in childhood include natural disasters, serious accidents or life-threatening illness, sudden or violent loss of a loved one, abuse (physical, sexual, emotional), refugee and war experiences, and military-related stress.  A 2009 study by Taylor and Weems identified witnessing community violence, entertainment violence, separation and loss events, and motor vehicle accidents as commonly reported traumatic experiences in childhood.  The effects of these traumatic experiences can manifest in school in a variety of ways.  Common indications of trauma within schools include emotion regulation concerns, behavioural concerns, learning difficulties, attention difficulties, social-emotional concerns, and withdrawal (Cohen et al., 2006; Lanius, Bluhm, & Frewen, 2013; Wright, 2014).  Trauma-informed practices have been recommended by many authors as an approach to mediating and/or addressing a range of the psychological and developmental impacts of trauma such as attachment disruptions, depression, posttraumatic stress symptoms, sleep disruptions, flashbacks and dissociation, learning difficulties, attention difficulties, anxiety, aggression, withdrawal, emotional dysregulation, and isolation/avoidance (e.g., Chafouleas, Johnson, Overstreet & Santos, 2015; SAMHSA, 2014).  As shown in school-based trauma-informed practices studies such as those by Perry and Daniels (2016) and Phifer and Hull (2016), this approach can contribute to the social-emotional development, well-being, and the overall educational successes of students, thus highlighting the importance of integrating this approach into the school curriculum.   4 Schools have frequently been identified as ideal settings to promote mental health initiatives across the student body and to provide intervention and support for at-risk children (Dusenbury, Brannigan, Falco, & Hansen, 2003; Weare & Melanie, 2011).  Jaycox, Kataoka, Stein, Langley, and Wong (2012) describe schools as an important access point for mental health support as they are a shared environment for children across socio-economic, ethnic, and cultural backgrounds.  Bruznel, Waters, and Stokes (2015) suggest that schools often provide the most regular and predictable routines in a child’s life and therefore, are an ideal setting to foster connection, belonging, and support.  Furthermore, Rivera (2012) notes that resources outside of schools may be difficult to access due to lack of knowledge of available services, scheduling concerns, logistics, and the perceived stigma associated with accessing services.  Given that trauma-informed practices are an important mental health initiative, schools can also offer a lower-barrier access point for trauma-focused support and intervention (Rivera, 2012; Shukoor, 2015).  Furthermore, Rivera (2012) posits that schools are often where early signs of traumatic stress emerge such as emotional dysregulation, behavioural concerns, and/or academic performance concerns.  Therefore, school counselling professionals can play an important role in the early identification and support of children who have experienced trauma.  Rationale  My interest in trauma-informed practices developed through my experiences working as a school-based mental health professional before the emergence of wide-spread discussions regarding trauma-informed practices in schools.  Several years into my work in schools, I started working a second job in the health care system.  The hospital that I worked for had recently adopted a formalized trauma-informed practices approach based on the   5 Trauma-Informed Practice Guide (Arthur et al., 2013), which was developed by the BC Provincial Mental Health and Substance Use Planning Council in consultation with researchers, practitioners, and health system planners from across the province of British Columbia.  The principles of trauma-informed practices played an important role in the way that support was provided in the hospital, from the general ways that the units were set up to the ways that staff intervened with patients who were expressing distress and harmful behaviours.  Each staff member (regardless of their position and discipline) was required to engage in basic training in trauma-informed practices and were encouraged to use the framework to inform their work.  This approach seemed to have benefits for both the hospital staff and the patients.  Therefore,	I envisioned the value that this paradigm would also have in the education system.  It seemed that this paradigm would be significant in supporting students who have experienced identified traumas and also in providing a general framework of care for the general student body, along with the staff and school-based professionals working with students  This led me to explore the existing research literature pertaining to trauma-informed practices and trauma interventions in schools.  It became apparent that school-based trauma-informed practices were a growing area of investigation, particularly with research and policy initiatives developing in the United States.  However, this literature base did seem to be limited in comparison to the considerable research that existed concerning trauma-informed practices with children and youth in other support settings such as pediatric health care, mental health care, and child welfare systems.  It became evident that there was significant room for growth and diversification of empirical investigation and implementation efforts specifically concerning schools and school professionals in the Canadian context.     6 The existing research and applied literature indicate that trauma-informed practices are a needed and valuable framework for creating safety and support in schools (e.g., Chafouleas, Johnson, Overstreet & Santos, 2015; Perry & Daniels, 2016; Plumb, Bush, & Kersevich).  Furthermore, research investigating trauma-informed interventions and programs frequently demonstrate that the interventions and programs can be beneficial in supporting the needs of students and other key school stakeholders such as educators, school staff, and parents (e.g., Rolfsnes & Idsoe, 2011; Wolmer, Laor, Dedeoglu, Siev & Yazgan, 2005).  There is emphasis on the need for and importance of training, resources, and formalized programs and interventions to help recognize and assess the signs and symptoms of trauma and subsequently, to provide both general support and specific interventions for any concerns that may emerge in school (Gonzalez et al., 2016; Langley et al., 2013; Perry & Daniels, 2016).  However, trauma-informed training, resources, and guidelines have not yet been formalized in schools at a provincial level in British Columbia or nationally in Canada.  School counselling professionals were selected as the population of interest for the present study as they are often a key contact point and support provider for students who have experienced trauma.  When concerns arise in the classroom pertaining to a student’s school performance and/or behaviour, teachers often refer to school counselling professionals such as a school counsellors, social workers, and psychologists to obtain consultation, assessment, and/or therapeutic support for the student (Tishelman, Haney, Greenwald O’Brien, & Blaustein, 2010).  Through my experience working in schools, I have noted that school counselling professionals not only serve as one-on-one care providers for students but are often an important part of the school-based team for at-risk students.  They often contribute to academic planning and case management initiatives for students, such as the   7 creation of Individual Education Plans (IEPs).   Furthermore, given the psychological basis of their roles, school counselling professionals seemed to be the school professionals who might be actively involved in learning about and applying trauma knowledge and trauma-informed practices initiatives.  Furthermore, Stewart (2014) notes that the school counsellor role uniquely lends itself to taking on a leadership and advocacy role in promoting social change.  Given that using trauma-informed practices often involves paradigm shifts and systemic changes, it seemed fitting that school counselling professionals might play an important role in these processes.  Thus, school counselling professionals were considered a valuable target population for the present study.   The Canadian literature base investigating trauma-informed practices is limited and often focuses on the establishment of practice guidelines rather than empirical investigations of trauma-informed practices.  This is in stark contrast to the significant number of studies regarding trauma-informed practices conducted in the United States and overseas.  While the findings of international studies have valuable implications for Canadian trauma-informed practices, there may be limitations in terms of the practical applicability to the Canadian education system and school districts specifically, as the policy, procedures, and approaches undoubtedly differ amongst educational systems and across countries.  Thus, there is a pressing need to gain a better understanding of the existing initiatives and the perceived best practices for supporting students who have experienced trauma in Canadian schools. Narrative Literature Review In preparation for the present study, a narrative literature review was conducted of the existing Canadian and international research regarding trauma-informed practices in schools (see Record-Lemon & Buchanan, 2017).  This literature examined 27 research studies   8 published between 2000 and 2016 that investigated a range of approaches to trauma-informed practices including trauma assessment, targeted interventions, and whole-school programs.  Three key themes were identified in the findings: trauma prevalence, systemic factors, and trauma interventions.  For the prevalence of trauma, the results of trauma assessment studies reviewed indicated that a significant number of school-aged children have been impacted by trauma and post-traumatic impacts of stress.  For example, a study by Gonzalez et al (2015) found that 24% of children in Grades 1 to 5 reported experiencing one or more traumatic events, and 75.4% of these children affected by traumatic events endorsed moderate to high levels of post-traumatic stress symptoms.   In terms of the systemic factors, important considerations for trauma-informed practices highlighted across the research were monitoring the school environment, recognizing school-related trauma triggers, and the importance of providing training and educational opportunities for school staff regarding trauma and trauma-informed practices.  With regards to research investigating specific trauma interventions, the findings suggested that many of these interventions were associated with significant improvements in concerns such as posttraumatic stress symptoms, anxiety, somatic complaints, depression, and functional impairments.  Overall, this review highlighted the importance of school-based trauma-informed practices and the opportunities for continued growth regarding empirical investigations concerning this phenomenon.  Research Purpose and Question School-based trauma-informed practices are an emerging area of research and practice interest in British Columbia and across Canada.  However, there is limited available knowledge regarding how trauma-informed practices are currently understood and used by school-based professionals.  School counselling professionals are a crucial stakeholder in   9 trauma-informed practices implementation and therefore, can be considered an important source of knowledge regarding current implementation efforts of trauma-informed initiatives.  The purpose of the present study was to examine the narratives of Canadian school counselling professionals who identified using trauma-informed practices in their schools.  The following research question was used as a framework to guide this study: What narratives do school counselling professionals construct regarding their experiences of using trauma-informed practices in schools?  Specific areas of the story that were explored in the interviews included the participants’ conceptualizations of trauma-informed practices, their past and current experiences using trauma-informed practices, factors that seem to facilitate or promote trauma-informed practices in schools,  challenges and barriers to using trauma-informed practices in schools, and resources and other factors that would be helpful in continuing to develop trauma-informed practices in schools. Narrative Inquiry as an Approach to Investigating Trauma-Informed Practices Narrative inquiry is a family of methods used to interpret texts that share the commonality of occurring in a storied form (Riessman, 2008).  It is an approach that examines the unique ways that humans interact with their social worlds (in this case, the social context of a school system) and connect their experiences over time through telling their stories (Bruner, 1991; Murray, 2003).  It offers an in-depth and exploratory means for understanding dynamic and evolving phenomena, such as trauma-informed practices (Given, 2008; Lieblich, Tuval-Maschiach, & Zilber, 1998).  Given that trauma-informed practices are very much a movement-in-progress, narrative inquiry seemed to be an appropriate fit for capturing this multi-dimensional movement.  Furthermore, narrative inquiry considers participants within their social environments as they actively engage in meaning-making   10 processes in the world, including with the self and others, which vary across individuals and circumstances (Lieblich et al., 1998).  This seemed highly important for understanding the variability of trauma-informed practices across participants.  The approach also allowed for an exploration of their processes of doing trauma-informed work individually and with other key stakeholders across their districts (e.g., students, parents, teachers, administrators).  Participants engaged in open-ended interviews that offered the opportunity for them to tell their stories of using trauma-informed practices.  Consistent with the tenants of narrative inquiry, no set structure (beyond exploratory probes) or limitations were placed on what participants could discuss in the interviews.  Thus, participants were given space to share information that they felt best represented their experiences of using trauma-informed practices.  Thematic analysis, as one analytic approach used in narrative research (Riessman, 2008), was selected as the approach for data analysis as it allowed for an in-depth examination of the participants’ stories and how they made sense of their experiences.  Through identifying key themes in each narrative, a composite narrative of the participants’ experiences was constructed that describes both the commonalities across their experiences and the unique stories that the participants shared of using trauma-informed practices.   Significance of the Research  Through the present research, I intended to support the process of continuing to develop trauma-informed knowledge by identifying opportunities for further Canadian research regarding trauma-informed practices in schools.  The aim was to provide in-depth insight regarding the experiences of using trauma-informed practices in Canadian schools and regarding what is needed for future development and implementation of trauma-informed support and resources.  To the best of my knowledge, no previous Canadian studies   11 have engaged in exploratory research specifically concerning school counselling professionals’ experiences of using trauma-informed practices in schools.   In summary, the present study investigated the experiences of school counselling professionals using trauma-informed practices in schools.  In Chapter 2, relevant literature is examined that pertains to childhood trauma, trauma-informed practices in general, and to implementing trauma-informed practices and interventions in schools specifically.  Then, the methodology for the present study is described in Chapter 3, including the main tenants of narrative inquiry, the study procedures, and a detailed outline of the data analysis steps.  The findings are presented in Chapter 4, including summaries of the individual narrative accounts, a composite narrative, and the six key themes that were identified across the participants’ stories.  Finally, in Chapter 5, the findings of the study are discussed in the context of the existing research literature and with regards to their implications for future trauma-informed practices initiatives and research.     12 Chapter 2 Literature Review Childhood trauma encompasses a range of events and/or adverse life experiences that a child may experience throughout their developmental years that overwhelm their ability to cope (Siegel, 2015).  Trauma can involve the direct experience of traumatic events or victimization.  It can also be experienced vicariously by witnessing a traumatic event or by learning about trauma happening to another person, particularly if that person is a caregiver and/or important attachment figure (Keats & Buchanan, 2013; Perry, 1995).  Trauma is distinguished from other life stressors and adversities by its sudden and unexpected nature, the involvement of death/threat to life or bodily integrity, and the involvement of feelings of intense terror, helplessness, or horror (Cohen, Mannarino, & Deblinger, 2006).  Furthermore, traumatic experiences can be either a single-incident or involve chronic and/or ongoing victimization, a phenomenon known as complex trauma (Cook, Blaustein, Spinazzola, & van der Kolk, 2003).   Literature is first reviewed that examines the scope and prevalence of childhood trauma.  Next, three theoretical perspectives for understanding trauma in the present study are overviewed including the biopsychosocial theory, attachment theory, and neurobiological understandings of trauma.   Then, literature will be reviewed that discusses the prevalent conceptualizations of trauma-informed practices and the key components of a trauma-informed approach.  Finally, research will be examined that investigates the implementation of trauma-informed practices in schools, including the efficacy of trauma-informed interventions and programs.  This literature is then discussed in terms of its implications for the present study.    13 Trauma in Childhood Childhood trauma can involve a range of adverse and/or life-threatening events and experiences encountered from infancy through adolescence.  What is identified as a traumatic experience for a child involves both external recognition of the event as a trauma as well as an internal experience of appraising the event to be traumatic (Green, 1990).  Children experience traumatic stressors differently depending on (a) their inherent resiliency,  (b) learned coping mechanisms, (c) external sources of physical, emotional, social support, and (d) the processes they go through to make meaning or sense of their experience (Green, 1990).  Several studies have examined the nature and prevalence of trauma in childhood.  These studies provide a helpful foundation of knowledge and understanding of the impetus for trauma-informed practices.  The nature of childhood trauma.  Taylor and Weems (2009) report that identified childhood traumatic events vary with age.  The authors engaged in a quantitative investigation of the developmental differences in trauma across 200 children in two different age groups.  The authors found that the type of events children ages 6-12 commonly identify as being traumatic include (in order of most reported) media or entertainment violence, witnessing violence outside the family, and separation or loss in the family.  For children ages 13-17, commonly reported traumatic events (in order of most reported) were separation and loss in the family, motor vehicle accidents, and media or entertainment violence.  For both groups, a significant number of unclassifiable traumas were also reported, indicating that what one perceives as being traumatic can also vary person-to-person (Taylor & Weems, 2009).  This study provides important insight regarding the most commonly reported traumas for children and adolescents as of 2009.  Given that no similar studies were identified within   14 the last decade, more research is required in this area to determine if any differences are seen in commonly reported traumatic events for today’s children and adolescents.  Furthermore, this seems to focus more on single incidents or isolated traumas than complex or chronic traumas such as abuse and neglect.  Further investigation is required to consider the representation of complex trauma amongst commonly reported traumatic experiences.   A series of ground-breaking research studies collectively called the CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) study were conducted in the United States (CDC, 2019).  These studies investigated the impact of a range of adverse childhood experiences on health, mental health, and well-being in adulthood.  The ACE study originated with a study by Felitti et al. (1998), which found a strong graded relationship between exposure to childhood abuse or household dysfunction and health and mental health risk factors in adults.  Adverse Childhood Experiences (ACEs) are defined by the Centre for Disease Control and Prevention (CDC; 2019) as all types of abuse, neglect, and other potentially traumatic experiences that occur to individuals under the age of 18.   The research studies outlined several predominant types of adverse childhood experiences including abuse (emotional abuse, physical abuse, sexual abuse), household challenges (mother treated violently, substance abuse in the household, mental illness in the household, parental separation or divorce, incarcerated household member), and emotional and/or physical neglect (CDC, 2019; Corso et al., 2008; Dube et al., 2002; Dube et al., 2006; Felitti et al., 1998).   The ACE studies provide an important contribution to the understanding of the range of adverse (and possibly traumatic) experiences encountered in childhood and the potential long-term impact of these experiences.  Kelly-Irving and Delpierre (2019) report that the   15 ACE research findings are potentially useful for population-level or structural policies but are limited in their use in clinical practice.  They also caution practitioners regarding hastily screening for and identifying ACEs, stating concerns that it may lead to stigmatization of individuals and social groups.  Finkelhor (2018) also cautions against widespread screening for ACEs in the healthcare setting.  Prior to ACEs screening, the author emphasizes that it is important to identify effective interventions and responses to support individuals with positive ACE screenings.  The author also notes that it is important to identify and address the specifics of screening and any possible negative outcomes and costs to the screening process.  There may also be a cross-cultural component affecting many children’s experiences of trauma.  Kataoka and colleagues (2018) reported that children from ethnic minority backgrounds can be at an increased risk for experiencing traumatic events and stressors due to some populations being disproportionally impacted by poverty, discrimination, and other factors related to socio-economic status.  In Canada specifically, there has been a stark influx in recent years of refugees fleeing unstable and conflict-ridden circumstances in their countries of origin, with a sizable proportion being school-aged children (Government of Canada, 2016; UNHCR, 2019).  These children may have experienced a range of traumatic experiences and stressors in their country of origin and in the migration/resettling process such as loss, violence, poverty, adjusting to a new culture, learning a new language, social discrimination, and/or family system changes (Driver & Beltran, 1998; Fazel, & Stein, 2002).  There are both primary and secondary forms of distress that a child may experience throughout the migration process (Chiumento, Nelki, Dutton, & Hughes, 2011).  Forced asylum is often considered a form of direct or primary distress inflicted upon a child, whereas   16 secondary stress may occur when a child is a witness to distress in a caregiver or family member that triggers their subsequent distress (Chiumento et al., 2011).   Research into cross-cultural factors concerning traumatic experiences in childhood is a growing area of research interest in Canada.  In a study by Beiser and House (2016), the authors investigated the role of pre- and post-migration trauma in explaining differences in refugee and immigrant mental health.  The authors drew from data gathered in the New Canadian Children and Youth Study to compare differences in emotional problems and aggressive behaviour between refugee and immigrant youth of the same age from six source countries.  The results indicated that refugee youth had significantly higher levels of emotional problems and emotional behaviour and had experienced more pre and post-migration trauma than immigrant youth from the same source countries.  Additionally, Stewart (2012) conducted a qualitative investigation into the educational experiences of refugee students who have immigrated to Canada.  She indicated that refugee students may have experienced a range of potentially traumatic experiences in their pre-migration and trans-migration experiences including loss, starvation, abuse, persecution, danger, displacement, and exposure to violence.  Post-migration challenges were evident in the accounts of the students including challenges related to various aspects of their education, responsibilities in assisting parents, economic challenges, psychosocial challenges, and environmental challenges.  These examples of Canadian cross-cultural trauma research highlight the importance of considering cultural factors contributing to traumatic experiences.  While this is a growing area of research focus in Canada, it is still limited in scope.  Further research is required in the Canadian context to gain a greater depth of understanding of the cross-cultural experiences of childhood trauma.   17 Trauma prevalence.  A significant number of school-aged children have been impacted by trauma (Gonzalez Monzon, Solis, Jaycox & Langley, 2016; Woodbridge et al., 2016).  Several studies conducted in the United States have investigated variables concerning the prevalence of childhood trauma or adverse childhood experiences.  Across the entire sample for the ACE study (n=17, 337), almost two-thirds of the participants reported at least one adverse childhood experience, and one in five participants reported three or more adverse childhood experiences (CDC, 2019; CDC, 2016).  A study by Gonzalez et al. (2016) screened 402 elementary school children in Grades 1-5 for trauma exposure using the Modified Events Screening Inventory for Children – Brief Form (TESI-C; Daviss et al., 2000; Ford, 2008) and for PTSD symptoms with the UCLA PTSD Reaction Index for DSM-IV (PTSD-RI; Rodriguez, Steinberg & Pynoos, 1998).  The authors found that 34% of children in grades 1-5 endorsed experiencing one or more traumatic events, and 75.4% endorsed moderate or higher levels of posttraumatic stress symptoms.  A further study by Woodbridge et al. (2016) screened 4,076 sixth grade students with the Traumatic Events Screening Inventory – Child Report Form (TESI-CRF-R; Ippen et al. 2002) and the Trauma Symptom Checklist Child Version – Posttraumatic Stress Subscale (TSCC-PTS; Briere, 1996).  The authors found that students reported an average of 3.62 traumatic events and that exposure to trauma was associated with elevated distress and/or posttraumatic stress symptoms in 13.5% of the sample.  Gonzalez and colleagues (2016) found no differences for gender, whereas, Woodbridge and colleagues (2016) found that males reported more traumatic events and posttraumatic stress symptoms than females.  Furthermore, the authors of the latter study found differences in the number of trauma events reported across racial   18 and ethnic groups but not in reported posttraumatic stress symptoms (Woodbridge et al., 2016).  Trauma prevalence in Canada.  The Canadian literature base is limited in terms of research specifically investigating trauma prevalence.  Widespread investigations regarding the prevalence and impact of adverse childhood experiences, like the ACEs studies, have not been conducted in Canada.  Furthermore, no studies were identified that specifically address trauma prevalence and posttraumatic stress symptoms in school populations.  However, several Canadian survey studies have been conducted with adolescent and adult respondents that have gathered data that provide helpful insight into the prevalence of certain adverse childhood experiences such as childhood maltreatment, loss, and interpersonal violence.  BC Adolescent Health Survey.  The BC Adolescent Health Survey (BC AHS; Smith, et al., 2019) is a comprehensive survey of the various factors associated with the health and well-being of British Columbia youth ages 12-19.  This survey has been conducted every five years since 1992, with the most recent iteration of the study being conducted in 2018 and the results published in 2019.  The 2018 BC AHS study surveyed 38,015 students across 840 schools in 58 school districts in British Columbia (BC).  This study provides some valuable insight into the prevalence of reported PTSD and adverse life experiences of BC students.  The study surveyed mental health and associated conditions and found that 3% of students reported having posttraumatic stress disorder.  The survey also examined the prevalence of childhood experiences that pose potential risks to healthy development such as poverty, bereavement, dating violence, physical and sexual abuse, and discrimination.  For poverty, the results indicated that 10% of students reported going to bed hungry because there was not enough money for food at home.  Bereavement had been experienced by a large proportion   19 of students, with 71% reported experiencing the death of at least one person close to them in their life.  In terms of interpersonal violence, 7% of students reported being the victim of physical violence in their dating relationship,14% reported being physically abused or mistreated at some point, and 11% reported experiencing some form of sexual abuse.  For discrimination and bullying, 39% of students reported experiencing at least one form of discrimination in the past year, 53% of students reported experienced that they had been bullied on at least one occasion, and 14% indicated that they had been cyberbullied in the past year (Smith et al., 2019).  BC AHS is not a trauma-specific survey but does provide indicators regarding the prevalence of adverse experiences that could potentially be traumatic to an individual.  It also provides some limited, self-report information regarding PTSD prevalence.  However, the study focuses on a limited range of adverse childhood experiences. The research would value from expanding the range of adverse experiences it examines and from linking these experiences to mental health outcomes such as posttraumatic stress symptoms.   GSS Canadian’s Safety Survey.  Another valuable source of childhood maltreatment statistics is the General Social Survey (GSS), which is a series of independent, voluntary, and regularly administered cross-sectional surveys covering a range of social themes with the goal of (a) gathering data on social trends to monitor any changes that occur in Canadians’ living situations and well-being over time, and (b) providing information pertaining to specific social policy issues (Statistics Canada, 2019).  One area that the GSS explores is Canadian’s Safety (Victimization), which aims to gather information regarding Canadians’ perceptions of crime and justice.  It is indicated to be the only national survey in Canada that   20 gathers information regarding experiences of victimization and trauma experiences (Statistics Canada, 2019).  A report on an iteration of the GSS Canadian’s Safety Survey conducted in 2014 offers a detailed profile of experiences of childhood maltreatment (Burczycka, 2017).  The retroactive data reported by respondents ages 15 and older indicated that 33% of Canadians have experienced some form of child maltreatment (i.e., physical and/or sexual abuse, witnessing violence by a parent or guardian against another adult) before age 15.  Of those respondents, 26% reported experiencing physical abuse, 8% reported experiencing sexual abuse, and 10% reported witnessing violence in the home.  For many of the respondents who reported physical and sexual abuse, the maltreatment occurred on multi occasions; 65% reported 1-6 instances of abuse, 20% reported 7-21 instances, and 15% reported more than 22 instances.  The survey also gathered information regarding experiences of victimization in particular demographic populations.  The survey found a higher incidence of reported childhood abuse in Indigenous-identified respondents (40%) ages 30 and over (compared to 29% in non- Indigenous respondents) and an equal incidence reported across respondents ages 15-29.  For respondents who identified as gay, lesbian, or bisexual, the incidence of reported childhood abuse was 48% compared with 30% reported in heterosexual-identified respondents.  Few reported differences were found across other demographic factors such as education, employment, and income.  Furthermore, there was a higher prevalence of self-reported mental health concerns and substance use concerns in adults who had experienced maltreatment compared with those who did not report experiencing maltreatment (Burczycka, 2017).    21 Van Ameringen et al. (2008) PTSD prevalence study.  A study by Van Ameringen, Mancini, Patternson, and Boyle (2008) also provides valuable insight into the impacts of childhood trauma on adult mental health outcomes on Canadians.  The authors screened 2991 Canadians over the age of 18 using the Composite International Diagnostic Interview (CIDI; WHO, 1997) PTSD module, portions of the Mini International Neuropsychiatric Interview (MINI; Sheehan et al., 1998), and portions of the Child Trauma Questionnaire (CTQ; Bernstein & Fink, 1998).  Of the participants screened, 645 participants reported experiencing symptoms of PTSD following a traumatic event and were screened for a diagnosis of PTSD.  Based on the data obtained from the participants, the authors estimated the prevalence rates of current PTSD in Canada to be 2.4% and the lifetime prevalence rate of PTSD to be 9.2%.  A further finding was that 61% of respondents who met the criteria for PTSD had a reported history of childhood physical or sexual abuse, which highlights the importance of identifying trauma and trauma symptoms in childhood.  It is important to note that the data for this study were collected in 2002 and the sample was intended to be nationally represented and comparable to the 2001 Canadian census reports.  Given that almost two decades have passed since the collection of this data, further research is needed to determine if prevalence rates are similar or have changed in the current population.   The results of the 2018 BC Adolescent Health Survey (Smith et al., 201), the 2014 GSS Canadian’s Safety Survey (Burczycka, 2017), and the 2008 PTSD study by Van Ameringen et al. (2008) indicate a high prevalence of childhood traumatic experiences in the Canadian population.  The studies also demonstrate potential links between traumatic experiences in childhood to the experience of posttraumatic stress symptoms from childhood into adulthood.  These findings highlight the importance of further investigation into the   22 prevalence of traumatic experiences in Canadians and if possible, obtaining this data before adulthood to support the early identification and intervention of traumatic stress in children.  Theoretical Understandings on the Impacts of Trauma on Children and Youth The impacts of trauma vary greatly from person to person and can undoubtedly permeate a child’s educational experiences.  In children, common psychological reactions to traumatic experiences include terror, helplessness, stress, learning difficulties, attention difficulties, and anxiety (Wright, 2014).  Not all children who have experienced trauma experience ongoing symptoms and impacts.  However, depending on the range/severity of symptoms and their impact on daily functioning, a child may meet the diagnostic criteria for Posttraumatic Stress Disorder (PTSD), as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; APA, 2013).  A diagnosis of PTSD requires that an individual has experienced one or more traumatic events (APA, 2013).  The hallmark symptoms of PTSD for children ages 6 and older (there are separate criteria for children under age 6) include negative alterations in mood and cognition, avoidance, intrusive memories, and alterations in arousal and reactivity (APA, 2013).  While the DSM-5 provides a useful framework for recognizing symptoms of posttraumatic stress, it does not provide a sufficient depth of understanding regarding the underlying factors contributing to posttraumatic stress symptomology.  The following section presents three prevalent theoretical perspectives that provide additional depth to the explanation of trauma impacts: (a) the biopsychosocial model, (b) attachment theory, and (c) neurobiological understandings of trauma.  A brief overview will be provided regarding each of the theoretical perspectives and then they will be used to discuss the common impacts of childhood trauma.    23 Theoretical orientation one: The biopsychosocial model.  George Engel developed the biopsychosocial model of mental health in 1977 as a holistic alternative to the biomedical model of understanding mental health and psychopathology.  Engel (1977) argued that the biomedical model was reductionistic as it focuses only on biological/somatic variables to find the underlying “cause” of diseases without considering the contribution of psychosocial variables.  Thus, Engel proposed the biopsychosocial model, which posits that personality and health are best understood as the complex interplay of biological factors, psychological processes, and social interactions. This model includes both the individual and the “illness” (i.e., the mental health concern).  Engel argued that the individual and the illness have a bi-directional influence on one another, where the illness may influence the individual and the individual can, at times, influence the illness.   There are four important factors to consider when conceptualizing trauma from a biopsychosocial perspective including pre-disposing factors, precipitating factors, perpetuating factors, and protective factors (Engel, 1997; Henderson & Martin, 2014).  Pre-disposing factors are the biological, psychological, family, and social/cultural factors in a child’s history that may contribute to a child’s current impacts of trauma (Henderson & Martin, 2014).  Examples of this could include a family history of mental health concerns and/intergenerational experiences of trauma.   Precipitating factors are the symptoms, events, and concerns that describe the presenting issue (Henderson & Martin, 2014).   This would include the traumatic event(s) and context surrounding the event.  Green (1990) proposed a multi-component stress model of trauma that provides a helpful contextualizing of precipitating factors.  This model offers a three-part model of the stress processes related to experiencing traumatic events.  These three   24 components include the input from the environment in the form of an event, the intermediating factors of one’s perception and immediate appraisal of the event, and the output of psychological reactions and responses to the event.  The stress model of trauma acknowledges the importance of one’s perceptions and appraisals of trauma in how one reacts and responds to traumatic stressors (Green, 1990).  The stress model of trauma has limitations.  While the model is helpful for viewing many types of childhood trauma, Green recognizes the conceptual difficulties in capturing the impacts of multiple or chronic traumas in trauma research and theory.  Furthermore, Green’s dimensions were created in 1990 and based on DSM-III-R-based conceptualizing of trauma.  Updates may be needed to the stressor dimensions to accurately reflect modern traumatic stressors, current research, and DSM-5 concepts of trauma.   Trauma symptoms not only occur when a child is faced with an immediate or tangible threat during the event but also arise in situations that are innocuous or safe but nonetheless, trigger a fear or memories of the trauma.  The perpetuating factors are the biopsychosocial factors that contribute to the impacts of the trauma impacts enduring over time.  After experiencing a traumatic event, a child may be left with a sense of impending doom or feeling that they need to be constantly “on” or scanning their environment for dangers (Perry, 1995).  Perry (1995) noted that traumatic stress can lead to pervasive neurobiological changes in the brain and the nervous system (see the Neurobiological Understandings of Trauma sub-section below for further explanation).  Trauma can have profound psychological impacts, particularly on the way a child perceives themselves, others and the world (Wright, 2014).  It is common for children to experience self-blame, shame, grief, loss, helplessness, and feelings of worthlessness following a traumatic experience(s) (Cohen et al.,   25 2006; Lanius et al., 2013).  A child may subsequently develop maladaptive beliefs or assumptions, which may involve self-blame, irrational fears, and concerns about the future (Cohen et al., 2006).   Furthermore, experiencing intense negative and/or fear-based thoughts and feelings may lead to feelings of overwhelm, difficulties focusing or concentrating, confusion, and/or dissociation (Schore, 2013).  If these reactions are pervasive throughout childhood and adulthood, it can increase a child’s vulnerability to ongoing mental health concerns such as depressive disorders, suicidal ideation, and substance use (DeBellis & Thomas, 2003).  Finally, social-behavioural reactions to trauma often emerge and persevere as a way of the child protecting themselves from the pain and/or fear brought on by posttraumatic stress symptoms (Ardino, 2014; Cohen et al., 2006).  Common trauma-based social-behavioural symptoms in children include avoidance of situations, people, places, or thoughts that trigger reminders of traumatic events, aggression towards self or others, developmentally inappropriate sexualized behaviour, maintaining or forming inappropriate/unhealthy relationships, and avoiding age-appropriate peer interactions (Cohen et al., 2006).  In the classroom, trauma-based behaviours may present as school disengagement, school refusal, reactivity, conflict with school staff or peers, or difficulties participating in academic or social activities (Wright, 2014).  Trauma-related expressed emotions and behaviours may also lead to learning difficulties (or be misconstrued as learning difficulties), strained relationships with peers and teachers, and/or result in disciplinary action (e.g., being sent to the principal’s office, being suspended) that impacts their participation in the classroom (Perfect, Turley, Carlson, Yohanna, & Saint Gilles, 2016).     26 It is also important to consider the protective factors or resilience factors that support healing from trauma impacts, including a child’s strengths and supports, (Engel, 1997; Henderson & Martin, 2014).  Resilience involves positive adaptation that occurs during or following exposure to adversities (such as trauma) that have the potential to harm (Masten, 2007; Wright, Masten, & Narayan, 2013).  Social support has been identified as an important protective factor that may contribute to resilience and coping with the trauma (Masten, 2007).  Social supports are defined as being social assets, social resources, and social networks that an individual can turn to when they require advice, information, help, assistance, approval, protection, and emotional support (Lazarus & Folkman, 1984).  For the majority of children, parents are considered to be the most important and/or preferred source of social support; however, outside supports such as peer, community, and professional services can also be significant sources of support (Cicognani, 2011).   Theoretical orientation two: Attachment theory.  Attachment theory was developed by John Bowlby with contributions from Robert Hinde and Mary Ainsworth (Bowlby, 1988).  His seminal work on the theory was developed in the 1950s and 1960s, resulting in the publication of his first book Attachment and Loss (Bowlby, 1969), which outlines attachment theory.  Attachment is an overarching term that describes the state and quality of an individual’s attachments, particularly with their key caregivers (Holmes, 1993).  An important contributor to caregiver-child attachment is the caregiver’s responsiveness and availability with regards to protecting the child from physical and emotional threats and danger (Bowlby, 1969).  Attachment behaviour subsequently, is any behaviour that a person engages in that results in proximity or closeness to another human being that is considered to be more resourced to cope with the world (Bowlby, 1988).     27 A fundamental task in the early years of human life is to create a secure attachment with one’s caregiver, which is shaped by the attunement of the caregiver to the psychobiological states of the child (Schore, 2013).  The attachment bond creates patterns of positive communication and expectation between the caregiver and the child, which helps them learn to self-regulate and self-sooth during times of stress (Schore, 2013; Siegel, 2015).  Depending on the consistency and quality of the attachment bond, patterns of attachment form between parent and child (Bowlby, 1988).  Bowlby (1969) initially identified two categories of attachment patterns, secure and insecure.  These categories were later expanded to three attachment styles by Mary Ainsworth (1971), including secure, anxious-resistant, and anxious-avoidant attachment.  Secure attachment involves a sense of confidence that a caregiver will be available, responsive, and helpful in times of need. (Ainsworth 1971, Bowlby, 1988). This attachment style allows a child to feel safe to explore and grow in the world, while at the same time knowing that their caregiver is available for comfort and protection when needed (Bowlby, 1988).  When secure attachments are impeded or disrupted, it can result in hyperarousal, dissociation, hypoarousal, distress, withdrawal, and the inability to manage life stressors throughout the lifespan (DeBellis & Thomas, 2003; Schore, 2013).   Insecure attachment patterns may result including anxious-resistant attachment and anxious-avoidant attachment (Bowlby, 1988).    Anxious-resistant attachment occurs when the child is uncertain about their availability/responsiveness of their parent and therefore, are clingy and fearful of separation.  Anxious-avoidant attachment occurs when the child has little confidence that their caregiver will be available and therefore, attempts to be self-sufficient without their love and support.  Attachment patterns are often pervasive and can impact an individual’s psychosomatic and social-emotional experiences throughout the   28 lifespan (Siegel, 2015).  This can lead to relational patterns with close others that are fearful, distrusting, conflictual, disengaged, and/or overly controlling (Alexander, 2013; Schore, 2013).   Complex trauma is an important concept regarding the relationship between trauma and attachment.  It is defined as exposure to prolonged and/or repeated adversity, often of a violent or interpersonal nature (e.g., physical abuse, sexual abuse, neglect), that is experienced in childhood (Cook, Blaustein, Spinazzola, & van der Kolk, 2003; Mooren & Stöfsel, 2014).  When these trauma events involve an important attachment figure(s) as the victim or perpetrator of the trauma, it can have a particularly profound impact on the attachment patterns of the child (Herman, 1992; Mash & Barkley, 2014).   While it is not a formal DSM-5 diagnosis, it has been proposed as a way of describing trauma experiences and impacts that are not adequately captured by a PTSD diagnosis (Mooren & Stöfsel, 2014).  Triesman (2017) notes that while useful, the DSM-5 is limited in capturing the often complex, co-morbid, atypical, and multi-faceted nature of childhood trauma, particularly when the trauma is relational and developmental in nature.   Complex trauma typically results in intense and enduring symptoms such as somatization symptoms (e.g., headaches, gastrointestinal issues, nausea), dissociation, changes in core beliefs systems, and disrupted attachment (Cohen et al., 2006; Herman, 1992).  Complex trauma can also impact a child’s sense of self, core beliefs, and ways that they build relational patterns with important others throughout their lives (Triesman, 2017).  Children may develop maladaptive coping strategies as a way of self-soothing and containing their emotional distress such as non-suicidal self-injury, suicidal ideation, disordered eating behaviours, aggression, substance use, and risky sexual behaviour (Pearlman & Courtois,   29 2005).  Common signs of complex trauma seen in a school setting include difficulties with affect regulation, interpersonal relationships, self-esteem and self-efficacy, academic functioning, and maintenance of personal safety (Cohen et al., 2006).  A study by van der Kolk, Roth, Pelcovitz, Sunday, and Spinazzola (2005) found that early interpersonal trauma (i.e., experienced before age 14) may result in more complex posttraumatic psychopathology than later interpersonal victimization.  They note that complex PTSD symptomology often includes effects beyond what is typically seen in DSM-5 diagnostic PTSD including affect dysregulation, aggression towards self/others, dissociative symptoms, somatization, and character pathology.  Therefore, it is important to take into account the complex, multi-layered relational contexts in which trauma may occur to gain a comprehensive understanding of the impacts these experiences may be having on children.  Theoretical orientation three: Neurobiological understandings of trauma.  Traumatic stress can impact the underlying processes and functions of the brain and body, which may subsequently impact a child’s development, health, and overall quality of life (Cohen et al., 2006; Mash & Barkley, 2014).  Following the experience of a traumatic event(s), there may be functional and structural shifts in the brain such as changes to neurotransmitter and hormonal activities, physiological responses, attention, and levels of alertness in both the short and potentially in the long-term (Perry, 1995).  Neurobiology is a growing area of focus in the area of traumatic stress studies and provides a helpful framework for understanding the impacts of trauma.   A basic overview of the neurobiology of traumatic stress will be presented next, along with research concerning three key areas of neurobiological trauma impacts including neurodevelopment, cognitive functioning, and academic achievement.    30 The Neurobiology of Traumatic Stress.  Trauma involves a series of neurobiological reactions called the acute stress response (also known as the “fight, flight or freeze” response), which is a stress response that occurs in the autonomic nervous system, the hypothalamic-pituitary-adrenocortical (HPA) axis of the brain, and the immune system (Perry, 1995).  Post-traumatic stress symptoms can interfere with normal sleep cycles, emotion regulation, and lead to over-activation of the stress-response systems of the brain (Carrion, Weems & Reiss, 2007).  Furthermore, post-traumatic stress can impact the neurotransmitter system, the neuroendocrine system, and the immune system (DeBellis & Thomas, 2003).  Finally, trauma can tax a child’s active coping mechanisms, resulting in a primary metabolic shutdown in the limbic system that can lead to dissociation and conservation-withdrawal, which are functional expressions of heightened dorsal vagal activity in the brain (Schore, 2013).  These systems are all related to major neurobiological stress response systems that play a key role in arousal, stress response, emotion regulation, and brain development (Perry, 1995).  Trauma and Neurodevelopment.  Trauma has been indicated to affect the neurodevelopment of the brain and the functioning of the brain.  Research has been conducted investigating both structural changes and functional impacts of trauma on the brain (e.g., Choi, Jeong, Rohan, Polcari, & Teicher, 2009; Choi et al, 2012; Carrion and Wong, 2012).  Neurological impacts have been studied in the research using neuroimaging techniques including Magnetic Resonance Imaging (MRI), functional MRI (fMRI) imaging, and Diffusion Tensor Imaging (DTI; Carrion & Wong, 2012; Choi, et al., 2009; Choi et al, 2012; Tomoda et al., 2011).     31 Studies by Choi et al. (2009) and Choi et al. (2012) found that trauma has an effect on the white matter tracts in the brain.  Choi et al. found that exposure to parental verbal abuse in childhood was associated with abnormalities in three areas of the brain in young adults:  (a) the arcuate fasciculus of the left superior temporal gyrus, (b) the cingulum bundle by the posterior tail of the left hippocampus, and (c) the left body of the fornix.  The authors note that impairment in these areas may have implications for language development, anxiety and/or symptoms of psychopathology.  In a second study, Choi et al. (2012) found association between witnessing domestic violence in childhood (between ages 7 and 13) and abnormalities in white matter tracts in young adults in areas of the brain that were involved in the visual-limbic pathway, which are involved in the emotional responses, learning, and memory functions specific to visual processing.  Specifically, the authors found abnormalities in portions of the inferior longitudinal fasciculus in the left occipital lobe, including differences in axial diffusivity which may be indicative of changes in myelination along white matter fibers.  Higher levels of psychological symptoms such as anxiety, depression, somatization, anger, and dissociation were also noted in individuals who had witnessed violence in childhood (Choi et al., 2012).  In addition to changes to white matter tracts, exposure to trauma in childhood is also associated with changes in grey matter volume.  A 2011 study by Tomoda et al. explored the relationship between exposure to parental verbal aggression in childhood and structural changes and neurodevelopment in the brain.  The authors found an increase in grey matter in the superior temporal gyrus of the brain in young adults who reported a history of parental verbal aggression compared with a control group. The authors note that this may be due to interferences in development and/or alterations in typical synaptic pruning processes due to   32 exposure to traumatic stressors.  Furthermore, they note that impacts in the superior temporal gyrus may have implications for speech and language processing for individuals who have experienced parental verbal aggression (Tomoda et al., 2011).  Cognitive Functioning.  Cognitive concerns may also become apparent in children who have experienced trauma.  Common areas of cognitive functioning impacted by trauma may include attention, executive function, and memory (DeBellis & Thomas, 2003).  DePrince, Weinzierl, and Combs (2009) examined the impact of familial violence on executive functioning deficits.  The authors found that exposure to familial trauma was associated with poorer performance on executive functioning assessments related to working memory, inhibition, auditory attention, and processing speed tasks.  Effects on basic executive functioning were noted to be present even after controlling for the influence of dissociation, anxiety, SES, and traumatic-brain injury on the child’s functioning (DePrince et al., 2009).  Research by Samuelson, Krueger, and Wilson (2012) explored the relationship between children’s exposure to parental intimate partner violence and executive functioning. They also looked at protective factors for trauma-related vulnerabilities including maternal emotion regulation and parenting factors (e.g., reinforcement/punishment, comfort, nonverbal affection).  The authors found that positive parenting behaviours were highly correlated with problem-solving and planning abilities in children exposed to parental interpersonal violence.  The authors also found a relationship between a mother’s self-reported emotion regulation abilities and cognitive flexibility in the children.  Furthermore, gender differences were found including that girls had greater emotion regulation and   33 executive functioning compared to boys, and that mothers of females reported greater emotion regulation capacities than mothers of boys (Samuelson et al., 2012).  A Brazilian study by Bücker et al. (2012) examined the cognitive functioning of 30 children ages 5 to 12 who had experienced early trauma, including their executive function, memory, and attention.  The assessments were conducted using a structured psychiatric interview, a short-form of the Wechsler Intelligence Scale for Children – III Edition (WISC-III; Wecshler, 1991; Wecshler, 2002), the Wisconsin Card Sorting Test (Heaton, Chelune, & Talley, 1981), and the Conners Continuous Performance Test (CPT; Conners, 1995) .  In children who had experienced early trauma, the authors found higher levels of sub-syndromal symptoms of psychiatric disorders, lower overall intellectual functioning scores, and attention, verbal memory and working memory impairments.  Perfect, Turley, Carlson, Yohanna, & Saint Gilles (2016) conducted a systematic literature review of school-related cognitive, academic, and social-emotional outcomes of traumatic events exposure and traumatic stress symptoms.  They reviewed 83 empirical studies that investigated these variables in school-aged children and youth from pre-kindergarten to grade 12.  Across the literature, the authors found cognitive, academic, and teacher-reported social-emotional-behavioral outcomes associated with trauma.  Cognitive outcomes included impaired visual, verbal, and working memory, and lower language and verbal abilities.  Academic outcomes included decreased performance in academic areas such as reading and math and higher rates of discipline referrals and suspensions.  Social-emotional-behavioural outcomes included externalizing symptoms such as aggression, hyperactivity, and defiance, and internalizing symptoms such as sadness, low mood, anxiety, and withdrawal.  The results of the review demonstrate that traumatic stress symptoms were   34 likely a mediating variable.  However, they also acknowledge that other factors may have influenced the individual including moderate variables such as gender, ethnicity, existing mental health concerns, and social support (Perfect et al., 2016).   Academic Achievement.  Many studies have found a relationship between academic achievement and trauma exposure.  A 2009 study by Baker-Henningham, Meeks-Gardner, Chang, and Walker found that exposure to violence was associated with a wide range of poorer achievement levels including in the areas of reading, spelling, and mathematics. Gender differences were also found, in that boys experienced significantly more violence and had significantly lower performance on assessments of academic achievement.  Additionally, a longitudinal 2007 study by Peek-Asa et al. found that children living in households with parent-reported interpersonal violence performed significantly lower on standardized test scores than peers whose parents did not report interpersonal violence.  The authors hypothesize that this may be due to neurological changes in the brain due to increased stress responses, which subsequently disrupt hormone levels and brain development.  Finally, a 2008 study by Duplechain, Reigner, and Packard found an adverse relationship between exposure to trauma, including violence exposure and loss, and reading achievement. It was postulated that traumatic experiences may lead to disruptions in the energy, motivation, concentration and other resources needed for engaging in reading-related tasks.  A 2002 study by Delaney-Black et al. explored the association between violence exposure and performance on standardized tests in early school-aged urban children, to determine whether outcomes are related to the violence exposure itself or the subsequent traumatic stress symptoms.  It was found that both community violence exposure and trauma-related distress were significantly negatively related to IQ and reading ability, even after   35 controlling for confounding variables such as gender, caregiver IQ, home environment, SES, and prenatal substance exposure.  The authors offer two explanations for the results (a) that children with lower IQ may be more vulnerable to experiencing or witnessing violence or  (b) that violence may lead to deficits that inhibit a child’s intellectual and academic functioning (Delaney-Black et al., 2002).  A further longitudinal investigation by Ratner et al. (2006) explored the impact of violence exposure on IQ and academic performance and extended this investigation to also look into the protective factors that mediate the risk of impacts.  The results of the study did show a significant negative relationship between violence exposure and scores on standardized tests of achievement and intelligence.  These effects, however, were only seen in children who directly experienced violence and were not seen significantly in children who witnessed violence without experiencing any direct infliction.  Protective factors the authors explored in the study were related to reported feelings of safety, including positive parent perceptions, which were positively associated with protective effects on academic performance.  Furthermore, individuals who reported feeling cognitively and physically competent and secure had higher levels of self-esteem.  These protective factors were seen in all study conditions including children who had experienced violence, children who had witnessed violence, and children who had not experienced trauma.  These findings suggest that perceived safety may be related to resilience factors related to the impacts of adversity in children (Ratner et al., 2006). Conceptualizing Trauma-Informed Practices in Schools Trauma-informed practices are a growing area of interest across a variety of systems including schools, child welfare services, medical and mental health care, the military,   36 universities, the criminal justice system, and beyond (Becker-Blease, 2017).  School-based trauma-informed practices research is a relatively new area of examination, having emerged largely over the past two decades.  Historically, school-based outcome literature has focused more on academic and behavioural issues over social-emotional and adverse experiences that may be impacting students’ academic performance and engagement (Chafouleas, Johnson, Overstreet, & Santos, 2015).  However, there has been an increasing focus on models and frameworks for trauma-informed approaches in schools.  There are no preferred definitions or models of trauma-informed practices that have been applied across school districts and educational systems.  However, a growing number of efforts have been made to outline the scope and principles of trauma-informed practices in schools.  Conceptualizations of trauma-informed practices have been inspired not only by school-based literature but also by literature pertaining to other systems of care such as mental health care, child welfare, and public health care policy.  Several definitions and frameworks of trauma-informed practices (or trauma-informed care) with relevance to schools have been offered in the literature.  These definitions and frameworks rarely offer a concise description of what trauma-informed practices are.  Rather, they typically offer a framework of overarching principles, policies, and procedures that broadly guide a trauma-informed approach.  In an effort to consolidate these common conceptualizations of trauma-informed practices, common frameworks will be overviewed and then the common themes noted across the frameworks will be identified.   Framework one - National Child Traumatic Stress Network.  The National Child Traumatic Stress Network (NCTSN; 2018), offers a broad definition of a trauma-informed system as well as an outline of a basic framework for trauma-informed practices in schools.  The NCTSN defines a trauma-informed school system as one that makes efforts to   37 recognizes and responds to the impact of traumatic stress on children, as well as the caregivers, staff, and other providers who are part of that system.  (NCTSN, 2018).  They provide further description for trauma-informed school systems (K-12) specifically, which is where all teachers, school administrators, staff, students, families, and community members recognize and respond to the behavioral, emotional, relational, and academic impact of traumatic stress on those within the school system.  Put into practice, the NCTSN suggests that trauma-informed practices take on a tiered approach to providing support.  The first tier of this approach starts with universal efforts put in place to create a safe school environment that promotes the health and success of all students, staff, administrators, and families.  Then, the second and third tier focus on early identification intervention and intensive services and interventions, respectively.  They further identify ten core areas of a trauma-informed school system that involve supports across the three tiers:  (a) identification and assessment of traumatic stress, (b) prevention and intervention related to traumatic stress, (c) trauma education and awareness, (d) partnership with students and families, (e) creation of a trauma-informed learning environment, (f) cultural responsiveness, (g) emergency management/crisis response, (h) staff self-care and secondary traumatic stress, (i) school discipline policies and practices, and (j) across-system collaboration and community partnerships.   Framework two –Trauma-informed services principles.  Elliott, Bjelajac, Fallot, Markoff and Reed (2005) engaged in a series of studies that attempted to bridge the gap between service delivery (across various substance use, mental health, and violence-against-women settings) and philosophy such as trauma theory, empowerment, and relational theory.  From this research, they established ten principles of trauma-informed services.  These   38 principles include: (a) recognizing the impact of trauma on child development and coping strategies, (b) prioritizing recovery from trauma as a primary service goal, (c) employing an empowerment model when working with clients, (d) striving to maximize client choices and control over recovery, (e) basing supports and services in a relational context, (f) creating an atmosphere that is respectful of the client’s need for safety, respect and acceptance,  (g) emphasizing strengths and resilience over pathology, (h) minimizing the possibility of re-traumatization, (i) striving to be culturally competent and understand each person in the context of their life experiences/cultural background, and (j) involving clients in designing and evaluating supports and services.   Framework three - SAMSHA (2014a; 2014b) framework.  In the United States, the Substance Abuse and Mental Health Services Administration (SAMSHA; SAMSHA, 2014a; SAMHSA 2014b) developed a framework for understanding trauma and a trauma-informed approach to mental health care based on an integration of knowledge gleaned from research and clinical practice with individuals impacted by trauma.  A key assumption of this framework is that understanding trauma and trauma-specific interventions alone are insufficient for optimal outcomes, rather it is important to also consider the context in which trauma is addressed.  Subsequently, they detail four key assumptions for a trauma-informed approach including: (a) having a basic realization about trauma and its impacts across an organization or system, (b) an ability to recognize the signs and symptoms of trauma in the individuals supported by the system, (c) responding in a way that is informed and knowledgeable about trauma in all policies, procedures and practices, and (d) making active efforts to resist re-traumatization.  They further define six principles that they indicate are key to a trauma-informed approach including safety, trustworthiness and transparency, peer   39 support, collaboration and mutuality, empowerment, voice and choice, and addressing cultural, historical, and gender issues.  Common themes across trauma-informed practices frameworks.   The above-detailed frameworks of trauma-informed practices all provide helpful frameworks from which to approach trauma-informed practices.   When applying these principles to work in schools, the challenge is determining which framework is most suitable for the schools/districts that they are being applied to.  As there are many commonalities across the prominent frameworks of trauma-informed practices, it seems it would be helpful to identify core themes across each framework with the goal of moving towards a set of basic universal principles that could be applied to trauma-informed practices in schools.  Upon examination of the frameworks, common themes in the frameworks identified include (a) a focus on recognizing the signs and symptoms of trauma, (b) prioritizing safety and relationships, and (c) developing cultural and diversity competency.  These three themes, along with the principles for implementing trauma-informed practices (see the Implementing Trauma-Informed Practices in Schools section next) are considered the key elements that could ultimately broadly define trauma-informed practices.   Understanding and recognizing trauma.  A key component of trauma-informed practices noted across conceptualizations is understanding that a significant number of students in any given school may have been impacted by trauma and striving to recognize and understand the signs and symptoms of trauma.  Therefore, it seems vital that school staff and support providers are equipped with a foundational knowledge of childhood trauma and how it may manifest in the brain, body, behaviour, relationships, and academic performance (as detailed in the ‘Trauma in Childhood’ section above; Plumb et al., 2016).  This   40 knowledge is particularly important as trauma symptoms can easily be misunderstood and met with consequences such as disciplinary actions, which can be detrimental to their functioning, education, and future well-being (Howard, 2018).  Several authors have also highlighted that understanding and recognizing symptoms of trauma requires a perspective shift from asking the question “What is wrong with you?” to “What happened to you?”  (e.g., Ardino, 2014; Dorado et al., 2016).  Furthermore, trauma-informed practices have been suggested to provide school-based professionals with a helpful framework to gain a deeper understanding of their students’ presenting concerns that avoid the tendency to blame students for their behaviour (Morgan, Pendergast, Brown & Heck, 2015).  Prioritizing safety and relationship.  The importance of the relationship between students and school staff have been highlighted across the trauma-informed practices literature and is indicated to be foundational for providing support, education, and trauma treatment.  Masten (2016) notes that the resilience of a child is often impacted by the systems they interact with, including, indicating the importance of caring and supportive relationships between children and school staff.  There are particular characteristics that have been emphasized as pertinent to a trauma-informed approach to building a relationship and rapport with students.  For example, (Adrino, 2014) notes that safe relationships are characterized by consistency, predictability, non-shaming, non-blaming, and non-violence.  A 2015 study by Morgan et al. explored relational ways of approaching trauma-informed educational practices.  The authors noted that relational pedagogy has the potential to mediate the impacts of trauma and social exclusion experienced by many students.  They also note that relational practices can influence educators in their personal and professional approaches to working with trauma both personally and interpersonally.  Finally, a qualitative case study by   41 Dods (2015) of three youth impacted by trauma indicated that school connectedness and building caring, safe, and supportive relationships with school-based supports (particularly teachers) can increase school engagement and reduce at-risk behaviours and emotional distress. Cultural and diversity competence.  The importance of cultural competence in providing trauma-informed care has been highlighted across the literature.  SAMHSA’s (2014) guide to trauma-informed approaches emphasizes the importance of shifting away from cultural and diversity stereotypes and biases in order to offer culturally responsible services.  They suggest building a focus on healing connections and incorporating polices and processes that are responsive to the diverse needs of the clients.  Stewart (2014) noted that school counsellors can play a vital role in advocating for the development of inclusive and socially just educational systems.  The author emphasizes that this process involves being aware of and responsive to the unique needs of students from diverse backgrounds.  Ardino (2014) highlighted the value of the healing process taking place within an individual’s cultural context and support network and noted that different cultural groups may have unique resources that support healing.  Furthermore, it was emphasized that cultural competence does not necessarily require that support providers have expertise in every culture (or even the specific culture of the individual being supported), but rather that the support providers recognize the importance of the cultural context and strive to understand the client through the lens of culture.  Furthermore, Beidas et al. (2016) and Ardino (2014) highlight the importance of being aware of inherent power imbalances that exist in support relationships and emphasize the importance of sharing power to ensure collaborative and culturally competent care.     42 Implementing Trauma-Informed Practices in Schools  Models and methods of implementing trauma-informed practices in schools have been a key focus of the research and applied literature concerning trauma-informed practices.  Many authors and organizations have detailed recommendations for the implementation of trauma-informed practices.  SAMHSA (2014a) detail ten elements important to a trauma-informed approach including governance and leadership, policy, physical environment, engagement and involvement, cross-sector collaboration, screening assessment, training and workforce development, financing, and program evaluation.  A trauma-informed framework proposed by Harris and Fallot (2001) outlines a number of conditions that they believe are necessary to establish trauma-informed systems including: administrative commitment, universal screening of all individuals seeking support/services to determine whether there is a trauma history, training and education of all staff in basic trauma information, and reviewing policies and procedures to ensure they take trauma into consideration and avoid re-traumatization.  A further framework proposed by Plumb and colleagues (2016) outline five core components (inspired by the model put forward by Milwaukee Public Schools in 2015) that they state are important to include in every trauma-informed practices model implemented including: training faculty and staff on the impact and prevalence of trauma; adopting a school-wide perspective shift from seeing students’ behaviours as attempts to get needs met instead of disobedience, fostering healing relationships among staff, caregivers, and students; maximizing caregiver capacity; and facilitating student empowerment and resiliency.   Many of the factors described above seem highly applicable to the successful implementation of school-based trauma-informed practices.  Literature exploring factors   43 pertinent to the implementation of school-based programs and interventions is important to consider for the present research.  Thus, the research of school-based prevention and trauma-informed programs will be further detailed below including trauma-informed practices training, the approaches taken to implementation, the involvement and collaboration of the school staff and system in trauma-informed practices efforts, and the efficacy of school-based trauma-informed prevention and intervention programs.   Training.  Training school staff in trauma theory and trauma-informed practices is an essential component of implementing a trauma-informed approach in schools.  Offering trauma training and using in-house professionals for trauma-informed interventions offers the unique opportunity to capitalize on school-based resources and relationships and help to increase the knowledge and skills of these professionals (Howard, 2018; Plumb et al., 2016).  Furthermore, when training, particularly trauma-informed training is offered, it can lead to reported increases in staff knowledge, relational engagement, role clarity and definition, and satisfaction with the trauma-informed intervention (Dorado et al., 2016; Langley et al., 2013; Morgan et al., 2015; Perry & Daniels, 2016).  Overstreet and Chafouleas (2016) noted that professional development training in trauma-informed practices typically focuses on educating school staff about the prevalence and types of trauma students may experience, the impacts of trauma on the child, and on offering ways to build the attitudes, beliefs, and behaviours required to create a trauma-informed system.  A 2018 study by Howard examined the needs, knowledge, and experiences of educators in Queensland, Australia regarding complex trauma and trauma-informed practice.  The author reported that educators found trauma-informed practices training to be important and valuable contributors to knowledge and skills, but the impact of the training was reported to be varied due to factors such as   44 access to training, educator motivation, and perceived depth/breadth of training.  A 2018 study by McIntyre, Baker, and Overstreet (2018) engaged in a pre-post training examination of a two-day Foundational Professional Development Training (FPD) as a tool for enhancing teacher knowledge of trauma-informed practices before their implementation.  From a sample of 183 teachers from six schools, the authors found a statistically significant knowledge growth and mastery performance demonstration.  They noted that mastery performance was demonstrated by 20% of teachers pre-training and this grew to 70% post-training.  Furthermore, they noted that teachers who perceived a better system fit with the training and in their knowledge and growth had increased perceived acceptability of trauma-informed practices.  The above studies were focused specifically on investigating various aspects of the training experience for school-based professionals, which is an important aspect of understanding the learning phases of trauma-informed practice implementation.  However, these studies are limited in obtaining the full perspective on the implementation process or the impact of the training on other stakeholders, such as students, when the learned material is implemented.  Implementation approach.  The approach taken in implementing a new paradigm or program in schools is key to its efficacy and its internal and external validity (Durlak & DuPre, 2008).  Implementation refers to how and how well a program/intervention and its elements are put in place (Domitrovich & Greenberg, 2000; Durlak & DuPre, 2008).  Implementation often starts before the program or intervention is first administered, with planning and early monitoring being important to correct problems quickly and ensure better outcomes (Ardino, 2014; Durlak & DuPre, 2008).  Implementation factors can be assessed through self-reports and/or independent behavioural observations and often include factors   45 such as quality, fidelity, dosage, participant responsiveness, program differentiation, monitoring of control/comparison conditions, program reach, and adaptions made to original program during implementation (Domitrovich & Greenberg, 2000; Durlak & DuPre, 2008).  Literature specifically investigating implementation factors for trauma-informed practice is limited.  However, a body of literature does exist for school-based mental health and prevention programs, many of which are considered to be both evidence-based and trauma-informed (Panlillio, 2019).  Given the relevance of this research to trauma-informed practices implementation, a brief overview of school-based program implementation research will be discussed next.  The quality of implementation has been indicated to have an impact on the effectiveness of school-based programs and interventions (Dix, Slee, Lawson & Keeves, 2012; Dunsbery et al., 2003).  A 2012 study by Dix et al. examined the impact of the quality of a whole-school mental health-promotion program implementation on academic performance.  Results of investigations using hierarchical linear modeling found a significant positive relationship between the quality of implementation and academic performance.  The authors note that the difference between high and low-quality implementation was potentially equivalent to the academic performance benefits of up to six months of schooling.  A review of school-based mental health promotion and problem-prevention interventions by Weare and Melanie (2011) found that school-based interventions were most efficacious if they were completely and accurately implemented.  Factors highlighted as important for high-quality implementation were a sound theoretical base communicated through training and linked explicitly to intervention components; a direct and explicit focus on the desired outcome; explicit guidelines for training and delivery, preferably manualized, and complete and sound   46 implementation.  The authors note that implementation difficulties can impede effectiveness, thus it is important to understand what common difficulties arise and how to mediate them.  Dusenbury and colleagues (2003) reviewed twenty-five years of research regarding the fidelity (the degree in which a program is delivered by service providers as intended by the program developers) of implementation of drug abuse prevention programs in schools.  The authors found that comprehensive empirical support for fidelity in the implementation of school programs was limited.  However, they reported that essential factors for fidelity seemed to be adherence to the program, dose, quality of program delivery, participant responsiveness, and program differentiation.  Durlak and DuPre (2008) conducted a review of the research regarding program implementation and the influence that attention to implementation factors has on program outcomes.  The authors found that in 76% of the studies reviewed, there was a significant positive relationship between the levels of implementation and many of the targeted program outcomes.  However, the authors also note that perfect/near-perfect implementation fidelity is unrealistic and does not occur in most implementation studies.  They state that the program implementers should strive for the right mix of fidelity and adaptation.  The authors further detail several factors important to consider for the fidelity of implementation including funding, positive work climate, shared decision-making, coordination with other agencies, formulation of tasks, leadership, program champions, administrative support, providers’ skill proficiency, training, and technical assistance. A 2010 study by Langley et al. examined the barriers and facilitators for implementing evidence-based mental health programs in schools.  The program of interest in this study was Cognitive Behavioural Intervention for Trauma in Schools (CBITS; Jaycox,   47 2014), a CBT-based trauma intervention program designed specifically for implementation in schools.  The experiences of 35 facilitators who had implemented the program in various sites across the US were explored using semi-structured interviews. The authors identified four main barriers to CBITS implementation including competing roles and responsibilities of facilitators in the school, lack of parent engagement, logistical barriers such as time, space and resources, and lack of support in the form of ‘buy-in’ from administrators and teachers, which ultimately impacted the logistics of implementation.  These themes were present as key barriers regardless of whether the program had been successfully implemented or not.  Facilitating factors for successful implementation of CBITS included having a strong professional network within the school, the relationship to CBITS facilitators, and having access to funding.   Systemic involvement and collaboration.  Providing trauma-informed support in schools is a complex systemic undertaking.  A key component of implementation with regards to trauma-informed practices is promoting collaboration and shifts in thinking at an organizational level, systems and community level (Phifer & Hull, 2016).  Successful implementation of trauma-informed supports and services requires the establishment of system-wide resources and the active involvement of key stakeholders such as school faculty, counsellors, teachers, and parents (Ardino, 2014; Langley, Nadeem, Kataoka, Stein, & Jaycox, 2010; Rivera, 2012).  Several studies have highlighted the importance of school administrators being supportive, involved, and knowledgeable about trauma in facilitating the implementation of trauma-focused supports (Dorado et al., 2016; Howard, 2018).  School counselling professionals have been indicated to be crucial in providing the assessment and therapeutic intervention component of trauma-informed practices; whereas teachers and   48 parents have been suggested to play a key role in reinforcing the support-seeking behaviours of students (Durlak & DuPre, 2008; Rivera, 2012).  For example, a study by Alisic, Bus, Dulack, Pennings, and Splinter (2012) surveyed 765 schoolteachers with a brief questionnaire measuring difficulties experienced in supporting children’s recovery after trauma.  The results indicated that a significant number of teachers surveyed were experiencing difficulties in supporting students including a perceived lack of knowledge and skills for providing support.  A further qualitative survey study by Alisic (2012) explored the perspectives of teachers on supporting students who have been impacted by trauma.  The author found that if teachers feel as though they have a supportive school environment, role clarity, and are equipped with trauma-focused skills and knowledge, they can be a powerful force in mediating challenges that arise in the classroom due to trauma impacts.  These studies highlight the value of trauma-informed practice efforts occurring within a collaborative system.  However, striving active involvement and buy-in from entire systems is likely to be a process faced with challenges and constraints such as commitment from school staff, budget for training and implementation efforts, and time available to devote to these efforts.   School-based trauma-informed interventions and programs.  There is a considerable research base that explores school-based programs and/or interventions that can be utilized to support the mental health and well-being of students.  Some of the many factors that school-based mental health and prevention programs have been indicated to be valuable in supporting include learning, behaviour, attitudes toward school, school performance, commitment to school, school attendance, mental health, and trauma (Weare & Melanie, 2011).  Trauma-informed practices model, programs, and interventions have been designed   49 with various levels of involvement from school staff in the training and implementation process.  Many of these programs involve methods of assessment to support the early identification of risk, varied levels and methods of support and intervention, and ongoing evaluation of the framework and its outcomes (Chafouleas et al., 2015).  School-based programs and interventions may range from targeted interventions delivered one-on-one or to a small number of students who are at-risk due to trauma and/or other mental health concerns, to classroom or system-wide programs, to multitiered frameworks of service delivery that may include involvement from parents and/or the community (e.g. Dorado et al., 2016; Langley, et al. 2015; Mendelson et al., 2015; Perry & Daniels, 2016; Wells et al., 2003).   Several literature reviews have examined the extensive research base investigating the efficacy of school-based mental health and prevention programs.  Given that trauma-informed practices may involve the use of mental health and prevention programs, the findings have importance relevance to trauma-informed practices.  Durlak & Wells (1997) conducted a meta-analysis of 177 primary prevention programs for children experiencing behavioural and social concerns.  The effect sizes ranged from small to large (0.24 – 0.93), which indicates a variable strength of intervention efficacy.  Interventions were indicated to be beneficial not only in reducing presenting problems but also in increasing skills and competencies.  A systematic review of universal approaches to mental health promotion in schools by Wells, Barlow, and Stewart-Brown (2003) found evidence of moderate effectiveness for whole-school prevention programs.  Finally, Hoagwood et al. (2007) reviewed 64 empirical studies of school interventions targeted at academic and mental health   50 functioning. The effectiveness of the programs for educational and mental health outcomes was deemed to be modest, and academic outcomes did not always seem to hold over time.  Targeted trauma-informed interventions.  Trauma-informed interventions are therapeutic interventions designed specifically for supporting or treating children who have been impacted by trauma and are subsequently experiencing posttraumatic stress symptoms.  Examples of common standardized and/or manualized school-based interventions are Trauma-Focused CBT (Cohen et al., 2012), Cognitive Behavioral Intervention for Trauma in Schools (CBITS; Jaycox, 2004), and Enhancing Resiliency Amongst Students Experiencing Stress (ERASE-Stress; Gelkopf & Berger, 2009).  Most of these interventions are intended to be implemented by school and/or community-based mental health professionals including community mental health clinicians, school counsellors, school social workers, and/or school psychologists (e.g., CBITS, Trauma-Focused CBT).  These are programs typically focus on targeted intervention/treatment of posttraumatic stress systems and thus, require training and experience in trauma theory and counselling skills.  However, select prevention/universal support programs or components of multi-level programs are designed for implementation to entire classrooms by teachers or non-mental health professionals (e.g., ERASE-Stress).  These select programs typically involve psychoeducation and teaching of basic coping strategies (rather than trauma-specific intervention), thus, could be delivered by trained, non-therapy professionals.   In studies of trauma-informed interventions, a common finding is that the interventions were associated with significant improvements in trauma impacts and symptoms.  A quantitative study by Berger, Gelkopf, and Heineberg (2012) investigated the delivery of an extended version of the ERASE-Stress program (EES) to 154 students exposed   51 to war-trauma.  The 16-week EES program is an integration of cognitive-behavioural skills, psychoeducation, and religious and spiritual practices.  The authors found statistically significant reductions in the intervention group in the number of PTSD diagnoses/severity, functional problems, somatic complaints, separation anxiety, and general anxiety as indicated by scores on the UCLA PTSD Reaction Index for DSM-IV (PTSD-RI; Rodriguez, Steinberg & Pynoos, 1998), the Diagnostic Predictive Scales (DPS; Lucas et al., 2001), and the Screen for Child Anxiety-Related Emotional Disorders (SCARED; Birmaher et al., 1997).   A 2003 randomized control study by Stein and colleagues examined the CBITS program with a sample of 126 middle school students.  The authors found lower scores on child-reported symptoms of PTSD and depression as indicated by scores on the Child PTSD Symptom Scale (CPSS; Foa, Johnson, Feeny & Treadwell, 2001) and the Child Depression Inventory (CDI; Kovacs, 1992).  Lower parent-reported psychosocial dysfunction and teacher-reported classroom problems were also noted in the intervention group as indicated by scores on the Pediatric Symptom Checklist (PSC; Jellinek et al., 1999) and the Teacher-Child Rating Scale (TCRS; Hightower, 1986).   A quantitative study by Mendelson, Tandon, O’Brennan, Leaf, and Ialongo (2015) examined the delivery of the RAP (Recognition and Prevention) Club intervention to 49 students.  The RAP club is an integration of psychoeducation, cognitive-behavioural therapy (CBT), dialectical behaviour therapy (DBT), and mindfulness designed to be delivered by a mental health counsellor and a young adult community member.  The authors found improved teacher-rated student emotion regulation, social and academic competence, classroom behaviour, and discipline as indicated by scores on the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997), the Academic Competence Evaluation Scale (ACES;   52 DiPerna, J. C., & Elliott, S. N., 1999), the Social Competence Scale (SCS; Werthamer-Larsson, Kellam, & Wheeler, 1991), and Student-Internalizing Symptoms (Achenbach, 1991; Achenbach & Edelbrock, 1986). School-wide trauma-informed models and programs.  School-wide trauma-informed programs have been examined in select studies (Dorado et al., 2016; Kataoka et al., 2018; von der Embse, Rutherford, Mankin, & Jenkins, 2019).  These studies involved investigations of multi-layered approaches to trauma-informed practices through the combination of training provided to school professionals, multi-disciplinary support for students and families, as well as specific trauma interventions for students suffering from posttraumatic stress symptoms.  The research that explores the efficacy of these system-wide models and programs is limited, and all existing studies highlight the need for further research that comprehensively investigates school-wide trauma-informed approaches.  However, these investigations do offer important preliminary data, guidelines, and recommendations that can be used to continue to support the development of these models and programs.  A study by Dorado et al. (2016) investigated the University of California, San Francisco’s Healthy Environment and Response to Trauma in Schools (HEARTS) program.  This program was intended to promote school success for students impacted by trauma through a whole-school multi-tiered support framework.  The program involved universal supports focused on changing school culture to be more safe, supportive, and trauma-informed (Tier I); capacity building with school staff to construct a trauma “lens” that guides the development of supports for at-risk students and to address school-wide concerns and disciplinary issues (Tier II); and intensive intervention for students directly impacted by   53 trauma (Tier III).  Through program evaluation surveys, the authors found preliminary support for the effectiveness of the program as indicated by significant increases in staff understanding of trauma and trauma-informed practices, significant improvements in students’ ability to learn, significant decreases in disciplinary concerns, and decreases in trauma-related symptoms for students who received Tier III therapeutic intervention.   A 2018 study by Kataoka and colleagues proposed the Trauma-Informed School System model based on the SAMHSA (2014a) trauma-informed domains and principles.  The components of this multi-layered model range from macro-level district-wide initiatives to intensive, targeted treatment.  At the macro-level, the authors describe initiatives such as leadership efforts, cross-sector collaborations, the establishment of school policy and funding, and ongoing evaluation.  The next level of the model is aimed at training school staff in trauma-informed practices, engaging students and families, and creating safe school environments that adopt a trauma “lens.”  Then, the focus narrows to offering multi-tiered systems of support in schools including universal prevention (Tier I), targeted prevention and trauma screening (Tier II), and intensive treatment (Tier III).  Three case studies of the implementation of this model in select schools in the Los Angeles Unified School District led to the construction of recommendations for continued assessment of school staff’s knowledge and awareness of trauma, for continued assessments of school and district-level implementation of trauma-informed principles and practices, and for the development and use of technology-based tools to further support the dissemination of practices, data, evaluation, and workforce training materials.  A recent study by von der Embse and colleagues (2019) investigated a new model for trauma-informed school mental health services that include universal screening for students   54 at risk for mental health concerns and teacher coaching.  These services were designed to support students who fall into Tier I support (universal supports for all students) and Tier II support (select supports for at-risk students) of the Multi-Tiered Systems of Support (MTSS) model.  Supports at Tier I included training in trauma-informed practices provided to all staff, training for teachers on the use of an evidence-based universal screening procedure, and delivery of the universal screening assessment to each classroom.  Tier II supports offered included intensive ongoing coaching for teachers in classroom management strategies for at-risk students, targeted strategies for classrooms, such as training in relaxation strategies; and trauma interventions, such as CBITS (Jaycox, 2004), offered to at-risk students.  The authors examined the impacts of the program on a large, urban school district in Philadelphia.  The preliminary data from this study suggested that the program is associated with a significant reduction in disciplinary concerns and suspensions. Strengths, Limitations, and Implications of the Literature for the Present Study Understanding and addressing childhood trauma is a highly pertinent topic for school counselling professionals.  The literature discusses a broad range of single-incident, chronic, and complex traumatic events that many children experience in their developmental years.  While the data is limited in the Canadian context, the available statistics indicate that traumatic events and adverse childhood experiences are encountered by many Canadian children.  Thus, highlighting the importance of determining best practices for recognizing and supporting children who are impacted by trauma.  The literature suggests that schools can be an ideal setting for the support and intervention with children who have been impacted by trauma and trauma-informed practices provide a potentially valuable framework for approaching this work.  Trauma-informed practice is still an emerging area of research   55 and thus far, the research suggests that school-based trauma-informed practices can play an important role in building safety, providing healing connections, and addressing posttraumatic stress and mental health symptoms.  However, the research is limited in offering consistent frameworks/definitions for how to implement trauma-informed practices and presently, there seems to be more variation than agreement in the literature regarding the best-practices.  This lack of consistency and dearth of research and applied literature examining Canadian schools highlights the need for continued investigation of trauma-informed practices in Canadian schools.  To move towards an expansion of the Canadian literature and the establishment of a widespread model of trauma-informed practices, we need to first identify how trauma-informed practices are understood and approached by Canadian school counselling professionals.  The present study aimed to address this gap in the literature by examining the narratives of Canadian school counselling professionals regarding their experiences of using trauma-informed practices.       56 Chapter 3 Methods The purpose of the present study was to examine the narratives of Canadian school counselling professionals who identified using trauma-informed practices in their schools.  Narrative inquiry was used to guide the investigation, which is both a way of understanding human experience and an approach to conducting research (Given, 2008; Lieblich, Tuval-Maschiach, & Zilber, 1998).  Narrative inquiry is grounded in social constructionism, which posits that knowledge is not universal or absolute but rather is partial, subjective, and ever-evolving (Given, 2008; Lieblich, Tuval-Maschiach, & Zilber, 1998).  Subsequently, context is highly important in understanding knowledge acquisition and meaning-making processes, which vary across individuals and circumstances (Lieblich et al., 1998).  Given the importance of the theoretical underpinnings and underlying assumptions to understanding and implementing narrative inquiry in qualitative research, the fundamental tenets of the narrative inquiry will be further described as a means of grounding the epistemological and methodological approach of the present research.  Then, the study procedures and data analysis steps will be presented in detail.  Social Constructionism Social constructionism is a perspective that has emerged over the last century in the context of the postmodernist movement (Burr, 1995).  Postmodernism is a multi-disciplinary intellectual movement that questions the fundamental assumptions of modernism, particularly about the nature of truth and knowledge.  Postmodernism rejects essentialist notions that there are ultimate “truths”’ that can be uncovered or that there are overarching   57 theories or systems of knowledge that can be used to understand the world.  Subsequently, based on the rejection of these principles, the social constructionist perspective emerged. In the social sciences, the historical roots of social constructionism are linked to the publication of a seminal paper in 1973 by Kenneth Gergen titled “Social Psychology as History.”  Gergen suggested that knowledge concerning human interaction, particularly in the area of the social sciences “cannot readily be developed over time because the facts on which they are based do not generally remain stable” (p. 310).  He suggests that human knowledge is historically bound, culturally-specific, and constantly changing.  Thus, it is imperative to look beyond the individual in isolation and examine the social, political, and economic context impacting psychological and social phenomena.  Gergen further argued that because psychological and social phenomena change and vary greatly across time and context, it is erroneous to assume that there is a single, true description of phenomena.  From these perspectives emerged a movement that emphasized the subjective, socially constructed nature of knowledge about the self, others, and the world (Burr, 1995; Gergen, 1973; Lieblich et al., 1998).   Main Tenets of Social Constructionism  Social constructionism is founded on four main tenets, as depicted by Burr (1995) based on the assumptions discussed by Gergen (1985): (a) that it is essential to take a critical stance against taken-for-granted knowledge or assumed truths; (b) it is important to consider specific historical and cultural contexts when examining phenomena; (c) knowledge is constructed and sustained by social processes; and (d) knowledge and social action are interdependent (pp. 2-4).  Several principles that underly these tenets including anti-essentialism, anti-realism, and an emphasis on the importance of language (Burr, 1995).    58 Anti-essentialism is founded on the idea that the social world is the product of social processes.  Therefore, a relativist ontological perspective is taken, which assumes that there are no absolute or given qualities or characteristics of people or the world.  Anti-realism in social constructionism denies the existence of an objective reality or truth in favour of a socially constructed perspective that states that reality is socially and culturally constructed.  Based on this notion that knowledge is socially constructed, it is important to consider the historical and cultural contexts in which psychological phenomena emerge.  Other important aspects to consider in the process of knowledge construction, according to Burr (1995), is the role that power and inequality play in one’s perceptions and understandings of self, others, and the world.  Finally, language is considered a necessary precondition for thought and a form of social action that facilitates the social construction of knowledge through dialogical interactions and social practices (Burr, 1995; Shotter, 1993; Gergen, 1999).  Ultimately, knowledge construction is constantly evolving and emerges through social processes and social interactions (Burr, 1995).  Narrative Inquiry  Historical underpinnings.  Narrative inquiry has deep historical roots and multi-disciplinary foundations.  The historical influences of narrative examination can be traced to the investigation of tragic narratives in Greek tragedy and later, to French structuralism, Russian formalism, poststructuralism, cultural analysis, and postmodernism (Riessman, 2008).  Contributions to the approach have come from psychology, anthropology, religion, medicine, linguistics, and beyond (Clandinin, 2016).  In psychology specifically, the works of Sigmund Freud studying cases in psychoanalysis and Carl Jung studying cases in analytical psychology have important influences on the philosophical underpinnings of   59 contemporary narrative inquiry (M. Buchanan, personal communication, January 31, 2017).  Contemporary narrative research traditions began to emerge in the 1960s in the context of four movements including (a) critiques of positivist approaches to inquiry and realist epistemologies in the social sciences; (b) the “memoir boom” in literature and popular culture; (c) a growing “identity movement” to emancipate individuals of diverse and/or marginalized groups; and (d) shifts in therapeutic approaches to explore the storied personal lives of individuals (Riessman, 2008).  Narrative inquiry emerged as a powerful approach to examining how humans construct and convey meaning through their life stories (Riessman, 2008).  Over the past five decades, narrative inquiry has diversified and grown in recognition and is now pervasive across social science disciplines (Riessman, 2008).   Basic tenets of narrative inquiry.  Narrative inquiry is a field of research that involves conducting case-centred examinations of narrative accounts, including the structure, content, and/or function of the stories that arise within the self and through social interaction (Murray, 2003; Riessman, 2008).  Narrative approaches describe a distinct way of knowing, distinguished from paradigmatic ways of knowing, that focus on how humans make sense of the world through connecting events over time through stories (Bruner, 1991; Murray, 2003).  Thus, narrative ways of knowing do not seek to determine empirical or objective truths but rather to understand an individual’s unique, socially constructed version of reality as expressed through their narrative accounts (Bruner, 1991).  According to Riessman (2008), there are several important uses of narratives in psychological research: (a) through the practice of storytelling; (b) through collecting narrative data, which are the empirical materials or objects of interest in research; and (c) through narrative analysis, the systematic study of narrative data.      60 In psychology, narratives are defined as long sections of speaking or extended life accounts that are constructed in the contexts that are generated through one or more research interviews or therapeutic conversations (Riessman, 2008).  Riessman (2008) notes that “narratives are composed for particular audiences at moments in history, and they draw on taken-for-granted discourses and values circulating in a particular culture.” (p. 3).  Narratives are socially constructed, and there is no fixed structure that a narrative must take on but rather the form that it takes depends on factors such as the narrator, the audience, and the broader social and cultural context in which it is situated, including issues such as social interaction, relationships, and social power (Clandinin, 2016; Murray, 2003).  Narrative inquiry researchers pay attention to the intention and the language used as a means of conveying the story (Riessman, 2008).  With regards to intention, questions around why a story was constructed and for what purpose are examined (Riessman, 2008).  Language is important in helping to understand how a story is conveyed and is not considered to be transparent, in that there is no one-to-one correspondence between a symbol and its meaning. (Lieblich et al., 1998; Riessman, 2008).   Rather, language is considered to be a culturally and socially constructed means of communicating a story and constituting the self of the narrator in the process (Lieblich et al., 1998).  Therefore, a narrative researcher is interested in the content of the story as well as the production of the story including how the story is constructed as it reveals the intentions of the narrator and how the narrator wants to be known to others (the listener/audience).   Role of the researcher in narrative inquiry.  In narrative inquiry, the role of the researcher is not considered innocuous, passive, or objective.  Narratives are not stories that speak only for themselves but rather are co-constructed with the participation of the   61 interviewer (Riessman, 2008).  Therefore, the research is a socially constructed process of creating knowledge that occurs between the participant and researcher, as well as through the interpretive processes that occur during the analysis (Riessman, 2008).  Thus, the influence and roles of the researcher need to be considered when engaging in narrative inquiry.  The researcher may take on varying roles depending on the stage of research.  However, the role of the researcher during the narrative process is to, first and foremost, encourage and support participants in the telling of their stories (Murray, 2003).  Issues of subjectivity as they pertain to the present research will be further addressed at the end of this chapter.  Model of narrative analysis.  The model of narrative analysis being used for the present study is based on the conceptualizations of thematic analysis work of Riessman (2008) and this model is complemented by the techniques of thematic content analysis detailed by Braun and Clarke (2006) to support the coding process.  Riessman (2008) posits that narratives can be elicited in multiple ways in psychological research including through the stories that research participants tell, through interpretive accounts developed by the investigator(s) based on interviews and/or fieldwork, and through the narratives that the readers construct.  Narrative inquiry is a case-centred approach and therefore, the unit of analysis in narrative research is the overall story or stories constructed in each interview.  She states that this is different from other research approaches (e.g., grounded theory) that break down the stories into parts (without piecing them back together) and only examine segments (such as sentences) of text as the units of analysis.  Furthermore, the purpose of looking at the whole story(s) contained within a narrative is to preserve the sequential and structural features of the narrative.     62 There are a variety of approaches that the researcher can take to analyzing narratives.  Riessman (2012) notes that these narrative analysis approaches should be viewed as a flexible repertoire of approaches that can be drawn on and expanded to fit the needs of the project.  Riessman (2008) describes four main approaches to analyzing narratives including: (a) thematic analysis, which focuses on content and meanings; (b) structural analysis, which examines narrative linguistic forms in addition to content; (c) dialogic/performance analysis, which examine narration and performance aspects of the story, and (d) visual analysis, which uses both textual and visual pieces as components of the narratives.  For the present study, a thematic analysis approach seemed to be the best fit for investigating experiences of using trauma-informed practices.  Riessman notes that thematic analysis is one of the most straightforward and likely, most commonly utilized approach to narrative analysis for research investigating applied settings (such as schools).  Thematic analysis is categorical and content-focused in its approach (Lieblich et al., 1998; Riessman, 2008).  It examines entire narratives to identify categories and themes apparent in stories (dialogic units) within the narrative, and focuses on content, which is the account of what happened, with whom, and why (Lieblich et al., 1998; Riessman, 2008) notes that the thematic approach is useful for finding common elements across research participants and the events they discuss.  This approach seemed most congruent to examine the common threads in the stories across school counselling professionals from similar professions but different school contexts.  Braun and Clarke’s (2006) thematic content analysis was selected as a technique to structure the steps of the coding process. It was selected for its adaptability to different theoretical frameworks, including narrative methodology and its congruence with Riessman’s (2008)   63 conceptualizations of thematic analysis.  The specifics of the analysis process will be further detailed below in the Procedures sections.  Appropriateness of the Method   Narrative inquiry is a qualitative approach in which researchers gather and analyze narrative materials that have been collected (Lieblich et al., 1998).  Narrative inquiry is flexible and has wide-ranging utility for understanding social phenomena (such as trauma-informed practices) in the social sciences (Riessman, 2008).  It can be used to investigate personal stories as well as stories from social groups and organizations with shared contexts (Riessman, 2008).  Literature in the area of trauma-informed practices largely focuses on proposing and investigating frameworks, models, and programs for approaching trauma-informed work in schools.  However, little is currently known about the experience of engaging with and using trauma-informed practices in schools.  Therefore, narrative inquiry seemed like a fitting approach for exploring these experiences and for creating an opportunity for the stories of trauma-informed practices to be shared.  Narrative methods have been used in traumatic stress studies and trauma-informed practices research  (e.g., Conradi, Kletzka & Oliver, 2010; Harden et al., 2015).  The rationale for using narrative methodologies for research in the field of psychology broadly and for investigating school-based trauma-informed practices specifically will be discussed next and demonstrated through examples of narrative research in this area of traumatic stress. Narrative Research in Psychology.  Narrative methodologies have been utilized for research across academic disciplines and in psychology specifically (Riessman, 2012).  They have been used across clinical, cognitive, counselling, developmental, and social psychology research (Lieblich et al., 1998).  In contrast to positivist approaches to psychological   64 research, narrative research allows for greater depth of investigation into individual and/or shared experiences and flexibility in analyses.  At a conceptual level, narrative inquiry aims to convey humans’ innate propensity to tell stories and to engage in meaning-making processes (Lieblich et al.,1998).  Riessman (2000) notes that “Storytelling, to put the argument simply, is what we do with research and clinical materials, and what informants do with us.  The approach does not assume objectivity but, instead, privileges positionality and subjectivity.”  Thus, the approach is congruent with psychological research, such as the present study, which intended to explore and understand the meaning that school counselling professionals make through telling their stories of using trauma-informed practices in their schools (Riessman, 2012). Examples of narrative research in traumatic stress studies.  Narrative methodologies have been utilized to examine trauma experiences in children.  A 2013 study by Jackson, Newall, and Backett-Milburn examined 2986 narratives of self-disclosure of trauma from children ages 5-18 years of age who contacted a confidential telephone hotline in Scotland.  The authors found that the narratives were detailed in contextual information centred around the following themes: talking about sexual abuse, language and terminology, coping strategies, violence/physical abuse, grooming and compliance, parental adversity, health and well-being, disclosure, and barriers to disclosure.  Simon, Feiring, and Kobielski McElroy (2010) examined the trauma meaning-making processes of 108 youth who had experienced childhood sexual abuse.  Upon examination of their narratives, the authors identified three processing strategies – constructive, absorbed, and avoidant.   A 2010 study by Conradi et al. utilized narrative methodology to conduct an in-depth analysis of a case study of a clinician implementing an assessment-based treatment for   65 traumatized children (Trauma Assessment Pathway; TAP).  Upon examining the clinician’s narratives, five themes were identified: (a) TAP is flexible and meets the individual needs of client, (b) TAP helps make sense of information and guide treatment, (c) benefits to utilizing a thorough assessment, (d) barriers to measuring administration, and (e) lack of fidelity to the TAP model across domains.  Harden et al. (2015) engaged in narrative analyses to examine the experiences of participants and faculty/staff regarding the implementation of a trauma-informed youth violence prevention and intervention program.   The authors report through their narrative analysis that the youth engaged in the program felt that they developed skills in leadership, trauma-informed practice, documentary production, theatre, and participatory action research.   Narrative methodologies and school-based trauma-informed practices.  To the best of my knowledge, no existing studies were identified that use narrative methodologies to specifically examine trauma-informed practices-related phenomena.  Risessman (2012) posits that narrative methods are appropriate not only for individual experiences but also for the study of social movements, political and macro-level phenomena.  Implementing a new paradigm, such as trauma-informed practices, often involves shifts in understanding and practices at both an individual and systems level.  Narrative methodologies are a case-centred approach that allows the researcher to look at the “case” as being both the individual and their personal story and the group (i.e., school counselling professionals) and the story that the common themes across their stories tell.  Description of the Participants The present study concerned the narratives of school counselling professionals who identified using trauma-informed practices in their schools.  School counselling professionals   66 were defined as professionals trained in a counselling and/or psychology-related field and work specifically in schools such as school counsellors, school-based social workers, school psychologists, and/or other mental health support professionals working in public and private elementary, middle, and high schools.  This group was selected as they work in a direct helping relationship with the student body and they typically have the training required to work in a therapeutic context with students.  Thus, they were considered to be appropriate professionals with whom to investigate trauma-informed practices.  Finally, school counselling professionals are bound by ethical standards of practice as defined by membership to one or more professional associations such as the British Columbia Teachers’ Federation, the British Columbia Association of Clinical Counsellors, the British Columbia School Counsellors’ Association, the British Columbia College of Social Workers, and/or the British Columbia Association of School Psychologists.  To be eligible for this study, interested school counselling professionals were required to hold or be in the process of completing a master’s degree or higher in psychology (school, counselling or clinical), social work, or child and youth care and be a member in-good-standing with at least one professional association.  Second, the school counselling professionals were required to indicate that they have received some formal training in trauma-informed practices, are using trauma-informed practices in some capacity in their school(s), and state interest in sharing their experiences of implementing trauma-informed practices in their school.   The size of the research participant group is not prescriptive in narrative methodologies.  Participants are not selected based simply on fulfilling representative requirements but rather because they can offer substantial contributions to discussing the   67 phenomena being investigated (Polkinghorne, 2005).  Participant group sizes in narrative inquiry are kept small based on the depth of the interviews and the considerable amount of data gathered in each narrative interview (Lieblich et al., 1998).  The typical participant group size for narrative inquiry is five to eight participants (e.g., Al-Mashat, Amundson, Westwood & Buchanan, 2006; Bowers & Buchanan, 2007; Walsh & Buchanan, 2012) and thus, the present participant group size of seven participants is consistent with narrative methodologies (Creswell, 2007).  A participant group of seven school counselling professionals participated in the present study.  The participants represented five school districts located in the Lower Mainland of British Columbia (BC).  All of the participants were certified teachers in BC and had experience working as a teacher in some capacity.  Five participants held master’s degrees in counselling psychology, one was about to graduate with a degree in counselling psychology, and one was in the process of completing a degree in counselling psychology.  Five participants were employed as school counsellors, one as a district-level counsellor consultant, and one participant was working in a special education role while completing a counselling degree and had an extensive background working in mental health roles.  All participants reported that they had engaged in training in trauma-informed practices and were using aspects of a trauma-informed approach in their work in schools.  Recruitment Procedures  Recruitment letters were shared with administrators and counsellors from Lower Mainland school districts (See Appendix A).  The letter contained email and telephone contact information that school counselling professionals could use to contact the researchers and express interest in participating in the study.  Ten school counselling professionals   68 expressed interest in participating in the study. All participants contacted the researcher via email.  Seven of the ten professionals had the time available to proceed to the screening phase of recruitment, three were unable to participate because they did not have the time to proceed.  A brief screening was conducted with interested school counselling professionals to obtain information regarding their position, their credentials, if and how they currently work with trauma-informed practices, and if they were interested in participating in the study (See Appendix B).  All seven participants were deemed eligible to participate based on the eligibility stated above and were booked for an interview.  The question of when to discontinue recruiting is a challenging one in narrative inquiry.  Saunders et al. (2018) describe saturation as a concept often discussed in qualitative research that refers to a point where no additional data are being obtained in the interviews and thus, data collection and/or analysis are discontinued.  The authors’ concept of data saturation has roots in grounded theory and is often made explicit in grounded theory and more deductive, structured forms of qualitative research.  However, they note that in narrative approaches, it is more challenging to identify and justify a role for saturation.  Furthermore, saturation is not a topic explicitly discussed in Riessman’s (2008) model of narrative analysis or thematic analysis as defined by Braun and Clarke (2006).  Overall, saturation is not typical of narrative inquiry because each participant’s story is considered to be unique and there is no one best account that the researcher is looking for.  Each story is considered to stand on its legitimacy.  For the present study, saturation was not an explicit technique used as a criterion to discontinue recruiting.  Rather, we considered the depth and breadth of stories being gathered by each participant.  However, it is important to note that by participant five, commonalties in the threads of ideas discussed were noted across the   69 participants’ stories.  Interviews were completed with the two remaining participants who had emailed with an expressed interest in participating and we continued to notice similar threads.  At this point, no new participants had expressed interest in participating, the data collected was comprehensive, and six solid themes had emerged through the analysis.  Each story points to how the discourse on trauma-informed practices is taken up in the larger culture.  Therefore, the data collection process was then deemed complete and recruiting was discontinued.  Informed Consent Informed consent for participation in the study was explained orally and in writing at the beginning of the interview.  It was explained that participation in the study was voluntary and that participants had the right to end their participation at any time.  Informed consent was obtained from all participants prior to the start of the interview and each participant retained a copy of the signed consent form (see Appendix C).   Study Procedures  Data collection – narrative interviews.  Participants partook in an audio-recorded interview consisting of open-ended questions to explore their experiences of using trauma-informed practices.  The narrative interview served the purpose of co-constructing a detailed account of the participant’s stories and experiences of using trauma-informed practices in their schools.  The goal of narrative interviewing is to have participants share detailed, in-depth accounts throughout the interview rather than brief answers or general statements (Riessman, 2008).  Therefore, a formalized interview structure was not imposed on the participants; however, a set of possible interview probes were prepared for the research interview that was deemed likely to open up in-depth storytelling and conversations from the   70 participants (see Appendix D).   The interview probes served as a guideline for exploring various topics related to trauma-informed practices and to open discussions around aspects of the story.  The probes explored topics such as the participants’ conceptualizations of trauma-informed practices, their experiences learning about and using trauma-informed practices, factors that facilitate or support using trauma-informed practices in schools, obstacles to using trauma-informed practices in schools, and resources and other factors that could be valuable for using trauma-informed practices in schools going forward.  The interview probes were not considered mandatory/necessary but rather were used as needed to open up a dialogue or to help participants provide a more comprehensive account of their experiences.  Participants were also given gentle encouragement to elaborate on their story throughout the interview, such as being asked “is there anything else you wish to add?” and “have we discussed everything you wish to say?”. None of the seven interviews required the use of all interview probes, however, most of the participants covered a broad range of the topics included in the probes.   According to Murray (2003), some basic conditions were important to create a safe space for participants to tell their stories.  These conditions included being empathic and supportive, taking time to get to know the participants, and allowing the participant to lead the way in identifying and expanding on pieces of their story that are important to share.  All participants were asked the first question “Let’s start at the beginning, tell me how you learned about or became interested in using trauma-informed practices”.  Following this question, the participants were informed that they were free to discuss any area of using trauma-informed practices that they wished in any order.  Most of the participants shared lengthy commentaries on a broad range of their experiences with minimal direction required.    71 Throughout the interviews, I used empathy, reflection, gentle encouragers for elaboration, and questions (both from and beyond the probes) to encourage the participants to continue sharing their story(s).   Data analysis.  Braun and Clarke’s (2006) thematic content analysis was used to guide the procedures for transcribing and coding the interviews.  The authors defined thematic content analysis as a method of identifying, analyzing, and reporting themes or patterns that occur in a set of research data, in this case, the participants’ narratives.  This approach was selected for its adaptability to different theoretical frameworks, such as the narrative methodology proposed by Riessman (2008) and fit with a social constructionist approach to examining knowledge (Braun & Clarke, 2006).  It is congruent and complementary to Riessman’s (2008) conceptualization of thematic analysis and provides a more detailed structure and steps for the analysis process.  The analysis process involved the following six steps: (1) transcription and data familiarization, (2) generating initial codes,  (3) consolidating/ collapsing similar codes into categories, (4) reviewing categories and sub-themes, (5) identifying main/major themes, and (6) writing-up the findings.  Step one, the transcription processes, was complemented by the detailed transcription processes outlined by Lapadat and Lindsay (1999).  Furthermore, two of the coding steps have been reconfigured to include collapsing and organizing codes into categories before identifying major themes, which are reversed in the original guidelines by Braun and Clarke (2006).  The steps of the analyses are further detailed below.  Transcription and data familiarization (Step 1).  Braun and Clarke (2006) state that transcription is not an objective act but rather a theoretical process that is inherently impacted by the researcher's assumptions.  They posit that it is theory-driven, interpretive, and   72 constructive.  Thus, there is no one-to-one correspondence between the oral conversations occurring during the interviews and what is transcribed, but rather different approaches to transcription can create meaning in different ways depending on the transcription practices used (Lapadat & Lindsay, 1999; Riessman, 2008).  Riessman (2008) notes that it is important to consider the co-constructed nature of the interview when transcribing it.  Therefore, it is necessary to present the co-constructed knowledge and interactive aspects of the interview.  A suggested way to approach co-constructing elements is to use a pre-generated transcription key (see Appendix E) to define elements of the story, which denotes elements such as voice tone, emotions, and disconnection (Lapadat & Lindsay, 1999).  Furthermore, I recognize that my own emotions, assumptions, and ideas were part of the co-constructed processes that occurred in the interviews and that they could impact the transcription process.  Thus, my dialogue was presented in the transcript and any underlying subjective factors impacting the interview were made transparent in the transcript.  I noted when a question or reflection I would give stemmed from a curiosity may have been driven by my theoretical pre-understandings or by my previous work in schools or with trauma-informed practices.  An example of this was an occasion where a participant spoke about a book I had previously read.  I recognize that my knowledge of the book may have impacted how I discussed the book and the ways I asked the participant to elaborate on their experience of the readings.  I also noted when my reflections/empathy statements may have inserted language into the participants’ stories.  For example, there was an instance where I used the word “collaboration” to describe the work that a participant was engaging in with a team of professionals and later realized that this was not a word that the participant had yet used to describe the experience of the work.  I then took this information into consideration when I   73 engaged in the coding process.  My dialogue and subjective factors impacting the interview were continually reflected on and considered as I went through the stages of the data analysis.  After the transcript was constructed, it was actively reviewed several times in full to ensure that all elements had been noted, to familiarize myself with the whole story, and to start taking some preliminary notes for coding before transitioning to the formal coding stages (Braun & Clarke, 2006).  The coding process (Steps 2 to 6).  The data was hand-coded, analyzed, and categorized in stages based on themes that were identified in the interviews.  It was an intentional decision to hand-code the material as opposed to using computer software.  Riessman (2000) notes that the coding process, such as deciding which segments to analyze and putting boundaries around them, is an interpretive decision, shaped in major ways by theoretical interests.  As mentioned above, I am also aware that I was an active participant in the research interview and my questions/responses had an impact on the process and findings.  Therefore, removing myself from this process by using more impartial coding approaches, such as using computer software, seemed incongruent with the co-constructor role of the researcher.  Also, the transcripts were considered separate individual narrative accounts which were the basis of the thematic analysis.   Coding for themes took on an inductive approach, which looked for the patterns that occurred in the stories without trying to fit it into a particular framework or preconceptions about what would emerge (Braun & Clarke, 2006).  The first phase of the coding process was to review the interviews in full and to start to generate a list of potential codes, which involved writing down words, phrases, and ideas about the data and what stands out in the narrative.  The next phase involved consolidating the codes and their corresponding data   74 extracts, reviewing the data, and “cleaning up the codes” by grouping similar codes or breaking down codes that were too broad.  Next, the codes were mapped using a thematic map developed by the researcher and categories and sub-themes were reviewed, refined, and documented.  The entire data set was reviewed as a whole and the trustworthiness of the categories and themes was considered (see Issues of Trustworthiness below).  Finally, a set of core themes was identified based on the examination of the overarching themes governing sub-themes and categories.  The overall story that each theme tells both on its own and with the other themes was also a consideration (Braun & Clarke, 2006). Writing up the findings (Step 6).  The final phase of the research involved constructing summaries of the individual narrative accounts for each participant, constructing a composite narrative, and description of the findings based on the stories that participants shared and the themes that were identified through the coding process.  The individual narrative accounts condensed the extensive stories told through each interview transcript into a summary of the key elements of each participant’s stories.  A composite narrative was composed to represent the depth and breadth of the stories described by the participants.  The themes and included sub-themes were then written into a detailed report, using examples or extracts of the interviews to convey the essence of each theme described.  Any relationships or links between themes were also discussed, considering how all were components of the story of using trauma-informed practices in schools.  Finally, the findings were discussed in terms of the strengths, limitations, implications for further research, and practical implications for trauma-informed practices in schools.    75 Issues of Trustworthiness In narrative methodologies, the “trustworthiness” of the data (i.e., narrative accounts) cannot be evaluated using traditional correspondence criteria seen in other methodological approaches in both quantitative and qualitative traditions (Riessman, 2000).  Riessman states that “there is no canonical approach to validation in interpretive work, no recipes or formulas,” meaning there are no standard procedures or techniques that the researcher must follow to validate the findings (2000, p. 22; Riessman, 2008).  She further notes that fixed criteria for reliability and validity are not suitable for evaluating narrative projects as the data and the findings are considered to be partial and interpretive (Riessman, 2008).  However, Riessman also notes that students in the social sciences are typically required to make arguments regarding the trustworthiness of their data and interpretations.  She indicates that this can be done by clearly outlining one’s theoretical perspectives, methodology, and analysis procedures.  For the present study, member checks were chosen as an additional approach to ensuring the credibility and trustworthiness of the findings from the perspectives of the participants.  Furthermore, an expert review process was used to verify the findings with an expert in narrative methodologies and with an expert in working from trauma-informed approaches in schools (Creswell, 2009).  Finally, as recommended by Riessman (2008), researcher subjectivity and reflexivity were also considered throughout the study.  Member checks.  Member checks are used in narrative inquiry to ensure cohesiveness, resonance, comprehensiveness, and pragmatic value (M. Buchanan, personal communication, January 31, 2017).  This process involved holding follow-up meetings with five of the research participants who were available for meetings.  The final written narrative of the themes was shared with the participants and they were given an opportunity to confirm   76 and comment on the narrative and the identified themes (Creswell, 2009).  The following questions were asked to determine the credibility of the findings: does the narrative convey the whole story? (cohesiveness); is there anything missing or that needs to be added? (comprehensiveness); how can this narrative be used to help other students and school counsellors? (pragmatic value); and overall, does the story resonate for you?  Oral feedback was obtained from participants, and Chapter 4 was updated accordingly.  Furthermore, the recommendations shared by the participants were taken into consideration when constructing the discussions regarding the significance of the research findings for future trauma-informed research and practices (see pages 146-153 of Chapter 5).  Expert review.  Two forms of expert review processes were also used to explore the credibility of the findings.  First, an expert in narrative methodologies who has been conducting narrative research in counselling psychology and traumatic stress for twenty-five years was consulted throughout the research.  Consultation occurred from the proposal through to finalization of the findings.  This individual reviewed all interview transcripts, along with each step of the coding process.  Once a draft of the findings had been prepared, a second peer reviewer was called in to review the findings.  The expert peer reviewer was an individual in the psychology field who has extensive experience as an educator (special education and indigenous education), experience in school psychology, and extensive knowledge of trauma-informed practices in schools.  To provide a neutral assessment of the findings, this individual was not involved with any of the research processes except for the expert review.  The expert peer reviewer was asked to examine the findings and then respond to the following questions: (a) Are the findings comprehensive?, (b) Do the findings resonate with what you know and/or have experienced working in schools?, and (c) Do the findings   77 have practical implications for counselling psychology?  The expert peer reviewer provided thoughtful and extensive feedback that aligned well with the feedback that the research participants provided in the member checks.  The feedback was used to confirm the findings presented in the final narrative and the key themes presented in Chapter 4.  Furthermore, the expert peer reviewer offered feedback relevant to the practical implications of the findings. This feedback was integrated into the practical recommendations discussed on pages 140-153 of Chapter 5.  Researcher subjectivity and reflexivity.  It is essential to the narrative research process that I am aware of the influence I, as the researcher, may have in the process of shaping the participants’ narratives (Murray, 2003).  Furthermore, Riessman posits that acknowledging and reflecting on these factors is an important component of ensuring the trustworthiness of the findings.  The following section details the theoretical and professional pre-understandings I brought to the research, along with my reflections on the factors that impacted my subjectivity throughout the research.  Theoretical pre-understandings.  One important factor that I considered when conducting this research is that I had considerable previous exposure to trauma-informed practices literature before entering doctoral studies.  My first exposure to trauma-informed practices was through reading the Trauma-Informed Practice Guide (Arthur et al., 2013) as part of my orientation to working for a local health authority.  At this work site, I was also encouraged to watch videos and read articles/books by Dr. Bruce Perry (e.g., Perry, 1995; Perry & Szalavitz, 2017) a psychiatrist and researcher in the area of childhood trauma.  From there, my interest in trauma-informed practices grew and I learned more about Canadian trauma-informed practices through reading the book Becoming Trauma Informed (Poole &   78 Greaves, 2012) and continuing my learning about trauma theory through my work as a counsellor (see further details below).  These theories were highly influential to every aspect of the research, from the literature I sought out to review through to the research design and data analysis.  An example of this influence was my interest in exploring the participants' definitions of trauma-informed practices.  Through my reading and review of the literature, I noted that trauma-informed practices are conceptualized differently across authors, organizations, and systems.  Therefore, I anticipated that there would be variability across the participants’ definitions as well. Considerable preparation went into ensuring that I had the theoretical foundation to approach narrative research.  I had no previous experience conducting narrative research before engaging in my doctoral research. Therefore, in the two years prior to proposing my research, I engaged in intensive coursework in qualitative methods, guided independent studies on narrative methodologies, readings of narrative studies, and receiving mentorship from an expert in narrative methodologies.  The first step of my journey to using narrative methodologies was delving into social constructionism, the perspective in which narrative research is often grounded.  I examined the works of many of the key contributions to the social constructionism movement including An Introduction to Social Constructionism (Burr, 1995), An Invitation to Social Construction (Gergen, 1999), Conversational Realities: Constructing Life Through Language (Shotter,1993), The New Language of Qualitative Methods (Holstein & Gubrium’s, 1997), and The Social Construction of Reality: A Treatise in the Sociology of Knowledge (Berger &Luckmann, 1991).  After a foundation was built in understanding social constructionism, there were several key works pertaining to narrative research methods that I reviewed to obtain a broad understanding of the various theories and   79 perspectives of narrative research including Narrative Construction of Reality (Bruner, 1991), Narrative Knowing and the Human Sciences (Polkinghorne, 1988), Narrative Research (Lieblich et al., 1998), Narrative Approaches in the Human Sciences; (Riessman, 1992; 2008), Interpreting Experiences: The Narrative Study of Lives (Josselson & Lieblich, 1993), Narrative and Psychotherapy (McLeod, 1997), and Engaging in Narrative Inquiry (Clandinin, 2016).  These works provided an understanding of the historical foundations of narrative research, an overview of the different approaches to narrative research, as well as a theoretical understanding to guide the design of my research.  From there, I was able to identify the narrative approach that most resonated with my research question (Riessman, 2008) and the complementary methodological techniques (e.g., Braun & Clarke, 2006; Lapadat & Lindsay, 1999) that would support the design and implementation of my research.  Professional pre-understandings.  As mentioned previously, I spent several years working as a counsellor for a trauma-informed health authority and as a school-based mental health professional for a Lower Mainland school district.  Through this work, I simultaneously experienced the value of working for a trauma-informed system and the need for trauma-informed programs and approaches in schools.  Going into this research, I was astutely aware of my motivation to see trauma-informed approaches effectively used in schools as a means of supporting vulnerable children.  I recognize that this has impacted my subjectivity in this research from conceptualization through to dissemination.   I have also been extensively studying trauma therapy and interventions throughout my career as a therapist, which started during my master’s degree and has continued to this day.  As a cognitive behavioural therapy (CBT)-oriented therapist, much of my learning has been focused on CBT-based approaches to working with trauma including prolonged   80 exposure, cognitive reprocessing therapy, and the third-wave CBT approach acceptance and commitment therapy.  I also have some basic training in narrative therapy.  I have engaged in training in two interventions programs that are commonly that are utilized in schools, Trauma-Focused CBT (TF-CBT; Cohen et al., 2012) and Cognitive Intervention for Trauma in Schools (CBITS; Jaycox, 2004).  I am aware that my focus on CBT-based therapies in my counselling practice may bias me towards these approaches.  To address these biases, I reviewed a broad range of literature regarding trauma therapy, theory, and trauma-informed practices throughout the research process.   Researcher subjectivity.  One important subjectivity factor to consider is that I interacted with participants in multiple tasks throughout the study.  I organized and set up the interviews, then I assumed the role of an interviewer when conducting narrative interviews, and finally, I conducted the member checks of the findings.  Engaging with me in these differing tasks may have impacted how the participants experienced the interviews and the stories that they constructed around it.  Several participants also asked me if I had experience working in schools before during the interview.  While I did not go into detail about these experiences during the interview (as it might shift the focus away from the participants’ stories), I did answer these questions briefly and honestly.  I am aware that this knowledge could have impacted what the participants shared and the detail that they went into.  However, I am also aware that if I censored or refused my responses, it could have impacted the rapport-building process and safety I built with the participants in the interviews.  My prior previous theoretical knowledge of and experience with trauma-informed practices may also have potentially impacted the type of questions that I asked in the narrative interview.  The narrative design of the study also helped to address this potential   81 influence, as the aim of the approach is to explore all aspects of the participants’ experiences of using trauma-informed practices, whether they be positive, negative, or neutral.  The aim of this study was not to see how successful trauma-informed practices are but rather to get a sense of each participant’s experiences to provide in-depth information regarding the participants’ understandings and use of trauma-informed practices to inform research and practice directions in this area.  The study design also allowed me to note how my experiences appeared in the research process, for example, by noting my thought processes during the interview and throughout the transcription and analyses.  I also kept a research journal of my reflections on the research process and any potential personal influences/biases that emerged along the way.  Finally, member checks allowed for a thorough check of the narratives by the participants to ensure that their stories and experiences have been correctly presented and to see if any misinterpretations had been made and expert review offered the opportunity to examine my research processes and findings through the reflections of professionals who are experienced with the method and with trauma-informed work in schools.  Delimitations  Several delimitations were present in the methodology of this study. The first delimitation was requiring that participants have previous training in trauma-informed practices and some experience using the approach (either formally or informally) in their work.  Including participants only with this training/experience allowed me to gather greater depth and breadth of experiences with trauma-informed practices (from pre-trauma-informed practices work to future hopes for their continued work).  A second delimitation of the study was the focus on school counselling professionals specifically and not including other school   82 stakeholders such as teachers, students, and administrators.  Based on the extensive depth of the interviews, the participant group size in narrative inquiry is kept small.  Thus, including a range of stakeholders would limit the ability to include multiple participants of the same stakeholder group.  Furthermore, it would limit the ability to discuss themes across the participants as there would likely be considerable variation across the narratives.  A final delimitation was in the choice of the geographic area that the participants were recruited from.  Participants were only recruited from the lower mainland of British Columbia (BC). This decision was initially based on the convenience of lower mainland schools to the University of British Columbia (UBC), which is located in Vancouver, BC.  Furthermore, based on my experience working in and with schools, I am aware that the lower mainland of BC has an extensive recruiting pool.  There are twelve diverse school districts located in the lower mainland with a considerable population of school counselling professionals from which to recruit.  Ethical and Diversity Considerations This study was approved by the Behavioural Research Ethics Board of the University of British Columbia before commencing the research.  Ensuring the psychological and emotional safety of the participants and the students that they support as crucial to the study.  It was explained to participants that they were free to withdraw from the study at any point in the process and that they are under no obligation to participate.  No participants chose to withdraw.  Now I turn to the findings of the study in Chapter 4.     83 Chapter 4 Findings In the narrative interviews in the present study, the participants were invited to share their stories of using trauma-informed practices in their schools.  These stories considered various aspects of their experiences with trauma-informed practices ranging from their experience before learning about trauma-informed practices, to their present-day engagement with trauma-informed practices, to their hopes and projections for the future of trauma-informed practices in schools.  The findings were constructed with an approach intended to describe the participants’ ongoing and evolving stories of using trauma-informed practices.  The findings will be presented in three parts.  First, individual narrative accounts will be presented that summarize the personal interviews for each participant.  The intention of these summaries is to introduce the reader to the individual voices that contributed to the findings.  Please note that the names are pseudonyms and accounts have been constructed without the use of identifying information.  Second, a composite narrative will be offered that has been constructed based on the shared experiences of the school counsellors. This is a storied version of the key findings of the study.  Third, the six key themes identified across the participants’ stories are detailed and discussed.       84 Part I: Individual Narrative Accounts Participant One - Linda Linda is an elementary school counsellor working in the public-school system in British Columbia.  She has a background as a classroom teacher and later went to graduate school to obtain her master’s degree in counselling psychology.  Linda first learned about trauma-informed practices through her master’s practicum, where she was working in addiction care and noticed a theme of trauma underlying substance use.  She has since taken multiple trainings and workshops on trauma-informed practices both within her school/district and external to it.  She reports that she has particularly benefited from workshops in play therapy, art therapy, EMDR, and complex trauma interventions for building her trauma-informed practice skill sets.  She also notes engaging in regular self-guided learning through reading books and research concerning trauma theory, intervention, and neurobiology. Linda discussed trauma-informed practice as understanding behaviour as a form of communication.  She shared a belief that children are not willfully disruptive but rather are acting in ways to seek safety and survival based on their adverse experiences.  She notes that she makes efforts to understand the impact of adverse childhood experiences on the brain and on mental health outcomes for children in the work that she does.  She described this as helping her look beyond behaviors and problems to gain a greater understanding of the “whole person”.  This understanding helps to guide the strategies and interventions she ultimately chooses to use with the child.  When she first started counselling work, Linda described understanding trauma-informed practices as something that was targeted towards individuals with significant identified trauma.  She now reports believing that trauma-  85 informed practices are beneficial for everyone, including the student population and the clinicians working with them.   Linda shared that she has noticed a trauma-informed practices movement emerging in her district and an increase in informal conversations and formal educating efforts (e.g., trainings, speakers and workshops) on the topic of trauma-informed practices.  She noted that she has taken trainings on how to write Individual Education Plans (IEPs) through a trauma lens and about different the tiers of school-based support and intervention (i.e., the multi-tiered system of support) for trauma-informed practices.  She described paradigmatic shifts in her school from focusing on problem behaviours and their detriments, to looking beyond a child’s behaviour with an understanding that behaviour is a communication of trauma.  She has found that this understanding has fostered a greater sense of empathy, acceptance, compassion, and gentler approach to working with students.  She also described the ways that her school has changed their disciplinary processes from being less punitive to more supportive when working with students demonstrating problematic behaviours. Linda mentioned that her role in school often involves a significant amount of stabilization, containment, and resilience-focused work.  She shared that the school counselling role does not lend itself well to engaging in trauma re-processing therapy.  She described mindfulness, sand tray therapy, guided visualization, play therapy, art therapy, grounding, emotion regulation, CBT, and teaching positive coping strategies as examples of the many tools and approaches that she uses to support her students.  She describes her overall approach as asset-building.  She also reports that an important part of her role is connecting her students who are experiencing posttraumatic stress symptoms to outside   86 agencies that can provide additional intervention.  Linda reports that challenges exist in her work based on the expectations of her work and the competing roles of her position. Linda described trauma-informed practices as a “hopeful” practice that is highly beneficial in building an environment of safety and connection in her schools.  Her hopes for the future include increased role clarity for school counsellors and additional training in and use of trauma-informed resources across schools.  A further hope mentioned was that trauma-informed practices become a best-practice in schools and are used as universal support across classrooms and schools.   Participant Two – Barbara Barbara is a school counsellor working in elementary schools for the public-school system in British Columbia.  She was a former classroom teacher, has her master’s degree in counselling psychology, and has worked in both the high school and elementary school systems.  Barbara first learned about trauma-informed practices through reading the book Waking the Tiger by Peter Levine on the recommendation of a counselling colleague.  Since reading the book, she has taken multiple trainings and workshops in trauma-informed practices along with self-guided learning.  She reports that she has particularly benefited from trainings in sand tray therapy and complex trauma response.  Barbara describes trauma-informed practices as awareness or sensitivity to the potential of past traumatic experiences and that these experiences could be at the root of the difficulties that a student is experiencing at school.  She describes behaviour as being a symptom of something that happened in the past that is causing a reaction in the brain and the nervous system.  From these reactions, she notes that behaviours emerge that are unpredictable and that can look like willful opposition but often are not.  Based on this   87 understanding, she believes that valuable trauma-informed interventions target the body, the emotions, and self-regulation rather than just behaviours and cognitions.  She also described the importance of shifting away from trying to “fix” trauma and related behaviours to trying to “heal.”  She reports that she initially thought that trauma-informed practices would be most helpful to children with identifiable mental health concerns that require targeted interventions but now notices that they are helpful to children who have experienced a range of stressful and adverse experiences.  Barbara emphasizes the importance of the school’s mandate to support students learning in schools.  She notes that creating safe and supportive attachment relationships and using an understanding of effective ways to support trauma is important in supporting the learning of children who have been impacted by trauma.  She reports that she is advocating for further training in trauma-informed frameworks. Her hope is that the school staff can have a shared language to talk about children in school-based team meetings and common knowledge of helpful ways to respond to and support behaviours in the classroom.  Barbara describes the goal of her counselling work as creating a safe way for students to express their inner worlds.  Key tools and strategies she described using include sand tray therapy, relaxation, mindfulness, and basic psychoeducation about stress reactions in the brain and body to help children understand their responses and strategies to cope with them.  She also described the ongoing work she does collaborating with teachers to come up with strategies to support students in the classroom.  Barbara describes the hope that more staff in her schools, such as teachers and administrators, adopt a trauma-informed perspective that will allow for more consistency of practice.  She hopes that teachers will have access to training in the basic neuroscience of   88 trauma and stress responses, social-emotional learning strategies, and ways to support children who are experiencing an overactive stress response in the classroom.  She also hopes for more collaboration with parents, mental health practitioners, and physicians in the community. Participant Three – Ann Ann is an elementary school counsellor working in the public-school system in British Columbia.  She has a background as a classroom teacher and a master’s degree in counselling psychology.  Ann first learned about trauma-informed practices in graduate school from one of her instructors.  She also reports a keen interest in social justice that started during her undergraduate degree.  She has since completed a significant amount of self-guided learning regarding trauma-informed practices including online coursework and readings, in addition to taking workshops on trauma and trauma-informed practices provided to her by the school.  Ann reports that trauma-informed practices help her understand that a variety of stressful and traumatic experiences impact people in an ongoing way and result in lasting reactions to those experiences.  Ann reports that trauma-informed practices help to shift perspectives from viewing students expressing problem behaviours as not “fitting the mold” to understanding that the behaviours make sense given the situations/events a student has gone through (although she states it is not necessary to have direct knowledge of the trauma to think this way).  She notes an increase in empathy and understanding for the child based on this notion.  She mentioned that she never looks at a child as being obstinate or choosing to be difficult, but rather that they are doing the best they can.  She also reports educating parents and teachers on how trauma affects a child’s development and learning.  She   89 advocates for shifts in expectations and interventions in the classroom to meet a child where they are at developmentally.  Ann has found that over time, her idea of who trauma-informed practices can support has expanded.  She also notes that it has helped her attend to how contextual factors, such as how socio-economic status and family stress, can contribute to her understanding of a student’s responses.  Ann notes that much of her work with students is non-directive and student driven.  When she does use structured interventions, the focus is on addressing how trauma is impacting the child in their emotions and body and ways they can cope with/regulate these reactions.  She indicated that she doesn’t engage in many behavioural-based interventions but rather focuses on co-regulating and educating the child on how to cope with emotions.  The focus of her work with children and their supports (e.g., parents, teachers) is to help them build a basic understanding of how stress impacts the different parts of the brain and strategies to manage these responses such as mindfulness.  She also reports giving small lessons on mental health topics to classrooms of students.  Ann highlighted the importance of trauma-informed practices across the different staff in the school.  She notes that these practices are a fairly new topic of conversation in her schools and that she is hoping that these conversations will increase.  She encourages educators to build attuned connections with their students and advocates for the benefit that these connections have for students.  She also discussed the value of building communities of wrap-around support for children that include all the different school-based personnel that interacts with the students including the administrators, teachers, educational assistants, counsellors, youth and family workers, and even the custodial staff and volunteers.      90 Ann described hopes for additional levels of support for students who are struggling with mental health concerns and/or the impacts of trauma.  Specific ideas include collaborative efforts with community agencies and classrooms that are more equipped to support the education of children who have experienced trauma.  She also states a hope for a more consistent presence of mental health supports in the school and clearer role definition for counselling professionals.  Overall, she sees an opportunity for school professionals to work together as teams to create a community of support and trauma-informed schools.  However, she mentioned that there has not been common training provided across professionals in schools.  She notes that different levels of knowledge about the approach exist across her schools.  She hopes for an increase in district-wide training in trauma-informed practices and more opportunities for the professionals to collaborate in their support provided to students.  She also hopes for an increase in collaboration amongst the school and community professionals, including having community professionals such as clinical counsellors and social workers based in the schools.  Participant Four – Diana  Diana is a district-level consultant in the public-school system in British Columbia.  She has a background as a classroom teacher and a master’s degree in counselling psychology.  Diana first learned about trauma-informed practices in her first year working as a counsellor through a speaker from a local health authority that came to speak to the staff at her school.  She also noted learning through a counsellor colleague who was advocating for trauma-informed practices and shared resources, such as the movie Paper Tigers with her.  She has also attended multiple trainings and workshops within her school and in the   91 professional community and engaged in different self-guided learning efforts to bolster her knowledge.  Diana described trauma-informed practices as an understanding that traumatic experiences or toxic stress can have an impact on brain development and subsequently, the functioning, behaviour, and learning of students.  She notes in having this understanding, the school can develop ways to meet the needs of students who have experienced trauma and other stressful/adverse experiences leading to behavioural or social-emotional challenges in the classroom.  She also highlighted the importance of creating safety in the school environment and connected relationships between school staff and students.  At the same time, Diana highlighted the importance of the school maintaining expectations and boundaries for the students.  Diana described multiple efforts she engaged in to promote trauma-informed practices in schools.  She has held a book club, shared research, and has had regular collaborative conversations with school staff in school-based team meetings and one-on-one regarding how to support students and families.  She notices that trauma-informed practices are helpful for both students with identified trauma experiences, as well as for any student who is struggling or needs support.  She notes that knowing a child’s background history or having an identified trauma is not necessary to implement trauma-informed practices.  She reports that this is because the general approaches to trauma-informed practices are typically valuable regardless.  Furthermore, she reports that it is important to consider trauma-informed practices if there are staff members that seem to be struggling with past or current events in their lives.  She notes that it is important to support the staff so that they can in turn,   92 best support the students.  She reports that trauma-informed practice is a lens that can be used across the individuals involved in a school system.  Diana reports that currently, trauma-informed practice efforts seem to be happening amongst individuals or small groups of people in schools.  She hopes that school staff members are open and receptive to the ideas so that they can move towards creating trauma-informed schools.  She also states a hope that trauma-informed principles may be useful in collaboration with currently utilized strategies to support students in schools such as applied behavioural analysis strategies.  Ultimately, she hopes that in the future, trauma-informed practices are no longer necessary to talk about because they have become inherent to the work that is done in schools.  Participant Five – Jill Jill is a resource teacher working in the public-school system in British Columbia.  She has a background working in a variety of mental health and school support roles, and in special education.  She is currently completing her master’s degree in counselling psychology.  Jill was first inspired to learn about trauma-informed practices through her work in schools and group homes.  She noted that she started thinking about these processes long before her formal learning on trauma-informed practices.  She mentioned feeling a sense of pressure within schools to “fix” behaviours to facilitate students being more manageable and teachable in the classroom, which she stated did not resonate well with her.  This led her seek different ways of understanding what is causing students to struggle and so she can “meet them where they are at.”  From there, Jill engaged in readings, school-based professional development, and external workshops (e.g., in trauma neurobiology) in trauma-informed practices to learn more about ways to support her students.    93 Jill reports that her understanding of trauma-informed practices has evolved.  Overall, she describes it as an understanding that people come with experiences that have impacted them in many ways.  She further discussed a shift in perspective from looking at students’ problematic behaviours to trying to understand what is leading to those behaviours (e.g., a traumatic event, lack of skill, difficulties self-regulating).  She also describes it as an awareness that behaviour (including defiance or “acting out”) is a form of communication.  She indicates that it is important to try and understand what a student might be trying to communicate through their behaviour and what need they are trying to have met.  Jill reports that what is most important to her with regards to trauma-informed approaches is building meaningful relationships with students/clients.  She detailed that this involves building trust, acknowledging, validating, and empathizing with them.  She also notes that the relationship allows students to build coping skills and strategies, including those that foster their ability to step outside of their comfort zones.  Jill discussed the importance of taking on an advocacy role for students. She mentioned that this may involve collaborating with other staff members and sharing information that can help the staff reframe what is going on with students who are struggling.  She has found this particularly helpful in shifting her approach to writing Individual Education Plans (IEP’s) and using them as a tool to advocate for students.  Jill finds that trauma-informed practices, while initially applied to the neediest students in her school (whom she was working with), actually seem to have applicability to all students she works with.  She reports that this fits with the idea of approaching all students with respect, empathy, and validation.  She mentioned that these principles are something that school staff can be mindful of with all of their students and be considering when approaching all educating and counselling work.   94 Jill mentioned that the school boards she is employed in are in a transition phase with regards to their movement towards trauma-informed ways of working.  She named time, money, and lack of resources as barriers to fully implementing these practices.  She indicated that most of the staff she works with are increasingly discussing trauma-informed practices and making efforts to learn about and use them.  She hopes for increased access to funding, training, and resources for trauma-informed practices to continue to move the transition forward.  She also hopes for an increase in collaborative approaches to educating and supporting students in schools.  Participant Six – Mary Mary is a high school counsellor in the public-school system in British Columbia.  She has a background as a classroom teacher and has a master’s degree in counselling psychology.  Mary first learned about trauma-informed practices two years ago and at the same time, heard about the movie Paper Tigers.  She noted that this information came at a time where many of her students were disclosing traumatic experiences to her in counselling sessions and when she was noticing an overall increase in trauma in her school.  Following her initial learning, Mary engaged in multiple trauma-informed practices learning efforts including book clubs, workshops, an examination of research in the area, and considerable self-reflection.   Mary describes trauma-informed practices as creating a school environment where students feel safe and supported.  She further notes the importance of the school staff members having an understanding of trauma and how it affects behaviours and emotions.  Based on the research that she has read, she also understands that trauma has the potential to affect school performance, GPA, attendance, graduation rates, and literacy rates.  She   95 highlighted the importance of focusing on building relationships between staff and students, fostering strengths, understanding student needs, and creating choice along with clear expectations.  Mary reports that trauma-informed practices have changed the lens that she uses to approach her work.  She notes that even without having knowledge of the adverse experiences a child has gone through, these principles help her move forward in a way that helps her support, connect, and advocate for the students she works with.   Mary has been engaged in a wide variety of individual and collaborative trauma-informed practice efforts in her school and district.  She has been involved in trauma-informed working groups, developed trauma-informed alternate programs, and is continually sharing knowledge (e.g., through presentations) in her school and across her district.  She regularly provides consultation to teachers and comes up with program plans for supporting students requiring support.   She also highlighted the value of working with supportive and collaborative staff and how this had led to looking at alternates interventions such as discipline and suspension.  However, she notes that there can be challenges in collaboration if the staff do not work from a trauma-informed lens or are limited in time/resources to consider a new perspective.  Mary considers herself an advocate for her students, particularly in her work communicating with other teaching staff and school-based supports.  She notes that children who have experienced trauma still need expectations, guidelines, and accountability but in the context of caring relationships and safe spaces to excel at school.  In practice, she described ways that school schedules and structures can be adapted to meet their needs.  She notes that this model has been shown to promote the motivation and educational success of students who are struggling.     96 Going forward, Mary hopes that trauma-informed practice knowledge will continue to be shared and implemented in schools.  She imagines the value that trauma-informed practices policies at a district and Ministry of Education level could have, but also recognizes that this would be challenging to establish.  However, she does believe that the small steps will continue to add up and continue to move the implementation of these practices forward.  Participant Seven – Sarah Sarah is an alternate school counsellor working in the public-school system in British Columbia.  She has a background as a classroom teacher and has recently completed her master’s degree in counselling psychology.  Sarah first learned about trauma-informed practices in her graduate program as second-hand knowledge through peers and through a professor who discussed it in one of her counselling courses.  From there, she has engaged in self-guided learning through reading books on trauma theory, online courses, and listening to podcasts on trauma/trauma therapy.  She also indicated that she hopes to attend trauma therapy and trauma-informed practice workshops in the community in the future.  Sarah notes that the more she has learned, the more she has been able to identify areas where she would like to continue to grow her skills and competencies in supporting students who have experienced trauma.  Sarah describes trauma-informed practices as an understanding that people (including her students) come with histories that may have involved difficulties including traumatic events and complex traumatic experiences.  She also notes that focusing on dealing with or trying to “fix” behaviours in isolation without attending to the underlying issues that may be contributing to behaviours can be unhelpful and potentially, even harmful.  She emphasizes the importance of looking at the child as a whole and beyond just their behaviours and   97 academic engagement.  She stresses increasing a sense of safety and sense of self for the students both in the counselling space and in schools in general.   Sarah also highlights the importance of focusing on attachment and discusses the healing effect that relationships with adults in the school can have on children who have experienced attachment disruptions.  Sarah reports that trauma-informed practices help her identify signs of trauma history or triggers may be present in her students.  Based on this knowledge, she discussed how her work focuses on building their safety and resources to cope in school.  She notes that emphasizing confidentiality (as required by ethics of the profession) and approaching her work without judgement help to support this process.  When Sarah does therapy with individuals who have experienced trauma, she notes the value of interventions that are body and emotion-focused such as exploring/naming body sensations and teaching grounding strategies.  Sarah is cautious of reprocessing trauma in schools and takes efforts not to provide intervention beyond her training or level of competency.  However, she notes that if students do open up discussions about trauma, she supports them by listening, responding empathically, providing encouragement, reinforcing their strengths, and building hope and a sense of agency.   Sarah notes that trauma-informed practices have not been a significant focus in former districts that she worked in.  She discussed the value a trauma-informed practices lens could have had in her previous work with students and amongst her colleagues.  However, she recognizes that trauma-informed practices are an emerging practice and increasingly used buzzword in the field of counselling and education.  She stresses the importance of those who are using trauma-informed practices to strive to be continually learning and striving for comprehensive knowledge in the area.  Going forward, Sarah shared the hope to continue to   98 increase her knowledge through training and implementation efforts in trauma-informed practices.  She also expressed the hope that the school system will strive to put better structures in place to support trauma-informed practice implementation efforts and collaboration across school professionals.  Ideas she shared were an increase in time available to students for counselling and a reconsideration of possibilities for adaptations to education plans for students who have been impacted by trauma.  She also shared a hope for increasing the focus on understanding cross-cultural and socio-economic factors that are contributing to the trauma and/or adversities that students may be experiencing.      99 Part II: Composite Narrative  Composite Narrative – Jane The following is a narrative that was constructed based on the stories of the seven research participants from the present study.  It is an amalgamation of their experiences, rather than an outline of one individual participant’s story.  The purpose of the composite narrative is to introduce the reader to the themes present across the participants’ narrative accounts (discussed in the next section).  As the themes have an inherent chronological nature (i.e., move from past, present through future) and as the focus in narrative inquiry is on the story, this introduction is presented in a storied form.  Please note that the name is a pseudonym and the story has been constructed without the use of identifying information.  Jane is a school counsellor from the Lower Mainland of British Columbia.  She has a background as a classroom teacher and later went to graduate school to obtain her master’s degree in counselling psychology.  She is now working as a school counsellor in a local school district where many of the students she works with seem to be impacted by traumatic experiences and ongoing life stress.   Jane gained basic knowledge of trauma theory and interventions in graduate school, but it was not a heavy focus of her program.  Over the last few years, she noticed discussions around trauma-informed practices emerge amongst her counsellor colleagues and in “pockets” with the other staff at her school.  Her district offered a workshop in trauma-informed practices on a professional day, which she attended with several of her colleagues.  She noticed that the workshop was well attended, and the ideas seemed to genuinely resonate with Jane and her colleagues.  However, she did find that the information presented in the workshop focused more on fundamental knowledge rather than specific trauma-informed   100 skills.  She was left wondering “where do we go next?” with regards to putting these ideas into practice in her school.  Subsequent to her early learning about trauma-informed practices, Jane has been actively engaged in efforts to bolster her knowledge and skills in this area.  She has been attending trainings offered within and outside of her district.  She has particularly appreciated training in models of care for complex trauma and training in creative and experiential therapies for supporting children who have experienced trauma.  Jane has also engaged in a self-guided learning process by exploring books, research, and other resources concerning trauma-informed practices.   Jane has found knowledge about trauma and trauma-informed practices to be very valuable in guiding how she works with students.  She notes that this knowledge serves as a “trauma lens” that helps her gain a better understanding of her students and what may be contributing to the concerns they are experiencing at and outside of school.  It helps her to see the “whole person” and not just their problems and/or unhelpful behaviours.  She notes that this knowledge also makes her more compassionate, empathic, and intentional in the support and intervention she provides.   Jane chooses trauma-informed approaches to provide counselling support to her students.  As her trauma knowledge increases, she finds herself shifting away from more behavioural approaches to therapy (e.g., cognitive behavioural therapy) to more body/emotional awareness and regulation therapies (e.g. mindfulness, grounding) and creative therapies (e.g., play therapy, art therapy).  Jane has also engaged in some basic training in specific trauma therapies and uses many of the principles and strategies in her approach.  However, she is cautious about engaging in trauma reprocessing therapy in school.  This is due to concerns regarding the appropriateness of doing this work in a school   101 context and due to her desire to gain more training/skill in trauma reprocessing therapy before considering bringing it into her work in schools.  Jane has noticed that trauma-informed practice is a gradually developing movement in her school and across her district.  While most of her colleagues seem to be on-board with the ideas and approaches that trauma-informed practices offer, many are new to the framework and have had little exposure to trauma-related concepts.  Given her interest in this framework, Jane has made several efforts to share her knowledge with her colleagues and advocate for trauma-informed practices across the system.  She has shared summaries of the ideas learned in her trainings and learning efforts in staff and school-based team meetings.  She has also had many one-on-one conversations and consultations with her teacher and support staff colleagues regarding trauma-informed strategies for supporting students in the classroom.  Overall, she feels that the ideas regarding trauma-informed practices are well-received and supported by her colleagues and administrators.  However, due to the emphasis on curriculum, competing demands, and/or experiences of stress and overwhelm in managing challenging student concerns, she is noticing that putting the ideas into practice is a slow-moving process in her school.  Nonetheless, she has noticed some positive changes in the way that she and her colleagues are supporting students through prioritizing relationships, intentionally creating safe spaces in the classrooms and across the school, and in the less-punitive approaches the school is now taking when disciplining students.  Jane has many hopes for where she would how she would like to see trauma-informed practices continue to grow in her district and across schools in general.  She has noticed how beneficial these ideas and approaches have been in her direct work with students, as she is now able to recognize the signs and symptoms of trauma in her students and come up with   102 ideas regarding how to support them in counselling and the classroom.  Based on these benefits that she has seen in her school thus far, she is hoping that her school and district administrators will prioritize (and fund) training and initiatives for the school counselling staff, and the other professionals working in her school.  Preferably, she would like to see trauma-informed practices be an approach that the entire school is knowledgeable in so that the system work can together to create a trauma-informed school.  She also believes that the development of resources, policies, and guidelines by district and ideally, from the Ministry of Education, would be very helpful in establishing system-wide buy-in for trauma-informed practices.  She also hopes that trauma-informed practices will support the establishment of greater clarity as to her roles and responsibilities as a school counsellor, and potentially lead to some shifts in her role so that she has the opportunity to optimize the support that she can provide to students.  Overall, Jane hopes that trauma-informed practices will continue to support and promote wellness for the students and staff across her school and district.       103 Part III: Key Themes Each of the seven participants in the present study had a unique and multi-layered story to tell regarding their experiences of using trauma-informed practices in their schools.  However, the were many commonalities across the participants’ accounts of their experiences and subsequently, the codes that were identified in the thematic content analysis of the participants’ narratives.  Six key themes were formed that represent various common experiences apparent across the accounts of the seven participants.  Each theme includes contribution from each of the seven participants.  Participant quotes will be shared throughout the description of each theme to highlight the story told throughout the themes.  The quotes are not attached to participant names/pseudonyms as the goal of the themes is to share the collective narrative of the participants.  The six themes are: (a) Defining Trauma-Informed Practices, (b) Experiences in Training and Learning About Trauma-Informed Practices, (c) Trauma-Informed Practices: A Movement, (d) Engaging in Trauma-Informed Work in Schools, (e) How Trauma-Informed Practices Support, and (f) The Future of Trauma-Informed Practices.   Theme 1: Defining Trauma-Informed Practices Definitions of trauma-informed practices included the participants’ explicit and implicit personal conceptualizations of the scope and meaning of trauma-informed practices.  These definitions emerged in response to the interview probes: “What is your understanding of trauma-informed practices and what would this would mean for your approach to school counselling?”, as well as through other explorations of the participants’ stories that arose throughout the interviews.  The interview probes led to a number of the participants explicitly expressing “that’s an interesting question” (i.e., that they had not been asked this   104 question previously) or taking a notable pause to consider the specifics of “What does this [trauma-informed practices] mean to me?”  However, as participants pondered this question, two core components of the definition of trauma-informed practices were identified:  (a) Understanding Through A Trauma Lens and (b) Putting Understanding into Practice.  Understanding through a trauma lens.  Trauma-informed practices were generally defined as a shift in perspective with regards to understanding and supporting students in schools.  This shift specifically focused on a change from seeing children as problematic and struggling to “doing the best they can”.  A theme that emerged was participants explicitly or implicitly labelling their trauma-informed perspective as being a “trauma lens.”  This lens was described as offering a way of understanding trauma’s impacts on the brain and the body, as well as the connection of trauma/adverse life experiences to mental wellness and expressed behaviours.  It was explained as allowing one to “see the person” and “look at the whole person,” rather than focusing simply on a student’s struggles or problems.  One participant stated, “the person is not just their addiction, they’re not just their bad behaviour in the classroom, there’s more to them.”  This lens was described as trans-theoretical and characterized by factors such as empathy, compassion, consistency, and a focus on strengths/assets.  The trauma lens was also described as a “shift” in understanding and approaching behaviour; a transition from focusing on behaviour at a surface-level to understanding what life circumstances, stressors, and/or trauma reactions might be leading to the behaviour in the first place.  In particular, this perspective shift helped participants gain a better understanding of the role that factors such as social-economic status, family systems, intergenerational trauma, and addictions may be playing in students’ experiences.  They indicated that these   105 factors contributed to an understanding that trauma symptoms such as dissociation, fear, and overwhelming emotions may be “a communication of their trauma” and potentially, at the root of a student’s challenging behaviours in the classroom (i.e., rather than defiance or malintent).  As one participant detailed:  All behaviour is communication and being trauma-informed means that I understand and I continue to try and gain understanding about how adverse childhood experiences affect brain development. And [with] the little people that I’m working with, the behaviours aren’t willful behaviours, you know, just for the sake of annoying the adults. The shift to a trauma lens was also described as leading to less “blaming,” less “judgement,” greater “compassion,” and generally, being “more supportive” towards the child.  It was reported to help school counsellors understand the nature of adverse childhood experiences and how they can affect the current and future mental health and academic outcomes for a child.  For example, one participant stated:  We invest in attachment, we give time and space; we understand when days are bad that those are just, bad days right? And we just accept and just do our best and not punish or say, “What’s wrong with you?”    Putting knowledge into practice.  Having a trauma-informed lens was described as a different, “more intentional” approach to guide what the participants described as the “practice” component of trauma-informed practices.  One participant noted that “it feels much more that we know where we’re going and why we’re doing the things we’re doing, what’s our intention, what do we want to get out of it.”  Knowledge of trauma and its impact was emphasized as vital for the practice component of trauma-informed practices.  However,   106 participants suggested that knowledge of a student’s trauma history or adverse childhood experiences was not always necessary to provide trauma-informed care.  One reason provided by participants to support this notion was that trauma-informed practice philosophies generally seemed supportive and applicable across student populations.  One participant stated, “anybody can benefit, whether there’s a trauma history or not, hopefully becoming best-practice to use those strategies with everyone!”  Furthermore, participants detailed that the trauma-informed practices paradigm seems to move away from a “one-size-fits-all”’ approach to education and counselling.  One participant stated, “we don’t have to treat every single child the same,” thus, different levels of support can be provided to meet the unique needs of the students across schools.  Participants also indicated that putting trauma knowledge into practice has expanded their perspectives of what situations/circumstances trauma encompasses and what the signs of posttraumatic stress look like.  One participant shared that “it’s a larger population than I would have very initially have expected, maybe there’s a standard of what counted as trauma initially. And now I don’t think that at all.”  A theme that came up was participants indicating that frightening, but non-life-threatening situations and/or chronic stress situations can potentially be traumatic for a child and lead to posttraumatic stress reactions.  One participant stated that: It can be small “t” trauma, right?  It can be because I’ve worked with some kids where their “quote-on-quote” traumatic experiences would not necessarily be defined from an adult point of view as a traumatic experience but in their response to it, the “quote-on-quote” behaviour or what comes out of it certainly speaks to a traumatic experience.    107 One participant shared the story of a young student presenting with symptoms that were initially construed as being separation anxiety (e.g., difficulty separating from the parent at the beginning of the day, stomach aches, tearfulness).  Later in the year, the participant described learning that the student’s reaction was triggered by an earlier frightening encounter with a boisterous stranger while on a family outing.  This participant described trauma-informed practices as something that can be useful in describing experiences that are not objectively life-threatening but still experienced as traumatic based on the child’s sense of threat to the physical and emotional safety of themselves and/or their family.  The participant described how this information helped them to consider that: Maybe now [they’re] imagining, “oh no at school, even though it is a safe place what if something happens.”  It wasn’t predictable, so “what if somebody comes into the  school . . . I just had this experience, what if in school, that could happen? Somebody comes into my classroom that is big and loud and scary, and mom is not there to protect me.” Finally, participants discussed the importance of attending to socio-economic and multicultural factors in their approach to putting trauma-informed knowledge into practice.  One participant noted that poverty and other socio-economic factors seemed to be highly correlated with trauma signs and symptoms.  Another participant discussed the importance of attending to the unique needs of refugee students in schools, stating “I worked with a lot of refugees when I was in my other schools so understanding their experiences, understanding that they may come in with a history and a whole host of experiences that are different than our own.”  Overall, culture and diversity were emphasized as valuable factors to consider when approaching work using a trauma-informed approach.    108 Theme 2: Experiences in Training and Learning About Trauma-Informed Practices Various experiences with training and learning about trauma-informed practices were discussed by all participants throughout the interviews and in response to interview prompts explicitly exploring their learning journey.  Trauma-informed learning experiences were multi-faceted for all participants, involving a combination of in-service workshops, formal training, and/or self-guided learning.  Participants spoke not only of their early learning experiences but also about the ongoing processes they were engaged in to gain knowledge and skills.  Furthermore, most participants spoke about a desire to translate their knowledge into practice either by applying it to their practice or through sharing the knowledge with their school staff.  The following key components of the trauma-informed practice learning process are discussed below: (a) Within-School Training, (b) Self-Guided Learning,  (c) External Trainings, and (d) Educating School Staff. Within-school training.  In-service and professional day workshops were discussed by participants as a component of their trauma-informed practices training and learning.  These included workshops and trainings provided by school staff and those provided by trainers and speakers from the community.  Some examples of in-service trainings discussed were trauma-informed approaches for writing Individual Education Plans (IEP’s), trauma-informed interventions, crisis prevention strategies, and general training in trauma-informed practice for schools.  There were mixed reactions about the utility of within school learning.  For some participants, within-school learning was crucial in sparking their interest in trauma-informed practices.  For other participants, the ideas, concepts, and theory conveyed in the workshops were valuable but the emphasis on trauma-informed skills or ways to put the knowledge into action felt limited.  Participants also shared having a range of knowledge of   109 trauma-informed practices going into in-service professional development trainings.  For some participants, this was the first point of contact with trauma-informed practices theory and models.  For others, in-service training came after significant trauma-informed learning had occurred and thus, they suggested that these trainings did not necessarily present anything novel to their current framework. Self-guided learning.  Self-guided learning discussed by participants frequently involved activities such as reading books on trauma theory and interventions, watching movies with trauma-informed practices-related content, and reading trauma and trauma-informed practices research.  All of the participants discussed doing some degree of self-guided learning independently and there were also instances shared of group-based self-guided learning (e.g., through book/movie clubs and collaborative groups).  Examples of research sources the participants discussed included the ACEs (Adverse Childhood Experiences) Study by Felitti, et al. (1998), trauma-informed practices research, neuropsychology research, and PTSD research as playing an important role in informing their practice.  Books were also discussed as being influential to early and ongoing learning.  Books mentioned in the interviews included van der Kolk (2014) The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma,  Levine (1997) Waking the Tiger: Healing Trauma, Perry & Szalavitz (2017) The Boy who was Raised as a Dog: And Other Stories from a Child Psychiatrist's Notebook-What Traumatized Children Can Teach Us About Loss, Love, and Healing, and Gomez (2019) Stories and Storytellers: The Thinking Mind, the Heart, and the Body.  The movie Paper Tigers (Redford & Pritzker, 2016) was also mentioned a useful tool for both individual learnings and for learning alongside the school-based team.  The National Institute for the Clinical Application of Behavioural Medicine   110 (NICBAM) online resources, videos, and trauma training was also cited by two participants as being a useful resource.  Additionally, a Canadian podcast called Other People’s Problems (Martinson & Rosevere, 2018), which focuses on live therapy sessions with therapist Hillary McBride, was indicated to be valuable for learning about trauma-informed approaches in action.  The self-guided learning process was discussed as important not only to participants’ initial trauma-informed practices knowledge-building but rather a process that is vital to their ongoing professional development as counselling professionals.  As one participant stated: “I think it’s important to stay current... and I think people do that, if you’re in this, you’re interested in that work, so, people are staying current right?”  External trainings.  Participants spoke about finding value in various trauma-informed practices learning opportunities and trainings provided through their post-secondary education and various organizations and resources in the community.  For two participants, their acquisition of trauma-informed knowledge began during their undergraduate degrees, and for another three participants, their interest and knowledge of trauma-informed practices emerged in their counsellor training programs.  Within these educational experiences, participants named their professors, clinical supervisors, and classmates as influential in sharing trauma-informed practices knowledge.  Community workshops were discussed as being a valuable part of their learning.  Influential workshops/speakers discussed by participants included Kim Barthel (trauma-informed practices), P.J. Lewis (trauma), Dr. Bruce Perry (childhood trauma), Dr. Yulita (trauma-informed practices), Dr. Vanessa LaPointe (parenting), Dr. Madeleine De Little (Satir Therapy in the Sand Tray), Ana Gomez (EMDR) and the Complex Trauma Resources Team (Complex Care and Intervention Program, Geddes et al, 2014).  Two participants   111 spoke at length about workshops that focused on art, play, and sand tray therapies to support students who have experienced trauma.  Another participant spoke about the potential value of child focused EMDR for supporting trauma reprocessing and stated that there were many aspects of the training that have been highly applicable to supporting students who experienced trauma.  However, participants who were trained or interested in being trained in trauma reprocessing therapies such as EMDR, a caution was mentioned for engaging in the full scope of trauma reprocessing treatments in the school setting.  The cautions stated were that the trainings were valuable but not sufficient alone to provide competency in engaging in trauma reprocessing work (i.e., further training would be required for competency to practice) and that the school environment is limited by factors such as time and availability of appropriate space in which to engage in the therapy(s).  Educating school staff.  Participants’ experiences with trauma-informed practices learning did not necessarily end with their learning but rather, it commonly translated to efforts to spread their trauma-informed practices knowledge to their fellow school professionals, both at a school-level and at a district level.  Participants discussed taking on the role of promoting and even “pushing” for the more trauma-informed knowledge and approaches in schools.  This trauma-informed knowledge dissemination took the form of formal and informal education offerings.  There were instances of previous or planned future professional development discussed including presentations for school staff delivered during their collaborative time, staff meetings, or on non-instructional professional development days.  One participant mentioned delivering presentations to specific groups of the school staff (e.g., child and youth care workers, educational assistants) and for district professional days.  Informal education discussed by participants included initiatives such as book clubs,   112 trauma-informed movie viewing groups (e.g., of the movie Paper Tigers), and one-on-one conversations with teachers sharing support strategies and providing trauma psychoeducation.  Overall, the participants mentioned many ways that they were exploring flexible and creative ways to share information with school staff, for example:  [I] find the things that would be appealing to others, in a way that’s understandable to others but also like okay, this isn’t going to take me three hours to delve through, I can get pieces. In particular, I guess the most recent part has been “is there a way to share some of this in a staff meeting over time as opposed to having people have to commit hours of time?”  So, are there 10-minute tidbits that could help to spark interest that then people could choose to delve into more to if they’re interested? Overall, the participants described school staff as being quite “receptive, open, and interested” in learning about trauma-informed practices.  As one participant stated:  I think that I would also add that the other experience has been is that when it’s shared, you know, teachers are very receptive and open to wanting to know that.  I think I’ve also felt that, you know, teachers really, really do care about their students so anything that is information that would help them, they’re open to that. Several challenges in educating school staff were also mentioned by the participants.  One challenge discussed was obtaining “buy-in” from teachers and other school staff for devoting professional development time to learning about trauma-informed practices.  Factors that impeded buy-in included limited time in the standard school day for professional development activities, competition for presentation time during non-instructional professional development days, and a perceived prioritization of curriculum-based professional development over professional development discussing mental health topics.    113 Another challenge mentioned was in encouraging teachers to use trauma-informed knowledge to shift their “practices” with regards to teaching and interacting with students.  However, this was described to be less about resistance to or lack of interest in trauma-informed practices, but rather due to teachers’ lack of time, uncertainty, or a sense of helplessness about how to move forward with supporting students.  One participant detailed, “but then I also think that what comes along with [trauma-informed practices] is some stress for teachers, ‘now what do I do, how do I change the trajectory for the student who is struggling right now?’”  Finally, one participant noted that many school staff may be contending with their own adverse life experiences and stressors or may be experiencing vicarious trauma from supporting challenging students and/or students impacted by trauma.  Thus, the stress associated with this may also make it challenging to take in new information or take on new initiatives such as trauma-informed practices.  Theme 3: Trauma-Informed Practices - A Movement  As part of their narrative interviews, all participants discussed aspects of the trauma-informed movement and how it has emerged in their schools.  Components of the movement included (a) their Pre-Trauma-Informed Practices Experiences, (b) general descriptions of the Current Trauma-Informed Practice Movement in their schools and across their districts, and (c) examples of specific Examples of Trauma-Informed Practice Initiatives using a trauma-informed approach.  Pre-trauma-informed practice experiences.  Many of the participants had been working in schools either as counsellors or as teachers before they learned about trauma-informed practices or before trauma-informed practices were introduced in their schools.  For those participants, trauma-informed practices were discussed as a recent phenomenon; one   114 participant mentioned that they noticed the movement emerge in the last three to four years in their school and another noticed it develop around two years ago.  This suggests that the timing of the trauma-informed practices movement has not only been recent but also unique to each school/district.  This notion is supported by the observation of two participants that trauma knowledge seemed to differ across districts.  They noted that some districts seemed highly engaged in trauma-informed practices, whereas other districts were limited in their engagement with trauma-informed practices or had not yet brought trauma-informed practices into their conversations at all.  Another pre-trauma-informed practice observation discussed was the role expectations that their school staff had for them prior to the introduction of trauma-informed practices.  One predominant pre-trauma-informed practice expectation that participants discussed was that a school counsellor’s role was to “fix” the problems that students present with at school.  They noted a sense of pressure, particularly from teachers and administrative staff, citing comments from their staff to help “make students more manageable and teachable.”  The participants also contrasted their approaches to educating and counselling before and after learning about trauma-informed practices.  For example, participants noted that signs of trauma may have been missed before using trauma-informed practices due to a lack of trauma knowledge.  Additionally, participants described situations before using trauma-informed practices where students disclosed traumatic experiences to them in counselling sessions or the classroom and they felt insufficiently resourced to support them.  There were also instances of these situations sparking interest in learning about trauma-informed practices, as a means of learning the best practices for supporting students who make trauma disclosures.    115 The current movement.  Participants described the trauma-informed movement as being in its “infancy phase” and a “transition phase” from pre-trauma-informed practices (e.g., more behaviour-focused practices) to the ongoing movement forward.  One participant detailed, “There’s been a shift from more outdated ways of thinking to more newer ways of thinking, like trauma-informed practices, and I feel like we’re kind of in the middle of that transition in that way.”  Some of the indicators of the trauma-informed movement that participants noticed were an increase in conversations about trauma occurring within their schools and in the education field in general.  They also noticed an increase in trauma-informed practices trainings and workshops being offered and trauma-informed practice educational materials being distributed across their schools and districts.  Overall, the participants described their administrators, school staff, and schools/districts as being generally supportive and interested in trauma-informed practices.  Based on this, there was a consensus that the movement is expanding but is not yet widespread.  Rather, it is occurring in what one participant described as “pockets” meaning certain schools/school staff seemed to be more “informed” and on-board with trauma-informed practices than others.  Participants discussed the differences in the “levels” of trauma knowledge and understanding across staff in their school.  There was a resounding expression of surprise to discover a dearth of basic trauma knowledge and trauma-informed practice competency amongst their peers.  It was also suggested that a discrepancy in knowledge base could lead to a discord between staff with a pre-trauma-informed practice perspective or minimal trauma-informed practice understanding and those working from a fully trauma-informed approach.  One participant noted that “in an education setting, people tend to focus on the behaviour that’s problematic and is making their job as an educator   116 difficult or is making the learning for that particular individual difficult, or the friendships for that kid difficult.”  However, while it was identified that there is “work to be done” to build shared knowledge across school staff, participants did express the hope that the movement is continuing to expand and move forward.  Furthermore, as discussed in the Experiences in Training and Learning About Trauma-Informed Practices theme, there was a trend of participants being actively engaged in efforts to cultivate trauma-informed practices in their schools through educating themselves and sharing knowledge about trauma-informed practices with their colleagues and staff in their schools and districts.  Examples of trauma-informed practice initiatives.  Special school programs and initiatives were discussed as a particular place of opportunity for trauma-informed practices.  Two counsellors spoke about their work within alternative programs that were indicative of the trauma-informed movement.  The programs discussed were designed and/or delivered with an understanding that many students in the program may have been impacted by trauma.  Factors that were noted to be valuable in supporting students in these programs included having a predictable routine, flexible expectations, a focus on building relationships, and having counselling support readily available.  Two participants also spoke about the value of trauma-informed practices in general and specific learning resource classrooms.  They noted that resource classrooms can serve as a particularly valuable safe space for students to learn and self-regulate outside of the regular classroom.  They also noted that building a connection to the resource teachers and support staff seemed to be meaningful for students.  They further mentioned that collaborations between resource teachers, the regular classroom teacher, and other members of the school-based team (e.g., school counsellors and administrative staff) were vital to building a trauma-informed safe space for students.    117 Changes in approaches to discipline.  Participants discussed changes that have occurred in approaches to discipline as a result of shifting to a trauma-informed lens.  As one participant described: “As administers and school-based teams, as they become more versed in trauma-informed practices, it seems that our discipline methods are becoming less punitive and more supportive.”  Changes discussed were alternatives to suspension, more collaboration with the school counsellor when concerns arise with students, and planning/teaching strategies for the classroom (e.g., having options for students to take breaks, having a collaborative safety plan) to prevent/mitigate concerns from escalating.  However, challenges were noted with regards to the discipline change process, particularly when teachers or administrators hold what was stated by participants to be a perceived “behavioural lens” belief that students should “conform” to certain expectations of classroom conduct.  The participants also identified that many teachers have multiple high-needs students enrolled in their classes each year, which can result in stress and difficulties in managing the classroom milieu.  A further concern noted by one participant is addressing the perception from staff and other students that a student is “getting away with something” if disruptive behaviours are not addressed with discipline.  One participant described an example of a student who was approached with what they described as a behavioural lens with regards to addressing concerns arising in the classroom.  The participant detailed that the child’s behaviour (e.g. “disrespect”, “shuts[ing] down, and do[ing] no work”) was addressed by removing privileges to participate in school activities and field trips.  The participant described the difference that a trauma-informed practice knowledge added to understanding what could be contributing to the student’s behaviour, such as multiple adverse childhood experiences and intergenerational traumas.    118 They shared an example of how a trauma lens would shift their approach to addressing the behaviour by creating opportunities for the student to be included in school-based activities such as field trips and physical education rather than excluded from them.  They conveyed that: If you had a trauma-lens perhaps, you would be like, oh my gosh, we’re going get this kid on the basketball team, we’re going to get [them] on each and every field trip.  You approach it totally different.  And you would want the kid to be connected to the school instead, rather than disconnecting [them]. Overall, the participants highlighted how a trauma-informed helps them to re-consider how discipline is approached.  They suggested a shift from the consequence of problem behaviour being time out of the classroom to exploring ways that the student can still be included and connected in the classroom while the behaviour is being addressed.  Theme 4: How Trauma-Informed Practices Support the Students, the School Professionals, and the School Environment In general, trauma-informed practices were described as beneficial to the students, the school professionals, and the school environment in many ways.  Participants described several specific domains regarding how trauma-informed practices provide support including (a) Collaboration, (b) Connection and Relationship, and (c) Safety.  Collaboration.   Collaboration with school-based team was highlighted as both a benefit of trauma-informed practices and an important factor for facilitating trauma-informed practices in their schools.  Trauma-informed practices collaboration was described as a “whole school,” “community” approach that involves counselling staff, teaching staff,   119 support staff, administrators, and even custodial staff and volunteers.  One participant stated, “and I think even just, as a whole, in terms of system, I think having more practitioners, teachers, and administrators be aware of what’s going on with trauma is important.”  Examples were shared of participants taking on an “advocacy” role within the school, whether that be to advocate for trauma-informed practices in general or specific ways that the school can meet students’ specific needs using a trauma-informed approach.  Furthermore, participants detailed hypotheses regarding how the collaboration around trauma-informed practices has and could continue to benefit students, such as improved school performance, increased literacy rates and GPAs, increased school attendance, increased graduation rates, and students having a more positive overall experience of school.  Furthermore, one participant indicated that the collaboration led to them feeling less like they were “doing my work in isolation,” speaking further about the value of a team-based trauma-informed practice approach. As one participant detailed: The other strength, I think, is the team factor; there really is with trauma-informed schools.  There really is a way for the whole school community to commit [to] meeting the needs of kids and to encourage teachers that like, “yes, you are making a difference with these kids when you take time for them, when you go get them a snack when they’re hungry, when you offer them a sweater to wear because they came to school dressed inappropriately. Like, you are meeting the child’s needs and you are making a difference.” I think I like that piece. Another form of collaboration occurred between the participants and the students that they worked with.  Classroom-based collaborations involved creating plans for strategies that the student could use in the classroom if they become emotionally overwhelmed or   120 disconnected.  Counselling-based collaborations involved giving the student a say in what they discussed and worked on in counselling.  One participant detailed:  I feel like it’s more working with clients to build something together as opposed to telling them to do something.  It feels more inclusive of the individual and their needs, their desires, their limits, their boundaries.  Finally, there were instances discussed of collaborations emerging with medical/mental health professionals, organizations, and agencies in the community.  Examples were discussed of collaborations occurring between the school, local health authorities, and members of the community.  These collaborations included formal coalitions formed between various stakeholders, jointly delivered workshops and presentations, and the organization of an upcoming community conference.  The reported benefits of these collaborations included a greater sense of “partnership” across professions, more widespread knowledge and understanding of trauma, and the development of a “shared language” that could be used across professionals and organizations to help support children.  Connection and relationship.  Schools were described as a place where a sense of connection can be built through relationships with teachers, administrators, school counsellors, and support staff.  Participants discussed the value of creating an environment where students experience genuine care, support, and positive connection with the staff in the school.  The connection piece was indicated to be built in simple ways and best approached across the school environment.  Examples of connection efforts were “teachers who they stand at the door when they’re leaving, and every kid does like a high-five or a fist bump, or a head nod.  There’s like that moment of connection with the teacher,” “a principal who every morning before we go into the gym stands at the door and greets every kid as they’re   121 going in,” or an education assistant scheduling in 15 minutes of “game time” with a student who is struggling in class so that they “would know that every day [they were] getting this connection with an adult.  One participant further detailed a way that they shared pieces of their trauma-informed training/knowledge with other school staff: “[The] encouraging piece I try to offer to teachers is this idea that the brain is constantly changing and growing and there’s evidence that experiential moments of attended connection can be repairing the brain from trauma.”  Another participant speculated that for students who are lacking secure attachments at home or who have experienced trauma, the school and the relationships they form with adults in the system can act as an “alloparent” (i.e., provide the student with a secure, trusting relationship).  Thus, having a strong relationship with school staff was indicated to create space for the students to not only learn in academic skills but also to learn social-emotional and self-care skills that may be missing from their learning at home.  Furthermore, one participant shared that their students seemed to genuinely enjoy their time in counselling and that the relationship was important for facilitating their use of trauma-informed interventions.  One participant also detailed that “as educators, we can create a community where kids are constantly having these moments of attuned connection and that can be re-wiring their brains.” Safety.  Establishing a sense of safety was commonly described in association with discussions regarding how trauma-informed practices support students.  This safety was described as both external safety in the school environment and an internal sense of safety.  One way that safety was discussed was in terms of how the teaching and counselling spaces were set up.  Participants indicated that trauma-informed practices influenced the creation of   122 calming, regulative, and “supportive” environments in the school by reducing stimulation (e.g., lighting, room décor), being mindful of seating configurations, and creating safe spaces in the room that students can go to if they are feeling overwhelmed.  Another aspect of safety the participants discussed was the value of confidentiality in supporting students who have experienced trauma.  It was detailed that confidentiality allows students space where they can safely discuss their experiences with the knowledge that they will not be shared with others (unless information sharing is requested by the student or necessary due to safety concerns).  Finally, participants noted that trauma-informed practices created the conditions for students to build an “internal sense of safety” and a “sense of self."  This was described as occurring through efforts to support students in building strategies to recognize their feelings, understand their internal experiences, regulate their feelings, and establish safe connections with their peers and the adults within the school.  As one participant stated: You know, we work in school and we want school to be a place where kids can, where their alarm system can maybe be less triggered.  And the only way that it’s going to be less triggered is if they know that they’re safe, right?  It all comes down to that safety and being connected.  So hopefully, they’re connected to their teacher and hopefully, they’re connected first and foremost to their family, but if they can’t be, maybe the school can provide some of those connections that they need to develop that resilience. Theme 5: Engaging in Trauma-Informed Work in Schools An important component of participants’ stories was sharing their experiences engaging in the practical component of trauma-informed practices in school.  Discussions of their trauma-informed practice work emerged throughout the interviews and in responses to   123 the interview prompt “How do you use trauma-informed practices in your school presently?”, including various aspects of (a) Trauma-Informed Educating and (b) Trauma-Informed Counselling.  Trauma-informed educating.  Participants detailed that trauma-informed practices involved a shift in one’s approach to case management and educating students.  They spoke about their experiences using a trauma-informed lens to assist in case management, in creating support plans, and in developing Individual Education Plans (IEPs).  Trauma-informed practices were indicated to be beneficial in shifting and prioritizing social-emotional and wellness goals for students (versus behavioural goals).  One participant detailed that “whenever we’re creating a plan or talking about it at a school-based team [meeting], it’s just kind of always talking about trauma-informed practice, talking about the impacts and then helping to create a plan that aligns with that understanding.”   Case management responsibilities were also discussed as a common challenge.  For a few participants, it felt like a competing or “dual” role when paired with the school counsellor’s therapeutic role.  Case management was described as taking up a significant portion of participants’ time and required that they take on the role of a mediator (and at times, a disciplinarian) when problems arose for students in the classroom.  Furthermore, for some, the case manager role occasionally led to ruptures in their relationships with their students, due to these stark differences in this role to their counselling work.   Concerning educating, participants emphasized the importance of the school’s overarching goal of providing a sound education to students and discussed using a trauma-informed approach to support this goal.  One participant described a trauma-informed approach to education as being:    124 A bottom-up approach where we look at the child’s needs and then we’re thinking about things like, how can they get breaks if they need them? Do they need to know what’s going to be happening next, like the shape of the day? This was detailed as allowing teachers to meet students’ basics needs for safety and connection (as detailed in the How Trauma-Informed Practices Support theme), as well as their needs for learning.  One participant shared their observations of the benefits of an educational approach that is trauma-informed and that prioritizes relationship:  You know, I ask so many who students come in and out of here all day, just to hang out at lunch and whatnot, and they will say “I can’t wait to go to so-and-so’s class,” versus dreading going to other teacher’s class and I know, I can see that the teachers that they’re excited to go to class to are the ones who are trauma-informed and who know how important the relationship is. Challenges were identified in supporting the learning processes of students, particularly in situations where multiple students are struggling in the classroom at the same time and when the teachers are potentially feeling “overwhelmed” in managing their students’ concerns.  Other challenges that the participants noted were educators continuing to use a behavioural lens to understand trauma-based learning challenges or misconstruing trauma impacts as being a disability in a student’s overall learning capacity.  They detailed that this could lead to a student being misunderstood or to providing interventions that do not sufficiently address the concerns contributing to a student struggling in class.  Trauma-informed counselling.  A common discussion with the participants was how trauma-informed practices influenced their approaches to school counselling.  Key aspects of the counselling work discussed were the counselling approaches used (and   125 avoided) and the importance of the advocacy role of the counsellor in providing trauma-informed care.  Counselling approaches.  With regards to the therapeutic approach, there was a focus on relationships and the prioritization of using client-centred, strengths-focused approaches.  There was a prevalent discussion of shifts that occurred in approach to counselling. For example, a shift from primarily utilizing cognitive, behavioural, and directive approaches.  One participant stated, “I have no expectation, it’s non-directive, they choose the majority of the time, probably 80% of the time, they choose how to use that time together.”  Other examples of approaches used included sand tray, expressive art, and play therapies.  These were highlighted as particularly valuable in supporting students who have difficulties articulating their experiences.  They noted that these therapies offer a safe and “contained” way for students to explore and express their “inner world,” without placing specific expectations on the student for what they have to verbalize in therapy. Another discussion on counselling approaches identified trauma-informed school counselling work as being “stabilization work,” which was described as focusing on normalizing emotions, basic psychoeducation on stress responses (e.g., “I typically do a little brain lesson with them so that they have an understanding [of] the amygdala and why the body is responding the way it does”), co-regulating (i.e., supporting the child with in-the-moment emotion naming and regulation), and teaching positive coping strategies such as mindfulness, relaxation, and grounding.  Cautions and/or perceived limitations in their ability to do intensive trauma-focused therapy or “reprocessing work” in schools were discussed.  This was due to factors such as limited time available in their week to meet with students, lack of perceived competence in conducting reprocessing therapies, and perceived   126 inappropriateness of doing reprocessing work in the school environment.  One participant detailed that:  In school, it’s tough because you do a lot of stabilization and you don’t do a lot of processing because the setting just doesn’t afford you that opportunity.  And it’s not okay to bring all of that stuff up and then send them back to class.  However, participants with training in trauma-specific therapies did emphasize that they were still valuable in helping them to conceptualize their students’ presenting concerns and offered many ideas/strategies that could be used or be modified for use in the school context.  For example, there were discussions regarding how the principles of somatic therapies such as somatic experiencing and EMDR can be beneficial for their case conceptualization and selection of skill-building activities (even if they are not delivering the treatment itself). The advocacy role.  Participants spoke about being a bridge between the student, their teachers, their family/caregivers, and/or the community.  With the teachers, participants mentioned taking on an advocacy role for the student by sharing information (if requested by the student), by educating teachers on strategies for working with students who are struggling, and generally, through encouraging teachers to use a trauma-informed lens when working with students.  Liaising with the family was reported to involve factors such as getting a detailed family and developmental history whenever possible, providing psychoeducation to the family about trauma and its impacts, offering the family support in the school, and/or connecting the family to resources in the community.  With regard to connecting with the community, most participants strongly emphasized the value of their role in connecting students to resources in the community such as Child and Youth Mental Health, non-profit organizations, and private practice therapists.    127 Theme 6: The Future of Trauma-Informed Practices The final theme discusses the participants’ continued story of working with trauma-informed practices in their schools including their hopes and plans for their students, for their professional practices, their schools/districts, and trauma-informed practices in general.  Participants spoke about these hopes throughout the interview as they shared various aspects of their journeys using trauma-informed practices.  Additionally, all participants were asked at the end of the interview: “What are your hopes for using trauma-informed practices in your school going forward?” and “What resources might you need or continue to use trauma-informed practices in the future?”  Key futures pieces regarding the future of trauma-informed practices that were identified included: (a) Being Informed, (b) Hopes for the role, (c) Collaboration, (d) Students Clients, and (e) Resources. Being informed.  Trauma-informed practices were discussed by the participants as being a “work-in-progress” in their schools.  Thus, there was a widespread hope that the learning and “informing” process continue for their professional practice, the school staff, and the larger community.  Common hopes were that trauma-informed practice knowledge would bolster their school staff’s awareness of and self-care around their vicarious trauma responses, which may emerge based on personal adverse life experiences and/or through experiencing secondary trauma as a result of supporting students who have experienced trauma.  There were expressed desires to see specific training in trauma-informed practices become a wide-spread requirement for school counsellors, educators, administrators, and staff across their districts to support the development of trauma-informed schools.  Another participant reported a hope to see the Ministry of Education become involved in promoting wide-spread standardization of trauma-informed practices education.  This was depicted as   128 involving trauma-informed educational materials being designed and distributed by the Ministry of Education to educate school professionals – “I think having some literature out there that’s like, B.C. Ministry of Education-stamped so people know where it’s coming from, and that it’s endorsed and that there’s research behind it, I think that those would be valuable resources.”  Additional expressed hopes were that trauma knowledge and research, such as from the ACE study and neuroscience literature, would become a part of educational policies and practices at the district and at the provincial level, as well as spread to the general public.  Finally, one participant shared a hope that trauma-informed knowledge becomes so pervasive that it is “something that’s not talked about eventually because it’s just done.” Hopes for the role.  Participants expressed hopes regarding how the school counsellor roles and responsibilities would transform to best support trauma-informed practices.  Suggestions offered included expanding the number of supports available for students, by hiring more staff in both the classroom teaching/support team and in the counselling team.   Hopes were also identified for creating a greater sense of clarity and “consistency” with regards to the establishment of roles and responsibilities in their work of providing support and care to the students – “there would be fewer holes in the care that the child was receiving and more consistency.”  Establishing clarity regarding division of roles was also emphasized, including “some discussion of how to divide that up between your team at a school.  Like, what’s the counsellor responsible for, what’s the administration responsible for.  How do you both have the same goal but different roles?” With regards to the school counsellor role specifically, participants discussed examples of specific changes that they would like to see in counsellor responsibilities such as   129 a reduction in case management duties, the ability to have longer sessions with students, and shifts to information sharing policies amongst school staff.  Concerning case management, it was suggested that the lessening or eliminating of this responsibility for school counsellors would free up more space for providing trauma-informed therapeutic support and reduce role conflict between administrative and therapeutic work.  With regards to therapeutic support, there was an expressed desire to have longer and more frequent sessions with students in need, particularly with students impacted by trauma.  In terms of confidentiality, there was a reported need for more ways to communicate the severity of a child’s adverse experiences without having to break confidentiality or require disclosure of the trauma by the child across their school-based team.  Finally, there were some instances where participants expressed a desire to engage in some additional work in private practice.  One reason for this was to allow more opportunities to fully engage in trauma-informed practices by setting up the physical space in a trauma-informed way and through using trauma-informed treatment interventions, such as trauma reprocessing therapies.  Another reported motivator for engaging in private practice work was to allow for greater space to work with the specific goals of the child and the parents/caregivers as a component of the child’s therapy.  A further reason was a greater sense of autonomy over therapeutic work, as school counselling was indicated to frequently involve input from “more players” in the child’s care team such as administrators, teachers, and other school staff than private practice work.  Collaboration.  The participants spoke about hopes to see various forms of collaboration occur and continue in their schools, districts, and/or with the community.  Collaboration within schools referred to greater collaboration amongst the school staff   130 including regular classroom teachers, resource teachers, support staff, school counsellors, and administrators.  Trauma-informed collaborations were hypothesized to be valuable with regards to educating staff about trauma-informed support, classroom support planning, and IEP construction.  A common discussion emphasized that “buy-in” and collaboration at the district level felt vital to their work with trauma-informed practices.  For example, school and district-level administrators were identified as responsible for allocating funding, approving training and education initiatives, and assigning roles and responsibilities throughout schools.  Thus, it was suggested administrator support may serve as a “gatekeeper” to moving trauma-informed practices forward in schools and across districts.  Finally, detailed that having some consistency and collaboration on how the school and classroom environment was set-up were identified as being potentially beneficial for supporting students.  Suggestions were having a “soft-start” in the mornings across classrooms and having consistency in how the physical space is set up across classrooms.  One participant further detailed that it would be valuable for collaboration to prioritize proactive strategies to support students rather than reactive strategies to address crises, stating:  If we are more proactive and have an understanding that they are all diverse learners and have varied needs and we take that into consideration in the planning aspect, then we might not need to be as reactive because we’ve already supported teaching in executive functioning in all of the students.   Another area of collaboration highlighted involved mental health services and supports in the community.  As mentioned in the Engaging in Trauma-Informed Work in Schools theme, there was a discussion of the school counselling professionals’ role in connecting students to trauma supports and services in the community.  Going forward,   131 hopes were expressed that community collaboration would not only continue but that community supports would become more integrated into the school.  For example, one participant suggested having community-based counsellors or social workers who are “linked to the school.”  It was suggested that this could facilitate building connections between the school and the greater community, thus leading to school professionals feeling less isolated in the work that they are doing.  Another participant spoke about the desire to see integrated services for refugee students in collaboration with community settlement support workers.  This hope was based on noting the significant number of refugee children and youth who had resettled in their district area, as well as noticing the frequency of support provided by the community does not always meet the significant trauma support needs of these students.  A further suggestion was collaborating with community professionals, such as medical and mental health professionals, with regards to providing professional development workshops for school staff.  One participant noted that: “I just wish there were more messengers who may have a little more credibility, I don’t know if credibility is more, but they perk up if a doctor visits in versus if a school counsellor visits.”  Student clients.  A general hope that was expressed across participants was that the students in their schools will continue to access and find valuable support in school-based resources.  One participant described trauma-informed practices as “hopeful, because the research says that people can recover.”  Another participant detailed account of their hopes for their students as a result of school-based trauma-informed practices support: My hopes are that I provide meaningful time with students, like that our sessions together are impactful in a positive way.  I think I have an acceptance that the process is slow and I’m not looking to give a child a pep-talk and then their behaviour has   132 changed the next day . . .  I hope for deeply-rooted, transformational changes in the child’s well-being and sense of self in a positive way.  Yeah, I hope that the child develops resources to be able to have a sense of self-worth and to be able to make healthy social connections and to be able to contribute to their society. [These] would probably be the three pieces that I would hope for the child. Another shared hope for students was for trauma-impacts to be officially recognized as factors that influence learning.  One participant suggested that a trauma category be developed as an official designation that could be included in a student’s file or IEP.  It was further suggested that this could help make the school-based team aware that a student has had adverse experiences and suggested that this would facilitate: Being able to advocate for adaptations based on trauma.  Like trauma, almost like, we identify students based on needs in other areas and have categories A, B, C, D, E, F, G and into Q.  So, then you can actually have a category like “past issues” or “past something” that allows it to make a difference in these kids’ lives so that they’re a little bit more informed without breaking confidentiality or that piece. This could allow for the school-based team to provide support and provide any needed adaptation based on this categorical knowledge.   Finally, suggestions were offered for having school-based supports for students extend to their families.  Examples of this included having social workers/youth and family workers in the school available for supporting the family, holding skills/support groups for parents in schools, or having parents integrated into therapeutic support provided to a student from the school counsellor.  Another suggestion was to have the school, the family, and the community all work collaboratively together.  One participant described:   133 It would be so much more impactful if the whole family was involved in the response to trauma as opposed to just the child.  Yeah, I don’t know how but I would love to be a part of a team approach that could work with families and that could work with the community. Resources.  Various logistical resources for further trauma-informed work in schools were explored by participants when discussing their hopes for the future of trauma-informed practices.  Funding (and lack thereof) and the availability of counselling and support staff were the resources most frequently discussed by participants.  They suggested that funding would help to address gaps in available resources and services to provide trauma-informed support, particularly for children with higher support needs.  As one participant stated: “so, if we believe in trauma, and as a school district we’re talking about it, then what other programming, funding, psychologists, counsellors, what else is in place for those kids?”  Another participant suggested that school staff be asked directly what resources and information they might need to further their learning and support processes – “Even that question being asked of me is a chance for me to ask ‘hey teachers, what do you wish were available?’” Additional resources discussed were evidence-based social-emotional learning programs such as the MindUp (The Hawn Foundation, 2011), Second Step (Committee for Children, 1992), and the Zones of Regulation (Kuypers, 2011) programs.  Participants generally spoke positively about these programs and the ongoing in-service training required to deliver them in classrooms.  They expressed a desire to see the programs used regularly by teachers/support staff in a collaborative manner in schools.  For example, one participant stated: “if there are groups of people working on things there might be some more cohesion,   134 or consensus, or cohesion around consistent language or messaging even.”  Overall, the participants highlighted the importance of identifying and consistently using pre-existing programs that fit within the trauma-informed practices framework as well as specific trauma-informed programs.  These suggestions will be explored further in the discussion section below.  Summary of the Findings Through the narrative interview, the participants in the present study shared various aspects of their experiences engaging with trauma-informed practices.  Through their stories, a conceptualization of trauma-informed practices emerged that encompassed how trauma knowledge informs their work and how that knowledge can be put into practice.  The participants’ trauma-informed practices knowledge base was built through a variety of learning sources and is now translating to a practice of sharing that knowledge with their fellow school professionals.  Participants also shared the stories of how a movement towards trauma-informed practices has emerged in their schools, then described how trauma-informed practices have been beneficial to their schools/students thus far, and what working with trauma-informed practices currently looks like in their educating and/or school counselling work.  Finally, the participants shared their hopes for the trauma-informed practices movement going forward, including for their professional roles, their schools, their students, the collaborations between supports and services, and the resources needed to continue the movement forward.  These findings offer meaningful contributions to the existing literature regarding trauma-informed practices in schools as well as have potential implications for research and practice in this area.  These contributions are detailed further in the next chapter.     135 Chapter 5 Discussion and Conclusions The purpose of the present study was to obtain detailed accounts of school counselling professionals who identified using trauma-informed practices in schools.  The seven school counselling professionals who participated in the study constructed multi-layered stories of their experiences using of trauma-informed practices.  They offered a discourse on their conceptualizations of trauma-informed practices, their ongoing learning efforts, the trauma-informed practice implementation efforts they are engaging in individually and in collaboration with their school(s), and their hopes for how the practices will continue to move forward.  To the best of my knowledge, this is the only Canadian research study to investigate the current understanding and use of trauma-informed practices from the perspective of school counselling professionals, who are school stakeholders vital to this approach.  This study presents novel research findings that offer important contributions with regards to complementing and addressing gaps in the present research literature and has implications for the next steps in research and practice initiatives concerning trauma-informed practices.  The findings of the study will first be discussed in the context of the existing theoretical and empirical literature concerning childhood trauma and trauma-informed practices.  Then, the findings will be discussed in terms of its unique contributions to the research investigations of trauma-informed practices in schools and the potential directions for future research.  A discussion of practical recommendations for various trauma-informed practices stakeholders will then be discussed, including suggestions for continued efforts and initiatives in Canadian schools.  Finally, the strengths and limitations of the research will be presented.    136 Discussion of the Findings in the Context of Trauma-Informed Practices Literature  The key themes of this study Defining Trauma-Informed Practices, Experiences in Training and Learning About Trauma-Informed Practices, Trauma-Informed Practices: A Movement, Engaging in Trauma-Informed Work in Schools, How Trauma-Informed Practices Support, and the Future of Trauma-Informed Practices demonstrate consistencies and deviations from the present theory and research literature concerning school-based trauma-informed practices.  These themes are discussed with regards to (a) how they relate to the literature on childhood trauma and school-based supports for children who have been impacted by trauma, (b) existing conceptualizations and models of trauma-informed practices, and (c) the engagement with and implementation of trauma-informed practices in schools. The findings and child trauma literature.  In much of the trauma literature and the DSM-5 (APA, 2013) diagnostic criteria for posttraumatic stress disorder (PTSD), trauma is characterized by its sudden and unexpected nature, the involvement of death/threat to life or bodily integrity, and the involvement of feelings of intense terror, helplessness, or horror (Cohen et al., 2006).  Consistent with this literature, the participants in this study discussed working with many students who had experienced identified trauma(s) and symptoms of PTSD that fit with the DSM-5 diagnostic criteria and indicated that these students would benefit from trauma-informed support.   However, examples were shared of observing PTSD-like symptoms arise within students who had not necessarily experienced the involvement of death/threat to life or bodily integrity.  These students instead had experienced incident(s) of perceived (but not actual) threat of danger and/or adversities involving a significant disruption to the relationships with their key attachment figures (e.g.,   137 physical and/or emotional abuse, neglect).  While these students may not necessarily meet the criteria for a diagnosable disorder, the participants contended that their reactions to these adverse life experiences certainty warrant counselling attention and support.  The participants’ observations are consistent with the trauma concepts described by Green (1990), who suggests that children experience traumatic stressors and adverse life experiences differently depending on (a) their inherent resiliency, (b) their learned coping mechanisms, (c) their external sources of physical, emotional, social support, and (d) the processes they go through to make meaning or sense of their experience.  These observations also fit with the types of adverse experiences described in the Adverse Childhood Experiences (ACE) study, which highlights the range of adverse childhood experiences that can have significant impact on an individual’s mental health, physical health, and other life outcomes (Felitti et al., 1998).  Furthermore, Perfect, Turley, Carlson, Yohanna,, and Saint Gilles (2016) contend that there is considerable variability across the research literature regarding what is considered a traumatic event and that definitions/diagnostic categories often do not fully acknowledge the individual differences in how an individual interprets and responds to adverse life events.  Additionally, the behaviours and trauma reactions of students noted by participants in this study were similar to those mentioned in the literature such as school disengagement, low attendance, reactivity, conflict with school staff or peers, or difficulties participating in academic or social activities (Wright, 2014).   An important finding in the present study was the significant influence that trauma knowledge and awareness had on the way that participants conceptualized and approached concerns that arise with their students.  Participants indicated that trauma-informed practices shifted them away from a primary focus on using behavioural strategies (such as a reward   138 system) to address problem behaviours to using a lens informed by trauma theory to understand what adverse experiences may be contributing to students’ behaviours.  Trauma theory posits that behavioural reactions can emerge as a child’s way of seeking protection from pain and/or fear brought on by posttraumatic stress symptoms (e.g., Cohen et al., 2006; Howard, 2018).  As Ardino (2014) suggests, the behaviours that emerge in the classroom may have self-protective functions in response to the adverse experiences a child has encountered.  The participants reported that having a theoretical understanding of trauma helped them to build a greater sense of empathy and understanding of what might be prompting a student’s behaviour.  Few studies in the existing trauma-informed practices literature extensively discuss specific trauma-theories in the context of the framework or intervention they are investigating.  However, the value of having an understanding of trauma theory and using a trauma lens is emphasized in the research, particularly in the school-wide trauma-informed practices studies such as those by Kataoka et al. (2018) and Dorado et al. (2016).  Consistent with the literature, participants emphasized ways that using a trauma lens helped them understand that symptoms of posttraumatic stress may be underlying students’ behaviours.  For example, a participant shared the story of a student that they initially thought had separation difficulties due to clinging behaviours seen when their mother dropped them off at school (see page 107).  The participant noted that they later learned that it was a past frightening incident that was leading to the student’s clingy behaviours and that this was not a simple case of separation anxiety.  Without a trauma lens, this student’s behaviour may have been perceived as developmentally inappropriate and problematic.  Having an understanding of the underlying experiences that are contributing to   139 the student’s reaction allowed this participant to shift their conceptualization of the behaviour.  Contributions to conceptualizations of trauma-informed practices.  One component of the present study that is unique to most pre-existing studies is the inclusion of definitions of school-based trauma-informed practices that are explicitly conceptualized by the participants (see Theme 1).  Many published works regarding trauma-informed practice provide some description of what they involve based on common frameworks and/or the author(s) own conceptualizations.  However, the involvement of research participants in that process of defining trauma-informed practices seems to be unique to this study.  As a component of the research interviews, the participants were explicitly asked to describe their understandings of trauma-informed practices, which resulted in the construction of a shared definition that involved two key components: 1. The trauma lens - described as a shift in perspective in understanding and conceptualizing presenting concerns that arise with students.  This trauma lens is informed by trauma theory and trauma-informed practice principles.   2. Putting knowledge into practice - described as intentionally approaching and intervening with students in a way that is informed by the trauma lens.  This can involve using new approaches/interventions, changing current approaches, and/or continuing to engage in practices in a way that has been explicitly identified as trauma informed.  Knowledge can be put into practice at the level of individual professionals but is most valuable when the practice is a collaborative effort amongst school teams and/or across school districts.  Interestingly, the participants’ descriptions of trauma-informed practices had many commonalities with the existing descriptions in the literature.  Similar to the participants,   140 several authors have discussed the importance of being knowledgeable about trauma and its impacts on an individual’s functioning, as well as the importance of striving to see the “whole person” and their life context (Beidas et al., 2016; Elliot et al., 2005; Plumb et al, 2016).  When put into practice, both the participants and many authors highlight the importance of relationships, safety, using a strengths-based approach, and using a flexible, client-centred framework to support students (e.g., Brunzell et al., 2015; Elliot et al., 2005; Morgan et al., 2015).  What is unique to the definition offered by the participants in the present study are their discussions concerning how trauma-informed practices impact how they experience their roles as service providers.  Specifically, the participants detailed how trauma-informed practices allowed them to approach support with less judgement, blame, and greater compassion, which allowed them to generally feel that their work was more helpful and impactful.  Future investigation is needed to determine how the factors described by the current trauma-informed practice frameworks and those by the participants could be operationalized and tested in future empirical research.  Relationships were another factor emphasized by participants in the present study as being vital to their understanding and approaches to trauma-informed practices.  Multiple participants discussed how the connections that students form with supportive and caring adults in the school are vital to trauma-informed practice.  Specifically, participants discussed the role that connections in the school can have in building a sense of safety and security for the students, as well as a sense of stability in lives that may otherwise be quite chaotic.  Research has consistently shown that trauma can also have profound impacts on the attachment patterns of a child, particularly when important attachment figure(s) are the   141 victim or perpetrator of the trauma (Alexander, 2013; Lanius Bluhm, & Frewen, 2013; van der Kolk, Roth, Pelcovitz, Sunday, & Spinazzola, 2005).   Furthermore, a fundamental task pertinent to the early years of human life is to create a secure attachment with one’s caregiver, which is shaped by the attunement of the caregiver to the psychobiological states of the child (Ainsworth, 1971; Bowlby, 1988; Schore, 2013).  However, when that secure attachment is not consistently available at home, the literature shows that attachments with adults in the school can be a significantly helpful support (Dods, 2015).  Furthermore, many frameworks of trauma-informed practice highlight the importance of delivering interventions in the context of a relational approach that is based on empowerment and connection (Ardino, 2014; Herman 1992; Masten, 2016).  Given that all participants in the present study extensively discussed the importance of relationships between school staff (including themselves) and students, the findings support the notion that context and connection matter in schools.  Implementation of trauma-informed practices.  Similar to the overall research base on trauma-informed practices, the establishment of trauma-informed practices in the participants’ schools seemed to be in an emerging phase of development.  However, some schools and districts seemed to be more involved in trauma-informed practices initiatives than others.  Much of the research is focused on constructing trauma-informed practices guidelines or programs (e.g., Chafouleas, Johnson, Overstreet, & Santos, 2015; Howard, 2019), or on examining the implementation of trauma-informed practices in select schools and districts, rather than widespread initiatives (e.g., Dorado et al., 2016; Gelkopf & Berger, 2009; Jaycox, Kataoka, Stein, Langley, & Wong, 2012).  Overall, the movement towards integrating trauma-informed practices was considered to be in a transition phase or a work-  142 in-progress for the participants in this study.  There was a consensus amongst participants that a significant number of students in their schools seemed to be impacted by trauma and that a framework needs to be put in place to support these students.  This is consistent with the research that reports that schools can play an important role in supporting students who have experienced trauma (Brunzell et al., 2015; Dorado et al., 2016).   The participants in the present study spoke about the considerable work they were engaged in to support various aspects of learning, building skills, and sharing knowledge regarding trauma-informed practices.  The importance of training in trauma-informed practices is frequently highlighted in the research and applied literature as an important component of building trauma-informed schools and systems (Howard, 2018; McIntyre et al., 2018; Plumb et al., 2016).  However, there were notable differences between the types of training/learning described in the literature and the educational experiences described by the participants.  Both the participants and the research literature discuss the importance of offering specific professional development training (within or external to the school district) in trauma theory and trauma-informed practices either to select school staff or across the school staff (Kataoka et al., 2018; Plumb et al., 2016).  However, the participants’ discussion of what built their trauma-informed knowledge extended beyond any basic training in trauma-informed practices provided by their school.  Many of the participants stated that school-based training only provided foundational knowledge or affirmed knowledge that they already had.  All of the participants discussed integrating this knowledge with a combination of training in specific trauma interventions/frameworks and self-guided learning regarding trauma knowledge such as neuroscience research, trauma theories, and empirically validated trauma therapies.     143 Many participants indicated that they were taking on the role of educating their colleagues and fellow school staff about trauma and trauma-informed practices.  Select studies also suggest that it may be valuable to train selected school professionals to be trauma-informed practice educators so that they can take on the role of spreading knowledge concerning trauma-informed practices across the staff in their schools and/or district (Adino, 2014; Dorado et al., 2016; Howard, 2018).  It would be important to evaluate and perhaps certify this knowledge transfer to ensure that it has efficacy.  However, few studies discuss the details of what the educating process entails in as much detail as the participants discussed when describing their own experiences of educating school staff.  Furthermore, the participants in this study indicated that the role of staff educator can come with considerable challenges such as scheduling, eliciting “buy-in” from staff, and working with different levels of background knowledge regarding trauma and mental health across their staff.  These challenges are not an evident focus of the present research literature and thus, the findings here make an important contribution to the discourse on trauma-informed practices.  The empirical literature in the area of trauma-informed practices often focuses on investigating specific whole-school models or targeted interventions for specific populations of students who have been identified as having experienced trauma.  In contrast to the focus of the existing research literature, the participants in this study did not discuss using particular models of trauma-informed practices or targeted interventions specific to trauma-informed practices.  Rather, the focus of the participants seemed to be using a combination of foundational counselling skills (e.g., rapport-building, empathy) along with an accumulation of trauma-specific knowledge, skills, and resources to guide their framework for supporting students.  However, the participants did mention standardized social-emotional learning   144 (SEL) programs that could be beneficial as a component of a trauma-informed approach, which has also been highlighted in studies by Chafouleas et al. (2015) and Overstreet and Chafouleas, (2016).   Many of the participants also discussed the importance of support and collaboration from their fellow school staff and administrators for implementing trauma-informed practices.  This observation is consistent with the literature, which indicates that the successful implementation of trauma-informed supports and services benefits from a whole-school approach, which includes the active involvement of key stakeholders such as school faculty, counsellors, teachers, parents, and community agencies (Ardino, 2014; Phifer & Hull, 2016 Rivera, 2012).  The participants in this study largely described their fellow staff and administrators as supportive.  However, there was a notion that trauma-informed practices can take time to implement due to the efforts required to get support for initiatives at a school or district-level.  At a systems level, trauma-informed practice does have the potential to evoke shifts to the status quo and disruptions of systems of power.  In her discussion of trauma-informed practices with refugee students, Stewart (2014) argues that school counsellors are in a unique position to advocate for social justice within schools.  The author notes that this advocacy has the potential to evoke shifts in thinking, strategy implementation, and overall transformation of the school environment to become increasingly fair, equitable, and just.  When discussing specific interventions used to support students who have (or are suspected to have) experienced trauma, the participants emphasized that certain therapeutic approaches feel more suitable than others.  Specifically, they highlighted the value of body-based interventions (e.g., grounding, mindfulness), creative therapies, and play therapy as   145 trauma-informed ways of engaging in counselling.  This is in contrast to much of the empirical research on trauma-informed interventions, which tends to focus more on cognitive behavioural therapy-based interventions for trauma such as Trauma-Focused CBT (TF-CBT; Cohen et al., 2012), Cognitive Intervention for Trauma in Schools (CBITS; Jaycox, 2004), and Enhancing Resiliency Amongst Students Experiencing Stress (ERASE-Stress; Gelkopf & Berger, 2009).  While participants stated that cognitive-behavioural therapy and other more structured, verbal approaches to therapy can be effective in certain circumstances, several participants suggested that flexible therapies with less verbal demands offer more space for participants to safely explore their experiences so they can learn to process and regulate their emotions.  There is empirical research to support this finding in the work of Pat Ogden (2015), Stephen Porges (Porges & Dana, 2018), and Dan Siegel (2015).  Furthermore, there were cautions stated for using therapies specifically designed to treat post-traumatic stress disorder in schools.  However, many of the participants were using language from the therapies (e.g., “stabilization” and “reprocessing”) to support their understand of their student’s concerns and help them define the boundaries of the work they can/cannot do within their skillset and role (Briere & Lanktree, 2013; Shapiro, Kaslow, & Maxfield, 2007).   Implications for Future Research  The present study has implications for several pathways of future research.  Given that rich storied data that was obtained from a small group of local school counselling professionals in this study, an expansion of the study is warranted to include a greater number of school counselling professionals across a larger geographic area.  It would be beneficial to include British Columbia school districts located outside of the Lower Mainland, including more rural areas of the province, to obtain representation from school   146 counselling professionals outside of a major metropolitan area.  This would allow for a more robust perspective of trauma-informed practices across the province and may have greater implications for informing policy and practice at a Ministry of Education level.  Ultimately, the goal would be to expand the research across Canada, which would allow for comparison across the diverse provinces and territories of the country.  Much of the present research regarding trauma-informed practices focuses on investigating the empirical outcomes of interventions and programs.  There is often limited attention directed towards understanding how trauma-informed concepts and interventions fit with the culture and the context of schools and their stakeholders.  The present study investigated the experiences of one group of key stakeholders, school counselling professionals.  Another potential expansion of the present research would involve examining experiences with trauma-informed practices across the various stakeholders impacted by schools using trauma-informed practices.  These stakeholders could include regular classroom teachers, support staff (e.g. youth and family workers, educational assistants), custodial staff, administrators, students, parents, and any involved community stakeholders.  This would allow for a more comprehensive and systemic view of the constructed experiences of the individuals involved in trauma-informed practices across schools.  Furthermore, this would be consistent with select qualitative studies that have explored the implementation of trauma-informed supports and interventions using approaches such as in-depth interviews, focus groups, and case studies with key school stakeholders (e.g. Langley et al., 2013; Kataoka et al., 2018; Nadeem et al., 2011).   The participants in the present study came from four districts across the Lower Mainland of British Columbia.  According to the reports from the participants, none of the   147 schools/districts were using specific standardized models of trauma-informed practices, nor was there a consistent use of trauma-informed practices across the school districts.  This indicates that further investigation is warranted to determine whether British Columbia school districts could benefit from standardized trauma-informed practices model(s) and implementation guidelines.  Studies focused on developing formalized trauma-informed practices training and/or school support paradigms would allow further movement towards establishing best-practices for supporting students, families, and staff impacted by trauma within school districts and potentially, across the province and country.  This is further supported by an observation by Overstreet and Chafouleas (2016), who noted that research on the implementation of trauma-informed practices is crucial in exploring cost-efficient and effective strategies to support the adoption and implementation of trauma-informed approaches by schools.  Recommendations for Practice   The present study intended to provide insight regarding the experiences of using trauma-informed practices in Canadian schools and regarding what is needed for future development and implementation of trauma-informed support and resources.  This study offers an understanding of the multi-layered, dynamic experiences of working with trauma-informed practices in schools.  While the findings of the present study are not generalizable to school counselling professionals overall due to the participant group size and exploratory nature of the study, the findings point to opportunities for further examination of practices in the field of counselling psychology in general and school-based trauma-informed practices specifically.  Consistent with the design of the research, many of the recommendations in this section have been co-constructed by the researcher and the research participants based on the   148 discussions in the interviews and during the member-checking meetings to review the study findings.  The feedback of the expert peer reviewer also discussed practical suggestions for the use of the findings and these suggestions are integrated into this section.  One of the primary intended contributions of this research is to share the knowledge generated in the present study with school districts and school professionals to support continued brainstorming around ways to advance trauma-informed practices in schools.  The participants stated a need for trauma-informed practices research, such as the present study and other pertinent literature, to be made easily accessible for review by higher-level administration, school staff, and school counselling professionals.  One participant also suggested that research knowledge (whether it be from this study or others in on the topic) be made accessible to the general public through online resources and/or social media.  Recommendations for different groups of stakeholders based on the study findings will be discussed next, including school counselling professionals, educators and staff, school administrators and districts, the Ministry of Education, and the counselling psychology profession.  Recommendations for school counselling professionals, educators, and staff.  The findings of the present study indicate that school professionals and staff are currently engaged in variable but ongoing processes of learning about and implementing trauma-informed practices in their schools.  One anticipated use of the knowledge generated by this study could be to advocate for further integration of different stages of training and professional development in trauma-informed practices.  The research participants emphasized the potential value of ongoing professional development in trauma-informed practices for themselves and the staff in their schools.  One recommendation is that basic   149 trauma-informed practice training could be provided as part of the orientation program that schools/districts offer to incoming staff.  For existing school staff, it would be valuable to offer ongoing training and workshops that are easily accessible and tailored to the roles, responsibilities, and knowledge-levels of the participants.  Furthermore, it could be valuable to create/schedule opportunities for staff members to have consistent collaborative, cross-discipline conversations regarding trauma-informed practices.  For example, the participants suggested that staff meetings, collaboration days, and district-wide professional days could be potential opportunities to schedule time to engage in trauma-informed learning and collaborative conversations.  The expert peer reviewer also suggested that having a counsellor team up with a classroom to implement trauma-informed practices would allow for greater teacher buy-in and allow “others [to] learn from the process and see its benefits.”    Several participants suggested that trauma awareness can also benefit school professionals and staff in recognizing and addressing the impact of their adverse life experiences and/or their own emotional reactions to working with students who have experienced trauma.  An important aspect of trauma-informed practices is establishing support and self-care practices for the supporters (i.e., school staff and counselling professionals working with students affected by trauma).  It is recommended that schools and districts have (or continue to have) resources available such as trauma-informed practices consultants or workgroups where staff can discuss challenges experienced in supporting students and brainstorm strategies for approaching these challenges.  Furthermore, based on the findings and the recommendations of the participants, it would be valuable for schools/districts to prioritize self-care and wellness initiatives.  Of particular importance   150 would be normalizing and making professional mental wellness services (e.g., counsellors, psychologists) easily accessible and available for staff in need. Recommendations for school administrators and districts.  The participants stressed the importance of collaboration and funding from school/district administration to engage in trauma-informed practices initiatives (e.g., ongoing professional development training, program implementation).  School and district administrators were commonly identified as important gatekeepers for trauma-informed practices and stressed that support from administrators is imperative to move initiatives forward.  One recommendation, based on the study findings, is that administrators offer consistent trauma-informed practices training and learning opportunities across the school professionals and staff working in a given school and/or district.  As stated earlier, this would allow school staff to build a shared understanding of trauma and facilitate opportunities for administrators and staff to have collaborative conversations around best-practices for working with trauma.  The participants also mentioned educational material and programs that they have found beneficial or believe could contribute to their understanding and implementation of trauma-informed practices in their schools.  They suggested that having these resources readily available through district-wide trauma-informed practices resource lists or integrated into a document that summarizes the key learning points of these materials could be highly valuable in supporting the widespread sharing of knowledge. Another important recommendation based on the finding is that further investigations examine the need for the creation of policies and best-practices guidelines in trauma-informed practices that could be used across schools and districts.  This research offers definitions and descriptions of current trauma-informed practices in British Columbia that   151 represent a collaboration between the research literature and the expressed conceptualizations of school counselling professionals.  This information could be a helpful catalyst for discussions amongst school professionals regarding what being trauma-informed “means” for their schools and districts.  It may also help explore opportunities for trauma-informed shifts to school-based practices such as case management, IEP construction, and the time/space available for school counsellors to engage in trauma support and intervention.   Suggestions for the Ministry of Education.  Ultimately, these findings in conjunction with other trauma-informed practices research and literature may be valuable in suggesting the eventual development of district- or ministry-wide policies and protocols for trauma-informed practices.  These policies could be used to standardize processes such as trauma-informed classroom set-up and teaching strategies, trauma screening, and targeted trauma counselling support and intervention.  Furthermore, it was suggested by the participants that the Ministry of Education could develop standardized trauma-informed educational materials.  These could be designed for use by schools in general or be tailored to different groups of school stakeholders (including families and students).  They indicated that these materials could then be distributed across school districts and serve as a consistent resource for educating and sharing knowledge across key school stakeholders regarding trauma-informed practices.  Recommendations for community professionals.  The study findings suggest recommendations relevant counselling and mental health professionals working with children and youth across schools and the community.  The findings emphasize the importance of trauma-informed approaches collaborating across systems and services working with trauma-affected individuals.  This would allow children and youth to potentially experience   152 consistent, wrap-around care from all of the professionals in their support team and throughout their community.  Furthermore, many counselling and mental health professionals have established expertise in working with trauma, trauma-informed practices, and/or in working with populations of students that are particularly vulnerable to experiencing trauma (e.g., refugee children, children in the foster care system, children living in impoverished or violence-affected neighbourhoods).  As most participants in this study mentioned finding value in workshops and trainings facilitated by professionals with trauma-informed practices expertise both internal and external to their schools/districts, there appears to be an opportunity for schools, community agencies, health care, and/or private practice practitioners to build collaborations with regards to training, intervention, and other support efforts concerning trauma-informed practices. Suggestions for counsellor and teacher training programs.  Many of the skills and strategies described by the participants as being valuable to trauma-informed practices were foundational relationship-building skills and knowledge of trauma theory and practice.  While some attention may be paid to trauma as a component of coursework and/or discussions in training programs, multiple participants suggested that explicit training in trauma-informed practices in their teacher and counsellor training programs was limited.  Several participants suggested that trauma-informed practices training be included (or continue to be included) as part of the pre-service curriculum for teacher and counselling professional training programs offered at post-secondary educational institutions.  Given that participants emphasized the importance of both knowledge and skills in this area, it would be valuable for training in trauma-informed practices to consider not only building trauma knowledge but also a focus on how to apply basic relational skills and specific trauma-  153 support strategies to educational and/or counselling practices at both the elementary and secondary level.  Strengths and Limitations The design and findings of the research have several strengths and subsequently, limitations.  A considerable strength of this study was the narrative approach to the investigation, which offered an exploratory, in-depth means of examining the participants’ unique accounts of their experiences of using trauma-informed practices.  Based on the extensiveness of the data obtained in each participant interview, the participant group size was deliberately kept relatively small (n=7).  Furthermore, the participant group was limited geographically as all of the participants recruited were located in the Lower Mainland of British Columbia.  Keeping the recruitment focused on one geographic area offered the opportunity to gain an extensive understanding of the experiences of Lower Mainland-based school counselling professionals.  However, this also denotes that the participant group cannot be considered representative of all school counselling professionals across the Lower Mainland, British Columbia, or Canada.   The exploratory narrative methodology used for the present research did not seek to obtain objective, quantifiable evidence regarding the most efficacious approaches to using trauma-informed practices.  The findings do not intend to imply causal relationships between trauma-informed practice and its outcomes for academic, social-emotional, or mental health outcomes for students.  Rather, this approach to the research recognized that the participants’ experiences are teaching tales that remind us that the implementation of trauma-informed practices may be highly influenced by the context and culture of each school and district.  Therefore, the goal of the research was not to produce findings that are generalizable across   154 school counselling professionals.   Rather, the purpose of this study was to extensively examine and integrate the stories of the participants into a shared narrative that constructs the current breadth of experiences using trauma-informed practices across these particular participants.  Their voices add to the growing evidence on the implementation of trauma-informed practices.  Unsurprisingly, the information obtained from the participants in the study varied considerably.  While noteworthy commonalities were found, the participants’ experiences were highly variable across the districts they worked in, the students that they work with, the types of trauma-informed practices training they have obtained, and the approaches to trauma-informed practices they ascribe to.  While detailed and equal attention was paid to analyzing each of the participants’ interviews, the findings may be limited in fully capturing the considerable depth of each narrative account based on this goal of creating a shared narrative and conducting a reductionistic thematic analysis across the seven participants.   Concluding Remarks The present study offers an in-depth exploration of the experiences of seven school counseling professionals using trauma-informed practices in their schools.  To the best of my knowledge, this one of the first Canadian studies to explore the various dimensions of using trauma-informed practices from the important perspectives of the school counselling professionals, who often serve as key school-based supports and service providers for students who have been impacted by trauma.  The findings of this research are potentially valuable across the stakeholders within the school system including students, educators, administrators, support staff, parents/caregivers, and the community. Ultimately, all school stakeholders have an important collaborative role to play in supporting the well-being of   155 students.  Research and implementation literature concerning trauma-informed practices in schools are still very much in the early stages of development in Canada.  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Retrieved from: http://search.proquest.com/openview/9a3e586f1e533eda445e74ae79ec2f1b/1?pq-origsite=gscholar&cbl=27755      184 Appendix A: Letter of Recruitment      185    Version 03 – February 22, 2019    1 of 1    a place of mind THE UNIVERSITY OF B R I T I S H  COLUMBIA  Faculty of Education  Department of Education and Counselling Psychology, and Special Education 2125 Main  Mall Vancouver, BC Canada V6T 1Z4  Phone 604 822 0242 Fax 604 822 3302 www.ecps.educ.ubc.ca Date, 2019 SCHOOL/ASSOCIATION NAME ADDRESS CITY, PROVINCE, POSTAL CODE Re: Recruiting Participants for a UBC Study Title: A NARRATIVE EXAMINATION OF SCHOOL-BASED TRAUMA-INFORMED PRACTICES  Dear ___________ I am a PhD Student in Counselling Psychology from the University of British Columbia and am currently commencing research for my Doctoral Dissertation.  My Supervisor is Dr. Marla Buchanan from the Department of Educational and Counselling Psychology, and Special Education. This research examines the narratives of Canadian school counsellors who identify using trauma-informed practices in their schools. This research intends to provide in-depth insight regarding the experiences of implementing trauma-informed programs and practices and regarding what is needed for future development of trauma-informed support and resources.   To conduct the present study, we will recruit 6-8 school counsellors who are interested in engaging in an in-depth interview concerning their experiences with trauma-informed practices and programs.  The findings of the study will be shared with school professionals/districts along with recommendations for future implementation of trauma-informed programs and practices. I am available by telephone or email to discuss the details of this study and to answer any questions you may have.  Thank you in advance for your time and consideration.  Sincerely, Dr. Marla Buchanan, Professor, Research Supervisor Department of Educational and Counselling Psychology, and Special Education phone: 604-822-4639 email: marla.buchanan@ubc.ca Rosalynn Record-Lemon, PhD Student, Counselling Psychology Department of Educational and Counselling Psychology, and Special Education phone: 604-418-2389 email: rrecord@alumni.ubc.ca       186 Appendix B: Telephone Screen     187       188 Appendix C: Informed Consent Form      189      190       191      192   Appendix D: Narrative Interview Protocol    193      194  Appendix E: Transcription Key       195 Transcription Key Simultaneous Talk // Pauses/Silences … Falling Intonation  . Continued Intonation  , Animated Intonation ! Elevated Voice Tone CAPITALS Quieting Voice Tone italics Mid-Speech Cut-Off - Rising Intonation or Query ? Emphasis Bold type Quoting Another Individual  “ ” Non-Verbal Expressions, Sounds, Laughter (Parentheses) Interview Commentary  [Parentheses]   

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