O P U S
Online Publication of Undergraduate Studies
Vol. XVI Issue I Spring 2025
The Online Publication of Undergraduate Studies was initiated in 2010 by undergraduate students in the Department of Applied Psychology, NYU Steinhardt. The ideas and opinions contained in this publication solely reflect those of the authors and not New York University All work is licensed under the Creative Commons Attribution Noncommercial No Derivative Works License To view a copy of
license,
O P U S
Online Publication of Undergraduate Studies
Vol. XVI Issue I | Spring 2025
editors-in-Chief
Sarah Faucette
Adam Goldstein
Contributing Writers Layout & Design CoOrdinators
Lea Burgos
Lauren Lee
Grace Li
Devanshi Loomba
Alice Madola
Sophia Masso
Laura Park
Ella Seward
Cecile Xu
Ashley Buk
Laura Zhu
Dr. Adina R. Schick
faculty mentor Special Thanks
Bethanie Railling
Dr. Linnie Green
Department of Applied Psychology
NYU Steinhardt
Contents
Letter from the Editors
08 Lea Burgos
Alice Madola
Living in the Margin: A Critical Examination of Suicidality Among LGBTQ+ Youth of Color in America
20
15 Cecile Xu
New York City School-Based Mental Health Services and Their Role in Addressing
Student Needs
Culturally Adapting Socio-Emotional Learning (SEL) Programs for Chinese Schools
Research Studies
26 38 51 Reviews
Laura Park and Lauren Lee
Burnout Among Research Staff Who Study Trauma-Organized Systems
Devanshi Loomba
The Role of Organizational Support in Implementing Trauma-Informed Training in
Juvenile Justice Settings
Grace Li, Sophia Masso, and Ella Seward
Exploring Peer Support Among Women with Spinal Cord Injuries
Letter From the Editors
New York University’ s Online Publication of Undergraduate Studies (OPUS) was initially published in 2010 as a platform for Applied Psychology students to showcase their exceptional academic work This publication is entirely run, written, and designed by Applied Psychology undergraduates, and remains one of the few undergraduate psychology journals in the United States
We are honored to present our 2025 spring issue As always, this journal reflects the intellectual curiosity and commitment to social impact that define Applied Psychology students at NYU Within this issue, our authors engage critically with topics ranging from trauma and disability to identity, education, and systemic reform, grounding their analyses in theory while centering lived experiences Together, these pieces demonstrate not only methodological rigor and scholarly insight, but also a dedication to amplifying marginalized voices and highlighting practices that promote well-being, equity, and resilience
In the first section, “Literature Reviews,” Alice Madola examines the heightened suicide risk among LGBTQ+ youth of color, highlighting the compounding effects of familial rejection, school-based discrimination, and anti-LGBTQ+ legislation, while advocating for more intersectional suicide prevention efforts in schools. In a condensed excerpt of a larger report, Lea Burgos discusses how school-based mental health services in New York City can act as preventative measures against the school-toprison nexus by replacing damaging practices, like Child in Crisis interventions, with trauma-informed, culturally responsive support. Cecile Xu reviews the impact of culturally adapted Social-Emotional Learning programs in Chinese schools, noting their success in improving student well-being and academic outcomes while emphasizing the need for long-term evaluation and equitable access across diverse educational settings.
In the second section, “Research Studies,” Laura Park and Lauren Lee examine burnout among research staff working in trauma-organized systems, particularly the Juvenile Legal System, and find that while emotional exhaustion is widespread, strong peer relationships and a solidified sense of purpose help to sustain motivation and counteract depersonalization Devanshi Loomba investigates how organizational support impacts the implementation of trauma-informed training in juvenile detention centers, revealing that while empathy and understanding of trauma often enhance staff-youth relationships, barriers like resistance to change and inconsistent institutional backing can hinder effective practice Grace Li, Sophia Masso, and Ella Seward explore how women with spinal cord injuries experience peer support in gender-specific virtual groups, finding that shared experiences foster empowerment, emotional safety, and practical guidance around sensitive topics like sexuality and independence
We would like to extend our gratitude to the incredible undergraduate authors who contributed to this edition Their talent, passion, and devotion to academic excellence have made this issue truly special We are also deeply grateful to Ashley Buk and Laura Zhu, the OPUS Layout & Design team, for their creativity and vision in bringing these pieces to life
Our sincerest appreciation goes to Dr Linnie Green, Co-Director of Undergraduate Studies in Applied Psychology, and to Bethanie Railling, the OPUS advisor, for their constant support of this publication. And finally, we thank Dr. Adina Schick, Co-Director of Undergraduate Studies in Applied Psychology, and our faculty mentor, for her ongoing guidance, encouragement, and dedication to student-led research and scholarship. Without the contributions of our countless mentors, editors, and student collaborators, this issue would not have been possible.
Best, OPUS Editors
Sarah Faucette and Adam Goldstein
Literature
Reviews
Living in the Margin: A Critical Examination of Suicidality Among LGBTQ+ Youth of Color in America
Alice Madola
Suicide is a leading cause of death among youth in the United States and a pressing public health issue (Centers for Disease Control and Prevention, 2025). From 2007 to 2021, deaths by suicide among 10 to 24 year olds increased by 62% (Curtin & Garnett, 2023) Although individuals from all backgrounds can be at risk of suicide, research indicates that lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ+) youth of color are particularly vulnerable (Green et al , 2021; Lardier et al , 2020; Murphy & Hardaway, 2017) In fact, 39% of LGBTQ+ youth seriously considered attempting suicide in 2023, and LGBTQ+ youth of color reported higher rates than their white counterparts (Nath et al , 2024) The environment surrounding LGBTQ+ youth of color plays an important role in their risk of suicide (Hong et al , 2011; Lardier et al , 2020; Nath et al , 2024) LGBTQ+ youth of color are often exposed to identityspecific stressors, including discrimination, homonegativity, and racism, which compound stress and increase their risk of suicide (Balsam et al., 2011; Green et al., 2021; Williams et al., 2022). These stressors occur at multiple levels. The current review article thus explored the micro- and macro-level influences that contribute to suicidality among LGBTQ+ youth of color.
When understanding the heightened suicide risk among LGBTQ+ youth of color, it is crucial to use an intersectional lens Kimberlé Crenshaw’ s intersectionality theoretical framework recognizes that social identities (e g , race, gender, disability, sexual orientation) are co-constructed and interdependent, and do not operate independently of one another (Collins, 1995; Crenshaw, 1991; Cuadraz & Uttal, 1999) This framework is vital because it highlights the complexities that are crucial for understanding health
disparities (Bowleg, 2012; Hankivsky & Christoffersen, 2008). As a multiply marginalized population, LGBTQ+ youth of color experience stress stemming from both racism and heterosexism (Balsam et al., 2011) These intersectional identities can form compounded experiences of marginalization during adolescent and emerging adulthood developmental stages and can influence help-seeking behaviors (Moore et al , 2019; Murphy & Hardaway, 2017) For instance, research suggests that the fear of being misunderstood or treated unfairly can prevent LGBTQ+ youth of color from seeking mental health care (Dawes, 2023; Moore et al , 2019; Trevor Project, 2022) Moreover, LGBTQ+ youth from racial/ethnic minority backgrounds are more likely than LGBTQ+ youth from ethnic majority backgrounds to feel that care providers would not understand their culture (Trevor Project, 2022). In turn, considering both racial/ethnic and LGBTQ+ identities is necessary to more fully understand suicidality among LGBTQ+ youth of color.
Micro-Level Influences on Suicidality Among LGBTQ+ Youth of Color
Micro-level influences include factors such as parental support, peer relations, and the school environment (Hong et al , 2011) These influences occur in an individual's immediate environment and most directly influence suicidality among LGBTQ+ youth (Hong et al , 2011) Literature shows that parental support can serve as a protective factor and can help reduce the risk of suicide among LGBTQ+ youth of color (Nath et al , 2025) Conversely, research indicates that there is a significant association between parental rejection and suicidality among LGBTQ+ youth (Bosse et al , 2023; De Lange et al , 2022; Ryan
et al., 2009). Findings from these studies show that LGBTQ+ youth who experience parental rejection are more likely to report suicidal ideation and/or suicide attempts (Bosse et al., 2023; De Lange et al., 2022; Ryan et al., 2009). Parental rejection can manifest in different ways, including silence and avoidance, namecalling, revoking a youth's access to housing, and more (DeChants et al , 2022) While limited empirical research has explored the association between ethnicity and parental rejection, existing studies suggest that ethnic minority LGB youth are more likely to experience parental rejection compared to ethnic majority LGB youth (Richter et al , 2017; Ryan et al , 2009)
In addition to family, school is another key microlevel component that can influence suicide risk among LGBTQ+ youth of color Previous research has shown that supportive school environments that foster healthy development of students are associated with fewer symptoms of depression among LGBTQ+ students (Colvin et al., 2019; Denny et al., 2016). More specifically, school Gender and Sexuality Alliance (GSA) clubs are a widely used intervention that may help reduce suicide risk among LGBTQ+ youth (Davis et al., 2014; Trevor Project, 2023a). GSAs are studentled clubs that aim to foster a safe and supportive school environment for LGBTQ+ students and their allies by creating space for dialogue, processing lived experiences, and engaging in collective advocacy (Adelman et al , 2022; Truong et al , 2020a; Truong et al , 2020b) Previous research indicates that schools with GSAs report lower rates of bullying and suicidality (Baams & Russell, 2020; Kosciw et al , 2022; Lessard et al , 2020) Students who go to schools with a GSA also report improved school functioning and better mental health (Baams & Russell, 2020; Kosciw et al , 2022)
Although GSAs primarily focus on LGBTQ+ issues, there has been a growing push to adopt an intersectional approach that better reflects the lived experiences of multiply marginalized students. Specifically, literature has begun to examine how discussions on race and immigration within GSAs contribute to understanding how these identities influence and intersect with LGBTQ+ identities (Adelman et al., 2022; Calzo et al., 2021; Rosenbach et al., 2021; Singh et al., 2024). Emerging literature suggests that the positive mental health effects of
GSAs are not as strong for students of color (Adelman et al., 2022; Baams & Russell, 2020), which may partially be due to queer and trans students of color not feeling equally safe and included within their school’ s GSA (Baams & Russell, 2020). Recent studies show that LGBTQ+ youth of color experience high levels of bias-based bullying (i e , bullying that targets individuals based on their perceived or actual identity) in school, which has been linked to increased suicidality among youth (Gower et al , 2023; Jadva et al , 2021; Shramko et al , 2019) While any student can be a victim of bullying, it is often motivated by prejudicial beliefs, leaving youth who are racial or ethnic minorities and/or sexual minorities more frequently victimized in school (Hong et al , 2018)
Macro-Level Influences on Suicidality Among LGBTQ+ Youth of Color
In addition to the micro-level , it is also important to acknowledge how macro-level factors, such as political systems, impact suicide risk. One relevant macro-level influence on suicidality among LGBTQ+ youth of color is the implementation of anti-LGBTQ+ legislation in the United States, especially in schools. For instance, the rapid rise in efforts to censor and ban books in schools disproportionately targets books that feature LGBTQ+ themes, discuss race and racism, or include characters of color (Langrock et al , 2023; Pickering, 2023) Literature suggests that removing access to books that speak to marginalized individuals leaves youth–especially those at the intersection of LGBTQ+ and Black, Indigenous, and people of color (BIPOC) identities–vulnerable to alienation, heightened feelings of exclusion, and increased risk of mental health issues (Pickering, 2023; Rich, 2024) Notably, research indicates that LGBTQ+ students with access to LGBTQ+ inclusive materials in places such as textbooks and school libraries were less likely to report having seriously considered suicide in the previous year (Kosciw et al , 2022)
Furthermore, 'No Promo Homo' laws, which are state and local education policies that prohibit the “promotion of homosexuality” in schools, impact approximately ten million public school students (GLSEN, 2018, p. 1). These anti-LGBTQ+ laws can negatively impact the mental health of LGBTQ+ youth and increase suicide risk (Barrett & Bound, 2015; Clark et al., 2024; Tran et al., 2023; Trevor Project, 9
2023b). These policies not only perpetuate stigma against LGBTQ+ youth but may also exacerbate their existing mental health conditions (Fenton et al., 2024; Gonzales & McKay, 2024; Kline et al., 2022). Recent studies indicate that there are associations between state-level anti-trans policies and the mental health of transgender and non-binary individuals (Dhanani & Totton, 2023; Du Bois et al , 2018; Lee et al , 2024) More specifically, research shows that in states where anti-transgender laws were enacted, transgender and non-binary youth experienced significant increases in past-year suicide attempts, with past-year suicide attempt rates rising up to 72% (Lee et al , 2024)
Despite these detrimental policies, schools are also an ideal setting for suicide prevention because youth spend a significant portion of their lives there (Ayer & Colpe, 2023; Poland & Ferguson, 2022) As a result, policies focused on school-based suicide prevention efforts are more accessible and can reach a larger number of youth compared to specialty mental health care (Alvarez et al., 2022; Ayer & Colpe, 2023). This provides an important avenue for addressing the mental health concerns of vulnerable LGBTQ+ youth of color.
Conclusion
Suicide remains a pressing public health crisis, and LGBTQ+ youth of color face especially heightened risk (Green et al , 2021; Lardier et al , 2020; Murphy & Hardaway, 2017) Micro-level influences such as parental rejection and school climate influence suicidality among LGBTQ+ youth of color (Bosse et al , 2023; De Lange et al , 2022; Richter et al , 2017; Ryan et al , 2009) While GSAs may play a critical role in suicide prevention (Davis et al , 2014; Trevor Project, 2023a), more research is needed to understand their impact on LGBTQ+ youth of color and ensure they fully meet their needs (Adelman et al , 2022; Baams & Russell, 2020; Truong & Zongrone, 2021) Beyond micro-level influences, macro-level factors, such as anti-LGBTQ+ legislation, can adversely impact the mental health of this population and increase suicide risk (Fenton et al., 2024; Gonzales & McKay, 2024; Lee et al., 2024; Trevor Project, 2023b).
However, schools, individuals, and organizations can help support the mental health of LGBTQ+ youth of color at all levels by cultivating environments that are supportive and affirming. Moving forward,
research-based support and interventions at the microand macro-levels should continue to address the intersectional needs of LGBTQ+ youth of color.
References
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New York City School-Based Mental Health Services and Their Role in Addressing Student Needs
Lea Burgos
The school-to-prison nexus, formally known as the school-to-prison pipeline, occurs when male students of color are unable to reach academic success due to systemic school barriers including ill-equipped teachers, being wrongly placed in special education, and being disproportionately exposed to expulsions and suspensions, leading to high disengagement (Darensbourg et al , 2010; Skiba et al , 2002; Skiba et al , 2006) This nexus is present in New York City public schools, where the use of Child in Crisis Interventions, a form of exclusionary discipline, disproportionately affects youth of color suffering from mental health difficulties (Advocates for Children of New York, 2021; NYCLU, 2023) Child in Crisis Interventions rely on police to remove children experiencing emotional distress from a classroom by any means necessary, including the use of handcuffs, in order to bring them to an emergency room (Advocates for Children of New York, 2021). This highlights the intersection between mental health and law enforcement, which has led to the overrepresentation of mental illness among youth in the juvenile justice system (Advocates for Children of New York, 2021; Grisso et al., 2001; Underwood & Washington, 2016). The disruption that Child in Crisis Interventions leave on students’ lives prompts an investigation into the role that school-based mental health programs play in better addressing youth mental health (Advocates for Children of New York, 2021) School-based mental health is especially important in marginalized communities, where the impact of adversity on behavior is not taken into account in school disciplinary policies, and the escalation of these situations has led to widespread juvenile system involvement, as schools have become the primary place for youth arrests (Crosby et al , 2018;
Stewart, 2022). This review explores the role of schoolbased mental health services in responding to the mental health needs of students in New York City public schools.
An Overview of the Mental Health Landscape for Youth in New York City
Consistent with other research on mental health among teens, a recent report highlighted that 38% of New York public high school students frequently report feeling sad or hopeless, which are known indicators of depression (Benton et al , 2021; Hamwey et al , 2024) This was even more prevalent among female, Black and Latine, and LGBTQ+ students, who also identified specific stressors related to their identities (Hamwey et al , 2024) Current research shows that children who identify as Black, Indigenous, of color (BIPOC), LGBTQ+, and youth of immigrant status experience multiple traumatic events that can disrupt their development by rendering them susceptible to factors that negatively impact wellbeing, including poor mental health and quality of life (Carliner et al., 2016; Copeland et al., 2007; Goodman et al., 2012; Mersky et al., 2021). Despite the fact that this population demonstrates increased need, 24% of teens in New York City reported that they wanted or needed mental health care but did not receive any in 2023 (Hamwey et al , 2024) Sixty percent of teens reported that they could fit mental health treatment into their school schedule (Hamwey et al , 2024), providing evidence that school-based mental health services are valuable, as they could become the main channel for mental health resources for students with unmet clinical needs (Cummings et al , 2010)
New York City Public Schools currently utilize what is referred to as a Multi-Tiered System of
Support (MTSS), which promotes mental health and reduces the prevalence and severity of mental health symptoms through three tiers: Universal SocialEmotional Learning and Wellness Programs, Selective Mental Health Supports, and Targeted Clinical Services (Beason et al 2024; NYC Public Schools, n d ) Though the New York City Public Schools website lists an extensive list of available resources, not all schools have access to the same mental health services (NYC Public Schools, n d )
Supporting Students in Emotional Distress
After pressure from multiple sources, New York City has progressed in bettering its school-based mental health system by taking measures to decrease Child in Crisis interventions and improve support for children facing emotional distress in school settings (New York City Department of Education, 2024; NYCLU, 2023). Black students and students with disabilities were overrepresented in the 12,050 Child in Crisis Interventions that had occurred from 2016 to 2020 (Advocates for Children of New York, 2021; NYCLU, 2023). Additionally, children were apprehended with handcuffs or velcro restraints 9.8% in this time frame, with the youngest child apprehended being 5 years old (Advocates for Children of New York, 2021; NYCLU, 2023). Under the current policies, Child in Crisis Interventions disproportionately impact youth of color, with reports showing Black and Latine students accounting for 85% of all Child in Crisis Interventions (Advocates for Children of New York, 2021)
The Chancellor’ s Regulation A-411 sets the guidelines all schools should follow when an emotional crisis occurs Advocates for Children of New York (2021) have criticized the policy for having a lack of detailed guidance and thorough steps to take before calling 911 In July of 2024, the New York City Department of Education released a revised version of the Chancellor’ s Regulation A-411 Included in the revisions are detailed guidelines and additional sources for schools to ensure that calling 911 is the very last possible option and steps must be taken before that decision is even considered, including using trained professionals, ongoing professional development, and the use of trauma-informed and culturally responsive strategies (New York City Department of Education, 2024). Updated policy details that once a crisis has
been successfully de-escalated, the student is to return to class, and no medical clearance is necessary in order for them to return to school if they are sent to the emergency room. If all steps have been taken and the crisis has not been resolved, only the principal or a designee can make the decision to call law enforcement, but the revisions again emphasize that 911 is not a disciplinary response and will not be used as an alternative to the de-escalation strategies (New York City Department of Education, 2024) With their added mental health support and clear new guidelines to follow, New York City public schools will be better equipped to help students who externalize unmet socio-emotional needs Less police involvement in schools and an increase in trauma-informed practices show the shift in attention to the impact of trauma on behavior, filling a gap that was once detrimental to youth of color When the relationship between adversity and behavior is not known to educators, they can wrongfully assume that youth are simply misbehaved and unmotivated, resulting in youth being taken out of the classroom and facing exclusionary discipline (Anderson et al., 2022; Goodman et al., 2012; Souers & Hall, 2016). This can be avoided by equipping teachers to recognize symptoms of trauma (Anderson et al., 2022) and implementing culturally responsive de-escalation practices (New York Department of Education, 2024), thereby increasing connectedness between faculty and students to foster a safe learning environment (Sanders et al , 2021)
Conclusion
New York City public schools have made promising changes in order to better equip their schools to handle emotional crisis situations, and mental health symptoms overall If staff have a greater skill set and resources when it comes to mental health, we should see a decline in the use of police involvement that is disproportionately impacting students of color, though these changes are recent, and it is too early to see results. Mental health resources should empower and bolster confidence in children by equipping them with coping mechanisms and resources to power through difficult circumstances. Equitable schoolbased mental health and trauma-informed policy are necessary to ensure personal and academic success for each and every student. Children should not feel as if they do not belong in a classroom or in their school
because of mental illness, nor should they be criminalized for having a crisis. Every child deserves the safety, security, and support necessary for optimal ability to function, which includes the ability to overcome mental health challenges.
References
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to the mental health crisis among Chinese students, existing literature highlights the significant role Chinese schools play in shaping students’ daily experiences and psychological well-being. Consistent with the Asian stereotype that emphasizes high achievement in mathematics, Chinese education places a strong emphasis on rational learning compared to schools in the U S (Mu & Pang, 2018) Students in China are primarily encouraged to focus on theoretical knowledge and the development of logical thinking, reflecting a common belief that science subjects (“Li Ke”) are more valued than the humanities (“Wen Ke” ; Yu & Jiang, 2017) For example, subjects such as mathematics, physics, and chemistry are heavily emphasized in the Chinese education system, with a strong focus on problem-solving, analytical reasoning, and the mastery of foundational concepts (Yu & Jiang, 2017) Overall, the focus on science subjects is largely driven by a meritocratic ideology, under which both parents and educators believe that academic success in science-related areas leads to greater economic stability and career advancement (Yu & Jiang, 2017). With rational thinking increasingly prioritized in educational settings, the development of personality and emotional competencies tends to be neglected in Chinese educational assessment criteria (Lu, 2004). As a result, there is limited attention given to students’ personal, social, and emotional development (Lin & Yao, 2014) Therefore, the combination of academic stress and neglected emotional development may be contributing to rising mental health and behavioral issues among Chinese adolescents Addressing these issues by targeting their emotional development is crucial (IHME, 2021; MOE, 2021)
In the U S , emotional development has been recognized as a crucial process (Yong et al , 2023) In line with this understanding, the Collaborative for Academic, Social, and Emotional Learning (CASEL) developed SEL programs to help individuals develop knowledge, skills, and attitudes across five areas: selfawareness, self-management, responsible decisionmaking, relationship skills, and social awareness (CASEL, 2015). The SEL curricula often include activities like role-playing, to teach students how to appropriately regulate emotion, show empathy to others, achieve personal goals, and establish positive relationships with others (Deli et al., 2021).
Adaptations of SEL Programs in China
In recent years, the Ministry of Education and the United Nations Children’ s Fund (UNICEF) have introduced SEL programs to help students adapt to learning, life, and future work (UNICEF, 2020) in over 250 schools across five provinces in western China (Chen & Yu, 2022) China’ s MOE has emphasized the importance of early interventions to improve students' mental health literacy (Central People’ s Government of the People’ s Republic of China, 2012; MOE, 2021) In particular, teaching in Chinese classrooms is now the main channel for helping students acquire mental health knowledge and skills, develop awareness of selfhelp, mutual support, and seeking assistance, and learn to effectively face challenges and difficulties (Wang, 2023)
These SEL programs have resulted in some positive outcomes (Durlak et al , 2011; Low et al , 2019; Shi & Cheung, 2024). Students participating in the SEL programs have exhibited improved academic performance, less emotional distress, and prosocial behaviors (Durlak et al., 2011). By participating in SEL activities like role-play or class debate, students learn to be aware of their peers' emotions and learn how to manage their own emotions (Chen & Lu, 2014; Li & Zhang, 2015). As Chinese students from middle and high school experience academic stress and higher parental expectations, incorporating the SEL curriculums in schools helps students build self-esteem and receive positive feedback from teachers and peers, enhancing their sense of security in learning and reducing academic distress (CASEL, 2015; Jiang et al , 2021) Furthermore, evidence shows that Chinese SEL programs can alleviate anxiety and help students view academic challenges more positively, thereby improving their mental health and academic performance (Corcoran et al , 2018; Deli et al , 2021; Elmi, 2020) However, a recent systematic review highlights mixed findings due to the use of Western-based course materials in these programs (Shi & Cheung, 2024; Yong et al., 2023). Cultural adaptations are necessary before implementing SEL programs in Chinese schools (Chung et al., 2020; Fan, 2023).
Compared to the individual-centered values of Western countries, Chinese collectivist education emphasizes the importance of being group-oriented and having a sense of collective cooperation (Tan et al., 2021; Zhu et al., 2024). Hence, Chinese scholars have
expanded the dimensions of the SEL programs from “self and society” to “self, others, and society” (Yu & Jiang, 2017). As a result, the Chinese SEL program builds upon CASEL’ s original five competencies while integrating the country’ s value system, redesigning six new focus areas (UNICEF, 2020) Beyond selfawareness and self-management, China’ s localized SEL programs place additional focus on understanding others (recognizing others’ emotions and viewpoints), managing interpersonal relationships (addressing emotional challenges with others), understanding the collective (grasping group rules, norms, values, and perspectives), and fostering a sense of belonging within the collective (UNICEF, 2020; Yu & Jiang, 2017) Consequently, the Chinese localized SEL curricula in schools help students strengthen relationships with their teachers and peers by improving their interpersonal skills and encouraging them to be more considerate of others (Shi & Cheung, 2022). Fu and her colleagues (2024) also demonstrated that the Chinese localized SEL program fosters Chinese students’ sense of empathy and solidarity, which in turn enhances their sense of belonging to the school. Future research should further explore how SEL programs can be systematically adapted to align with the cultural, educational, and developmental needs of Chinese adolescents, and evaluate their effectiveness across diverse school contexts to address the ongoing mental health challenges in this population Sample diversity should also be emphasized (e g , students in rural areas, students who need special education, leftbehind children) to refine the social-emotional development framework for Chinese students
Conclusion
School-based SEL programs show strong potential for supporting Chinese adolescents’ mental health by fostering emotional awareness, interpersonal skills, and prosocial behavior (Corcoran et al , 2018; Deli et al , 2021; Durlak et al , 2011; Fu et al , 2024) Drawing from the success of SEL implementation in the United States, China has begun exploring culturally responsive adaptations of these programs to address the emotional development needs of its students (Fu et al., 2024; Shi & Cheung, 2022; Yu & Jiang, 2017). As China continues to prioritize student well-being, integrating SEL into school curricula in ways that reflect local cultural values will be essential for
maximizing its impact. Additionally, addressing cultural differences and implementing culturally adapted SEL programs into Chinese schools will heighten the known benefits of SEL programs to provide support and assistance for Chinese youth.
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Burnout Among Research Staff Who Study
Trauma-Organized Systems
Laura Park and Lauren Lee
Trauma-organized systems (TOS) are defined as systems that are built upon trauma and inadvertently perpetuate it (Bentovim, 1992; Keinan & MalachPines, 2007). The Juvenile Legal System (JLS) exemplifies a trauma-organized system as it is shaped by relational trauma that impacts system-impacted youth and the professionals responsible for their care (Bloom & Farragher, 2010; Cavanagh et al , 2022; Crosby, 2016) Research staff in these settings are especially critical, as they facilitate interventions and contribute to systemic change (Cavanagh et al , 2022; Nagy et al , 2019; Sharma et al , 2020; Sichel et al , 2019) However, their role is often overlooked, and the challenges they face, including burnout, may lead to critical outcomes that influence the population they seek to heal In fact, recent research has shown an uptick in burnout among working professionals In 2021, the majority of respondents to the American Psychological Association Work and Well-being Survey had experienced work-related stress in the past month, and nearly 60% of those respondents reported negative impacts on their well-being as a result (Abramson, 2022). Furthermore, 26% of respondents reported lacking interest, motivation, or energy, and 32% dealt with emotional fatigue (Abramson, 2022). Burnout has been extensively studied in high-stress environments, including healthcare to social work (Childs et al , 2024; Dugger, 2024; Fan et al , 2024; Prentice et al , 2023) However, there is a large gap in the experiences of burnout among research staff in TOS If the struggles of research staff go unnoticed, their ability to help the system may be compromised, resulting in poorer outcomes for system-involved youth (Nagy et al , 2019; Sharma et al , 2020; Sichel et al , 2019) This paper thus sought to investigate how trauma-organized systems and burnout may intersect to impact research staff
Trauma-Organized Systems (TOS)
In environments where trauma resonates through every interaction, the challenge is not only to heal those affected but also to support the individuals tasked with facilitating that healing Trauma-organized systems (TOS) reflect the dynamics of relational trauma by recreating the abusive, neglectful, and discriminatory experiences that individuals lived through before entering the systems (Bentovim, 1992; Cavanagh et al , 2022) This negatively affects the emotional health of those directly impacted and those working within the systems, because staff are at risk of internalizing secondary trauma experienced at work (Bentovim, 1992; Bloom & Farragher, 2010) Such systems include the child welfare and juvenile legal systems (Brennen et al , 2019)
The child welfare system manages a high percentage of young people shaped by traumas of abuse, neglect, and violence, as well as mental health issues precipitated from these exposures (Finkelhor et al., 2015; Horwitz et al., 2012). Children in the welfare system are negatively impacted by the dearth of service providers who are trained to recognize and be mindful of the trauma in youths' lives, as well as the systemic barriers that may prevent certain groups of youth from accessing services for specific needs (Gudiño et al., 2012; Stein et al , 2016) These systemic issues are exacerbated by the lack of resources and overworked system workers (Boyas et al , 2022) Additionally, the system’ s philosophy to serve and protect the needs and safety of children is contradicted by the practices of removing, relocating, and policing children without careful attention to their trauma history (Dawson & Berry, 2002) These system deficiencies impact the experiences of individuals’ trauma responses and perpetuate them throughout their system involvement
which can make them feel uncared for (Childs et al., 2024; Lombardero-Posada et al., 2023). If burnout is prevalent among research staff studying traumaorganized systems, consequences like these could directly impact their target populations, which defeats the purpose of conducting research to help them in the first place
Additionally, when employees are burnt out, they are at higher risk of quitting their jobs, leading to staff shortages (Childs et al , 2024; Lambert et al , 2015; Lombardo-Posada et al , 2023; Senter et al , 2010) With fewer people on staff, it is difficult for organizations to reach their goals effectively, whether it be caring for served populations, completing necessary administrative tasks, or acquiring enough money to stay afloat (Childs et al , 2024; Fan et al , 2024; Lombardo-Posada et al , 2023) In the context of research, being understaffed could lead to challenges in securing adequate funding to run projects, including program evaluations for vulnerable populations (Forrester, 2023). Examining factors that lead to burnout in specific work settings, such as research in trauma-organized settings, could inform interventions that reduce staff turnover and thereby improve overall outcomes (Childs et al., 2024; Forrester, 2023; Lombardo-Posada et al., 2023).
Burnout is particularly prevalent in traumaorganized settings, where staff at all levels–including psychologists, correctional officers, system workers, and other professionals–grapple with the demands of their work (Lambert et al , 2015; Sichel et al , 2019) Staff are often obligated to personify the paradoxical roles of disciplinarian and rehabilitator, which can intensify emotional strain and contribute to high levels of stress and fatigue (Sichel et al , 2019) While studies on burnout among correctional staff are abundant, the experiences of research staff in trauma-organized systems remain underexplored (Lambert et al , 2015; Sichel et al , 2019) Without visibility and intervention, burnout among these professionals can compromise the efficacy of their research and, by extension, the systemic improvements they aim to facilitate.
Current Study
While many studies have been conducted on burnout among professionals in high-stress environments, there is a notable gap in studying research staff in traumaorganized systems (Lambert et al., 2015; Sichel et al.,
2019). Their work often involves direct engagement with the same emotionally taxing environments and individuals as other professionals within the system, which implies that they could also be at risk of burnout (Keinan & Malach-Pines, 2007; Lambert et al., 2015; Sichel et al , 2019) By shedding light on their unique challenges, this study aimed to emphasize the importance of supporting research staff to ensure their well-being and enhance their capacity to contribute positively to the rehabilitation of system-impacted youth Therefore, this study sought to answer the following question: How does working with trauma‐organized systems, such as the Juvenile Legal System, relate to burnout among research staff?
Method
Participants
The current study has a sample of six participants who work at the Researching Inequity in Society Ecologically (RISE) Lab at New York University. The RISE Lab was selected as the primary target for participant selection due to convenience sampling and its strong connection to the Juvenile Legal System, an example of a trauma-organized system (Bentovim, 1992; Cavanagh et al., 2022). All participants contribute as research staff in various capacities within the JLS, ensuring a direct and relevant link to the study’ s objectives Across all participants, there were three supervisors (50 0%) and three student workers (50 0%) There is a wide variety of their primary responsibilities, including managing staff, collecting data at juvenile detention centers, and advocating for individuals impacted by the system Participants had between four months (min) and eight years (max) of experience as research staff studying the Juvenile Legal System (M = 31 167 months) All participants identified as women, and their ages ranged from 20 to 32
Procedure
Participants were interviewed over Zoom using a semi-structured interview method. Each interview was approximately 30 minutes. Interviewees were asked to provide demographic and background information regarding their jobs (e.g., “Could you share your workplace, role, years in position, and any other relevant information?”). The interview protocol consisted of three sections. Description of Work
(Protocol A) contained four questions covering experiences at work (e.g., “How would you describe your interactions with system-involved people?”). Emotional State (Protocol B) contained three questions regarding sense of emotional well-being (e.g., “Can you describe your general state of being at the end of a workday?”) Self-care (Protocol C) contained three questions touching on self-care practices (e g , “What strategies do you use to manage stress?) During the interviews, the interviewers asked follow-up questions to seek clarification and encourage elaboration, but adhered closely to the preset interview protocol For the full interview protocol, see Appendix A
Coding
The interview data were coded using items from the Maslach Burnout Inventory to account for the different facets of burnout (Maslach et al., 1997). Following the creation of the initial codebook, the two authors coded the same two interviews blind to each other’ s work. Finally, the coding was compared, and any discrepancies were discussed to come to a consensus. Overall, there were minimal differences between the authors’ initial rounds of coding. However, the authors refined the codebook to account for additional emerging themes within the dataset. After reviewing the data, the authors created the final codebook with three parent codes with seven child codes The first parent code, Emotional Exhaustion, with child codes a) Frustration, and b) Overwhelm, is the state of feeling emotionally drained as a result of excessive and prolonged stress This can occur as a product of a person ’ s inability to cope or meet the demands placed on them, either in their personal or professional life Increased levels of emotional exhaustion have been positively correlated with burnout (Maslach et al , 1997) Next, Depersonalization, with child codes c) Positive Interactions at Work, and d) Negative Interactions at Work, refers to feeling detached, negative, or cynical toward others in a work setting (Maslach et al., 1997). This often shows up as emotional withdrawal, reduced empathy, or treating people more like tasks than individuals. Finally, Personal Accomplishment, with child codes e) Feeling Rewarded, f) Low Sense of Efficacy, and g) Motivation, reflects a person ’ s sense of effectiveness and achievement in their work. It
measures how competent and successful individuals feel in fulfilling their job responsibilities. This is considered to be a protective factor against burnout, whereas a low sense of accomplishment may contribute to it (Maslach et al., 1997).
Following the revision of the codebook, the two authors independently coded the remaining interviews and compared their work Excerpts flagged for several codes were double-coded if deemed necessary All disagreements between interview codes were discussed and resolved No subsequent revisions were made to the codebook
Results
Overall, the data revealed high levels of emotional exhaustion across participants, implying burnout Additionally, there was high variability in the participants’ interactions with others at work, yet there were minimal indicators of depersonalization. Finally, participants also discussed how feeling accomplished and a sense of responsibility in their work positively impacted their workplace motivation.
Emotional Exhaustion
Participants expressed high levels of emotional exhaustion in both frustration and overwhelm. Frustration encapsulates the participants’ experiences of anger or annoyance toward any aspect of their work researching the Juvenile Legal System While the child code reached saturation with 18 excerpts across five participants, the data revealed that it was more common amongst participants with more experience researching the Juvenile Legal System Furthermore, across participants, all frustration was directed towards the system itself, rather than any other aspect of their work For example, Participant 5, who had eight years of experience in the field, said,
We're working with the system, and we're kind of like, you know, doing our best to fight them back and fight them at their own game I'm tired of their game I like, I kind of want out of their game completely.
Another important component of emotional exhaustion is feeling overwhelmed, which includes acute stress, emotional drainedness, and poor work-life balance. Overwhelm was one of the most prevalent child code in the data, with 25 excerpts across all six
participants. However, there was considerable variation across participants in the root cause of the overwhelm. Some attributed it to the sheer volume of work that must be done, along with other commitments like schoolwork. Participant 2, a full-time data collector and Master's student, stated,
I would say I kind of just push through [work] just because, like, there is really no time to take that time for myself and relax, because it's either I'm at the lab or I have to study, or I have to go to class, or my family needs me, or something else Like, I don't really manage it per se I kind of just have to roll along with it
On the other hand, some identified specific aspects of working with a trauma-organized system that affect their stress levels For example, Participant 5, a supervisor, said,
I have had, like, PTSD episodes in relation to stuff that's happened at work, and I have had times where I'm just, like, really low energy after stuff at work. I do my best to keep a layer of, I guess, like, compartmentalization. But sometimes, there's a certain stimuli that you can't control, you know, it just happens.
Having to constantly interact with system-involved people or front-line staff can negatively affect research staff ’ s work-life balance, contributing to overwhelm
Depersonalization
Across both child codes, the data revealed low levels of Depersonalization, with participants frequently reporting positive exchanges at work and remaining emotionally invested Positive Interactions with People at Work captures participants’ recollections of positive interactions with coworkers, clients (i e , systeminvolved youth), or people who work in the Juvenile Legal System This was the most saturated child code in the dataset, with 26 excerpts across all participants, who particularly highlighted the supportive nature of their fellow staff members. Additionally, the data revealed that participants viewed coworker support as a protective factor against symptoms of burnout. Participant 3, a full-time project coordinator, remarked:
I think we have such a large team, and we emphasize
community building and being in community to one another so much that whenever it starts to feel like a little bit too much… it's always nice to know that there are other people on the team that I can reach out to to be like, ‘Hey, I'm not having a great day right now ’ or ‘Hey, when you get a chance, can we talk about this?’ so I feel like definitely leaning on the other people that do the work has been really supportive and, my time over three years of figuring out ways of how to both feel the emotional demand of the work that we're doing, while also not letting it like bog me down, if that makes sense
Negative Interactions with People at Work, on the other hand, encapsulates participants’ stressful, frustrating, or upsetting interactions at work, which were hypothesized to contribute to depersonalization This code appeared eight times across five participants, making it one of the least prevalent in the dataset Interestingly, when instances were reported, none of the participants indicated that the interactions led to emotional detachment from their work. Instead, it spurred an urgency to seek help and increased motivation. This shows that participants largely care about their work, which is antithetical to depersonalization. When prompted to describe a challenging aspect of work, Participant 4, a student data collector, said:
Recently I went on a site visit, and one of the youths was an ‘F3’ which is high suicidality there are some situations where youth tell us ‘I feel really suicidal, like, I don't know how to, like, go about life, and I have an active plan of committing ’ So I think that is a situation where a lot of the data collectors have to, like, get in touch with our supervisors, but also be very present in the moment and make sure that we make the youth feel comfortable
She characterized these interactions as distressing, yet she still displayed motivation to connect the youth to help. There are several other similar excerpts where participants describe negative interactions, but that only fuels them to continue doing the work to fight the system.
Personal Accomplishment
Overall, this parent code revealed mixed results, with some feeling more accomplished than others. In
general, a sense of personal accomplishment is viewed as a protective factor against burnout. The child code Feeling Rewarded captures the broad feeling of fulfillment from one ’ s work, emerging 11 times across five participants. Their experiences ranged from the pride of implementing large-scale change to feeling accomplished by helping individuals impacted by the JLS When describing her interactions with systemimpacted youth, Participant 4 said,
I like that I am emotionally connected to these people because it makes my work all the more fulfilling You know, like, even though it is emotionally draining, because I'm so emotionally involved with these people, it just is really fulfilling It doesn't feel like work
Another important subtheme to address is the research staff’ s sense of helplessness in the context of their work. This runs counter to feeling rewarded and can contribute to higher levels of burnout (Maslach et al., 1997). In this dataset, there was relatively low saturation, with eight excerpts across four participants. Interestingly, there was high variability in the reported causes of low efficacy. Some reported feeling powerless due to individual interactions with system-impacted youth, such as Participant 6, an advocate who said, “You know [weed is] seen as such a devilish thing, or like, so horrible that it was, very emotional for me I left there feeling so defeated I was like, dude, like, how am I supposed to help somebody?” On the other hand, several participants attributed the low sense of powerlessness to the system itself When describing challenging aspects of work, Participant 1, a supervisor, said, “For example, attending court and seeing like a young person getting a stern talking to from the judge, and just like having them be made felt bad about something there's a lack of hope ” This exemplifies that there are aspects of working with trauma-organized systems that research staff feel unequipped to change, particularly in these individual instances, which contribute to burnout.
Motivation was yet another important theme that arose in the interviews, with 11 excerpts from five participants contributing to this child code and explicitly naming motivating factors in their work. The overarching theme was that the research staff were intrinsically motivated by their personal ambition to dismantle the existing Juvenile Legal System and to
help individuals they encountered in their work. Participant 5 noted,
And that is like, that's what this is all about The reason we go to fight the system is to keep young people in community And the reason why we focus so much on their personal empowerment, their strengths, their talents, and their goals is where our hope is
Having motivators was shown to act as a protective factor against burnout across participants by keeping the research staff engaged in the workplace and continuing their fight against the system
Discussion
This paper discussed research staff’ s experiences with burnout in trauma-organized settings, specifically the Juvenile Legal System The qualitative analysis revealed that the themes of emotional exhaustion, depersonalization, and personal accomplishment, as outlined in the Maslach Burnout Inventory, emerged consistently across participant responses (Maslach et al., 1997). This aligns with previous findings that working in high-stress environments can lead to burnout among staff (Armstrong & Griffin, 2004; Dugger, 2024; Lambert et al., 2015; Prentice et al., 2023). However, the current study highlights the nuances that exist between the three dimensions and how unique aspects of conducting research in the JLS can contribute to burnout as a whole
Emotional exhaustion was a predominant theme, with participants frequently expressing feelings of being overwhelmed and drained by their work, compounded by systemic challenges and a lack of work-life balance Depersonalization did not emerge as a salient symptom of burnout within this population, despite reported positive and negative interactions Positive interactions fostered a sense of community and provided a counterbalance to the emotional demands of the work, while negative interactions served as motivating factors to continue research and fighting the system, overall reflecting low levels of depersonalization. This signifies a departure from the existing literature, which could potentially be attributed to the nuances of working within trauma-organized systems (Bentovim, 1992; Fan et al., 2024; Prentice et al., 2023). Personal accomplishment emerged as a significant protective factor against burnout, with
participants finding fulfillment in both individual and systemic contributions. However, a low sense of efficacy in addressing systemic issues occasionally diminished these positive effects. These findings highlight the complex interplay of emotional exhaustion, interpersonal dynamics, and the sense of achievement in shaping the participants’ experiences of burnout
The data reflected a recurring trend among participants, particularly those with greater involvement in system-related work or those carrying more responsibilities, who experienced higher levels of overwhelm One contributing factor to this effect was their awareness of the system’ s oppressive operations Their abolition-based work focused on challenging a system resistant to change, which exacerbated the severity of their tasks For instance, participants spent more hours with clients facing severe charges due to what they perceived to be the inflexibility and harshness of the system toward the population RISE serves. Additionally, participants noted facing increased hours researching system workers to address the barriers preventing these workers from creating positive work environments. These findings align with research conducted on individuals in other high-stress professions (Childs et al., 2024; Dugger, 2024; Lambert et al., 2015). However, this study adds to the existing literature because previous studies have not captured the specific aspects of trauma-organized systems that can contribute to employee burnout
Another significant factor contributing to the overwhelm was the increased workload caused by the system’ s over-policing of the girls, leading to additional mandated hours with clients One participant recalled the emotional burden of consistently working with individuals under surveillance, which extended to both her and her client Prolonged exposure to the system heightened the risk of triggering her past traumas as a system-impacted young person, highlighting the role of personal experiences in influencing burnout within trauma-organized systems. While the individual’ s experience is not representative of all who work in trauma-organized systems, the general trend of high workload and emotional burden contributing to burnout is well established in the literature (Childs et al., 2023; Fan et al., 2024; Keinan & Malach-Pines, 2007; Lombardo-Posada et al., 2023). Being aware of these factors specific to working in this environment
could help inform interventions to mitigate these symptoms and ensure that research staff can effectively continue their work.
In addition, participants' sense of personal accomplishment from their roles in conducting research and contributing to their clients' well-being was a protective factor against burnout This sense of achievement gave them purpose and fulfillment, which helped them view their work as impactful However, despite these positive feelings, some participants expressed concerns about the sustainability of this work, noting that the challenges and systemic barriers could still contribute to symptoms of burnout over time Furthermore, working within the Juvenile Legal System reduced participants’ sense of efficacy, as the systemic challenges and emotional demands overwhelmed their capacity to experience success Participants expressed feeling that their efforts often went unrecognized or were undermined by the rigid structures of the system, leading to a diminished sense of accomplishment. Several also perceived a diminishing ability to make a meaningful impact, which led to feelings of helplessness and frustration. Many shared that, despite their dedication, the repetitive nature of dealing with systemic bureaucracy eroded their confidence in their ability to effect lasting positive change. These experiences highlighted the tension between the personal sense of fulfillment and the broader systemic frustrations they encountered, impacting their overall well-being and emotional exhaustion
Despite the reported symptoms of burnout, there was a trend of help-seeking behaviors among participants Community and positive interactions at work served as protective factors that fostered a sense of support and connection These interactions enhanced the research staff ’ s motivation, helping to counteract burnout symptoms and improve overall well-being Participants highlighted that engaging in supervision sessions where newer and older RISE participants came together to discuss the week's progress provided a safe space for connection, finding comfort in knowing that other people were experiencing the same struggles mentally as them. These sessions further strengthened their sense of accomplishment and reduced feelings of isolation. This supportive environment allowed participants to navigate the challenges of their work more effectively,
fostering a more resilient and fulfilling experience. Findings of the study have the potential to inform interventions that could reduce symptoms of burnout, particularly by enhancing community aspects of the workplace. Examining the role of positive workplace interactions and opportunities for professional growth across these contexts may help identify potential protective factors that enhance resilience and job satisfaction, ultimately improving outcomes for both workers and the population they serve Furthermore, these interventions could be tailored to specific aspects of researching trauma-organized systems, such as strategies for navigating the rigidity of the system, dealing with emotional drainage, or maintaining hope during frustrating periods
Future research should expand on different types of trauma-organized settings beyond the Juvenile Legal System, as the findings from this study highlight the complex interplay between emotional exhaustion, depersonalization, and personal accomplishments within such environments. Exploring diverse settings, such as child protective services or education systems, as trauma-organized settings could add nuance to the existing literature on how individuals navigate the challenges of working in TOS and reveal new factors that contribute to burnout. This study is a critical starting point in TOS research that demands further inquiry, not only to help staff improve their efficacy but also to better serve impacted populations
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Research Question:
Greeting/warmup and consent:
Interview Protocol
“Hello, thank you for agreeing to participate in this interview. I am a student in the Applied Psychology program at the Steinhardt School of Culture, Education, and Human Development at New York University. I am conducting a qualitative study for a class, and my research aims to understand the At any point during this interview, please let me know if you are uncomfortable, and we can skip the question Also, just so you know, this interview will be recorded and transcribed Before we begin, do you have any questions?”
Warm-up and demographic information:
“Could you please state your name, age, gender identity, and ethnicity?”
“Could you share your workplace, role, years in position, and any other relevant information?”
Protocol A: Description of Work
1 Could you please walk me through your career thus far?
2 What does a day in your life look like for your job?
3 How would you describe your interactions with system-involved people?
4 What are the most challenging aspects of your work?
Protocol B: Emotional State
1.How does your work affect your emotional state in general, if at all?
2.Can you describe your general state of being at the end of a workday?
3.How does that affect your motivation at work?
Protocol C: Self-care
1.What does a typical recovery/self-care day look like for you?
2.What strategies do you use to manage stress?
3.How would you characterize the support you receive from colleagues or the organization?
Closing/Conclusion:
1 Is there anything else you would like to add about anything we talked about?
2 Thank you so much for sharing your experiences and insights Your participation is very valuable to our research
3 If you have any questions or think of anything else you ’d like to share, please feel free to contact us
The Role of Organizational Support in Implementing Trauma-Informed Training in Juvenile Justice Settings
Devanshi Loomba
Justice-involved youth often experience disproportionately high levels of trauma and abuse during early childhood, resulting in significant mental health challenges later in life (Dierkhising et al., 2013; Reid & Loughran, 2019; Salem et al , 2022) Given this context, providing trauma-informed training to frontline staff who work directly with these youth is essential to address their unique needs and promote healing Such training equips staff with the necessary skills to effectively identify and address mental health and substance use issues, fosters positive perceptions of youth mental health, improves interactions with youth, and contributes to an overall safer environment within juvenile justice settings (Anderson et al , 2020; Baetz et al , 2022; Lockwood et al , 2021) However, research indicates that perceived barriers to delivering traumainformed care can undermine staff efficacy in utilizing these trauma-informed approaches (Stevens et al., 2019). These barriers often stem from organizational factors, including equitable opportunities, improved beneficiary functioning, enhanced accessibility, and positive working conditions, all of which have been shown to significantly influence the effectiveness of trauma-informed training in varied settings (Fernández et al., 2023). Despite the acknowledged importance of such organizational support, a notable gap exists in research regarding its availability and impact on frontline staff ’ s ability to implement trauma-informed practices with youth specifically involved in the justice system (Bazemore & Dicker, 1994; Mikytuck et al , 2019; Rhoades & Eisenberger, 2002)
Trauma and Mental Health in Justice-Involved Youth Youth who experience higher levels of trauma in early childhood are more likely to face incarceration
compared to their peers who do not (Baetz et al., 2021; Lockwood et al., 2021). This trend is evident among justice-involved youth, many of whom report experiencing various forms of trauma and abuse–including physical and sexual abuse–during their early years, which significantly impacts their mental wellbeing (Dierkhising et al , 2013; Kowalski, 2019; Salem et al , 2022) These individuals face an increased risk of developing a range of mental health conditions, including internalizing disorders such as anxiety and depression, as well as externalizing disorders like Oppositional Defiant Disorder (ODD) and antisocial behaviors (Dierkhising et al , 2013; Salem et al , 2022)
The high prevalence of behavioral and mental health conditions among this demographic adversely affects their emotional regulation, complicating their rehabilitation and reintegration into society (Dierkhising et al., 2014; Reid & Loughran, 2019). A common consequence of this emotional dysregulation is aggressive outbursts, which can hinder the progress of these youth and increase their risk of future incarceration (Finkelhor et al., 2007; Kilpatrick & Saunders, 2000; Reid & Loughran, 2019). Additionally, susceptibility to suicidality and substance abuse further elevates the likelihood of incarceration and recidivism among delinquent youth, as these factors increase their vulnerability to engaging in risk-taking behaviors, often including illegal activities (Reid & Loughran, 2019; Salem et al , 2022)
Beyond their involvement in illegal or inappropriate activities, exposure to trauma also impairs delinquent youths’ ability to develop and maintain healthy relationships, both within and outside of detention centers (Reid & Loughran, 2019) This challenge is particularly pronounced among adolescents facing developmental hurdles related to trust and connection
(Finkelhor et al., 2007; Reid & Loughran, 2019; Reid & Sullivan, 2009). These hurdles are often exacerbated by early childhood trauma, resulting in adverse neurodevelopmental and health outcomes, such as insecure attachment and tendencies toward isolation (Kowalski, 2019; Salem et al , 2022) Therefore, it is crucial to integrate a trauma-informed approach within juvenile detention centers to support these youth by addressing their early traumas and providing ongoing assistance to help them cope effectively (Dierkhising et al , 2013; Salem et al , 2022)
Importance of Trauma-Informed Training for StaffYouth Dynamics
Building on the understanding of the complex trauma and mental health needs of justice-involved youth, it is important to recognize the critical role that frontline staff play in supporting these individuals Frontline staff in juvenile detention centers work directly with youth and are responsible for managing their mental health conditions while ensuring that their personal biases and stigmatizing views do not interfere with the support they provide (Anderson et al., 2020; Lockwood et al., 2021). Navigating these biases can be particularly challenging without a thorough understanding of the trauma that delinquent youth have experienced (Anderson et al., 2020; Jackson et al., 2023; Lockwood et al , 2021) Consequently, the knowledge and understanding that staff possess significantly influence the effectiveness of their interactions with youth, shaping the quality of these engagements (Jackson et al , 2023; Lockwood et al , 2021)
To ensure that staff are equipped to effectively support these youth, it is vital to implement targeted training programs that develop their skills in addressing the unique trauma-related challenges these individuals face (Anderson et al , 2020; Bilchik et al , 2017; Hayes, 2009) In this context, effective engagement refers to the ability of staff to identify and appropriately respond to the mental health and substance abuse issues prevalent among these vulnerable youth (Anderson et al., 2020; Jackson et al., 2023). For training to be effective, it must be practical, accessible, and tailored to the specific roles of frontline staff in detention centers (Anderson et al., 2020; Bilchik et al., 2017; Hayes, 2009). Trauma-informed care is critical in this regard, as it is a framework that
integrates an understanding of trauma’ s prevalence and its effects on individuals into the provision of care (Classen & Clark, 2017). Training given to provide this care, known as trauma-informed training, involves providing frontline staff with the knowledge and skills necessary to identify and address the impacts of trauma on delinquent youth (Anderson et al , 2020; Jackson et al , 2023)
Some practices derived from trauma-informed training (i e , trauma-informed practices), include providing emotional support, employing de-escalation techniques in conflict situations, and training in trauma recognition (Baetz et al , 2022) These practices not only enhance communication and understanding between staff and youth but also improve staff’ s ability to de-escalate situations that could lead to negative socio-behavioral and legal outcomes for delinquent youth (Baetz et al , 2021; Griffing et al , 2020) Equipping staff with skills to implement traumainformed practices has been shown to reduce incidents of violence and aggression, which helps prevent future incarceration. Additionally, improved youth behavior facilitates the development of a positive rapport between staff and youth, as trust and cooperation become easier to establish (Baetz et al., 2021). These improved staff-youth relationships do not just benefit youth; for staff, these relationships lead to enhanced perceptions of safety, reduced burnout rates, and increased job satisfaction (Griffing et al , 2020; Sheppard et al , 2022)
Need for Organizational Support
While trauma-informed training is essential for improving interactions between staff and youth, research shows that perceived barriers to providing trauma-informed care can significantly impede staff effectiveness in applying these approaches (Stevens et al , 2019) Most frontline staff in juvenile justice settings recognize the importance of and are willing to engage in trauma-informed training (Baetz et al , 2022). However, studies reveal that without clear policies and strong organizational backing, the successful implementation of this training remains limited (Branson et al., 2017; Donisch et al., 2016; Moreland & Ressler, 2021).
This highlights the critical role that organizational factors and the social climate within detention centers play in bridging the gap between training and practice.
The successful integration of evidence-based practices, such as trauma-informed approaches, depends heavily on the organizational environment that supports, reinforces, and sustains these initiatives (Heffernan & Viggiani, 2015; Kramer et al., 2013; Taxman et al., 2014) Organizational support–manifested through equitable opportunities, supervisor backing, and positive working conditions–serves as the foundation for fostering a culture conducive to trauma-informed care (Fernández et al , 2023; Rhoades & Eisenberger, 2002) This support not only enhances employee wellbeing but also directly impacts staff motivation, job satisfaction, and performance, which are vital for maintaining a consistent and effective traumainformed environment (Bazemore & Dicker, 1994; Mikytuck et al , 2019; Rhoades & Eisenberger, 2002)
The Social Support Theory by Cohen and Wills (1985) further underscores the importance of a supportive environment, suggesting that perceived organizational support can buffer stress and enhance coping strategies among staff. When juvenile justice agencies actively provide emotional and practical support, it creates a positive social climate that enhances staff resilience and capacity to deliver trauma-informed care effectively (Cohen & Wills, 1985). Ultimately, nurturing these supportive relationships among staff and youth is essential for creating an environment that promotes healing, reduces behavioral issues, and improves overall outcomes within detention settings (Baetz et al , 2021; Bazemore & Dicker, 1994; Fernández et al , 2023; Rhoades & Eisenberger, 2002)
Despite these insights, there remains a significant gap in understanding the specific needs of juvenile justice staff working with adolescents facing complex developmental challenges (Branson et al , 2017; Conners-Burrow et al , 2013; Zajac et al , 2015) Moreover, the lack of standardized guidelines and actionable strategies within juvenile justice systems results in inconsistent implementation of traumainformed practices across centers and states (Mathys, 2017). Addressing this gap by developing clear, evidence-based protocols and ongoing support initiatives is crucial for ensuring that trauma-informed care is effectively integrated into practice, ultimately strengthening staff-youth relationships and improving outcomes for youth (Mathys, 2017; Moreland & Ressler, 2021).
Current Study
Existing literature highlights the high prevalence of trauma among justice-involved youth (Kowalski, 2019; Salem et al., 2022), which often leads to mental health challenges and complicates rehabilitation efforts (Dierkhising et al , 2013; Kowalski, 2019; Reid & Loughran, 2019) While the importance of traumainformed training for frontline staff is well-recognized, significant gaps remain in understanding how organizational support influences the effective implementation of these training programs Specifically, there is limited research on how organizational policies, climate, and resources facilitate or hinder the translation of trauma-informed knowledge into daily practice within juvenile detention centers Furthermore, little is known about the ways in which organizational backing affects staff’ s ability to build positive relationships with youth and maintain a trauma-sensitive environment over time. Addressing these gaps is critical for developing sustainable strategies that enhance trauma-informed care and improve outcomes for justice-involved youth. Consequently, this study aims to explore the following research question: What is the role of organizational support in the implementation of trauma-informed training during interactions between frontline staff and justice-involved youth?
Method
Participants
Twenty frontline staff members from juvenile detention centers across New York City participated in the current study Participants ranged in age from 25 to 50 years and included a balanced representation of genders, with nearly equal numbers identifying as male and female The majority of participants (n = 15) identified as African American, while five identified as Hispanic or mixed race To be eligible for participation, staff members were required to have at least four years of experience working with delinquent youth, to have completed trauma-informed training and certification, and to be actively engaged in an ongoing trauma-informed training support program for at least one year.
Procedure
Four observations were conducted with frontline staff at juvenile detention centers in New York City
interactions, shaping the identified facilitators and barriers.
Facilitators to Effective Staff-Youth Interactions
Empathetic communication. The term “empathy” was mentioned 41 times during the observations, with participants expressing warmth and understanding for the youth they work with During one of the observations, a participant remarked, “Empathy makes it easy to put yourself in their shoes ” Many displayed warm facial expressions when discussing their feelings about these youths A key code within this theme was “knowing trauma,” which was mentioned 11 times One participant recalled, “I remember when they (delinquent youth) first came to the facility; they wouldn’t even look me in the eye I was okay with that because I know what they have gone through,” accompanied by a soft smile Four participants referred to a trauma-informed approach, with one noting, “Knowing about their trauma is more important for them than for us because these kids have faced so much trauma, and at the end of the day, we go home.” Additionally, seven participants discussed their empathy in relation to conflicts or verbal altercations with youth. The code “fights” arose when addressing situations requiring empathetic communication, with one participant stating, “Sometimes the youth are not as tough as they act; they fight, but they are very soft and get upset ”
Enhanced understanding of trauma. Often coexisting with empathy, an enhanced understanding of trauma was extensively noted during the observations A prominent code was “past trauma,” mentioned 22 times, highlighting its significant role in influencing youth behavior One participant stated, “Understanding past trauma allows us to approach the situation with compassion rather than frustration ” Many participants displayed open body language and nodded in agreement while discussing this concept Nine participants emphasized the impact of an enhanced understanding of trauma on their relationships and interactions with youth, with one stating, “Understanding their backgrounds can really change how well we interact with them.” Seven participants described how they implemented this understanding by emphasizing the need to take “accountability” for their own actions, with one stating, “He was rude, but we know he has parental
issues, so I just needed to take accountability and calm down.” Additionally, the code “ reassurance ” was mentioned nine times, notably in a situation where a distressed youth joined the training session, demanding immediate attention from the staff. A staff member requested to step out and attend to the youth, explaining, “He gets overstimulated when upset and lashes out; I need to reassure him ”
Supportive resources. The second most prominent theme was supportive resources, with the term “support” mentioned 39 times during the observations The coaches began sessions by inquiring about staff well-being, urgent topics, logistical issues, and resource needs A common question from the coaches was, “What do you need right now?” This question elicited varied responses but a shared eagerness to engage The code “grateful” appeared eight times, with many participants expressing appreciation for the support provided through trauma-informed training and coaching programs. One participant remarked, “Sometimes it gets frustrating because you cannot discuss the youth’ s issues with anyone outside of the system, so it is good to have you guys. ” Another prominent code, mentioned seven times, was “burden.” One participant noted that the availability of coaching “takes some burden off of us; it’ s like unloading some of the baggage we carry, ” accompanied by a sigh of relief Ten participants referenced support in relation to the trauma-informed training sessions, discussing specific techniques learned, with a prominent code of “de-escalation ” One participant stated, “Without training and support from you guys, we would be in the dark on what to do in difficult situations and how to de-escalate them,” while other participants nodded in agreement, some with nervous laughter
Positive relationships. A significant code within this sub-theme was “strong relationships,” mentioned 22 times During one of the observations, a youth entered and shared a fist bump with a participant, making inside jokes and sharing laughs This was accompanied by smiles and playful gestures as they discussed a soccer game and a potential match between the staff and youth. During another observation, a participant left the training for a few minutes to give a youth their favorite snack, accompanied by a gentle pat on the back. Another code mentioned 11 times was “friendship.” Participants explicitly spoke about the progression of their relationships with youth, with one
sharing, “It took time, but then they realized we were their friends.” Learnings from the trauma-informed training sessions were mentioned while describing staff-youth relationships, with one participant stating, “We need to actively use techniques to continue to be friends ” The code of “mutual respect” came up seven times among participants at the same facility, with one mentioning the widespread belief: “Treat everyone with respect, the way you want to be treated,” while others nodded their heads in agreement A participant at a different facility shared a similar belief, saying, “We are nice to each other now because I get them, and they want to get me, ” followed by smiles and affirming gestures
Staff job satisfaction. Within the sub-theme of staff job satisfaction, the word “home” appeared 11 times There was an instance where a participant greeted the coaches, saying, “Welcome to our home; we live, love, and laugh here,” accompanied by warm smiles and open gestures. Another prominent code, “relationships,” was mentioned 14 times as participants described varying levels of job satisfaction. One participant said, “These relationships make my day; these kids were menaces, but after many arguments, I know these babies, and I get them,” as they chuckled and shared knowing glances with other participants. Coexisting with this code, “stress” was mentioned seven times when conversing with coaches about the high-stress environment of the facilities One participant shared how, “Getting love from these kids makes this job worth all the stress,” a sentiment followed by nods and encouraging expressions from peers The availability of training and resources also emerged as a factor affecting job satisfaction, with the code “being good at the job” appearing eight times One participant stated, “If I were not good at my job, I would simply quit,” followed by a firm nod and a resolute expression
Barriers to Effective Staff-Youth Interactions
Resistance to change. In addition to factors that promoted effective interactions between frontline staff and delinquent youth, participants identified barriers hindering communication. Resistance to change was a common theme throughout the observations. While discussing the implementation of trauma-informed practices–such as de-escalation techniques and strength-based approaches–12 participants expressed
“struggles” in executing these strategies. One participant noted, “I know what to do, but sometimes I struggle with how to do it.” The code “acceptance” also came up nine times, with less than half of the participants reporting difficulties in accepting traumainformed training, often expressing skepticism During a session focused on strength-based approaches, one participant said, “How can I accept this training when they are being horrible this week? They should know what to fix,” followed by a dismissive hand gesture In a specific observation at a facility with increased youth aggression, two participants discussed the issue, stating, “We understand their trauma, but patience is not always effective, so we ice them out,” while crossing their arms defensively
Misunderstandings of trauma. The theme of understanding trauma has been previously mentioned but also arises as a barrier to effective interactions between staff and youth. Less than half of the participants showed misconceptions about trauma’ s effects, complicating their relationships with the youth. Four participants expressed a preference for punitive measures in response to behaviors potentially stemming from trauma. The code “punishment” was mentioned six times throughout the observations. During one observation, a participant argued with a coach, stating, “Sometimes kids just act up; they need punishment to realize what they have done is wrong, ” while speaking in a detached, stern tone There were also instances where participants made overly simplistic statements about trauma, such as, “We talk to them and bam, it’ s fixed ” Moreover, three participants mentioned employing a “glass half full approach” when discussing youth anxieties and traumas, accompanied by some encouraging nods and some opposing gestures
Lack of supportive resources. The previously mentioned theme of supportive resources was also examined from a deficit perspective The code “unpreparedness” emerged eight times, with participants linking it to a lack of organizational resources to effectively implement their traumainformed training. During one observation, a participant stood up and gestured to the outdated materials in their interactive living room, stating, “We are not prepared for these children; the books are old, and if we want to have a chat with someone, people barge in, and there is no privacy,” accompanied by a
frustrated hand gesture. Coexisting with “unpreparedness,” the code “feeling alone” was noted, with seven participants expressing this sentiment while managing youth-related issues. One participant shared, “The mental health clinicians do not work after 5 p.m., so we are expected to act as psychologists even when we do not have the qualifications,” while others nodded in agreement
Staffing shortage and time constraints. Within this sub-theme, “limited time” was referenced 22 times throughout the observations Many staff members expressed that their long working hours hindered their ability to engage with youth in a trauma-informed manner One participant said, “With everything we have to do, it’ s hard to find the time to really connect with the youth,” shaking their head in frustration During one observation, four morning shift participants appeared visibly exhausted and disengaged during the coaching session, with one exclaiming, “Oh, we have to do this too,” while slumping in their chair. Participants also shared how these extended hours impacted their mental health, with one stating, “It’ s hard to find time for self-care when you ’ re focused on helping others,” accompanied by a deep sigh. Additionally, the code “having multiple roles” was mentioned nine times, with some participants describing it as “wearing different caps. ” Inconsistent implementation. The code “different application” of trauma-informed practices was mentioned six times during the observations, highlighting a lack of uniformity among staff During a training session, two participants engaged in a disagreement, with one asserting defensively, “You should do what you think is right, and I will do me ” Another significant code, “difficulties in application,” was noted seven times One participant voiced concerns about maintaining the standards of traumainformed practices, stating, “The energies are low for some of us who are overworked,” which elicited nods of agreement from others who appeared visibly frustrated.
Discussion
This study investigated the role of organizational support in implementing trauma-informed training during interactions between frontline staff and delinquent youth in juvenile justice settings. Existing research highlights the benefits of trauma-informed
training in these environments, noting improvements in staff perceptions of youth, enhanced safety within detention centers, increased job satisfaction, and ultimately, stronger staff-youth relationships (Baetz et al., 2022; Salem et al., 2022; Sheppard et al., 2022). This investigation examined both the facilitators and barriers to effective staff-youth interactions, with a particular emphasis on the availability of organizational support and resources for frontline staff
The findings indicate that frontline staff recognize the importance of empathetic communication and a deeper understanding of trauma in fostering strong, supportive relationships with youth Empathy emerged as a critical facilitator, frequently mentioned in discussions about building trust and effectively navigating conflicts in the detention centers Many participants noted that acknowledging trauma allowed them to approach youth with compassion, highlighting its central role in improving the effectiveness of their interactions. Additionally, most staff members emphasized the value of supportive resources, such as coaching sessions and trauma-informed training, which were deemed essential for creating a safe atmosphere in facilities for both staff and youth. This sentiment was echoed by many participants who linked their job satisfaction to positive interactions with youth and the valuable training received, particularly in communication techniques and de-escalation strategies These findings align with prior research indicating that trauma-informed training enhances communication, equips staff with conflict management skills, and reduces incidents of violence among justiceinvolved youth (Baetz et al , 2022; Salem et al , 2022) Ultimately, this leads to improved staff-youth relationships, as well as enhanced staff perceptions of safety and job satisfaction (Griffing et al , 2020; Sheppard et al , 2022)
The study also identified several barriers to effective interactions between staff and youth, particularly in implementing trauma-informed practices. Many staff members expressed skepticism and a lack of confidence in their ability to apply these practices effectively. Additionally, misconceptions about the effects of trauma led some to favor punitive measures over a more empathetic approach, undermining the trauma-informed model and negatively impacting their relationships with youth. Insufficient organizational
resources, such as mental health support for staff, contributed to feelings of unpreparedness and isolation, with many participants reporting that they felt alone in managing youth-related issues. Moreover, long working hours and the demands of balancing multiple roles further hindered staff ’ s ability to engage meaningfully with youth and address their mental health needs Variability in understanding and applying trauma-informed practices also created confusion and inconsistency in interactions, as staff reported difficulties in translating insights from training into practical application In essence, a lack of support–evidenced by inequitable workload distribution, unreasonable working hours, and inadequate mental health resources–significantly affected staff job satisfaction This dissatisfaction, in turn, affected their relationships and interactions with youth, fostering a less empathetic and more authoritarian environment in the detention centers. These findings align with existing literature, which indicates that inadequate policies and organizational support–including mental health resources and professional development opportunities–hinder the effective implementation of traumainformed practices in juvenile justice settings (Branson et al., 2017; Donisch et al., 2016; Moreland & Ressler, 2021). Therefore, addressing the gap in research regarding effective organizational support is essential for enhancing the impact of trauma-informed training programs in these settings Such support is crucial for improving the implementation of trauma-informed practices, ultimately leading to better outcomes for both staff and youth, as well as enhancing the overall environment of the detention centers
While this study highlights significant findings, it also has several limitations that should be considered when interpreting the results First, the qualitative nature of the research involved a limited scope, with only four observations and a sample of 20 participants Additionally, observations were conducted exclusively in New York City detention centers, with most participants representing a specific cultural and socioeconomic background, predominantly African American. This narrow focus limits the generalizability of the findings to broader populations. Future research should aim to include a larger and more diverse sample, incorporating participants from various geographical and cultural backgrounds to enable a more nuanced understanding of the topic.
Furthermore, as the study relied on observations, direct engagement with staff regarding their perceptions of trauma-informed training and organizational support was not possible. Supplemental studies utilizing alternative qualitative methods, such as interviews, could enhance the research by allowing frontline staff to share their insights and experiences directly Lastly, comparative analyses between nonsecure, secure, and limited secure placement facilities were not conducted, which could yield valuable insights not captured in this study Despite these limitations, this study offers valuable insights for enhancing organizational support in the implementation of trauma-informed training, thereby suggesting ways to improve staff-youth interactions in juvenile detention centers
The findings from this study emphasize the critical role of trauma-informed training and practices in enhancing staff-youth interactions and relationships. However, the lack of organizational support–particularly in areas such as mental health services, workforce equity, and professional development–hindered staff from fully applying the knowledge gained from trauma-informed training sessions. To address these challenges, this study offers several specific recommendations for policymakers. First, there is a pressing need to address staffing shortages in New York City detention centers by increasing recruitment efforts and improving retention strategies Enhancing mental health and support resources for staff is also essential, as participants indicated that inadequate support contributed to feelings of isolation and unpreparedness Moreover, this research lays the groundwork for future studies aimed at identifying gaps in the implementation of trauma-informed training in facilities facing organizational challenges Longitudinal studies could assess changes in staff job satisfaction and their ability to apply trauma-informed practices once adequate resources and support are provided On a broader level, the findings encourage discussions on policy reforms that prioritize mental health resources and workforce equity, potentially leading to systemic changes within juvenile justice settings. While further research is necessary for a comprehensive understanding, this qualitative study serves as an important first step in guiding improvements in the field. By implementing these recommendations, organizations can better support
staff in their efforts to foster positive interactions with youth, ultimately leading to improved outcomes for both staff and the young people they serve.
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A
Observation Template
Observation Date: Time:
Location:
Number of Participants:
Constructs to Observe
1.Setting:
a.Physical Environment: Layout and atmosphere of the interaction space.
b.Designated Areas: Specific spaces for staff-youth interactions and trauma-informed training sessions.
c.Resources Available: Presence of trauma-informed resources like mental health services, peer advocacy, and educational tools
2 Gestures and Nonverbal Interactions:
a Body Language: Posture, facial expressions, and eye contact
b Supportive Cues: Calming gestures and open body language
c Signs of Discomfort: Indicators of tension or avoidance
3 Verbal Interactions:
4 Content and Tone: Language and emotional tone used by both parties
5 Conversational Style: Open-ended versus direct conversations among staff, coaches, and youth
6 Turn-Taking Dynamics: Frequency of interruptions and engagement
Exploring Peer Support Among Women with Spinal Cord Injuries
Grace Li, Sophia Masso, and Ella Seward
Between 250,000 and 500,000 people worldwide experience a spinal cord injury (SCI) each year (GBD Spinal Cord Injuries Collaborators, 2023; World Health Organization, n.d.), an estimated 18,000 of whom are in the United States (U S Department of Health and Human Services, 2025) The leading causes of SCIs are falls and road accidents (U S Department of Health and Human Services, n d ; World Health Organization, n d ) Depending on the type and location of the injury, the level of paralysis and associated outcomes, such as bladder and bowel dysfunction, sexual impairment, and loss of motor or sensory function, may vary (U S Department of Health and Human Services, n d ) Given the often drastic and sudden life changes that result from SCIs, researchers have examined the mental well-being, life satisfaction and readjustment process of individuals with SCIs (Bhattarai et al., 2021; Silveira et al., 2018). The psychological impact of SCIs is significant, with 18.7% to 26.3% of individuals developing major depressive disorder due to chronic pain and loss of physical function (Tang & Yu, 2024; Williams & Murray, 2015), and 30-45% of individuals with SCIs experiencing a significant level of anxiety surrounding symptoms related to the injury and their future (Budd et al., 2022).
Appropriate and timely access to rehabilitation measures is imperative for optimizing physical and mental health outcomes (World Health Organization, n d ) Emotional and practical support from friends and family has consistently emerged as another key resource in this readjustment process (Naimat et al , 2023; Rintala et al , 1992) In addition to professional medical care and support from loved ones, peer support from individuals with shared experiences offers unique benefits, such as a deeper understanding,
empowerment, and a sense of community for people with SCIs (Barclay & Lalor, 2022; Beauchamp et al., 2016; Houlihan et al., 2017). However, existing research predominantly focuses on men with SCIs, who comprise around 80% (i e , the majority) of SCI cases (McColl, 2002; Slocum et al , 2020) Little is known about the specific and nuanced experiences of women with SCIs receiving peer support (McColl, 2002; Robinson-Whelen et al , 2025; Slocum et al , 2020)
Spinal Cord Injuries
The spinal cord consists of numerous nerves that run from the base of the skull to the lower back (U S Department of Health and Human Services, n d ) It is divided into four main sections: cervical (C1-C7), thoracic (T1-T12), lumbar (L1-L5), and sacral (S1-S5), and each section is integral in transmitting information between the brain and various body parts (U.S. Department of Health and Human Services, n.d.).
Spinal cord damage can lead to either a total loss (i.e., complete SCI) or partial loss (i.e., incomplete SCI) of nerve function below the point of injury (U.S. Department of Health and Human Services, n.d.). SCIs are categorized as either traumatic or nontraumatic; traumatic SCIs occur due to sudden impacts (e.g., motor vehicle accidents, falls, sports injuries), whereas non-traumatic SCIs are caused by gradual processes (e g , infections, neurological diseases, birth complications; World Health Organization, n d ) This damage often results in chronic pain, fatigue, impairments in bladder and bowel function, sexual health, and cardiac, digestive, and respiratory problems (Forsythe & Horsewell, 2006; McColl et al , 2004; Nevedal et al , 2016; Spungen et al , 1997)
In addition to these physical changes, there are also a variety of psychosocial impacts of SCIs (Beedie &
participants report feeling deeply connected and valuing the opportunity to share common experiences and challenges (Barclay & Lalor, 2022; Starosta et al., 2024). As technology becomes more prevalent in today’ s society, online peer support groups hold great potential for enhancing well-being in this community (Barclay & Lalor, 2022; Starosta et al , 2024)
Women with Spinal Cord Injury
While existing literature highlights the effectiveness of different forms of support, those findings are largely based on and centered around men, who make up the majority of the SCI cases (Slocum et al , 2020) While women represent a smaller percentage (20%) of the SCI population, their unique experiences and health needs are equally important, deserve consideration, and warrant further exploration (McColl, 2002; Robinson-Whelen et al , 2025; Slocum et al , 2020)
Women with SCIs have a double-minority status, facing specific challenges at the intersection of their sex and disability (Hunt et al., 2021; Kennedy & Rogers, 2000; McColl, 2002; Slocum et al., 2020).
Women with SCIs experience distinct gynecological, reproductive, and endocrine health concerns, including but not limited to additional assistance with bladder and bowel care, increased risk of urinary tract infections (UTIs), anorgasmia, autonomic dysreflexia (AD), and increased pregnancy complications (Budd et al , 2022; McColl, 2002; Slocum et al , 2020) They also require specific health management and preventative care for these medical issues (i e , urologist referrals, cystoscopy, etc ), often unaccounted for in SCI treatment plans (Slocum et al , 2020) These physical changes often lead to a sudden loss of independence, impact their relationship with their body and partners, and further contribute to psychological vulnerabilities, such as a heightened risk of depression compared to both men with SCIs and the general population (Beedie & Kennedy, 2002; Kennedy & Rogers, 2000; McColl, 2002; Rintala et al , 1992; Robinson-Whelen et al., 2025; Slocum et al., 2020; Tang & Yu, 2024).
Furthermore, women with SCIs experience poorer self-esteem and life satisfaction, especially in terms of sexuality (Bailey et al., 2016; Moin et al., 2009; Nario‐Redmond, 2010). Due to physical changes in their bodies, women with SCIs often do not feel as attractive, desirable, or feminine as before their injury (Bailey et al., 2016; Nario‐Redmond, 2010). Many
women report feeling unable to fulfill both the societal expectations of traditional female roles (i.e., homemaking, nurturance, motherhood) and their partner’ s sexual desires due to these negative views (Budd et al., 2022; Federici et al., 2019; Pentland et al., 2002) These unfavorable perceptions also make it harder for single women with SCIs to find partners and engage in the dating scene (Budd et al , 2022; Nario‐Redmond, 2010)
While it is clear that there are numerous genderspecific challenges, rehabilitation approaches and peer support programs have been based on research focused on male experiences (Samuel et al , 2007) Therefore, these environments are often heavily shaped and tailored to men, leaving women ’ s specific needs unaddressed (Krause & Broderick, 2004; Nosek & Hughes, 2003; Samuel et al , 2007) Women-only support groups provide a vital space to discuss specific issues without fear of judgment or unwanted reactions from male participants (Lennon-Dearing, 2008; Robinson-Whelen et al., 2025). The stronger sense of similarity and connection among same-gender peer support groups can allow for normalcy, understanding, and validation (Lennon-Dearing, 2008; Robinson-Whelen et al., 2025).
Current Study
Previous literature identifies significant benefits of social support to the general SCI population in terms of health outcomes, emotional engagement, and awareness of appropriate resources, but still, many gaps remain in the literature (Beedie & Kennedy, 2002; Isaksson & Hellman, 2012; Müller et al , 2012; Rintala et al , 1992) Most apparent is the lack of focus on the women-specific SCI experience, as the existing literature primarily depicts the male experience of SCI and rehabilitation (Krause & Broderick, 2004; Nosek & Hughes, 2003; Pentland et al , 2002; Samuel et al , 2007; Slocum et al , 2020) Even though women are an underrepresented group within the SCI population, their unique experiences and challenges are still essential to understand and must not be overlooked (McColl, 2002; Rintala et al., 1992; Samuel et al., 2007; Slocum et al., 2020). It is essential to explore social support, particularly peer support, through a qualitative lens that can provide a more in-depth understanding of women ’ s experiences. This way, research can identify the most beneficial and
meaningful aspects of social support for women with SCIs (Barclay et al., 2016; Barclay & Hilton, 2019; Barclay & Lalor, 2022; Starosta et al., 2024). Furthermore, in order to highlight the most relevant perspective and create the greatest benefit, research must also be designed in collaboration with women with SCIs (Barclay & Hilton, 2019; Kelly, 2005; Smith et al , 2010) Therefore, the current study sought to work directly with community members to address the following question: How do women with spinal cord injuries (SCIs) describe their experience of receiving peer support?
Method
Participants
Participants (N = 10) were recruited from Women on Wheels (WOW), a nonprofit organization based in New York City that provides remote, weekly peer support group meetings for women with SCIs worldwide. All participants had been participating in the WOW peer support group for at least three months, with the majority participating for one or more years. All participants also identified as cisgender women. The age range of participants was 35-69 (M = 47.20, SD = 10.08). Participants identified as one or more of the following racial/ethnic identities: White (23%), Black (46%), Hispanic (15%), Indigenous (15%). A diverse range of types of SCIs were represented (see Table 1)
Procedure
Semi-structured interviews were conducted to explore the participants' descriptions of their experiences in a peer support group for women with SCIs All interviews were recorded and transcribed via Zoom in English Each researcher was randomly assigned to conduct interviews with 2-4 WOW members The semistructured interview allowed for consistent and standardized communication and questioning between the researchers, while still giving participants the room to steer the conversation in ways that were meaningful to them. Transcripts were generated using Zoom’ s automatic transcript generator and were reviewed against audio recordings to verify accuracy.
The interview protocol was developed using findings in the literature and participatory action research (PAR) principles (Kelly, 2005; Smith et al., 2010) to ensure that the questions were accurate, sensitive, and
reflective of the lived experiences of women in the SCI community. Given that none of the researchers were part of this community, protocol was co-created with the founder and executive director of WOW (a woman living with SCI) and the president and operations manager (who has extensive experience caring for individuals with SCIs) (see Appendix A)
Coding
All coding was conducted using grounded theory as no existing coding system, to the authors’ knowledge, addressed the specific experiences of women with SCIs in peer support groups Thematic analysis extracted themes directly from the participants' narratives (Braun & Clarke, 2006) Reliability was established through a multi-step process Each researcher independently reviewed the same two transcripts (20% of the total 10 transcripts), then compared codes and addressed inconsistencies until percent agreement reached 90%. The remaining transcripts were divided among researchers and read at least twice. Codes relevant to the research question were established using open coding per text segment; more specifically, a segment was defined as 1-3 sentences within an exchange conveying a complete idea. Codes were also mutually exclusive, meaning that each segment could only represent one code and could not belong to more than one code This decision ensured clarity so that codes would be related but distinct Additionally, the exclusivity of codes increases inter-rater reliability/consistency in the coding process, allowing for a reduction of ambiguity and the most accurate findings possible The researchers then discussed these initial codes and worked together in the process of axial coding to identify the overlapping and persistent themes A total of 12 codes emerged
Results
Four overarching themes emerged from our qualitative data analysis: empowerment through shared experiences, fostering open dialogue, transforming perspectives, and benefits and challenges of remote peer support groups. Each theme encompasses multiple codes that describe the experience of women with SCIs receiving peer support (see Appendix B).
Empowerment Through Shared Experiences
Participation in peer support groups emerged as
profoundly impactful across multiple dimensions. The defining characteristic of peer support is the presence of shared lived experiences, which leads to greater mutual understanding and more effective resource sharing. All of the participants shared that mutual understanding was a unique aspect of peer support As compared to the support provided by able-bodied individuals, Participant 1 noted:
Well, I mean, just other people want to be helpful generally, but they don't really understand without going through it So, it's just you can kind of connect and talk about things on a different level with people who have the same experiences as you You know, you can kind of skip the groundwork
Participant 3 echoed this sentiment, stating, “ because for the first time, I encountered like I didn’t have to explain what I was going through. They knew what I was going through.” The ease of communication and sharing information and experiences without supplementary explanations was a prominent and recurring idea throughout all the interviews.
Sixty percent of participants also mentioned how the shared experiences offered the benefit of practical advice and resources that contributed to their physical well-being. These ranged from sharing adaptive techniques for mobility to recommending surgeries to demonstrating the use of medical devices Notably, Participant 5 described a particularly meaningful moment:
It was when someone shared how to drain your bowels using a catheter I didn’t know how to do that, even at the hospital, they didn't tell me anything about that, and I learned this from WOW I appreciate that because it's useful for me
Because other peers have shared similar experiences, they can comfortably and openly share practical information and help one another.
Fostering Open Dialogue
In these peer support groups, women with SCIs can feel safe and engage in conversations surrounding the unique challenges they face. However, it is important to distinguish that 80% of participants noted discomfort in co-ed peer support groups that they had been a part
of before WOW. Participant 9 recounts what the conversations in co-ed support groups were like:
A lot of sports talk, car talk, when's my dick gonna work again talk, what do you use to make your dick work again talk… and so there's a lot of women that are very uncomfortable around those kinds of conversations, or just feel left out
Participant 9 also notes that as “ a pretty vocal woman, even I felt railroaded by the men's conversations ” This quote highlights that if very vocal women feel disregarded and silenced, more reserved women may never get to express their feelings, thoughts, and gender-specific concerns
Therefore, gender-specific peer support groups create space for the free exchange of ideas on various matters, as noted by 90% of participants Participant 2 notes, “there's nothing that we don't discuss or we don't delve into.” Participant 4 also mentions that the peer support group is “ a free platform to talk, so don't hold back, do whatever… you don't have to be afraid.” This openness to speak without fear of judgment made many women feel safe, comfortable, and connected. Furthermore, topics specific to women ’ s experiences can be discussed more openly. 90% of participants valued the ability to relate and speak on matters of sexuality and dating Participant 4 expressed frustration over the lack of information surrounding sexuality for women with SCIs:
We get no information on how to live again sexually Nothing There’ s always, you will see, brochures of what a man can do But as a woman we have to sort of, and still, we have to figure it out on our own as we go along
In addition to sexuality, Participant 8 also notes how “ men seem to either want to take care of me, which I don't need, or they are afraid of, like, not having the intimacy that they would have with an able-bodied woman. ” Having a safe space to discuss these more taboo topics was crucial in the women ’ s experience within WOW.
Ninety percent of participants also highlighted how their experiences with bladder and bowel care differ significantly from those of men, often requiring unique routines and considerations. Participant 2 expressed that men “have a dick, and it's easy just to put in a
practical assistance (Barclay & Lalor, 2022; Chemtob et al., 2018; Houlihan et al., 2017; Maggio et al., 2024). Individuals going through similar experiences are better able to connect and relate, reducing some of the exhaustion associated with having to repeatedly explain their condition and feelings (Barclay & Lalor, 2022; Beauchamp et al , 2016; Houlihan et al , 2017)
Peer support also provides a community where peers can learn from one another, whether that be through mindset shifts or actual resources regarding medical support, enhancing one ’ s psychological well-being (Beauchamp et al , 2016; Chemtob et al , 2018; Houlihan et al , 2017; Maggio et al , 2024; RobinsonWhelen et al , 2025)
Particularly, peer support that was specific to one ’ s gender created more comfort and deeper understanding in conversations that were more personal, such as those surrounding sexuality, dating, and bladder and bowel care, highlighting the importance of tailored peer support approaches (Bailey et al., 2016; Budd et al., 2022; Lennon-Dearing, 2008; Nario‐Redmond, 2010; Robinson-Whelen et al., 2025; Slocum et al., 2020). In fact, the lack of understanding experienced in co-ed support groups can potentially negate the benefits of mutual connection, further underscoring the necessity of women-only spaces to support self-esteem, life satisfaction, and overall well-being (Budd et al , 2022; Lennon-Dearing, 2008; Robinson-Whelen et al , 2025)
Online peer support groups did show challenges, such as a lack of connection and technological complications, consistent with previous literature regarding remote formats for peer support groups (Barclay & Lalor, 2022; Starosta et al , 2024) However, they were also found to offer unique benefits in terms of accessibility, discoverability, and connection while eliminating barriers such as transportation costs and physical limitations (Barclay & Lalor, 2022; RobinsonWhelen et al , 2025; Starosta et al , 2024) Therefore, as indicated by previous and current findings, peer support for women with spinal cord injuries should address the intersectionality of identities and adopt personalized approaches to optimize healing and wellbeing. The format of online peer support groups should also be considered, as this could offer more convenience and allow more women with SCIs to attend and experience the benefits of peer support (Robinson-Whelen et al., 2025).
The current study adds great value and insight to expand the scant literature surrounding peer support for women with SCIs, but the limitations must also be acknowledged. The sample was exclusively drawn from a single peer support group, and while there was a variety of race/ethnicities, all participants identified as cisgender women The authors acknowledge that gender is not a binary and exists on a spectrum, so findings may not represent more diverse perspectives beyond the dynamic of this particular group Additionally, the current study should be replicated with participants from multiple peer support groups with varying demographics (e g , gender, age, socioeconomic status) to further expand on how peer support can be best tailored to specific populations This emphasis will help address the gaps in the existing literature By centering research on underrepresented populations, future studies can continue to inform practice by developing more inclusive and effective support models. Peer support can offer substantial future benefits, such as fostering mutual understanding, facilitating resource sharing, enhancing psychological well-being, and serving as supplemental support systems, particularly when it considers and integrates the intersectionality of one ’ s social identities.
Acknowledgment
We would like to express our gratitude to all the women at Women on Wheels for allowing us to interview them Special thanks to our two direct supervisors at Women on Wheels for providing feedback on the interview protocol through participatory action research and their general support and guidance throughout the paper writing process
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Interview Protocol
Hi [Participant Name]! Thank you so much for participating in this interview. We are doing this for a class project to better understand the social support that women with spinal cord injuries receive. Please feel free to stop us anytime if you feel uncomfortable answering anything, need clarification, or have any questions!
So we ’ll start by asking you some demographic information first:
1.How old are you currently?
2.What are your preferred pronouns?
3.What is your race/ethnicity?
And now, we ’ll move into the Interview Questions:
1 If you ’ re comfortable, can you share when and how you acquired your spinal cord injury? (*if needed, clarify traumatic or non-traumatic, complete or incomplete, level/type of injury)
a How did your initial diagnosis impact your outlook on life at that time?/How did this diagnosis impact your outlook on life growing up?
2 What were the biggest challenges you faced as someone with a SCI?
a As a woman with SCIs, do you feel that there are specific challenges or needs that you face that might differ from men with SCIs?
b What initial support systems did you have, and what type of support did they provide?
c Did you ever encounter additional support systems, and what were they?
3 How did you learn about the weekly peer support group at Women on Wheels (WOW)?
a Have you participated in other support groups in the past, and for how long/how frequently did you attend those meetings?
b.What motivated you to join a women-only peer support group?
i.How long have you been participating in the WOW peer support groups, and how frequently do you attend these meetings?
ii.How does the women-only peer support group format address some of the specific challenges you mentioned before (in question 2a)?
iii.Do you think there are particular benefits to being in a group specifically for women with SCIs?
c.What were your expectations before joining a peer support group?
i.How have your experiences with the WOW peer support group compared to your original expectations before joining?
ii How does the WOW peer support group differ from other forms of support you have received (e g , from family, friends, healthcare providers)?
d Could you describe your first experience attending a WOW support group meeting and how it made you feel?
e How has your participation in the WOW peer support group shaped your experience in coping with/adjusting to your spinal cord injury?
4 Can you describe any specific moments you felt were particularly meaningful during your experience with the WOW weekly support group?
5 Have you encountered challenges or difficulties while participating in a peer support group? If so, what were they?
6 How do you feel about the remote format of the WOW peer support group meetings?
a What benefits or challenges have you experienced in this online setting?
7.Is there anything else you'd like to share about your experiences receiving support from the weekly WOW support group?
Thank you so much again for your time in participating in this interview!
Transforming perspectives
Sexaulity and dating
Bladder and bowel care
Discussions around changes in sexual activity, relationships, and dating experiences specific to women with SCIs
Cognitive reframing
Discussions around the management of bladder and bowel care specific to women with SCIs
Participant 8: “I have a lot of friends who are men with SCIs I feel that dating can be easier for them because women tend to be natural caretakers or caregivers, so I think that some women don't see a chair when they're dating a guy ”
Participant 4: “Well, it's women, right? Like I said, information to know, to navigate like, how do I do this? We have, you know, we have our bathroom routine So what helps? What works?”
Participant 10: “The other day, I asked [peer], have you ever gotten a colonoscopy? And this is something I've been dying to ask my [sports] teammates for the past 3 years I never could have, because they will look at me like it's a taboo ”
Describes how peer support groups help members shift their perspectives on challenges, fostering a more positive and motivated mindset
Social reintegration
Describes how peer support groups help members in rebuilding their social roles, relationships, and community engagement to achieve a fulfilling life
Participant 10: “I feel more comfortable now in my own skin just because now I know more about other people's perspective and life in a wheelchair.”
Participant 10: “Seeing [peer] accomplish so much makes me wanna accomplish my goals I now create products for wheelchair users. ”
Benefits and challenges of remote peer support groups
Accessibility
Online format contributes to the convenience of joining and participating in peer support group meetings
Connection Sense or lack of community due to online format
Participant 1: “I like [the online setting] because it is so much more inclusive, you know… we have such a far reach It makes it so easy to attend ”
Participant 3: “It's good because everybody's from different places, and there's no way that we'll be able to have just one in one place From different states and stuff like that So for all of us to meet at one time for this communication, I think, is the best thing that ever happened.”
Participant 10: “The only challenge I see is you won't get that physical emotion Obviously, there's some people that will have an emotional breakdown and I would just look around my house and just get distracted, you know it’ s harder to be in the present.”
Discoverability Participants found out about peer support groups through the Internet
Technological complications
Unreliable internet or unfamiliarity with online platform functions
Participant 6: “I was looking through the Internet for support groups And they just popped up ”
Participant 3: “Sometimes it's hard to get in but anytime I have trouble with the tablet, I just go through the more reliable iPhone ”
Biographies
Editors-in-
Sarah Faucette
Editor-in-Chief sef8206@nyu.edu
Sarah is a senior at NYU majoring in applied psychology with a minor in creative writing She is pursuing departmental honors with her research into preschool teacher's pre-reading practices
and their relation to child engagement during book reading Her main areas of interest are education and literacy, and she is passionate about ensuring children have support to learn and love to read. After graduation, she hopes to pursue a career in
research or publishing.
Adam Goldstein
Editor-in-Chief afg4614@nyu.edu
Adam is a senior majoring in Applied Psychology and Global
Public Health He is an honors student with extensive research
experience in adolescent mental health and suicide prevention.
After completing his undergraduate degree, Adam hopes to gain real-world experience in the field and pursue a career in mental health counseling or psychological intervention.
La
yout
& Design Coordinators
Ashley Buk
Layout and Design Director amb10288@nyu.edu
Ashley Buk is an Applied Psychology and Global Public Health
student at NYU Steinhardt She is also an undergraduate research
assistant in several NYU Applied Psychology research labs (CFD
Lab, FACES Lab, CEH Lab) and hopes to pursue a doctoral degree in psychology. Her interests in research lie in the
intersectionalities of culture and child development. She is particularly interested in how immigrant children leverage sociocultural capital towards academic achievements.
Zhixuan Zhu
Layout and Design Director zz4668@nyu.edu
Laura is a sophomore at New York University, majoring in Applied Psychology with a minor in Data Science She also has previously participated in research on child development and cognition at
Zhejiang University, where she gained experience in observational methods and cognitive assessments. She is particularly interested in how early experiences shape emotional and cognitive development across childhood. She plans to pursue advanced graduate study in psychology at the doctoral level.
Devanshi Loomba
Contributing Writer dl4664@nyu.edu
Devanshi is a senior studying Applied Psychology at NYU, with aspirations of becoming a law student dedicated to advancing social justice. Her passion lies at the intersection of law and psychology, where she aims to advocate for the rights of women, BIPOC individuals, and the LGBTQ+ community Her goal is to foster a more equitable society and represent marginalized communities through her work in this field
Alice Madola
Contributing Writer aym9818@nyu edu
Alice Madola is a junior majoring in Global Public Health and Applied Psychology They are currently a research assistant in the Researching Inequity in Society Ecologically (RISE) Lab at NYU Steinhardt Alice is deeply passionate about eliminating mental health inequalities in marginalized communities
Sophia Masso
Contributing Writer smm9946@nyu.edu
As a recent graduate with a major in Applied Psychology on the pre-health track at NYU, Sophia is dedicated to academia and gaining knowledge that will prepare her for a career as a child and adolescent psychiatrist Beyond academics, her experiences working in a pharmacy for four years, interning with Women on Wheels NYC, singing and writing music, and volunteering at Hassenfeld Children's Hospital reflect her commitment to using knowledge to support others. The following research furthers this goal, contributing to the broader pursuit of knowledge for a meaningful impact.
Laura Park
Contributing Writer lhp8915@nyu edu
Laura is a graduating senior in Applied Psychology at NYU on the accelerated Master's track in Counseling. She is passionate about helping others navigate life ’ s stressors and improving overall mental health outcomes She has worked at three psychology labs during her time at NYU, focusing on areas ranging from developmental to suicide prevention research She hopes to leverage these experiences as she works with diverse clients at a counseling practice following graduation
Ella Seward
Contributing Writer ess9145@nyu.edu
Ella Seward is a fall graduate of the Applied Psychology program. She is very passionate about supporting young children's mental and developmental health. While at NYU, she gained hands-on experience as a Jumpstart member, AmeriCorps volunteer, and tutor, working directly with children to build literacy, executive functioning, and social-emotional skills As an intern with Women on Wheels, Ella contributed to research, led social media and outreach efforts, and supported disability-focused initiatives to increase accessibility and awareness This work deepened her commitment to disability advocacy and inclusive care Ella is currently pursuing her master's degree in Applied Behavior Analysis She has accepted a position at Autism Early Enrichment Services to begin her work in early intervention as a future Licensed Behavior Analyst.
Cecile Xu
Contributing Writer yx2667@nyu edu
Cecile Xu is a senior at NYU majoring in Applied
Psychology, with hands-on research experience in child development, suicide prevention, and Asian American
mental health She is passionate about potential risk factors behind children and adolescents' suicidal thoughts and behavior, and also curious about suicide ideation prevention strategies.