Leadership Education in Neurodevelopmental and related Disabilities (LEND) Program

Division of Developmental and Behavioral Pediatrics

Cincinnati Children's Hospital Medical Center
University of Cincinnati University Center for Excellence in Developmental Disabilities

Project Abstract

Trauma-Informed Strategies for Staff Working with Families Experiencing Homelessness

Laura Srivorakiat, PsyD; Nichole Nidey, PhD; Amber Massa, PsyD; Pamela Williams-Arya, MD;
Randi Phelps, MA; Autumnlee Brown, BA; Hannah Adazzio, BA

Background:
In 2018, one-third of the homeless population in the United States consisted of families with children.
Bethany House homeless shelter in Cincinnati requested assistance in developing programming
targeting the emotional and behavioral needs for caregivers and children experiencing homelessness.

Project Objectives:
Study objectives included: modifying and delivering an existing positive parenting program to educate
staff on trauma-informed strategies within Bethany House; increasing staff knowledge of trauma and its
effects on parenting and child behavior; and increasing positive relationships between staff and families
in shelter.

Methods:
This study created a trauma-informed curriculum for staff. COMPASS for Hope, a positive parenting
program, was adapted to provide two trauma-informed trainings for shelter staff based on the modified
curriculum. The modified curriculum focused on topics that included trauma-informed environment,
learned helplessness, social disaffiliation theory, childhood behaviors and antecedents, and the iceberg
model of behavior. Staff members were given pre-training and post-training surveys to measure the
effectiveness of the training sessions, using a five-point Likert scale (strongly agree, agree, neutral,
disagree, strongly disagree).

Results:
Pre-survey results indicated that only 30-40% of staff had knowledge of trauma theories including social
disaffiliation, learned helplessness, and emotional regulation. Post training, 100% of staff members were
familiar with the trauma theories. Prior to training, there was a range of responses from strongly
disagree to strongly agree, concerning how trauma can have different effects on people based on when
it happened. However, after the training, 100% of the staff agreed/strongly agreed that timing matters.
Similarly, prior to training, there was a range of agreement with the following statements: parents and
children have a hard time adjusting to shelter rules, offering choices is an effective method to improve
parental independence, and having knowledge of how to create a trauma-informed environment for
residents. In the post-survey, almost 100% of staff shifted to agree/strongly agree with the above
statements. Qualitatively, staff members indicated the following needs to be able to utilize trauma-
informed care strategies: more trauma-informed training, patience and consistency among staff using
trauma-informed care, and dedicated spaces to meet with families confidentially. In addition, staff
members identified life events that can trigger trauma in individuals such as parent abuse history, sexual
abuse, loss, and home violence. The staff used these examples to discuss the potential behaviors
associated with their interactions with residents.

Conclusions / Next Steps:

Based on pre-and post-survey results, it appeared shelter staff gained knowledge related to trauma-
informed strategies and how to improve resident/staff relations. Qualitative and quantitative findings
support the need to provide trauma-informed education for shelter staff and promote effective
communication among staff and families. Next steps include sharing results with Bethany House,
seeking staff feedback regarding the training, and offering to disseminate the curriculum and study
findings with other homeless shelters.