Running head: TRAUMA-INFORMED EBP

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A Trauma-Informed Intervention Using Mindfulness to Improve Early Childhood Classroom
Environments
Heather A. Ryan
Arizona State University

TRAUMA-INFORMED EBP
Table of Contents
Abstract……………………………………………………………………………….……..…4
A Trauma Informed Intervention Using Mindfulness to Improve Early Childhood Classroom
Environments
Chapter 1……………………………………………………………………………………..…5
Problem Statement……………………………………………………………………...7
Search Sources and Processes…………………………………………………………..8
Critical Appraisal and Synthesis………………………………………………………..9
Conclusion……………………………………………………………………………..10
Chapter 2……………………………………………………………………………………….11
Purposes/ Aims…………………………………………………………………………11
Conceptual Framework and EBP Model………………………………………...……..11
Methods……………………………………………………………………………...…12
Outcomes/ Results……………………………………………………………………...15
Discussion………………………………………………………………………………17
Chapter 3………………………………………………………………………………………..20
Conclusion…………………………………………………………………………...…21
References……………………………………………………………………………………....22
Appendix………………………………………………………………………………………..26
Appendix A: Evaluation Table………………………………………………………….26
Appendix B: Synthesis Table………………………………………………………...…47
Appendix C: Polyvagal Theory………………………………………………………...53
Appendix D: Iowa Model………………………………………………………………54

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TRAUMA-INFORMED EBP
Appendix E: Five Factor Mindfulness Questionnaire Study Results…………...……..55
Appendix F: First Things First Star Rating Chart for CLASS Tool……………...……56
Appendix G: Approval Letter from ASU IRB…………………………………………57
Appendix H: ACE Questionnaire………………………………………………….…...59
Appendix I: Five Facet Mindfulness Questionnaire Tool……………………….……..61

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Abstract
Research has shown adverse childhood experiences (ACEs) have a lifelong negative
impact on a person’s physical, mental, and social well-being. ACEs refer to experiences related
to abuse, household challenges, or neglect that occur before the age of 18. Some of the effects of
ACEs include anxiety, depression, increased stress, increase in high-risk behaviors, and early
death. Mindfulness practices have been shown to be an effective tool in reducing some of these
symptoms. In looking for ways to prevent or mitigate the effects of ACEs, it is important to
provide tools and resources to the adults taking care of children including; parents, guardians,
and teachers. The purpose of this evidence based project (EBP) was to evaluate mindfulness and
classroom environments after the implementation of a mindfulness intervention. The intervention
consisted of a three day training followed by four weeks of mindfulness practice prior to
beginning the school day. Ten preschool and Early Head Start teachers from seven classrooms at
a school in inner city Phoenix participated in the project. Utilizing the Five Factors Mindfulness
Questionnaire pre and post intervention, a paired sample t-test showed a significant increase in
two factors of mindfulness. The CLASS tool was used to assess classroom environment pre and
post intervention and showed significant improvement in five classes. These findings support
ongoing mindfulness training and practice for preschool and Early Head Start teachers to
improve classroom environments.

Keywords: adverse childhood experiences, mindfulness, classroom environment, stress

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Chapter 1
Adverse childhood experiences (ACEs) are traumatic or chronically stressful life events,
harmful to children, usually caused by their parent or guardian. These include verbal, physical,
sexual abuse and neglect, substance abuse, violence in the home, criminal activity, and mental
illness related issues (Felitti et al., 1998). Most of these issues stem from poor coping on the part
of the adult(s) in the home. Often times the adult was the recipient of the same behavior when
he/she was a child, and failed to develop adaptive coping skills into adulthood. Thus, a cyclical
pattern of abuse and neglect tends to continue generation after generation (Kuffer, Thoma, &
Maercker, 2016).
Kaiser Health System and the Centers for Disease Control (Felitti et al., 1998) completed
a landmark study looking at ACEs and various lifelong physical and mental health challenges. A
stepwise relationship was found between number of ACEs and risks for poor health and
wellbeing outcomes. The greater number of ACEs a person reported directly correlated to an
increase in risk for several different negative outcomes including depression, increased stress,
increase in suicidality, addiction issues, heart disease, cancer, diabetes, and early death. As a
result, health professionals began to reconsider the ways to think of and address childhood
trauma. Knowing the effects of childhood trauma are so pervasive has caused greater urgency in
finding ways to prevent and treat the various manifestations of it. Many now acknowledge this as
a public health crisis. Because trauma affects so many areas of life, it has implications for
education, health care, mental health care, justice, and general public safety.
Interventions centering on mindfulness have come to the forefront of the conversation
around how childhood trauma impacts health and wellbeing. New research has implicated that

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trauma, especially in early childhood, builds pathways in the brain that work to help that person
survive in chronic stressful situations but often become maladaptive later in life. Mindfulness
practices have been shown to be effective for rewiring these pathways towards healthier patterns,
mitigating the risks associated with ACEs. Mindfulness can be defined as “an individual’s innate
ability to be aware of what is happening internally and externally with open curiosity and
without judgement” (Perry-Parrish, Copeland-Linder, Webb, & Sibinga, 2016).
Mindfulness instruction began with Jon Kabat-Zinn’s (1992) curriculum called
mindfulness-based stress reduction or MBSR, derived from Buddhist meditation practices.
MBSR was originally developed for people suffering from chronic pain and commonly used to
treat stress and anxiety symptoms (Kabat-Zinn, 1992). The goal of mindfulness training is to
learn to focus one’s attention on the present experience while letting go of any negative, selfcritical thoughts (Perry-Parrish, Copeland-Linder, Webb, & Sibinga, 2016). Using mindfulness
to react to difficult experiences has been thought to decrease stress, improve psychological
functioning and increase positive coping (Perry-Parrish, Copeland-Linder, Webb, & Sibinga,
2016). Additionally, mindfulness has been shown to increase empathy and assist in improving
relationship happiness (Sawyer Cohen & Semple, 2010).
The project presented in this paper focuses on using mindfulness training for early
childhood teachers that are at high risk for ACEs. Mindfulness interventions foster listening to
others with full attention without judgement, encourage compassion and a sensitivity to the needs
of others which are critical skills to impart to our teachers. Apart from parents or guardians,
teachers spend the most time with children throughout the day, therefore it is imperative that they
have healthy self-regulation tools.

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Research on mindfulness and teachers is emerging. Frank, Jennings, and Greenberg
(2015) showed that mindfulness encourages self-awareness and a sense of calm, which can help
teachers maneuver the different challenges that arise throughout their day. Crain, Roser, &
Schonert-Reichl (2017) discuss the potential for mindfulness to decrease feelings of stress
throughout the day and hopefully decrease burnout rates among teachers. They report
improvement in teachers’ sleep, decrease in negative moods throughout the day and a decrease in
rumination about work while at home after participating in their mindfulness program .
Problem Statement
Wanting to further assess how mindfulness practices could impact teachers in an early
childhood setting, Early Head Start was identified as an area for opportunity. The director of a
school in downtown Phoenix, Arizona recognized the potential benefit to a mindfulness
intervention for the teachers in her program, including improving skills of self-regulation,
coping, and conflict management along with decreasing emotional reactivity. As mindfulness has
been indicated to be effective in improving the above skills (Sharp, & Jennings, 2015), a
mindfulness-based intervention was developed for implementation in this setting. This led to the
following PICOT question: Compared to current professional development training (not based in
mindfulness), does mindfulness training and associated practices help to (a) increase mindfulness
in preschool and Early Head Start teachers and (b) improve their classroom environments?

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Search Sources and Processes
Multiple databases were utilized in order to complete a comprehensive and exhaustive
search of the literature regarding mindfulness as it relates to teachers of children ages 0-4,
specifically. Four major medical databases made up the majority of the search process including
PsycINFO, CINAHL, Cochrane, and PubMed. Literary search terms used were mindfulness,
preschool and teacher. These searches were further limited by specific parameters: Full text,
English language, and peer reviewed journals. Only literature from the past five years was
included in this inquiry.
Using the search terms ‘mindfulness’ and ‘teacher’ and ‘preschool’ gave 13 results on
PsycINFO. Search terms ‘mindfulness’ and ‘teacher’ produced 27 results on CINAHL. The
Cochrane database was consulted using the terms ‘mindfulness’ and ‘teacher’ resulting in 58
trials. The last database that was consulted was PubMed with the search terms ‘mindfulness,’ and
‘teachers’ resulting in 69 different results. Additional studies were hand-searched based on how
frequently they were referenced in studies reviewed. One landmark study was consulted due to
the incredible impact it has had on this area of research.
A total of 167 studies were reviewed. Thirty were included for critical appraisal and 10
were chosen for the purposes of this literary review. Excluded studies were either not specific to
the topic being studied, did not provide substantial evidence, or did not provide for enough
clarity in their data. Valuable studies included here outline the impact that mindfulness has for
teachers and the children they care for daily.

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Critical Appraisal and Synthesis
Ten studies chosen for this literature review examine the effectiveness of mindfulness in
teachers (Appendix A). Of these ten studies, five are randomized controlled trials; one is a quasiexperimental study; two are cross-sectional/ correlational studies; two are qualitative studies
(Appendix B). Eight of these studies focused on teachers, and two of these studies was focused
on a general adult population. A wide variety of tools were used for evaluation of the different
populations represented in this literature. The majority of the tools used in this literature are ones
that have been widely accepted and shown to be valid. Additionally, the few tools used that did
not have the same level of reliability were discussed by the researchers to have appropriate
Cronbach alpha testing with results between (0.70-0.91).
Mindfulness was evaluated in many different contexts and formats throughout all of the
studies represented here (Appendix A). Although the concept of mindfulness was the same
throughout all of the research, the studies summarized the effectiveness of certain mindfulness
training programs or yoga therapies. None of the mindfulness training programs were the same,
although three reported utilizing concepts from Mindfulness Based Stress Reduction created by
Kabat-Zinn (1992). While proving a benefit to understanding a wide variety of evidence-based
mindfulness interventions for our purposes, it was difficult to determine a specific protocol or
intervention effective to train teachers.
The literature analysis confirmed interventions centered in mindfulness combat the
effects of trauma including anxiety, depression, and increased stress, in addition to improving
teacher well-being (Molloy Elreda, Jennings, DeMauro, Mischenko, & Brown, 2018; Becker,
Gallagher, & Whitaker, 2017; Harris, Jennings, Katz, Abenavoli, & Greenberg, 2015; Jennings,
Frank, Snowberg, Coccia, & Greenberg, 2013). Links were seen between teachers’ social and

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emotional wellbeing, classroom environment, and student academic outcomes. Teachers’ high
levels of stress were associated with behavioral interventions in the classroom that were reactive
instead of proactive, strained teacher/ student relationships, and poor classroom climate (Molloy
Elreda, Jennings, DeMauro, Mischenko, & Brown, 2018). For instance, Jennings et al.(2013)
report a correlation between teacher stress and student behavior, stating that a teacher’s positive
attitude in the classroom reduces problem behaviors and increases student productivity.
Conclusion
Evidence indicates teachers should have a high level of social and emotional competence
in order to manage the social and emotional dynamics of the classroom effectively. Essentially,
these studies imply the need for teachers to obtain skills of social and emotional competence
before imparting maladaptive behaviors to their students. These important observations suggest
that one effective way to help a child grow and develop is to enable the adults in their life acquire
the skills needed for social and emotional competence. Mindfulness training has been shown in
prior work to improve these skills.

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Chapter 2
Purposes/ Aims
A mindfulness intervention was developed for teachers that incorporated known effective
practices, while also being tailored to the needs of stakeholders. The intervention included a
three day professional development training for teachers followed by four weeks of mindfulness
practice. Teacher mindfulness qualities and classroom environment were measured pre and postintervention to evaluate our project’s effectiveness.
Conceptual Framework and EBP Model
Polyvagal Theory was the conceptual framework that guided the mindfulness
intervention. It is an explanatory model used to understand human behavior and stress. The
model describes the connections between neurophysiological patterns of autonomic regulation
and how those are expressed as emotions and social behavior (Sullivan, Erb, Schmalzl, Moonaz,
Taylor, & Porges, 2018). Mind-body therapies, like mindfulness, encourage somatic awareness in
conjunction with nonjudgement, non-reactivity, curiosity, and acknowledgment in order to reassess our current situation and modify our physical/ emotional reaction to it. This has been
found to increase adaptability, self-regulation, and resilience, which can lead to an increase in
wellbeing (Appendix C).
In addition, the Iowa Model of Evidence Based Practice (EBP) was utilized to provide an
implementation framework (Appendix D). Steelman (2016) describes the Iowa Model as a
pragmatic and systematic approach to evidence based practice demonstrating a step by step
methodological approach to the EBP process. With the school director, possible issues (triggers)
were reviewed and discussed if they are a priority for the organization. The next step included
the review of the literature, as was completed in this paper, prior to developing and implementing

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the evidence-based intervention. The final step included an evaluation of the project (Doody, &
Doody, 2011).
Methods
This evidence-based project was conducted with Early Head Start and preschool teachers
in an underserved community in downtown Phoenix, Arizona. The director of the Early Head
Start program described a need for this intervention, reporting many of her teachers came from
this same underserved community, were at high risk for childhood trauma, and were exhibiting
challenging behaviors related to poor self-regulation and coping. Additionally, the culture of
developing leadership skills and healthy habits were discussed. For example, many teachers had
already exhibited motivation to participate in team health challenges by self-initiating a weight
loss and exercise goal.
After receiving approval from Arizona State University Institutional Review Board
(Appendix G), the project began with a three-day professional development program focused on
areas of trauma, mindfulness, positive discipline, and self-regulation strategies. This program
was previously developed for a grant through the Kohls Foundation and has been implemented in
many schools throughout the valley. Instructional material was infused with mindfulness
practices throughout the day with the addition of yoga instruction the third day of the training.
Teachers then participated in four weeks of mindfulness practice that included yoga,
meditation, and deep breathing for 10-15 minutes prior to their work day. Mindfulness was led
by both an instructor certified in mindfulness and an electronic app-based guided meditation.
Teachers were asked to participate in mindfulness practice at least three of the five work days for
four weeks. All were given the option of doing mindfulness exercises at home for 10-15 minutes
prior to their work day via a mindfulness cellphone app. Participation was tracked via an

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anonymous log sheet utilizing participant’s unique four digit code . The same four digit code was
utilized on all written materials, keeping responses and participation anonymous.
Demographic information was recorded for the teachers pre-intervention. Pre and postintervention data included ACE scores, the Five Factor Mindfulness Questionnaire (FFMQ) and
qualitative short-answer questions to measure mindfulness and teacher’s understanding of and
experience with this mindfulness intervention. Adverse childhood experiences (ACE) scores
were measured using an assessment based on 10 items related to abuse, household challenges,
and neglect. Classroom environment was measured pre and post-intervention via the Classroom
Assessment Scoring System (CLASS) tool which is an ongoing observational assessment used
for teacher professional development throughout Arizona, and currently utilized for both the
preschool and Early Head Start classrooms. All tools are described in detail below.
The ACE tool (Appendix H) was utilized more specifically for our purposes, to evaluate
exposure of the teachers to childhood trauma. It contains 10 items asking about divorce, mental
illness, substance abuse, physical abuse, food insecurity, sexual abuse, neglect, verbal abuse, and
domestic violence (Felitti, 1998). Test, re-test reliability testing was done by Dube, Williamson,
Thompson, Felitti, and Anda (2004), which showed a weighted kappa coefficient of .64 (95% CI,
.36–.60). Its validity is currently widely accepted in its field.

The Five Factors Mindfulness Questionnaire (FFMQ) (Appendix I) was used to measure
mindfulness. This tool is 39-item instrument, using a Likert-type scale (1-5), with answers
ranging from “never or very rarely true” to “very often or always true.” The five factors
designated here which are used to define dimensions of mindfulness include: observing, acting
with awareness, describing, non-judging of inner experience, and non-reactivity to inner
experience (Baer et al. 2006). Park, Reilly-Spong, and Gross (2013) conducted reliability and

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validity tests for this tool. They state in their work that this tool shows an internal consistency
seen by a Cronbach’s alpha for all five subscales between 0.67 to 0.93.
The CLASS tool is already currently utilized in preschool and Early Head Start systems
in multiple states. It was created to be a professional development instrument which could be
utilized by schools to assess teacher performance related to three domains; Emotional Support
(ES), Classroom Organization (CO), and Instructional Support (IS) and for the infant classroom,
Responsive Caregiving (RC). At the project site, CLASS evaluations are conducted twice a year,
one in the beginning of the first semester and one towards the beginning of the second semester.
Experts conduct this evaluation and provide the results to the school and the aggregated data was
shared at two time points for the project. Support for the use of this tool comes from the fact that
it was derived out of foundation steeped in early childhood theory and because of the fact that it
is widely used for quality testing throughout many states, including Arizona (Perlman,
Falenchuk, Fletcher, McMullen, Beyene, & Shah, 2016). Additional validity and reliability
information for this tool was otherwise not found.
Qualitative short-answer questions were asked pre and post-intervention. Pre-intervention
questions covered: How do you define mindfulness? When you feel upset, describe your usual
immediate response? What do you hope to learn from this experience? Post-interview questions
are as follows: How would you define mindfulness after going through this training? Has your
response to feeing upset changed at all after practicing mindfulness? If so, please describe how it
has changed? What do you feel has been the most important thing you have taken away from this
experience? What challenges did you face while participating in this study (if any)? Did you
complete all four weeks of mindfulness practice before work at least three days a week, Monday-

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Friday for 5-10 minutes? If you did not, please state what barriers you had to completing
mindfulness practice.
Prior to running analysis, normality testing was done using Kolmogorov-Smirnov
statistic in addition to evaluating Stem-and-Leaf plots for all five aspects of mindfulness in the
FFMQ. Based on these results, a paired samples t-test was determined to be appropriate for
evaluation of this data. SPSS was utilized to run this statistical analysis. Due to the relatively
small sample size, demographic and ACE questionnaire data were evaluated by adding up results
to address frequency. Results of the CLASS tool were compared pre and post-intervention and
then evaluated per the tool’s written criteria for ‘low,’ ‘middle,’ or ‘high’ ratings. Qualitative data
was evaluated by spreading out all question/ answers forms, pulling out themes from answers
given by making a check-list of all responses and checking for frequency. All answers and
themes reviewed with statistical consultant for validity and reliability.
Outcomes/ Results
Twenty-four teachers participated in the 3-day intervention training. Seventeen teachers
completed all surveys pre and post-intervention. Ten out of the 24 teachers participated in
mindfulness practices in the four weeks following, for a total participation rate of 42%. Twentythree teachers reported being female, all but two teachers self-identified as Hispanic, one as
white, the last identified as African American/ Asian or Pacific Islander. The majority of the
teachers reported being between 23-32 years old, three reported being 33 or older and two
identified as being between 18-22. Five teachers reported no previous experience with
mindfulness, eight stated they had tried it one time prior, six mentioned practicing mindfulness
occasionally. Seven teachers had between 0-2 years of experience, six had 3-4 years of
experience, three reported having 5-6 years of experience teaching in a preschool. Four teachers

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reported a 0 ACE score, seven teachers reported having between 1-3 ACEs. Seven teachers
reported having an ACE score of 6 or above on the ACE questionnaire.
A paired sample t-test was run on FFMQ data from teachers that completed the three-day
training and completed all surveys pre and post-intervention regardless of participation in
mindfulness practice. Pre to post-intervention analysis of mindfulness factors were seen as;
observing pre-intervention (M=24.47, SD=4.53) to post-intervention (M=25.24, SD=7.22),
(t(16)=-.48, p= .64); describing pre-intervention (M=23.82, SD=2.07) to post-intervention
(M=27.65, SD=5.29), (t(16)=-3.53, p= .003); awareness pre-intervention (M=24.18, SD=4.82) to
post-intervention (M=26.24, SD=3.78), (t(16)=-1.37, p= .19); nonjudging pre-intervention
(M=24.82, SD=4.75) to post-intervention (M=27.82, SD=3.99), (t(16)=-1.58, p= .13);
nonreactivity pre-intervention (M=19.91, SD=3.39) to post-intervention (M=21.41, SD=3.59),
(t(16)=-2.46, p= .03) (Appendix E).
Qualitative data showed a greater depth of understanding mindfulness by the teachers
post-intervention as seen through descriptions of mindfulness going from one-two words, to
descriptive, more involved statements (i.e. “Just knowing my emotions and how I feel in certain
situations.” and “being in the present.”). Benefits experienced from this intervention as described
through qualitative short answer questions included: Awareness of importance of self-care,
increased awareness of emotions, improved ability to take a deep breath and pause before acting,
improved ability for being in the present moment, and increased ability to destress oneself.
CLASS scores for the preschool classroom pre-intervention in the three sub-scales are as
follows (ES=4.9, CO=3.2, IS=2.5), which increased post-intervention to (ES=6.81, CO=6.33,
IS=3.58). Toddler classroom scores went from pre-intervention (ES=4.8, CO= 3.65, IS=3.55), to
(ES=5.50, CO=4.0, IS=4.0) post-intervention. Infant classroom scores went from pre-

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intervention (RC=3.38), to post-intervention (RC=4.5). Classroom environments improved in all
three, infant, toddler, and preschool classrooms with the preschool room showing the greatest
improvement increasing from ‘middle’ to ‘high’ range in scores, whereas the infant and toddler
classrooms remained at a ‘middle’ rating (Appendix F). Preschool and toddler classroom values
are correlated with a star rating through an organization called First Things First, as they evaluate
preschool programs throughout Arizona (Appendix F).
Discussion
Teachers in this program did report having a significant number of ACEs with 7 teachers
reporting an ACE score of 6 or greater. This was consistent with our prediction for this
population. Significant increases were seen in the data on the describing and non-reactivity
factors of mindfulness whereas the other three domains saw an insignificant increase in scores.
This significant increase in describing and non-reactivity correlated with qualitative data findings
which suggested that many teachers found this intervention to increase ability to pause and take a
deep breath before reacting and improved ability to be in the present moment. It is possible also,
that as teachers, skills of describing are easier to hone and so are adapted to earlier than the
others.
The sample for this project was homogenous with most of the teachers reporting being
Hispanic, female, and between the ages of 23-32 years old. This makes it difficult to generalize
project findings to other populations, although the teaching profession is still majority female. As
this community is largely Hispanic, it may be indicative of mindfulness interventions with this
population.
While an improvement in CLASS scores was seen, many factors may explain the change.
The preschool classroom had a different person completing the CLASS tool pre and post-

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intervention whereas the toddler and infant classroom had the same examiner. CLASS results
showed an increase in all three preschool, toddler, and infant classrooms. This increase was
highest in the preschool classroom. The preschool classroom had the highest attendance through
all portions of this project including mindfulness practice. Additionally, they experienced no
turnover whereas the Early Head Start program had both a new director and subsequently, a large
teaching staff turnover prior to the second CLASS evaluation period. Teachers expressed
increased stress throughout this time because of the change in director. The new director began
work during the last week of this intervention and was available throughout dissemination of
results. Stability was seen in the preschool classroom with no change in staff throughout this
process. This suggests that classroom environment is most affected by teachers who participate
in mindfulness training in addition to mindfulness practice. Additionally, it is difficult to
determine the full effect on classroom environment for the toddler and infant classrooms as it is
unclear how many of those teachers had been present for the EBP. It is possible that without this
staff turnover, those classrooms would have experienced a larger increase in scores as well.
Qualitative data provided a depth in understanding this experience for these teachers.
Responses such as, “I am important, my health and mental health is my priority to succeed in
other aspects of my life (personal and professional),” and “I catch myself breathing before
acting,” give additional meaning to the impact of mindfulness in this population. Verbal feedback
from the teachers throughout this program provided understanding of other ways in which some
teachers were utilizing mindfulness outside of the suggestions of this project. Some reported
using the app in the evenings at home with their children and to help them sleep at night. These
same individuals reported an increase in patience with their children, and improved behavior in

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their children in addition to improved sleep for both themselves and their children. One
mentioned using it at home with a spouse as well, reporting increased calm for them both.
As teachers were required to attend professional development, one strength of the project
included 100% participation from teachers with paid time through their work. However, the
extended mindfulness practice proved to be a barrier as it required teachers to arrive 10-15
minutes early every day. Some reported having issues with transportation or with their children
needing early childcare. A few teachers were able to do mindfulness before work by utilizing the
cell phone app but others stated it was difficult to even take this time with the chaos of the
morning and demands on their time with their children at home. Others explained that it was
difficult to participate in the mindfulness practice as it was a new habit they had not built into
their schedule prior to this intervention.

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Chapter 3
There are a number of implications for the outcomes of this data. An improved ability to
pause and take a deep breath before reacting, which was found in the teachers’ qualitative data
post-intervention survey results, can lead to improved self-regulation and improved ability to be
emotionally supportive of others. This in turn can lead to improved relationships between
teachers and their students as well as between teachers and their coworkers. Increased awareness
of one’s emotions, improved ability to “destress” oneself, and improved ability for being in the
moment, which were also found in our data, all work to help teachers have a calmer demeanor
and less reactivity (Becker, Gallagher, & Whitaker, 2017). By instilling mindfulness in teachers,
they may develop better skills to manage the emotions of the children in their classroom.
An increase in mindfulness can also lead to an improvement in classroom environment,
as was seen in our data from the CLASS tool. Improvement in mindfulness in teachers might
help lead to a more cohesive team and potentially greater teacher retention, which improves
stability of the classroom and workplace. The CLASS tool ratings are correlated to sources of
grant funding through organizations such as First Things First. CLASS scores are associated with
a star rating that is published and accessible to parents looking for a preschool or Early Head
Start environment for their children. An improvement in CLASS scores, therefore, can be
directly linked to greater sustainability through higher state rating and higher demand for
enrollment.
Mindfulness cell-phone applications were utilized in this study in an attempt to
familiarize this method and modality of mindfulness practice for teachers. Cell-phone
applications are easy to use, and many have free meditations to follow, making continuing
mindfulness practice after this intervention a possibility for those that may not have time or

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money to find an outside resource. This study population consisted primarily of Latina women
ages 23-27, making it difficult to generalize study findings to other populations. Additional
research is needed to formulate best practice as it relates to mindfulness with early childhood
educators. Study findings do point to the fact that mindfulness can improve teacher selfregulation, lower teacher stress, and improve classroom environments. This, in conjunction with
ease of usability, lead us to conclude that mindfulness practice should be encouraged for early
childhood teachers in the workplace.
Conclusions
Research on mindfulness in relation to teachers is lacking in cohesive program structure.
However, literature is consistent in reporting an increase in mindfulness to improve many aspects
of teacher wellbeing in addition to relationships between teacher and student and classroom
organization. These findings in the research are consistent with what was seen in the results of
this evidence based project. Through the combination of training and practice, mindfulness
increased in this teaching population. Additionally, an improvement in classroom environment
scores were noted post-intervention. Qualitative data supported these results as well and
provided for a greater depth of understanding of these findings.
Teachers expressed general acceptance of this program although some found it
challenging to participate before work most days. Additional research is critical to discovering if
there is a best practice mindfulness, professional development program that should be adopted by
school systems. In general, these findings support the ongoing utilization of this EBP as a way of
increasing mindfulness for teachers and affecting positive change in classroom environments.

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TRAUMA-INFORMED EBP

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management and wellbeing in educators: Feasibility and Efficacy of a school-based yoga
and mindfulness intervention. Mindfulness, 7(1), 143-154. doi: 10.1007/s12671-015-0451-2
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relation to classroom quality and attitudes towards challenging students. Mindfulness, 6(4),
732-743. doi: 10.1007/s12671-014-0312-4
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Improving classroom learning environments by cultivating awareness and resilience in
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TRAUMA-INFORMED EBP

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psychoeducational and support group for teachers. Journal for Specialists in Group Work,
41(2), 117-139. doi:10.1080/01933922.2016.1151470
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TRAUMA-INFORMED EBP

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Sharp, J. & Jennings, P. (2016). Strengthening teacher presence through mindfulness: What
educators say about Cultivating Awareness and Resilience in Education (CARE) program.
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Running head: trauma-informed EBP

26
Appendix A

Table 1
Evaluation Table

Citation

Becker
(2017)
Teachers’
dispositional
mindfulness
and the
quality of
their
relationships
with
children in
Head Start
classrooms
Funding: 0

Conceptual
Framework

Article
proposed
conceptual
framework
between
study
variables

Design/
Major
Method/
Variables
Sampling
Sample/Setting Studied
(Grounded
(describe)
and
Theory,
Their
phenomenology,
Definitions
Narrative)
Design: COR S,
CR S

Purpose: This
study investigated
mindfulness
disposition in
teachers and its
association with
quality of
relationship
between teacher
and preschool aged
children.

n= 1001
classroom
teachers
PA Head Start

550 lead teachers
451 assistant
teachers
98% women
89% white
6% Hispanic

IVdispositional
mindfulness

DV-1
teacher/
child
relationship
DV-2
depressive sx
DV-3
workplace
stress

Measurement/
Instrumentation
Data
(focus group,
Analysis
1:1, openended survey)
IV- CAMS-R
DV-1- STRS
DV-2- CES-D
DV-3- JCQ
One time, web
based survey

Path
analysis
with
robust
(HuberWhite)
standard
error
estimates

Findings/
Themes

All bivariate
correlations
between
conflict,
closeness,
dispositional
mindfulness,
depressive
symptoms,
workplace
stress
significant
(p< 0.001)

Level/Quality
of Evidence;
Decision for
practice/
application to
practice/
Generalization
Level IV

Findings support
importance of
mindfulness in
improving
quality of
relationship
between
teachers/
students
Weakness:
May not be
generalizable to
all Head Start

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable

trauma-informed EBP

Citation

Cormack
(2018) A
“collective
effort to
make
yourself feel
better”: The
group
process in
MBI
Funding:
None
Bias:
See
weaknesses
Country:
England

Conceptual
Framework

Margaret A.
Newman’s
theory of
health as
expanding
consciousness

27
Design/
Major
Method/
Variables
Sampling
Sample/Setting Studied
(Grounded
(describe)
and
Theory,
Their
phenomenology,
Definitions
Narrative)
Design: GT
Purpose: “This
study aimed to
develop a detailed
theory of MBI
group process
utilizing a
grounded theory
methodology.”
Recruited through
MBI T, TR by
email or in person
at mindfulness
conferences.

Participants=
MBI S (within
last 18 mo.), T,
TR.
n=12
MBI S n=6
MBI T n=2
MBI TR n= 4
11 SI White
British
1 SI White
American
8=F, 4=M
Attrition: 0

This study
explored the
group
experience
as it pertains
to MBI.
New GT was
established
to explain
the
experience
of group
MBI from
the
perspective
of S, T, TR.

Measurement/
Instrumentation
Data
(focus group,
Analysis
1:1, openended survey)

1:1 semistructured
interview 4590 minutes
long

Line by
line open
coding
supported
by
theoretical
notations
and
conceptual
links
between
codes

Findings/
Themes

Core
category:
the group as
a vessel on a
communal
journey
Higher order
category:
-charting the
course
-building
and sailing
-communal
experience

Level/Quality
of Evidence;
Decision for
practice/
application to
practice/
Generalization
Level VI
evidence.
Weaknesses:
Homogenous and
self-selected
sample. Not from
clinically
complex sample.
Strengths:
Feedback
received from S,
T, TR, gives
more wellrounded view of
group MBI.
Good insight for

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP

Citation

Conceptual
Framework

28
Design/
Major
Method/
Variables
Sampling
Sample/Setting Studied
(Grounded
(describe)
and
Theory,
Their
phenomenology,
Definitions
Narrative)

Measurement/
Instrumentation
Data
(focus group,
Analysis
1:1, openended survey)

Findings/
Themes

Level/Quality
of Evidence;
Decision for
practice/
application to
practice/
Generalization
potential work
with mindfulness
in a group
setting.
Feasibility:
easily replicable
design, good
feasibility.

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP

29

Citation

Theory/
Design/
Conceptual Method
Framewor
k

Sample/
Setting

Major
Variables
&
Definition
s

Measurement/
Instrumentatio
n

Data
Analysis
(stats
used)

Findings/
Results

Crain, T.,
(2016).
Cultivating
teacher
mindfulness:
Effects of a
randomized
controlled trial
on work, home
and sleep
outcomes

Transactional
model of
stress and
coping

N=113 public
school
teachers

IV-time
DV-1
Mindfulness
DV-2 Job
rumination
DV-3
Satisfaction
and mood
DV-4 sleep
quality
DV-5 sleep
quantity and
sleepiness

Data collected via
take home survey
at baseline, post
program, and 3
month follow up

Controlled
for baseline
using
analyses of
covariance
(ANCOVA)

(DV-1) MI INC
SIG between MI
group and CG
after completion
(F(1,109)
=16.92, p<.01,
Cohen’s d =.79),
& INC a little bit
more at 3 month
FU (F(1,95) =
17.37, p<.01,
Cohen’s d
= .87).

Funding:
Spencer
Foundation,
Fetzer Institute,
Mind and Life
Institute,
Portland State
University

Lazarus &
Folkman
“The effects
of
randomizatio
n to a
workplace
mindfulness
training
(WMT) or a
waitlist
control
condition on
teachers’

RWCT
Flyers sent to all
eligible teachers
in each district.
First 65 teachers
were chosen.
Randomly
assigned to wait
list or WMT.
8 week, 11
session program,
36 total contact
hours.

Canadian=58
E. Can= 67%
A. Can=
18%
Other=15%
US=55
E. AM =93%
Mix
Race=5%
A. AM= 2%
F = 89%
M= 11%

Five Factor
Mindfulness
Questionnaire
(FFM)
Job rumination at
home
(Chronbach’s
alpha >.70)
Satisfaction and
mood/ sleep
quality, sleep

Analyses of
variance
(ANOVA)

(DV-2) Job
rumination DEC
SIG between
MG & CG after
completion
(F(1,107) =

Level/Qualit
y of
Evidence;
Decision for
practice/
application
to practice
Level II
research

Strengths:
High level
research shows
this MI
program
effective in
DEC job
rumination,
INC MI, IMP
mood, & life &
work
satisfaction.
Weaknesses:
This program is
labor and time
intensive but

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP

Bias: None
Country:
Canada,
USA

well-being…
examined in
two RCT.”

30
EX= 1-35
years
From western
Canada and
western part
of US
Average age=
46.9
73%= with
master’s
degree
Attrition: 0

quantity, and
sleepiness
(Kahneman et al.,
2004)
No reliability
report
documented

14.97, p<.01,
Cohen’s d =-.82)
& DEC more at
3 month FU
(F(1, 94) =
19.58, p<.01,
Cohen’s d= -.87)
(DV-3) Bad
moods at work
DEC SIG
between MG &
CG after
completion of
study (F(1,97)=
6.43, p<.01,
Cohen’s d =
-.59) and DEC
more at 3 month
FU (F(1,86)=
6.96, p<.01,
Cohen’s d =-.66)

does show
effectiveness of
MI with Ts.
Feasibility:
due to labor
and time
intensive nature
of this
program.
Feasibility is
poor for
replication of
this study.

SIG DEC bad
moods at home
(F(1,97)= 10.75,
p<.01, Cohen’s
d=-.64), & after
Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP

31
(F(1,83) = 9.33,
p<.01, Cohen’s
d =-65)
IMP satisfaction
with work
(F(1,106)=4.57,
p<.01), Cohen’s
d =.45)

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP

32

Citation

Theory/
Design/
Conceptual Method
Framewor
k

Sample/
Setting

Major
Variables
&
Definition
s

Measurement/
Instrumentatio
n

Data
Analysis
(stats
used)

Findings/
Results

Harris (2016)
Promoting
Stress
Management
and Wellbeing
in Educators:
Feasibility and
Efficacy of a
School-Based
Yoga and
Mindfulness
Intervention

Polyvagal
theory

RCT with wait
list

N= 64

IV- CALM

DV-1 FFMQ 39

Stephen
Porges

Purpose: Assess
for feasibility
and efficacy of
the Community
Approach to
Learning
Mindfully
(CALM)

98% white
88% female
Mean age 43
years
Average
teaching
experience=
14 years

DV-1
Mindfulness
DV-2 Affect
DV-3
Emotion
regulation
DV-4
distress
tolerance
DV-5
relational
trust
DV-6
teaching
efficacy
DV-7 Time
urgency

DV-2 Positive
and Negative
Affect Scheduleshort form
(PANAS)

DV-1
(Observatio
n p<0.05)

CALM
increased
observation,
classroom
management.
Did not alter
frequency of
negative affect,
but helped
coping with
negative
emotions. Well
received.
Positive affect
on lowering BP
and cortisol.

Funding:
grants from the
1440
Foundation and
Penn State
Children,

2 middle
schools
Attrition=1

Demographics
:

Inclusion:

DV-3 Emotion
Regulation
Questionnaire
(ERQ)
DV-4 Distress
Tolerance Scale
(DTS)

DV-2
(positive
affect
p<0.01)
DV-4
(distress
tolerance
P<0.01)
DV-6
(classroom
managemen
t p<0.05)

Level/Qualit
y of
Evidence;
Decision for
practice/
application
to practice
Level of
evidence: II

Strengths:
diverse
outcome
management
Weaknesses:
homogenic data
(female and
white)
Feasibility:
this study is
moderately
feasible due to
brief yoga
intervention

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP
Youth, and
Families
Consortium. In
addition to
grant
R305B090000
7, TIES predoctoral
fellowship
from the
Institute of
Education
Science
Bias: small,
homogenous
sample
Country: USA

33
DV-8
Perceived
stress
DV-9
Professional
burnout
DV-10
Physical
symptoms
DV-11 Sleep
related
impairment
DV-12 blood
pressure
DV-13
Cortisol

DV-5 TeacherTeacher
Relational Trust
DV-6 Teacher’s
Sense of Efficacy
Scale (TSES)
DV-7 Time
Urgency
DV-8 Perceived
Stress Scale

DV-10
Fewer daily
physical sx
(p<0.05)
DV-12 Sig
Decrease in
DBP but not
SBP
(p<0.05)

throughout the
day. May be
difficult to
obtain yoga/
mindfulness
instructor for
ongoing
practice in this
setting.

DV-9 Maslach
Burnout
Inventory
DV-10 The Daily
Symptom Scale
DV-11 PROMIS
Sleep-Related
Impairment scale
DV-12 Blood
pressure x3 @ in
person
assessment

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP

34

DV-13 Saliva

Citation

Theory/
Design/
Conceptual Method
Framewor
k

Sample/
Setting

Major
Variables
&
Definition
s

Measurement/
Instrumentatio
n

Data
Analysis
(stats
used)

Findings/
Results

Jennings, P.
(2013).
Improving
classroom
learning
environments
by cultivating
awareness and
resilience in
education
(CARE):
Results of a
randomized
controlled trial
Funding: U.S.
DEIES

Social
Cognitive
Theory of
SelfRegulation

n= 53

IV-CARE
program

Positive and
Negative Affect
Schedule
(PANAS)
Coefficient alpha
for positive and
negative (0.92,
0.85)
Emotion
Regulation
Questionnaire
(ERQ)
Coefficient alpha
for reappraisal
and suppression

Single-level
analyses

(DV-1) Wellbeing, SIG
finding reports
of DPS,
F(1,47)= 10.2,
p=.002; d=-.32
(DV-2) teacher’s
sense of selfefficacy:
F(1,47)=10.6,
p=.002, d=.60;
Efficacy in
student
engagement:
F(1,47)=10.3,
p=.002, d=.59;

Albert
Bandura
The
Prosocial
Classroom
Model

RCT
Self-report
measures pre
and post
Purpose: “The
present study
examines
whether the
CARE
professional
development
program can
improve
teachers’ socialemotional

Urban and
suburban
public
schools in
two districts
in NE U.S.
89% =female
47= white
2=AA
2= Hispanic
1= biracial
1= declined
to report

DV-1
General
well-being
DV-2
Efficacy
DV-3
Burnout and
time
pressure

Independent
t- test= no
significant
difference
between
intervention
and control
group for
baseline
data.
ANCOVAs

Level/Qualit
y of
Evidence;
Decision for
practice/
application
to practice
Level of
evidence: 1I

Weaknesses:
Homogenous
population,
unsure if
reflective of the
community
based on
limited race
related data for
the area.
Need outcomes
related to

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP
#R305A09017
9
Bias:
homogenous
sample/
program
studied was
developed by
these
researchers
Location: U.S.

Jennings,
Greenberg
(2009)
The CARE
Intervention
Model

35
competence and
well-being.”

72%=graduat
e degree
Mean age=36
Mean years
teaching=
11.7
(more educated
and more
female than
general
population of
teachers for
that area) no
info for racial
demographics
for same area
teachers

ELE=47%
P/S n=3
H/S n=6
Mixed grade
N=16

DV-4
Mindfulness

subscales (0.90,
0.67)
The Center for
Epidemiologic
Studies
Depression Scale
(CES-D-20)
(α=0.87)
The Daily
Physical
Symptoms
(DPS)
(α=0.77)
Teachers’ Sense
of Efficacy
Questionnaire
(TSES)
(α=0.95)
Maslach
Burnout
Inventory (MBI)
The Time
Urgency Scale
(TUS)
Speech patterns
(α=0.72), eating
behavior

(DV-3)
Burnout/timepressure
General hurry
subscale
F(1,47)=5.4,
p=.025, d=-.42;
personal
accomplishment
subscale of
MBI,
F(1,47)=3.9,
p=.05, d=.40
(DV-4)
Mindfulness
Observing,
F(1,47)=9.8,
p=.003, d=.73;
FFMQ summary
mindfulness
score:
F(1,47)=4.29,
p=.044, d=.56
Program
evaluation

student
performance
impact of this
program &
long term
potential
mediating of T
burnout.
Program was
time intensive.
Program was
evaluated by
the program
creators (bias)
Strengths:
Ts provided
positive
feedback
regarding this
program’s
impact on their
ability to care
for students
and increased
MI, IMP
feelings of SE

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP

36
(α=0.92),
competitiveness
(α=0.70), taskrelated hurry
(0.84)
The Five Facet
Mindfulness
Questionnaire
(FFMQ)
CARE
Acceptability
Questionnaire
(CAQ)

87% agreed or
strongly agreed
that this type of
program should
become part of
in-service
training
96% IMP selfawareness
92% IMP GMH
77% IMP ability
to manage
classroom
behaviors
effectively and
compassionately
83% IMP
relationships
with students.
76% IMP
student prosocial behavior
66% IMP on
task behavior
56% IMP
academic
performance

and increased
well-being
Good fidelity
as program
studied was
conducted by
researchers
who developed
the program
Feasibility:
Questionable
feasibility due
to time
intensive nature
of CARE
program

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP

37

Citation

Theory/
Design/
Conceptual Method
Framewor
k

Sample/
Setting

Major
Variables
&
Definition
s

Measurement/
Instrumentatio
n

Data
Analysis
(stats
used)

Findings/
Results

Jennings
(2015) Early
Childhood
Teachers; WellBeing,
Mindfulness,
and SelfCompassion in
Relation to
Classroom
Quality and
Attitudes
Towards
Challenging
Students

Prosocial
Classroom
Model

RCT

n= 35

Purpose:
“examining
teachers’
psychosocial
characteristic in
relation to the
dimensions of
quality learning
environments.”

21 teachers
in private
preschool
14 teachers
from Head
Start

IV-1
mindfulness
IV-2
affect
IV-3
depression
IV-4
burnout
IV-5
Selfcompassion
IV-6
Teacher
Efficacy
DV-1
Classroom
environment

Demographic
data

Pearson
correlation
coefficients

DV-1
Correlations
between CLASS
and depression
was SIG NEG
COR with all
three domains of
CLASS=
emotional
support (r=-0.42,
p,0.05),
classroom
organization
(r=-.45, p<0.01),
instructional
support (r=-.51,
p<0.01).

(Jennings
and
Greenberg
2009)

Mean
age=45.53
M=15 years
experience
3=male
9= Hispanic

IV-1 FFFMQ
IV-2 PANAS
IV-3 BDI
IV-4 MBI
IV-5 Self
compassion scale
(SCS)

Level/Qualit
y of
Evidence;
Decision for
practice/
application
to practice
Level of
evidence: II
Strengths:
RCT design
Weakness:
small sample
size, limits
generalizability
Correlations do
not show
causal
directionality.
Feasibility:
good

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP
Funding: grant
from the Fetzer
Institute
Bias: small
sample size
Location:
USA

38
2= Filipino
4=African
American
Others=
white
Recruited via
flyers/ group
presentations

DV-2
Teacher
interactions
and
emotional
response to a
challenging
student

IV-6 Teacher
Efficacy Scale
(TES)
DV-1 CLASS
DV-2 Teacher
Relationship
Interview (TRI)

DV-2 observe
sig cor with
perspective
taking (r=0.37,
p<0.05),
awareness sig
cor with
sensitivity of
discipline
(r=0.41, p<0.05).
Depersonalizatio
n neg cor with
sensitivity of
discipline (r=0.46, p<0.01)

“supporting
teachers wellbeing and
social and
emotional
competence
may improve
performance
and classroom
quality”

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP

39

Citation

Theory/
Design/
Conceptual Method
Framewor
k

Sample/
Setting

Major
Variables
&
Definition
s

Measurement/
Instrumentatio
n

Data
Analysis
(stats
used)

Findings/
Results

Molloy Elreda
(2018)
Protective
Effects of
Interpersonal
Mindfulness
for Teachers’
Emotional
Supportiveness
in the
Classroom

Prosocial
classroom
model
(Jennings &
Greenberg,
2009)

N=224
general
education
teachers

IVmindfulness

IV- Interpersonal
Mindfulness in
Teaching Scale

Linear
regression
analysis

“teachers with
high levels of
perceived stress
were
substantially
more
emotionally
supportive in the
classroom if they
were also high
on interpersonal
mindfulness.”
(p=.04)

Funding: the
Institute of
Educational
Sciences (grant
#
R305A120180)

RCT
Purpose: does
“interpersonal
mindfulness in
teachers increase
ability to be
emotionally
supportive in the
classroom, even
under conditions
of high stress
and ambition.”

93% female
K-5th grade
36 urban
public
schools in
low income
community
33% white
31%
Hispanic
26% African
American
4% Asian

DV-1
classroom
environment
DV-2
Stress
DV-3
ambition

DV-1
CLASS
DV-2
The Perceived
Stress Scale
DV-3
Competitiveness
subscale of the
Time Urgency
Scale

Level/Qualit
y of
Evidence;
Decision for
practice/
application
to practice
Level of
evidence: II

Strengths:
Large, diverse
sample size.
Multimethod
measurement
approach
Weaknesses:
Not
generalizable.
Feasibility:
good

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP
Location:
USA

40
5% mixed
race
96% had
graduate
degree
Inclusion:
lead teachers,
general ed.,

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP

41

Citation

Theory/
Design/
Conceptual Method
Framewor
k

Sample/
Setting

Major
Variables
&
Definition
s

Measurement/
Instrumentatio
n

Data
Analysis
(stats
used)

Findings/
Results

Reiser, J
(2018).
Preliminary
investigation of
a stress
prevention and
mindfulness
group for
teachers

Social
Cognitive
Theory of
SelfRegulation

n= 45
teachers from
3 public
schools in
southwest.

IV- SPAM
DV-1
vulnerability
to stress
DV-2 job
satisfaction
DV-3
mindfulness

The Classroom
Appraisal of
Resources and
Demands
(CARD)
Demand scale(α
pre-test .863,
post-test=.865)
Resource scale (α
pre-test .943,
post-test .866)

Independent
sample
t-test

DV-3
Mindfulness
increased post
intervention for
those in the MG
F(1,37) =5.55,
p <.05)
Major Themes
RQ1-an
exploration of
the SPAM
group’s impact
on teachers
a)utilization of
content and
skills outside of
the group
b)positive
personal and

Funding: none
Bias: Research
is testing a
SPAM program
that the
principle
researcher
developed

Albert
Bandura

Mixed methods
approach
Quasiexperimental
cohort design
Semi-structured
interview
Purpose: to
explore the
outcomes and
experience of a
brief stress
prevention and
MI group with
teachers.

26
participants
attended
more than
half of group
meetings
Power=28

RQ-1
perceptions
of SPAM
group impact
RQ-2
patterns in
how
participants
described

14-iten Job
Satisfaction scale
(α pre-test .893,
post-test .935)
The Five Facet
Mindfulness

analysis of
covariance
(ANCOVA)
Semistructured
interview
method/
thematic
analysisprotocol by
Braun and
Clarke
(2006)

Level/Qualit
y of
Evidence;
Decision for
practice/
application
to practice
Level of
evidence: VI

Strengths:
quantitative
and qualitative
data
Findings of
INC MI
consistent with
recent studies
on MI & T.
Weaknesses:
Quasiexperimental
design does not
show causality,
small sample

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP

Country: USA
Southwest

42
their
experiences

Questionnaire
Short Form
(FFMQ-SF)

profession
impact of
participation
RQ2-an
exploration of
how group
members
described their
experiences
c)a positive and
valuable
experience
d)being in a
group with
colleagues was
therapeutic
-positive
personal and
professional
impact
-engagement
with emotion
-engagement
with stress
-responding vs.
reacting

size,
predominately
white/ female
Feasibility:
good

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP

43

Citation

Theory/
Design/
Conceptual Method
Framewor
k

Sample/
Setting

Major
Variables
&
Definition
s

Measurement/
Instrumentatio
n

Data
Analysis
(stats
used)

Rhodes,
A.(2016). Yoga
for adult
women with
chronic PTSD:
A long-term
follow-up
study.

Social
Cognitive
Theory of
SelfRegulation

n=49

IV- yoga

all women

DV- 1 PTSD
symptoms

Clinician
Administered
PTSD Scale
(CAPS)

Bivariate
correlation
analysis

DV-2
dissociative
experiences

Dissociative
Experiences
Scale (DES)

DV-3
Depression

Beck Depression
Inventory (BDI)

Country: USA
Funding: none
Bias: none

Albert
Bandura

RCT
original study
with 60
participants.
1.5 years after
initial study as
follow up
Purpose:
examine whether
there are greater
changes in longterm mental

71.4% white
46.9% single
71.4% college
graduate
46.9% <$40,000

Inventory of
Altered Self

Hierarchical
linear
regression
analysis

-compassion for
self, colleagues
and students
-strengthened
relationship with
colleagues

Findings/
Results

Greater
frequency of
continuing yoga
practice was
DV-1 SIG
predictor for
greater DEC in
PTSD symptom
severity
(b=12.24;
p<0.05)
DV-1, DV-3
DEC DEP
symptom

Level/Qualit
y of
Evidence;
Decision for
practice/
application
to practice
Level of
evidence: II
Strengths:
RCT
Weaknesses:
Did not
determine
length of yoga
practice
required for
beneficial
effect, nor if

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP

44
health outcomes
for yoga
participants vs
control

annual
income
38.8% - fulltime
employment
Mean age+
SD
42.8+11.8

DV-4
psychologica
l functioning
DV-5 life
stress

Capacities
Tension
Reduction
Activities (IASCTRA)
Stressful Life
Events Screening
Questionnaire
(SLESQ)

severity
(r=0.348;
p<0.05)with
greater
likelihood of loss
of PTSD
diagnosis (r= 0.283; p<0.05)

types of yoga
have different
effect
Feasibility:
Yoga is an
widely
accepted form
of exercise and
mindfulness
intervention.
Good
feasibility

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP

45

Citation

Theory/
Design/
Conceptual Method
Framewor
k

Sample/
Setting

Major
Variables
&
Definition
s

Saylor (2018)

“employing a
teachercentered PD
program
featuring
mindfulness,
reflective
practice, and
clinical
supervision
drives the
conceptual
foundations
of the present
study.”
Teacher-

n= 5

Question 1How do
Montessori
Early
Childhood
and
Elementary
teachers
experience
an integrated
PD program
that contains
mindfulness,
reflective
practice, and
teacher-

TeacherCentered
Mentorship as
Meaningful
Professional
Montessori
Development
Funding: none
Country: USA

Qualitative
Purpose:
“A real-time,
multidimensiona
l, professionaldevelopment
program that is
connected to
both practice and
school culture
was delivered to
a group of
Montessori
teachers with the
goal of

3-elementary
school
teachers
2- preschool/
kindergarten
teachers

Measurement/
Instrumentatio
n

Quick writes,
check-in survey
questions
throughout study,
and researcher
observations

Data
Analysis
(stats
used)

Findings/
Results

Case study
analysis

Themes:
Mindfulness as
precursor
A community of
trust
Structure and
focus
Supportive
accountability
and change

Level/Qualit
y of
Evidence;
Decision for
practice/
application
to practice
Level of
evidence: VI

Strengths:
adds to
descriptive
literature for
further
understand of
the experience
of mindfulness
pd programs
for teachers

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP
Centered
Mentorship

46
improving
teaching
practices and
increasing
student success
by exploring the
potential benefits
of mindfulness,
structured
reflective
practice, and
teacher-centered
mentorship.”
8 month long PD
program

centered
mentorship
Question 2How do the
teachers use
the new
knowledge
ot improve
their
teaching

Weaknesses:
Small sample
size. Limited
generalizability
Feasibility:
poor. Long
program length

Question 3Do the
teachers
believe they
improve
their
teaching
practices as
they
participate in
the PD
program
containing
mindfulness,
reflective
practice, and

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

trauma-informed EBP

47
teachercentered
mentorship

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size, QE,-Quasi-experimental

Running head: trauma-informed EBP

48
Appendix B

Table 2
Synthesis Table

Basics
General pop

Molloy Elreda

Reiser

Rhodes

Saylor

III

II

VI

RCT

QE/ Mixed

RCT

Case

Jennings

II

Harris

II

2018

2016

2016

2013

IV

VI

II

II

II

COR S

GT

RCT

RCT

RCT

RCT

2017

CR S

Teachers

2018

Crain

Design

2016

Cormack

LOE

2018

Becker

Year

Jennings

Studies

2015

2018

waitlist

X

X

X

study

X

X

X

X

X

X
X

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size

trauma-informed EBP

49

Country

USA

ENG

CAN USA

USA

USA

USA

USA

USA

USA

USA

Bias

SR

0

0

Creator of

HS

0

0

RB

0

SSS

53

35

224

45

49

5

program
# of

1001

12

113

64

participants

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size

trauma-informed EBP
Tools Utilized

50

CAMS-R

Semi

STRS

structured

FFMQ

CES-D

interview

Job rumination

JCQ

PANAS
FFMQ

CARD

Case

ERQ

FFMQ

CLASS

114-item job

CAPS

DPS

PANAS

Perceived Stress

satisfaction

DES

PANAS

CES-D

BDI

Scale

scale

BDI

ERQ

TSES

MBI

Competitiveness

FFMQ-SF

IASC-

DTS

MBI

SCS

of the TUS

TUS

CLASS

FFMQ

TES

CAQ

TRI

study

TRA
SLESQ

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size

trauma-informed EBP

51

Interventions

Yoga

X

MBI

X

X
X

X

X

X

X

X

X
X

X

Survey only

X

X

Work place

↓

↓

↓

↓

stress
Depression

Outcomes

Mindfulness

X

↑

↑

↓

↑

Emotionally

Observe sig

Teachers with

supportive

cor sensitivity

high stress

to discipline-

Inc emotionally

Depression neg

supportive if high

cor with

in interpersonal

sensitivity of

mindfulness

discipline
Positive affect

↑

↑

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size

trauma-informed EBP

52

Distress

↑

tolerance

Child/Adult

↑

(parent or

↑

teacher)
relationship
Job rumination

↓

↓

Classroom
management

depression

↑

NEG COR
↑

Classroom

depression

organization

NEG COR

Instructional

depression

support

NEG COR

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size

trauma-informed EBP
Bad Mood at

53
↓

Work
General Mental
Health
DBP

↓

PTSD sx

↓

Self-awareness

Daily Physical

↑

↓

↓

sx
Burnout

↓

Key: MBI- Mindfulness-based intervention, SI- Self- identified, T- Teacher, TR- Trainer/teacher, S- Student, F-Female, M-Male, GT- Grounded theory, MI- Mindfulness, CR S- Crosssectional, COR S- Correlational study, CON S- Convenience sampling, MOP- Married or partner, WMT-Workplace mindfulness training, EX- Experience in years, RWCT- Randomized wait-list
controlled trial, E. Can- European Canadian, A. Can- Asian Canadian, E. AM- European American, A. AM- Asian American, AA- African American, NE- North East, DD- Developmental Delay, AUAutistic, MBSR- Mindfulness Based Stress Reduction, PAD- Positive Adult Development, US DEIES- US Department of Education Institute of Educational Sciences, MAOT- Medication assisted
opioid treatment; IV- Independent Variable, DV- Dependent Variable, (+)- Positive, (-)- Negative, R- Relationship, SIG- Significant, COR- Correlation, MP-Mindful parenting, PS-Parental stress,
DEP-Depression, GMH-General mental health, DEC-Decrease, MH- Mental health, INC-Increase, CG- Control group, FU-Follow-up, IMP-Improving, SE- self-efficacy, ELE-Elementary school,
P/S- Preschool, H/S-High School, SD- Standard deviation, ACE- Adverse childhood events, SR-self report, SSS- small sample size

Running head: trauma-informed EBP

54
Appendix C

Polyvagal Theory

trauma-informed EBP

55
Appendix D

Iowa Model

trauma-informed EBP

56
Appendix E

Five Factor Mindfulness Questionnaire Study Results

trauma-informed EBP

57
Appendix F

First Things First Star Rating Chart for CLASS Tool

trauma-informed EBP

58

Appendix G
Approval Letter from Arizona State University Institutional Review Board

APPROVAL: EXPEDITED REVIEW
Lesly Kelly
CONHI: Research Faculty and Staff 602/496-0809
Lesly.Kelly@asu.edu
Dear Lesly Kelly:
On 8/21/2018 the ASU IRB reviewed the following protocol:
Type of Review: Initial Study
A Trauma-Informed Mindfulness Intervention to Improve Early Childhood
Title:
Classroom Environments
Investigator:
Lesly Kelly
IRB ID:
STUDY00008517
Category of
(7)(b) Social science methods, (7)(a) Behavioral research
review:
Funding:
None
Grant Title:
None
Grant ID:
None
• Appendix B, Category: Recruitment Materials; • Appendix M, Category:
Resource list;
• Appendix E, Category: Technical materials/diagrams;
Documents
Reviewed:

Page 1 of 2

• Appendix G, Category: Measures (Survey questions/Interview questions
/interview guides/focus group questions);
• Appendix I, Category: Measures (Survey questions/Interview questions
/interview guides/focus group questions);
• Appendix C, Category: Technical materials/diagrams;
• Appendix J, Category: Measures (Survey questions/Interview questions
/interview guides/focus group questions);
• Appendix D, Category: Technical materials/diagrams;

trauma-informed EBP

59

• Appendix H, Category: Measures (Survey questions/Interview questions /interview
guides/focus group questions);
• FAEHS Letter.pdf, Category: Off-site authorizations (school permission, other IRB approvals,
Tribal permission etc);
• Protocol, Category: IRB Protocol;
• Appendix K, Category: Measures (Survey questions/Interview questions /interview
guides/focus group questions);
• Appendix L, Category: Measures (Survey questions/Interview questions /interview
guides/focus group questions);
• Appendix A, Category: Consent Form;
The IRB approved the protocol from 8/21/2018 to 8/20/2019 inclusive. Three weeks before
8/20/2019 you are to submit a completed Continuing Review application and required
attachments to request continuing approval or closure.
If continuing review approval is not granted before the expiration date of 8/20/2019 approval of
this protocol expires on that date. When consent is appropriate, you must use final, watermarked
versions available under the “Documents” tab in ERA-IRB.
In conducting this protocol you are required to follow the requirements listed in the
INVESTIGATOR MANUAL (HRP-103).
Sincerely,
IRB Administrator
cc: Heather Ryan Heather Ryan
Lesly Kelly Ann Guthery

trauma-informed EBP

60
Appendix H

ACE Questionnaire

Adverse Childhood Experience (ACE) Questionnaire Finding your

ACE Score ra hbr 10 24 06

While you were growing up, during your first 18 years of life:
1. Did a parent or other adult in the household often ...
Swear at you, insult you, put you down, or humiliate you?
or
Act in a way that made you afraid that you might be physically hurt?
Yes No
2. Did a parent or other adult in the household often ... Push, grab, slap, or throw something at you?
or
Ever hit you so hard that you had marks or were injured?
Yes No
If yes enter 1
If yes enter 1
3. Did an adult or person at least 5 years older than you ever...
Touch or fondle you or have you touch their body in a sexual way?
or
Try to or actually have oral, anal, or vaginal sex with you?
Yes No If yes enter 1
4. Did you often feel that ...
No one in your family loved you or thought you were important or special?
or
Your family didn’t look out for each other, feel close to each other, or support each other? Yes No If yes
enter 1 ________

trauma-informed EBP

61

5. Did you often feel that ...
You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you?
or
Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
Yes No If yes enter 1
6. Were your parents ever separated or divorced?
Yes No If yes enter 1
7. Was your mother or stepmother:
Often pushed, grabbed, slapped, or had something thrown at her?
or
Sometimes or often kicked, bitten, hit with a fist, or hit with something hard?
or
Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
Yes No If yes enter 1
8. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?
Yes No If yes enter 1 ________
9. Was a household member depressed or mentally ill or did a household member attempt suicide?
Yes No
10. Did a household member go to prison? Yes No
If yes enter 1 ________ If yes enter 1 ________

Now add up your “Yes” answers:
_______
This is your ACE Score

trauma-informed EBP

62
Appendix I

Five Facet Mindfulness Questionnaire Tool
Five Facet Mindfulness Questionnaire (FFMQ) Ruth A. Baer, Ph.D.
University of Kentucky
-----------------------------------------------------------------------------------------------------------------Please rate each of the following statements using the scale provided. Write the number in
the blank that best describes your own opinion of what is generally true for you.
_____ 1. When I’m walking, I deliberately notice the sensations of my body moving. _____ 2.
I’m good at finding words to describe my feelings.
_____ 3. I criticize myself for having irrational or inappropriate emotions.
_____ 4. I perceive my feelings and emotions without having to react to them. _____ 5. When I
do things, my mind wanders off and I’m easily distracted.
_____ 6. When I take a shower or bath, I stay alert to the sensations of water on my body.
_____ 7. I can easily put my beliefs, opinions, and expectations into words.
_____ 8. I don’t pay attention to what I’m doing because I’m daydreaming, worrying, or
otherwise distracted.
_____ 9. I watch my feelings without getting lost in them.
_____ 10. I tell myself I shouldn’t be feeling the way I’m feeling.
_____ 11. I notice how foods and drinks affect my thoughts, bodily sensations, and emotions.
_____ 12. It’s hard for me to find the words to describe what I’m thinking.
_____ 13. I am easily distracted.
_____ 14. I believe some of my thoughts are abnormal or bad and I shouldn’t think that way.
_____ 15. I pay attention to sensations, such as the wind in my hair or sun on my face.
_____ 16. I have trouble thinking of the right words to express how I feel about things
_____ 17. I make judgments about whether my thoughts are good or bad.
_____ 18. I find it difficult to stay focused on what’s happening in the present.
_____ 19. When I have distressing thoughts or images, I “step back” and am aware of the
thought or image without getting taken over by it.
_____ 20. I pay attention to sounds, such as clocks ticking, birds chirping, or cars passing. _____
21. In difficult situations, I can pause without immediately reacting.

trauma-informed EBP

1
never or very rarely true

63

2
3
4
5
rarely true sometimes true often true very often or always true

FFMQ p. 2

1
never or very rarely true

2
3
4
5
rarely true sometimes true often true very often or always true

_____ 22. When I have a sensation in my body, it’s difficult for me to describe it because I can’t
find the right words.
_____ 23. It seems I am “running on automatic” without much awareness of what I’m doing.
_____24. When I have distressing thoughts or images, I feel calm soon after.
_____ 25. I tell myself that I shouldn’t be thinking the way I’m thinking.
_____ 26. I notice the smells and aromas of things.
_____ 27. Even when I’m feeling terribly upset, I can find a way to put it into words.
_____ 28. I rush through activities without being really attentive to them.
_____ 29. When I have distressing thoughts or images I am able just to notice them without
reacting.
_____ 30. I think some of my emotions are bad or inappropriate and I shouldn’t feel them.
_____ 31. I notice visual elements in art or nature, such as colors, shapes, textures, or patterns
of light and shadow.
_____ 32. My natural tendency is to put my experiences into words.
_____ 33. When I have distressing thoughts or images, I just notice them and let them go.
_____ 34. I do jobs or tasks automatically without being aware of what I’m doing.
_____ 35. When I have distressing thoughts or images, I judge myself as good or bad,
depending what the thought/image is about.
_____ 36. I pay attention to how my emotions affect my thoughts and behavior. _____ 37. I can
usually describe how I feel at the moment in considerable detail. _____ 38. I find myself doing

trauma-informed EBP

64

things without paying attention.
_____ 39. I disapprove of myself when I have irrational ideas.
FFMQ Scoring instructions
For all items marked “R” the scoring must be reversed. Change 1 to 5, 2 to 4, 4 to 2, and 5 to 1
(3 stays unchanged). Then sum the scores for each subscale.
Observing
1, 6, 11, 15, 20, 26, 31, 36
Describing
2, 7, 12R, 16R, 22R, 27, 32, 37
Acting with awareness
5R, 8R, 13R, 18R, 23R, 28R, 34R, 38R
Nonjudging of inner experience
3R, 10R, 14R, 17R, 25R, 30R, 35R, 39R
Nonreactivity to inner experience
4, 9, 19, 21, 24, 29, 33