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
The Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center
Background
 In 2018, one-third of the total homeless
population in the United States consisted of
families with children
 In 2018, 7,036 people experienced
homelessness; of those individuals, 25% per were
children
 Individuals experiencing homelessness often
experience trauma at disproportionate rates
 Trauma is defined as a set of responses to
emotionally overwhelming, and personally
uncontrollable life events
 Trauma responses can occur one time or be
ongoing and effects are different for every person
 Trauma is known to have an adverse impact on
social-emotional development (e.g., loss of
control and trust in relationships), especially on
children
 Previous focus groups involving parents
experiencing homelessness in Cincinnati have
indicated a need for behavioral supports,
including trauma-informed strategies
 Bethany House Services management requested
assistance in improving trauma-informed training
for staff members
Objectives
 Modifying and delivering a positive parenting
program to educate staff on trauma-informed
strategies within a homeless shelter in
Cincinnati, OH
 The goal of this intervention is to increase the
knowledge of staff as it relates to trauma and
its effects on parenting and child behavior
 This intervention aims to increase positive
relationships between staff and caregivers and
their children
Leadership Education in Neurodevelopmental and related Disabilities (LEND) Program
The University of Cincinnati University Center for Excellence in Developmental Disabilities
Methods
 Completed an updated literature search
regarding homelessness and trauma
 Consulted with a trauma-informed expert
to identify pertinent content areas for our
training curriculum
 Toured and met with management at
Bethany House Services to determine
current parenting needs
 Conducted observations to better
understand the daily operations of the
shelter
 Reviewed then adapted a positive
parenting program, COMPASS for Hope (C-
Hope) for use with staff in a homeless
shelter
 Specifically focused on incorporating
trauma-informed strategies into our
curriculum
 Provided two trainings (2 hours each) to
staff based on the modified curriculum
 Created measures to gauge knowledge
gains as result of training and assessed
needs of staff to implement trauma
informed strategies
Figure 1. Trauma events identified by staff
Results and Findings
Quantitative 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
knew what the trauma theories were
 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; after the training,
100% of the staff agreed/strongly agreed that
timing matters
 Prior to training, there was a range in agreement
with the following statements: parents and children
have a hard time adjusting to shelter rules, offering
choices is an effective method to improve parent
independence and knowledge of how to create a
trauma-informed environment for residents; post-
survey data indicated almost 100% of staff shifted
to agree/strongly agree with the statements
Qualitative results:
 Bethany House environmental strengths identified
included respect, accountability and safety;
challenges included communication and lack of
appropriate outside community/support
 Staff 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
 Staff reported life events that can trigger trauma in
individuals such as parent abuse history, sexual
abuse, loss and home violence (see Figure 1)
Discussion
 Based on the pre- and post-survey
results, it appeared the shelter staff at
Bethany House gained trauma-
informed strategy knowledge to
improve resident/staff relations at
Bethany House
 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
References
Cincinnati Strategies to End Homelessness data. (2018).
Home: Our 2018 Impact Report. Retrieved from
https://www.strategiestoendhomelessness.org/wp-
content/uploads/home-2019-final-digital.pdf. Accessed
December 16, 2019.
Kuravackel, G., & Ruble, L. (2019). COMPASS for Hope
Training Program. Encyclopedia of Autism Spectrum
Disorders, 1-6. doi:10.1007/978-1-4614-6435-
8_102431-1
Ruble, L., Kuravackle, G., & Reese, J. COMPASS for Hope:
A Parenting Support Program for Autism Spectrum
Disorder. Unpublished Manuscript.
US Department of Housing and Urban Development
(2018). Annual Homeless Assessment Report (AHAR) to
Congress. Part 1: Point-In-Time Estimates of
Homelessness. Retrieved from
https://files.hudexchange.info/resources/documents/20
18-AHAR-Part-1.pdf. Accessed November 15, 2019.
Acknowledgements
This project is funded by Maternal and Child Health
Bureau Grant T73MC00032.