Exposure to trauma during childhood is highly prevalent. This review seeks to evaluate the current state of the literature in regard to trauma-informed care within the school setting. A number of models have been put forth to describe broad trauma-informed approaches integrated within school systems, which incorporate trauma-sensitive care and practices within the broader structure of an organization. The goal of this paper was to systematically review papers detailing relevant interventions to the provision of trauma-informed and trauma-responsive practices within schools. Using a three-tiered system of service delivery as our organizing framework (where the level of support increases across tiers depending on the student's individual needs), the research that has evaluated the efficacy of traumain-formed interventions is reviewed. Results indicated that much of this work has been exclusively conducted within one level of a three-tiered system that comprises a trauma-informed approach to the school setting. Although there is a foundation of research on interventions applied within specific tiers, few studies have sought to integrate the tiers to test the effectiveness of a fully trauma-informed model within the educational system and most that have integrated the three tiers do not include statistically rigorous evaluations of program effectiveness, such as randomized control trials. A basic model for trauma-informed schools with considerations for intervening directly with students is provided as well as recommendations for future research, which is necessary to inform clear, specific models for fully integrated trauma-informed schools.
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