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Using collaborative research strategies to advance anti-racist, evidence-based trauma treatment

This article originally appeared in the School of Social Work 2024 Fall Impact Report.

While pursuing her master’s of social work degree in 2015, Yeni Silva-Renteria focused her research on immigrants and refugees.

An immigrant herself, she was sensitive to the extra layers of trauma those migrating to the United States experience — the trauma that drove them out of their country of origin; the arduous journey to the U.S.; for some, years in a refugee camp in a country that didn’t want them; and the struggle of adapting to new systems, values and policies amid a vocal backlash against immigrants.

Yet many of her classmates didn’t understand why working with traumatized families required a different layer of cultural awareness and sensitivity. One student asked, “Don’t you think you’ve talked about it enough already?”

Research by Associate Professor Sarah E. “Betsy” Bledsoe and Research Professor Virginia Strand at the University of North Carolina at Chapel Hill School of Social Work suggests there is still more work to do in addressing trauma through an anti-racist, anti-oppressive lens. Sandra Reeves Spears and John B. Turner Distinguished Professor of Social Work Trenette Clark-Goings and Clinical Associate Professor Travis Albritton are also part of the research team. Bledsoe and Strand together created a center that is part of the National Child Traumatic Stress Network.

Bledsoe and Strand have developed online training programs to reach practitioners, clinicians and social work graduate students to raise awareness to the additional barriers of racism and oppression that can thwart trauma treatment. Clinical Assistant Professor Karon Johnson adapted the course for the School’s online MSW program.

“Our goal is to get more evidence-based trauma training in the hands of practitioners,” Bledsoe said.

Bledsoe and Strand have used their curricula to train about 1,000 MSW students and close to 2,000 practitioners over the past two years. They’ve written a manual and conducted follow-up consultation calls.

“Clinicians who complete the course have more confidence and can implement practices better,” Bledsoe said.

Strand pointed out some of the difficulties community-based agencies face incorporating evidence-based trauma treatment into their mental health treatment retinue: identifying treatment specific to their clientele, paying for staff training, and providing client-specific outcome data to give feedback on efficacy.

“The other issue is most places that have the resources to do this have predominantly white clinicians,” Strand said. “We’re trying to reduce that disparity by prioritizing MSW training to HBCUs.”

The two researchers have disseminated the course to 40 schools so far and plan to train an additional 20 schools this year. They’re prioritizing HBCUs and minority-serving institutions as defined by the Council on Social Work Education. The Health Resources and Services Administration (part of the U.S. Department of Health and Human Resources) published a report a few years ago noting health disparities between BILPOC (Black, Indigenous, Latinx and other people of color) families and their white counterparts, and a scarcity of BILPOC clinicians trained in evidence-based trauma treatment.

“Communities of color are more likely to experience trauma because of their proximity to natural or manmade disasters or community violence and structural racism,” Strand said.

Laura Quiros, an associate professor of social work at Montclair State University and a trauma-informed social justice consultant, was among the first to teach Bledsoe and Strand’s common trauma-informed practice elements course. Now she supports the instructors and facilitates the course. As a Black/Latina/Jewish woman, she knows firsthand the trauma of racism and anti-Semitism. She said the study is expanding the landscape of social work practice because it’s a systems-level intervention.

“A lot of social work practice is deficit-focused and only on individuals,” Quiros said. “This curriculum helps clinicians understand it’s not the person who is deficit, but the system.”

Systems of oppression impact the mental health of the individual, Quiros said, and the Bledsoe/Strand curriculum pushes practitioners to look at the macro systems of oppression and the socio-political traumas that show up as trauma responses. International political environments and conflicts intended to obliterate ethnicities and cultures have heightened awareness of how systems cause trauma and impact mental health.

“We’re moving beyond individuals and looking at how systems cause harm,” Quiros said. “Using an anti-racist lens is critical to trauma work.”

Bledsoe and Strand are in the third year of their nearly $3 million five-year grant. They’ll begin incorporating implementation, including how to implement anti-racist principles and how to change practitioners’ knowledge and confidence. The grant is renewable, and they plan to continue their work.