Purpose The purpose of this document is to provide trauma informed considerations for work settings as we all navigate the uncharted territory and response to novel Coronavirus (COVID-19). We will refer to organizations in this document, but this includes schools, clinics, and other places where services are provided. The following considerations are grounded in the principles of trauma informed care (see SAMHSA Guidance for a Trauma Informed Approach for more information). We invite you to use the same framework as you are making decisions and communicating to staff. Rationale For most people, COVID-19 will be associated with increased uncertainty and stress. When we are under acute stress we are more likely to be operating from the survival areas of our brain, which means that our thinking becomes much more black and white, our attention is more narrowly focused on the immediate here and now, we start to have difficulty planning or thinking ahead, we have difficulty regulating our emotions, and we become less able to make decisions. Stressful times are associated with threats to our safety and a loss of power and control. A trauma informed approach can help reduce or prevent a trauma response.

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Concerns about achievement levels of students who struggle in school, including those with disabilities, have led to major changes in U.S. education policy. These changes have included increased expectations and accountability for student achievement and calls for improving the practice of teachers (e.g., the Every Student Succeeds Act of 2015 and its predecessor, the No Child Left Behind Act of 2001; NCATE, 2010; U.S. Department of Education, 2010). Improving teacher practice has become a major focus of policy makers and teacher educators for several reasons, including research revealing that (a) improving the effectiveness of teachers is the most direct approach to improving outcomes for low-achieving students (Hanushek & Rivkin, 2010; Master, Loeb, & Wyckoff, 2014), and that (b) many effective practices that can substantially improve student achievement are not routinely used by teachers (Cook & Odom, 2013). The need to improve teacher practice has led several prominent teacher educators (e.g., Ball & Forzani, 2011; Grossman, Hammerness, & McDonald, 2009; Leko, Brownell, Sindelar, & Kiely, 2015; McDonald, Kazemi, & Kavanaugh, 2013) to take the position that teacher education should focus more deliberately on instructional practice, and that teacher preparation programs should be developed that address this goal. In these programs, teacher education would be centered on a set of effective practices that all teachers need to learn (i.e., practices that are used frequently in classrooms and have been shown to improve student outcomes). Programs also would embed much of teacher preparation in clinical settings to systematically support teacher candidates in learning to use these HLPs (Grossman et al., 2009; NCATE, 2010). This emphasis on using practice-based teacher education to improve instructional practice has emerged in both general and special education (Leko et al., 2015; McDonald et al., 2013).

While a lThis paper provides a synthetic review of research on school-based mental health services. Schools play an increasingly important role in providing mental health services to children, yet most school-based programs being provided have no evidence to support their impact. A computerized search of references published between 1985 and 1999 was used to identify studies of school-based mental health services for children. Study inclusion was determined by (i) use of randomized, quasi-experimental, or multiple baseline research design; (ii) inclusion of a control group; (iii) use of standardized outcome measures; and (iv) baseline and postintervention outcome assessment. The application of these criteria yielded a final sample of 47 studies on which this review is based. Results suggest that there are a strong group of school-based mental health programs that have evidence of impact across a range of emotional and behavioral problems. However, there were no programs that specifically targeted particular clinical syndromes. Important features of the implementation process that increase the probability of service sustainability and maintenance were identified. These include (i) consistent program implementation; (ii) inclusion of parents, teachers, or peers; (iii) use of multiple modalities; (iv) integration of program content into general classroom curriculum; and (v) developmentally appropriate program components. Implications of these findings and directions for future research are discussed