Trauma-informed behaviour support: A school-based, stepped approach to promoting child mental health and wellbeing.

Trauma-informed behaviour support: A school-based, stepped approach to promoting child mental health and wellbeing.

Trauma-informed behaviour support: A school-based, stepped approach to promoting child mental health and wellbeing.

Govind Krishnamoorthy1,2, Kay Ayre3, Sonja March1,2, Emily Berger4, Vicki Dallinger1, Sabrina Ong1 and Sandra Chafouleas5

1School of Psychology and Wellbeing, University of Southern Queensland, Ipswich Queensland, Australia
2Manna Institute, Centre for Health Research, University of Southern Queensland, Queensland, Australia
3School of Education, Edith Cowan University, Mt. Lawley, Western Australia, Australia
4School of Educational Psychology and Counselling, Monash University, Victoria, Australia
5 Neag School of Education, University of Connecticut, Connecticut, United States of America

Background: There are growing calls for improved prevention and early intervention for primary school age children in Australia. School-based mental health and wellbeing programs can provide accessible, affordable and needs-based support for children. Despite their promise, most programs show limited impacts on priority groups of children, such as First Nations children, those living in regional areas and those exposed to adversity and maltreatment. The aim of this program of research was to co-design, implement and evaluate a school-based, trauma-informed care program for priority groups of children.

Methods: The Trauma-informed Behaviour Support (TIBS) program was co-designed over four years in partnership with First Nations children (n = 28), families (n = 11) and educators (n=23) in the Northern Territory. By integrating culturally responsive practices with principles of trauma informed care and behaviour support practices, the TIBS program provides an analytic process for schools to (a) promote a psychological and culturally safe school climate, (b) provide targeted classroom-wide, small group and individual support practices and (c) build capacity in educators to develop social and emotional skills in children. A mixed method program evaluation assessed changes in student wellbeing and educational outcomes across all students at the school, and changes in educator’s knowledge and practice of trauma-informed care.

Results: Changes in student outcomes (n = 72) revealed a reduction in behavioural difficulties and gains in numeracy scores across the implementation of the program over 18 months. Surveys of trauma-informed care knowledge and attitudes amongst teachers showed improvements in trauma-informed care practices following the TIBS program, Qualitative findings revealed the importance for school leadership in promoting feelings of improved self-efficacy and flexibility in utilising trauma-informed care practices. However, the program was found to have limited impact on attendance and literacy of students. These findings highlight complex and multisystemic influences on the design and implementation of such programs. Key learnings from this study have informed an ongoing pragmatic trial of the program across two schools in West Moreton region in Queensland.

Conclusion: The project highlights the challenges and opportunities of codesign with priority populations for school-based mental health programs. With growing demands on school, the project findings highlight key ideas in implementing novel programs that avoid overburdening educators, while promoting equity in child educational and mental health outcomes.