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Trauma

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Full-Text Articles in Social and Behavioral Sciences

Does Self-Care Moderate The Association Between Adverse Childhood Experiences, Trauma Symptoms, And Parental Reflective Functioning?, Vinaya Thomas Dec 2024

Does Self-Care Moderate The Association Between Adverse Childhood Experiences, Trauma Symptoms, And Parental Reflective Functioning?, Vinaya Thomas

Electronic Theses and Dissertations

Unresolved adverse and traumatic experiences in parents can amplify the risk of perpetuating intergenerational transmission of trauma. Parents’ positive and adaptive practices such as self-care might act as a protective factor against this ripple effect. This study investigated whether self-care moderated the relationship between parental ACEs, post-traumatic stress symptoms, and parental reflective functioning in mothers who are experiencing high psychosocial stress (n = 59) residing in rural Appalachia. Within our sample, there was no statistically significant linear relationship between our predictors, ACE score and PTSD symptoms, and our outcome of interest, maternal pre-mentalizing. We did not find empirical support for …


Animation As Therapy For Mental Health Treatment Across Diverse Populations And Contexts, A Literature Review, Daneile Tabana Sep 2024

Animation As Therapy For Mental Health Treatment Across Diverse Populations And Contexts, A Literature Review, Daneile Tabana

Expressive Therapies Capstone Theses

Scientific research has explored and identified the beneficial relationship between health and creative expression, recognizing art therapy as a source of healing. Animation has been newly recognized as an art therapy medium with potential for therapeutic healing and increased psychological well-being. This review of the literature on animation therapy explores the history of the modality’s interaction with the population observed and the effects of animation on the cognitive processes, discusses current theoretical orientations and treatment options for treating a range of conditions that affect mood, thinking, and behavior with animation therapy, and considers culturally informed and client-centered practices alongside traditional …


Utilizing Flow Arts Movement As An Expressive Arts Therapy Tool To Treat Trauma: A Literature Review And Autoethnography, Shannon Mcgrail May 2024

Utilizing Flow Arts Movement As An Expressive Arts Therapy Tool To Treat Trauma: A Literature Review And Autoethnography, Shannon Mcgrail

Expressive Therapies Capstone Theses

This expressive arts-based autoethnography research explores the effectiveness of using flow arts movement as a tool of expressive arts therapy to treat symptoms of trauma for individuals who experienced a traumatic event in their lifetime. While research on the use of flow arts movement to treat mental illness is in its early stage, much can be drawn from the literature on expressive arts therapy and dance/movement therapy research with a range of populations addressing trauma. Through exploration of trauma through neuroscience, mind, body, and integrated mindfulness through flow, this work aims to bring an understanding of using intermodal expressive arts …


Dyadic Expressive Arts Therapy For Parent-Child Attunement In Children’S Attachment-Based Trauma Treatment: A Literature Review, Mia Ballard May 2024

Dyadic Expressive Arts Therapy For Parent-Child Attunement In Children’S Attachment-Based Trauma Treatment: A Literature Review, Mia Ballard

Expressive Therapies Capstone Theses

This literature review explores current research about the use of expressive therapy methods in parent-child dyadic treatment, with a focus on attachment-based healing for children’s trauma treatment. I aim to answer the following question: how can expressive arts therapy be used to enhance nonverbal communication, foster attunement, and deepen connection between parent and child as an integral part of a child’s attachment-based trauma treatment? Children have an inherent need for an intimate emotional bond with a primary caregiver during the first few years of life and this early attachment relationship sets a foundation for mental, emotional, and physical health throughout …


How Did You Get Here? A Map Making Art Therapy Intervention For Adolescents In Crisis, Ayala Dayan May 2024

How Did You Get Here? A Map Making Art Therapy Intervention For Adolescents In Crisis, Ayala Dayan

Expressive Therapies Capstone Theses

Partial Hospitalization Programs (PHPs) are an important mental health resource for crisis intervention. PHPs support clients transitioning between levels of care or aiming to avoid a higher level of care, provide safety and stabilization, offer services such as group therapy and medication management, and oversee referrals. This study investigates the helpfulness of an art therapy mapmaking intervention for adolescents in crisis at a PHP location. The design of this program drew from Narrative Therapy concepts. Results support that the intervention can be beneficial for this population in their recovery efforts and yielded four major themes: 1) the development of self …


Regulation Through Rhythm: A Literature Review On Dance/Movement Therapy Approaches To Facilitating Nervous System Regulation, Elizabeth Barbera May 2024

Regulation Through Rhythm: A Literature Review On Dance/Movement Therapy Approaches To Facilitating Nervous System Regulation, Elizabeth Barbera

Expressive Therapies Capstone Theses

Abstract

The mental health field has started to pay attention to how trauma plays into a person’s overall mental and physical well-being. Because of this more research has shown the connection between mind and body. Yet the clinical implications and literature on theories of how to treat trauma and trauma related disorders do not always connect. This review of literature seeks to analyze the literature on Porges’, Polyvagal Theory and Amighi’s, Kestenberg Movement Profiles. An investigation of the current literature makes a connection between the phylogenetic order of both the nervous system and developmental movement. Considerations of how trauma, in …


All In The Image: Nightmares, Posttraumatic Stress, And Expressive Therapy: Critical Literature Review, Emma Geller May 2024

All In The Image: Nightmares, Posttraumatic Stress, And Expressive Therapy: Critical Literature Review, Emma Geller

Expressive Therapies Capstone Theses

This paper reviews the therapeutic potential of combining expressive therapy approaches with dreamwork protocol in treating recurrent nightmares seen in populations with PTSD. The intersection between the dreaming state, nightmares, dreamwork, and trauma can provide important insights into the purpose of dreaming, subconscious processing of trauma, and effective treatments for individuals struggling with nightmares. Clinical implications of dreamwork are considered in working with posttraumatic stress disorder along with this condition’s connection to recurrent nightmares. In working with trauma and the arts at a sensory and affective level of experience, there is potential for individuals to explore and process their recurrent …


Embodied Social Action: How Dance Movement Therapy Can Support Resistance Against Systems Of Oppression, Lauren Pope May 2024

Embodied Social Action: How Dance Movement Therapy Can Support Resistance Against Systems Of Oppression, Lauren Pope

Expressive Therapies Capstone Theses

This thesis explores the ways in which the field of dance/movement therapy has been impacted by colonialism through examination of power dynamics within the therapeutic movement relationship and use of body/movement observation and analysis. This literature review examines the historical context of the field of dance/movement therapy while outlining ways that dance/movement therapy practices and approaches can target trauma due to experiences of oppression which can be a contributing factor toward creating social change. Themes of power, privilege, oppression, and cultural identity are explored in a variety of populations and settings to highlight the indiscriminate ways colonialism impacts all people …


Perceived Stress From Covid-19 On High School Students With Previous Trauma In A Rural County In The Southeastern United States, Kari Anne Russell May 2024

Perceived Stress From Covid-19 On High School Students With Previous Trauma In A Rural County In The Southeastern United States, Kari Anne Russell

Doctoral Dissertations and Projects

The COVID-19 pandemic created historical trauma that will be felt for years to come. As the world begins sifting through the impacts, adolescents with previous trauma could be among the greatest sufferers. Rooted in trauma theory, this study aimed to examine the effects on high school students with previous trauma in a rural county in the southeastern United States. Variables such as previous mental health or counseling services, gender, socioeconomic status, race or ethnicity, and number of generations living in the home were all examined for those students having four or more ACEs. Through a quantitative design and with passive …


Bridging Faith And Restoration: A Phenomenological Study Exploring Evangelical Pastors’ Experiences Ministering To Congregants With Trauma In The Greater Toronto Area, Lindsay Knox Mcvety May 2024

Bridging Faith And Restoration: A Phenomenological Study Exploring Evangelical Pastors’ Experiences Ministering To Congregants With Trauma In The Greater Toronto Area, Lindsay Knox Mcvety

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to understand how evangelical pastors in the Greater Toronto Area describe their experiences with discussing trauma with congregants and their experiences with trauma-informed care in the church. The theory guiding this research is Transformative Learning Theory (TLT). As discussed by Mezirow (1991), TLT explains transformation occurs by increasing knowledge by learning about topics where outdated or misinformed concepts previously existed. The main research question is, how do evangelical pastors in the Greater Toronto Area describe their experiences ministering to congregants who have experienced trauma? Further sub-questions ask, how do evangelical pastors in …


Best Practices For Working With Children Who Have Experienced Sexual Abuse: A Training Resource Manual For Mental Health Counselors, Olivia Johnson May 2024

Best Practices For Working With Children Who Have Experienced Sexual Abuse: A Training Resource Manual For Mental Health Counselors, Olivia Johnson

Dissertations, Theses, and Projects

This paper reviews literature related to issues and practices associated with childhood sexual abuse including best practices for working with victims of sexual abuse. Children who are victims of sexual abuse often suffer from trauma related symptoms and the use of certain approaches can provide better treatment outcomes. Following the review, a training will be presented that provides counselors with information on best practices when working with children who have experienced sexual abuse.

Keywords: Childhood Sexual Abuse, Trauma, PTSD.


Online Criticism Of Parents After Child Accidents: A Reflexive Thematic Analysis, Kelsi Toews, Jorden A. Cummings, Michelle Mclean, Laura Knowles May 2024

Online Criticism Of Parents After Child Accidents: A Reflexive Thematic Analysis, Kelsi Toews, Jorden A. Cummings, Michelle Mclean, Laura Knowles

The Qualitative Report

When a child is harmed, parents frequently experience condemnation and blame from others. This blame is amplified online. Our online worlds reflect our offline ones, and this negative atmosphere toward parents can influence both parents themselves and societal expectations for parents. Previous research on parental blame has either directly asked people about their blame attributions or utilized hypothetical vignettes. Our thematic analysis expands on this research by analyzing unsolicited online comments left on news stories about two, real-world incidents of child harm: A child who fell into a gorilla enclosure at the Cincinnati Zoo, and a child who was killed …


The Use Of Music Therapy To Mitigate Trauma-Related Music Associations And Restore Personal Relationships With Music, Courtney Pitzer May 2024

The Use Of Music Therapy To Mitigate Trauma-Related Music Associations And Restore Personal Relationships With Music, Courtney Pitzer

Expressive Therapies Capstone Theses

For many people, music is positively associated with nostalgic memories, emotions, and experiences. But for some, it can be a painful reminder of the past. This literature review examines how music serves as a cue for reexperiencing trauma and demonstrates ways in which music therapy may be beneficial in reframing and reassociating those connections. Drawing from existing trauma treatment models such as CBT and exposure therapy, this review highlights the unique potential of music therapy in allowing clients to expose themselves to the activating stimulus while maintaining elements of safety within the music. This thesis prompts further exploration of desensitization …


Opening The Trauma Window: Embodied Storytelling With Adolescent Survivors Of Domestic Violence, April Reck May 2024

Opening The Trauma Window: Embodied Storytelling With Adolescent Survivors Of Domestic Violence, April Reck

Expressive Therapies Capstone Theses

Adolescents who have experienced trauma may develop a neutral state, which they use to shield themselves from the trauma so they can perform daily life tasks. Though it is acknowledged in the literature that trauma lives in the body, adolescent survivors of trauma may often stay in this neutral state until they seek mental health services. This thesis asks: How can drama therapy’s core processes, such as embodiment, widen the window of tolerance of an adolescent who has experienced trauma to begin to feel emotions beyond the neutral state and become open to new roles? The method that I have …


Effectiveness Of A Peer-Supported Digital Brief Intervention: Reducing Alcohol Use & Related Harms In Young Adults With Histories Of Interpersonal Trauma, Caitlin Mcgettrick May 2024

Effectiveness Of A Peer-Supported Digital Brief Intervention: Reducing Alcohol Use & Related Harms In Young Adults With Histories Of Interpersonal Trauma, Caitlin Mcgettrick

Masters Theses & Specialist Projects

Alcohol is the most frequently used substance in the United States, and young adults ages 18-25 have the highest rates of heavy alcohol use. Heavy and persistent alcohol use is associated with a host of negative outcomes in young adults, including poor mental health, lower life satisfaction, cognitive impairments, poor academic performance, increased risk for motor vehicle accidents, and substance use disorders. Brief interventions (BI) are low-resource, short-term interventions designed to reduce problematic substance use and mitigate the substantial harms posed by heavy and persistent use of substances such as alcohol. BIs have limited effectiveness in trauma survivors despite trauma …


Investigating The Level Of Evidence Of Adverse Childhood Experiences And Parenting Practices: A Systematic Review, Eloisa Deshazer May 2024

Investigating The Level Of Evidence Of Adverse Childhood Experiences And Parenting Practices: A Systematic Review, Eloisa Deshazer

Electronic Theses, Projects, and Dissertations

Background: Adverse childhood experiences (ACEs) are associated with mental and physical health outcomes of children, but less is known about how ACEs impact parenting. Objective: This study systematically reviewed the evidence of the association between parental adverse childhood experiences and parenting behaviors. Methods: The study employed a rigorous methodology, including searching several electronic databases, such as the CSUSB search engine, EBSCOhost Academic Search Premiere, PsycINFO, PubMed, and ScienceDirect. The keywords used for the search process included Adverse Childhood Experiences, ACEs, Maltreatment, Adverse Experiences, Traumatic Experiences, and Parenting or Childrearing. Inclusion criteria were restricted to studies published between 2014 and …


Integration Of Adverse Childhood Experiences In Adulthood Through Dance Movement Therapeutic Techniques, Kimberly Hoj May 2024

Integration Of Adverse Childhood Experiences In Adulthood Through Dance Movement Therapeutic Techniques, Kimberly Hoj

Expressive Therapies Capstone Theses

Expanding knowledge about how to self-regulate when faced with challenging circumstances has the potential to benefit individuals and communities, especially in our post-pandemic environment with increasing needs for mental health support. This thesis provides a psychoeducational basis for use of dance movement therapeutic techniques to integrate adverse childhood experiences. The literature review refines an understanding of big T and little t trauma as it relates to mental illness, polyvagal theory, nervous system regulation, the window of tolerance, body armoring, somatic psychotherapy, trauma- informed care, adverse childhood experiences and post-traumatic growth.

This thesis culminates in a personal arts-based autoethnography informed by …


The Alexander Technique Applied To Dance And The Choreographic Process: Freeing Physical Expression From Trauma-Based Tension, Julia Johnston Apr 2024

The Alexander Technique Applied To Dance And The Choreographic Process: Freeing Physical Expression From Trauma-Based Tension, Julia Johnston

Senior Honors Theses

Ballet, contemporary, and modern dancers have expressed incurring trauma during their training and professional dance experiences; in a 2020 survey, 41% of professional dancers and 30% of ballet students reported experiencing or witnessing sexually inappropriate behavior in their respective workplaces and schools (DDP). This is just one example of a potential source of trauma for dancers. The physiological effects of trauma cause physical effects, creating tension in a dancer’s body. Dance relies on physical expression, the expression of thought and feeling through movement, to connect with the audience. Trauma-based tension inhibits a dancer’s range of physical expression and connection to …


Christian Meditation And Yoga Breathwork: Complimentary Interventions For Ptsd, Beulah Savithri Joshua Apr 2024

Christian Meditation And Yoga Breathwork: Complimentary Interventions For Ptsd, Beulah Savithri Joshua

Doctoral Dissertations and Projects

This multiple-baseline experimental design study examined the impact of trauma-informed Christian yoga (TICY) and Christian meditation (CM) on posttraumatic stress disorder (PTSD) and its symptoms for adult trauma survivors at Lifepath Counseling, a private mental health treatment practice. The theories guiding this study were Adlerian and trauma theory, based on the idea that any trauma is defined as extremely upsetting emotional event that overwhelms the individual's internal resources, potentially leading to long-lasting psychological symptoms of PTSD in some cases. It was vital to explore efficacious and cost-effective treatment interventions to alleviate PTSD symptoms in this study. Complementary and alternative medicines …


The Intersection Of Trauma, Faith, And Addiction Among Women In Recovery At The Walter Hoving Home, Jessica I. West Apr 2024

The Intersection Of Trauma, Faith, And Addiction Among Women In Recovery At The Walter Hoving Home, Jessica I. West

Doctoral Dissertations and Projects

The association between substance use disorders (SUDs), childhood trauma, and post-traumatic stress disorder (PTSD) is becoming increasingly evident. There are faith-based programs available to assist women in overcoming addiction; however, there is presently no research examining the relationship between trauma, faith, and addiction among women in such programs as the Walter Hoving Home (WHH). Through a multiple regression analysis, this quantitative study evaluated the relationship between these three variables of interest among women in recovery. This study collected data through an anonymous Qualtrics survey with a self-report questionnaire, the Adverse Childhood Experiences Questionnaire (ACEs), Tobacco Alcohol Prescription medication and Other …


A Phenomenological Study Of Adoptive Parents’ Distress, Erica Rhoads Apr 2024

A Phenomenological Study Of Adoptive Parents’ Distress, Erica Rhoads

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to explore the lived experiences of distress in parents who have adopted internationally. The aim was also to discover what this lived experience is like through the perception of both objective and subjective reality, providing understanding and meaning from the perception and experience of adopting and then parenting children who have experienced significant trauma. An additional goal of this study was to evaluate the experience of sharing their adoption story within a narrative therapy support group as a way to alleviate some of their distress. A focus on the background of adoption …


A Phenomenological Examination Of The Experiences Of College Theater Majors In Regard To The Covid-19 Pandemic And Lockdowns In The United States, Ronda Celeste Jones Apr 2024

A Phenomenological Examination Of The Experiences Of College Theater Majors In Regard To The Covid-19 Pandemic And Lockdowns In The United States, Ronda Celeste Jones

Doctoral Dissertations and Projects

The COVID-19 pandemic and resulting lockdowns were phenomena experienced by the majority of the modern world, but not everyone experienced it in the same way. Each person brings their own past, their own interests, and their own needs to the lived experience. Pre-pandemic research on art therapy suggests that creative expression could be helpful to adolescents experiencing such trauma. Theater majors are a particular set of people for whom creative expression through theater is a huge part of their life. Theater majors are also participating in a creative activity that requires social contact, and that social contact was limited or …


Pentecostal Hope In The Age Of Covid-19, Peter Althouse, Audrey E. Mccormick Apr 2024

Pentecostal Hope In The Age Of Covid-19, Peter Althouse, Audrey E. Mccormick

Salubritas: International Journal of Spirit-Empowered Counseling

This research sought to identify how Pentecostals and charismatics responded to the Coronavirus pandemic. Specifically, what role did eschatology play in provoking hope, and how did theologies on healing influence responses? Data revealed that Pentecostals were generally not casting their responses to the pandemic as a millennial expectation of a better future but were grieving their losses and seeking to provoke hope amidst suffering. While minimal miraculous healings were reported, healing was cast primarily as the ongoing presence of defiant hope amidst trauma, grief and suffering. We propose that grief and grieving is an eschatological response to loss and death.


A Responsible Parrhesia? A Review Of The Price Of Secrecy, Sara Tafakori Apr 2024

A Responsible Parrhesia? A Review Of The Price Of Secrecy, Sara Tafakori

RadioDoc Review

The Price of Secrecy immerses the listener in stories of individual trauma, of child abuse and rape, yet also draws lessons from them of wider social significance. It includes moments of narrative catharsis, interspersed with repeated reminders that the stories are unfinished and open-ended—that the solutions lie out there, in social action, rather than in the stories themselves. The series also gestures towards structural critique, especially of ‘the legal constraints’ it identifies, yet it places greater importance on changing the wider culture through challenging the culture of secrecy and shame around victims’ stories of rape and abuse. This centrally means …


Combating Trauma And The Immigrant Paradox In Schools, Emma Bergman Apr 2024

Combating Trauma And The Immigrant Paradox In Schools, Emma Bergman

Honors Projects

Over time, research on immigrant populations has revealed a trend known as the immigrant paradox in which, the further generations get from the generation of immigration, the poorer their outcomes are in areas such as mental health, delinquency, substance abuse, and education. Though a definitive explanation for this trend has yet to be identified, prevailing theories include several social, familial, and community-based factors such as the impacts of bilingualism, parental expectations, biculturalism, co-ethnic peers, quality of schools, and community support. Little attention has been paid to individual factors such as mental health and trauma. The present study proposes the transgenerational …


Foster Parents’ Perspectives On Factors Influencing The Development Of And The Impact Associated With Secondary Traumatic Stress, Latronia Smith Apr 2024

Foster Parents’ Perspectives On Factors Influencing The Development Of And The Impact Associated With Secondary Traumatic Stress, Latronia Smith

Doctoral Dissertations and Projects

The purpose of this qualitative phenomenological study was to understand secondary traumatic stress (STS) for foster parents who care for children who have experienced trauma. The three research questions that guided this study were: how do foster caregivers describe their experience with STS, what factors do foster parents perceive as contributors to the development of STS, and how do foster parents cope with symptoms of distress associated with STS? The theoretical framework for the study was based on the stress process theory by Pearlin (1981) which focuses on sources of stress, manifestations of stress, and coping strategies. Data was collected …


Trauma Is A Wound: Demonstrating The Use Of Character Analysis To Practice Clinical Analysis, Madisyn Beare Apr 2024

Trauma Is A Wound: Demonstrating The Use Of Character Analysis To Practice Clinical Analysis, Madisyn Beare

Honors Projects

Evidence-based treatments of trauma require clinicians to base their treatments on the client’s specific and individual needs, experiences, cognitions, and place in recovery. Essentially, each new client is a new and unique case, and the practice of understanding how trauma may affect an individual only comes from clinical exposure.Literature provides the public with somewhat of an aid in these circumstances: fictional characters are not real people, and therefore can undergo limitless character analyses. Analyzing a fictional character allows clinicians the ability to practice their exploration of various behavioral indicators of mental health concerns while honoring the ethical code of non-maleficence, …


A Phenomenological Study Detailing Psychotherapeutic Perspectives Of Psychotherapists Who Treat Individuals Living With Pathological Dissociative Practices, Ebony M. Martinez Apr 2024

A Phenomenological Study Detailing Psychotherapeutic Perspectives Of Psychotherapists Who Treat Individuals Living With Pathological Dissociative Practices, Ebony M. Martinez

Doctoral Dissertations and Projects

The present phenomenological study endeavors to offer a comprehensive and profound insight into the phenomenon of pathological dissociation and the working experiences of psychotherapists who specialize in treating individuals with this condition. The primary objective of this study is to shed light on the intricate nature of pathological dissociation and provide a better understanding of the challenges that psychotherapists encounter during the therapeutic process. Nine licensed psychotherapists agreed to share their expertise and experiences in working with pathological dissociation. The trauma model was used as the theoretical framework to interpret reported pathological dissociative experiences. Based on participant reports, this theory …


A Phenomenology Study- Vicarious Trauma Among School Counselors And Teachers Working With Students From The Northern Triangle In Elementary Title I Schools, Janeth B. Santiesteban Apr 2024

A Phenomenology Study- Vicarious Trauma Among School Counselors And Teachers Working With Students From The Northern Triangle In Elementary Title I Schools, Janeth B. Santiesteban

Doctoral Dissertations and Projects

The present phenomenological study aimed to describe the lived experiences of school counselors and teachers working at elementary Title I schools in Maryland with students from the Northern Triangle (a region of Central America comprising El Salvador, Guatemala, and Honduras). The assumption was that these education professionals may undergo struggles and demands that may put them at risk of vicarious trauma due to the trauma those students and their families have endured. The theory guiding this study was the transactional theory of stress and coping (Lazarus,1966; Lazarus & Folkman, 1984) and the stress theory (Cohen et al., 1997), which converge …


Project Attain: Advancing Trauma-Informed Care For Youth With Intellectual And Developmental Disabilities And/Or Gender Diverse Youth, Kady F. Sternberg, Charlotte E. Bausha, Charlotte Jones, Erin Knight, Crystal N. Steltenpohl, Rebecca R. Parton, Jennifer L. Mclaren, Erin R. Barnett Apr 2024

Project Attain: Advancing Trauma-Informed Care For Youth With Intellectual And Developmental Disabilities And/Or Gender Diverse Youth, Kady F. Sternberg, Charlotte E. Bausha, Charlotte Jones, Erin Knight, Crystal N. Steltenpohl, Rebecca R. Parton, Jennifer L. Mclaren, Erin R. Barnett

Developmental Disabilities Network Journal

Children with Intellectual and Developmental Disabilities (IDD) and/or gender diversity are at higher risk of experiencing trauma. Provider knowledge is lacking; trauma, disability, and LGBTQ+ resources are often siloed; and few providers screen for trauma in this population. This paper describes the design, delivery, and initial evaluation of Project ATTAIN (Access to Trauma-informed Treatment and Assessment for Neurodivergent and/or Gender-expansive Youth).

ATTAIN is an ongoing 5-year state-wide initiative aiming to assess readiness to engage in new roles and practices over time; provide state-wide training and consultation in trauma, disability, and LGBTQ+-informed practices; install screening and assessment of trauma exposure and …