Although there is not a causal relationship between adverse childhood experiences (ACEs) and/or trauma and mental health, according to Office on Women’s Health (2023), experiencing ACEs and/or trauma is correlated with mental illness—in other words, those who have experienced trauma and/or ACEs have a higher risk of developing a mental health disorder. To better equip Certified Family Life Educators (CFLEs) and respond to the growing needs of the current child and adolescent mental health crisis occurring in the United States, professors at a rural university in middle Tennessee added a Child and Family Trauma Informed Care certificate to the current CFLE approved program of study in Human Development and Family Sciences. The idea for the certificate came from post-interviews with alumni working in the field with an overwhelming number of children who have ACEs and/or exposure to trauma, and my personal experience of implementing a trauma-informed classroom. Health and human services workers, including CFLEs, have increasingly become aware of trauma and its effects on physical and mental health. The momentous ACEs Study published in The Journal of Preventative Medicine by Felitti et al. (1998) indicated that the more exposure an individual had to adverse experiences—such as neglect, physical, and sexual abuse—the higher risk for negative health outcomes such as heart disease, depression, diabetes, and risky behaviors (i.e., smoking, drinking, and drug use). Trauma-informed care is an approach in health and human services that assumes that an individual has more than likely experienced trauma. Trauma-informed care recognizes the symptoms of trauma while acknowledging the role that trauma plays in the lives of individuals. It is an organizational approach that works to change the culture of an institution. According to the Substance Abuse and Mental Health Services Administration (SAMHSA; 2018) in its publication of Helping Children and Youth Who have Experienced Trauma: National Children’s Mental Health Awareness Day, approximately 46% of American children under age 18 have experienced at least one trauma, and the Centers for Disease Control and Prevention (2018) reported in its publication Adverse Childhood Experiences (ACEs): Preventing Early Trauma to Improve Adult Health that one in every six adults report four or more ACEs. Considering these statistics, trauma-informed care is becoming a standard approach in health and human services, including educational settings. As the professors saw the demand in the field for CFLEs to implement a trauma-informed care approach, they developed the Child and Family Trauma Informed Care certificate, which is embedded into the coursework of the Human Development and Family Sciences Concentration. The certificate includes the following required courses: (a) Life Span Development, (b) Families in Society, (c) Trauma Informed Care; there is a choice of two courses from the following list: (a) Positive Psychology: The Science of Well-Being, (b) Family Violence Across the Life Span, (c) Parent–Child Relationships, (d) Family Stress Management; and finally a choice of one course from the following list: (a) Loss and Bereavement for Children and Families, (b) Concepts of Caregiving, and (c) Concepts of Gerontology.  

Because health/human service organizations value knowledge and experience with trauma-informed care, students who are obtaining a degree in any of the health or human sciences would benefit from a certificate in trauma-informed care, especially those who plan to work in the field of Family Life Education (FLE). Students who have the certificate are better prepared to meet the challenges of individuals and families who have experienced trauma by implementing SAMHSA’s (2014) recommendations (published in Concept of Trauma and Guidance for a Trauma Informed Approach), including the four Rs of trauma-informed care approach: the realization of the widespread impact of trauma, recognition of the signs of trauma, responding by equipping all people of an institution or agency to apply a trauma informed response, and resisting retraumatization of any clients and/or staff. Students also learn how to implement the six principles of a trauma informed care approach, including (a) how to establish and build safety; (b) trustworthiness and transparency; (c) peer support; (d) collaboration and mutuality, (e) empowerment, voice, and choice; and (f) cultural, historical, and gender issues (SAMHSA, 2014). Students learn skills such as how to recognize trauma triggers, respond instead of react, de-escalate a person who is triggered, and give emotional space to individuals. Students who complete the trauma-informed certificate gain an understanding of trauma throughout the lifespan, and learn how to prevent ACEs and trauma, but also how to build resiliency and posttraumatic growth to those who have experienced ACEs and/or trauma. 

The capstone course in the Child and Family Trauma Informed Care certificate, called Trauma Informed Care, “explores types of trauma and implications on both human and brain development, with an emphasis on parenting and supporting children who have experienced trauma, and the importance of trauma informed responses by professionals to individuals and families.”

Main topics in the course include the following:   

• Healthy brain development 

• Adverse childhood experiences (ACEs) and resiliency 

• Impact of trauma on the brain 

• Three types of stress and effects of stress 

• Trauma throughout the various stages of the lifespan 

• Types of trauma 

• Responses to trauma in care professions 

• Behaviors in children in response to trauma 

• Parent/caregiver responses to children experiencing trauma 

• Professional responses to individuals and families experiencing trauma 

The course complements the 10 FLE content areas by including a developmental approach to trauma across the lifespan and FLE methodology by incorporating strategies to work with individuals who have experienced trauma. This certificate has proved to be most helpful in equipping future CFLEs who will work in the field, as students gain the concepts of typical and atypical development, families within the context of society, and choices of other courses that provide content on normative and catastrophic family events. 

Some of the strategies and methods discussed in the capstone course are included on the Resources page 15 to help all CFLEs currently working in the field. For example, the video on the 5-4-3-2-1 Method is a grounding exercise and is beneficial when working with people of all ages. The short video can be used in a variety of classroom or small group settings, especially when teaching on topics such as anger management, conflict resolution, or social emotional learning. This exercise helps individuals avoid and manage negative thinking and anxiety. The video How Mindfulness Empowers Us can be used in a classroom or small group setting when teaching on the aforementioned topics as well, and I suggest including thinking questions for personal reflection, such as “How is the story of the two wolves meaningful to you?” The Healing Guidebook is filled with a variety of activities that CFLEs can use with children and adolescents, including games and art activities in a variety of settings. There are several resources listed that give more information on a trauma-informed care approach, as well as a suggested reading list. 

References 

Centers for Disease Control and Prevention. (2019). Adverse childhood experiences (ACEs): Preventing early trauma to improve adult health. https://www.cdc.gov

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventative Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8 

Substance Abuse and Mental Health Services Administration. (2018, May 10). Helping children and youth who have experienced trauma: National Children’s Mental Health Awareness Day. https://www.samhsa.gov/sites/default/files/brief_report_natl_childrens_mh_awareness_day.pdf 

Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. https://ncsacw.acf.hhs.gov/userfiles/files/SAMHSA_Trauma.pdf 

Office of Women’s Health. (2023). Abuse, trauma, and mental health. https://www.womenshealth.gov/mental-health/abuse-trauma-and-mental-heal…;

Elizabeth Ramsey, Ph.D., CFLE. After years working in the field as a CFLE, family mediator, developmental specialist, and K–12 educator, Dr. Ramsey is now a professor at Tennessee Technological University in Human Ecology. E-mail: [email protected].