Trauma & Resiliency Toolkit for CHWs

In the United States, two-thirds of children reported at least one traumatic event by age 16 (SAMHSA, 2023). This widespread public health issue comes with several unique challenges surrounding trauma treatment and service delivery, especially among communities of color. These challenges include mistrust of traditional medical and mental health professionals, lack of culturally appropriate trauma prevention and intervention services, lack of access to treatment in rural areas, and distrust and access concerns among undocumented immigrants.  

This evidence-informed Toolkit was developed by Arizona State University Office of Community Health, Engagement and Resiliency’s (OCHER) Center for Resilient Communities (CRC) through funding provided by the Substance Abuse and Mental Health Services Administration (SAMHSA), in partnership with the National Child Traumatic Stress Network (NCTSN).  

The information and resources found in this Toolkit are aimed at providing tools to Community Health Workers (CHWs), Promotores de Salud, Community Health Representatives, Community Health Advisors, Peer Support, Navigators, and other related titles, who primarily serve historically marginalized and disenfranchised communities, in efforts to build on their existing knowledge, and provide education and guidance on how to respond and support children, adolescents and families who experience trauma and toxic stress.  

  • Provide a foundational understanding of trauma across the lifespan, toxic stress, and the short-term and long-term effects of trauma on the body  
  • Support CHWs in their efforts to reduce distress and other adverse mental health impacts among children and their families who have been exposed to traumatic events 
  • Learn how to cultivate individual and community resilience and protective factors, as well as offer strategies for CHWs to enhance and promote these factors with the communities they serve 
  • Provide a library of resources that support CHW’s response to child and family trauma based on the type of trauma they experience

Alisic, E., Zalta, A., Van Wesel, F., Larsen, S., Hafstad, G., Hassanpour, K., & Smid, G. (2014). Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: Meta-analysis. The British Journal of Psychiatry, 204(5), 335-340. doi:10.1192/bjp.bp.113.131227 

Center for Disease Control and Prevention. (2021). Violence Prevention Risk and Protective Factors. Retrieved from https://www.cdc.gov/violenceprevention/aces/riskprotectivefactors.html on May 19, 2023.  

Center on the Developing Child at Harvard University. (2020, August 17). Toxic stress. Retrieved April 21, 2023, from https://developingchild.harvard.edu/science/key-concepts/toxic-stress/ 

Felitti, Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8  

Forde AT, Crookes DM, Suglia SF, Demmer RT. The weathering hypothesis as an explanation for racial disparities in health: a systematic review. Ann Epidemiol. 2019 May; 33:1-18.e3. doi: 10.1016/j.annepidem.2019.02.011. Epub 2019 Mar 19. PMID: 30987864. 

The National Child Traumatic Stress Network (n.d.). About Child Trauma. Retrieved from https://www.nctsn.org/what-is-child-trauma/about-child-trauma on March 29, 2023. 

Petruccelli, Davis, J., & Berman, T. (2019). Adverse childhood experiences and associated health outcomes: A systematic review and meta-analysis. Child Abuse & Neglect, 97, 104127–104127. https://doi.org/10.1016/j.chiabu.2019.104127 

Prevention Institute. (2017). Minimizing the Impact of Adverse Childhood Experiences through a Focus on Adverse Community Experiences. Retrieved May 19, 2023, from https://www.preventioninstitute.org/unity/publications/minimizing-impact-adverse-childhood-experiences-through-focus-adverse-community  

Substance Abuse and Mental Health Services Administration. (2023). Understanding Child Trauma. Retrieved April 3, 2023, from https://www.samhsa.gov/child-trauma/understanding-child-trauma 

Substance Abuse and Mental Health Services Administration. (2018). Culture is Prevention. Retrieved from https://www.samhsa.gov/sites/default/files/nc-oy1-task-3-culture-is-prevention-final-2018-05-31.pdf 

Waters A & Asbill L. (2013). Reflections on cultural humility. American Psychological Association. Retrieved May 15, 2023, from https://www.apa.org/pi/families/resources/newsletter/2013/08/cultural-humility 

Zero to Three. (n.d.). What are aces and why do they matter? Aces Aware. Retrieved April 21, 2023, from https://www.acesaware.org/wp-content/uploads/2019/12/1-What-are-ACEs-and-Why-Do-They-Matter-English.pdf