Empowering Adolescents: The Imperative of Integrating Trauma-Informed Approaches into Comprehensive Sexuality Education

15 April, 2024

Blog

 

Written by Ananya Asad, a global health professional from Bangladesh with 9+ years of experience in public health interventions focused on adolescent and youth well-being in South Asia, the Caribbean, and Sub-Saharan Africa. 

Adolescence is a transitional phase marked by physical, emotional, and social changes. This is the time when young individuals embark on a journey of self-discovery, navigating the complexities of identity, relationships, and sexuality. Comprehensive sexuality education (CSE) plays a crucial role in equipping adolescents with the knowledge and skills they need to navigate relationships and make informed decisions about their sexual health. However, the integration of trauma-informed approaches into CSE is a nuanced endeavour, with both successes and challenges.

Comprehensive Sexuality Education (CSE) serves as a globally recognised framework, aiming to provide adolescents and young individuals with precise, supportive, and socially aware information about sexuality.[1] Despite the widespread prevalence of childhood maltreatment, CSE barely caters to the needs of young individuals with histories of trauma . [2,3] This leads to development of educational materials and curricula that overlook the of gender, diversity & inclusion, relationships, empowerment, and consent, merely focusing on the biological aspects of reproduction, [4] which in turn ignore the lived experiences of physical, sexual, emotional traumas among a proportion of students within sexuality education settings.

Trauma refers to ‘A disturbing or distressing experience that produces psychological injury or pain which may have long-term effects on an individual’.[5] It is the emotional aftermath of distressing events, such as accidents, sexual assaults, natural/manmade disasters etc. In the immediate response, it’s common for individuals to experience shock and denial. The long-term emotional impact of trauma can manifest as erratic reactions, recurrent memories of the event, difficulties in personal relationships.

A trauma-informed approach is essential for the sexual health of adolescents, fostering lifelong well-being for youth who have faced adverse life experiences.[6] A trauma-informed approach: (1) realises the widespread impact of trauma and understands potential paths for recovery; (2) recognises the signs and symptoms of trauma in students, staff and families; (3) responds by fully integrating knowledge about trauma into policies, procedures and practices; and (4) prevents further trauma by avoiding practices that inadvertently create stressful or toxic environments. In the context of comprehensive sexuality education, this involves acknowledging the potential trauma adolescents may have experienced and adapting educational approaches to be sensitive, supportive, and empowering.[7] One specific example of this approach is the ‘Girl Shine Curriculum’ designed by the International Rescue Committee (IRC), specifically tailored to address the unique needs and challenges faced by girls who are living in crisis and conflict-affected environments.  [8]

Successes of Fostering Inclusive and Supportive Learning Environments

Trauma-informed approach integrated CSE has been successful in creating safe and inclusive learning environments.[9] This contributes to a sense of trust and openness in the learning environment.

A notable success is the tailored approach trauma-informed CSE takes to address individual needs, recognising that a one-size-fits-all approach is inadequate.[10] This may involve offering additional support to adolescents who have experienced trauma, adapting content and delivery methods to accommodate various learning styles and providing additional support (e.g. creating safe spaces, individual mentoring) when necessary. This individualised approach ensures makes sure everyone gets to learn about sexual health without anyone missing out.

Trauma-informed approaches underscore the importance of teaching about consent and boundaries in a respectful and empowering way. Successful programmes go beyond the basics and delve into discussions about communication, respect for autonomy, and recognising and responding to non-verbal cues. This success empowers adolescents with a nuanced understanding of healthy relationships and consent, enabling them to be informed, empowered and respectful individuals.

The success of trauma-informed CSE is amplified by investing in the capacity-building of educators/facilitators. When teachers know more about trauma and how it can affect people, they can make a caring and knowledgeable space for learning. This success transforms educators into advocates [11], guiding adolescents through sensitive topics with care and proficiency.

Challenges of Navigating Barriers to Implementation

One significant challenge is that some CSE programmes fail to adapt trauma-informed approaches to fit into different cultures and backgrounds. Cultural factors can influence traumatic experiences, and a lack of cultural adaptation in educational materials and methodologies can lead to misunderstandings or overlooking specific needs of adolescents. Appropriate contextualisation to promote inclusivity and cultural sensitivity in curriculum development and delivery helps overcoming this challenge.[12]

Insufficient resources can hinder the successful integration of trauma-informed approaches. In some cases, schools or organisations may lack the necessary resources to provide additional support for adolescents who have experienced trauma. This can result in missed opportunities to address individual needs effectively. Advocacy for increased funding and resource allocation is crucial to address this challenge and ensure that trauma-informed CSE is accessible to all.[13] Cost-effective CSE interventions like ‘If I Were Jack’ is a great example of an accessible programme across the UK.[14]

The persistent stigma surrounding discussions about trauma, mental health, and sexuality remains a substantial challenge. Some CSE programmes may hesitate to address these topics directly due to societal taboos. A concerted effort to recognise and destigmatise these conversations around trauma, mental health, and sexuality, is necessary. It will provide appropriate support and make necessary referrals [8] are key for avoiding stigma and taboo.[2]

Widespread prevalence of secondary trauma among facilitators dealing with traumatised adolescents is also evident.[15] This concerns that sexuality educators might face similar dangers when they learn about adolescents’ experience To address the identified gap, it’s very important to train the master trainers and facilitators of CSE programmes on how to handle trauma. This means giving them the right skills to notice, deal with, and stop themselves from getting overwhelmed by these experiences, making sure they stay mentally healthy while teaching.

A Transformative Way Forward

Integrating trauma-informed approaches into comprehensive sexuality education for adolescents is a complex endeavour. Going forward, we need to improve and expand CSE programmes considering different perspectives. This means engaging young people (through participatory approaches) and using teaching methods that make them think critically. Also, we should use language that respects their rights and fits the situation they are in. Targeted approaches like public awareness campaigns using inclusive terminologies, community discussions, and collaboration with mental health organisations can change societal perceptions and create an environment that encourages open dialogue. Employing both quantitative and qualitative methodologies to review and understand the effects and valuable lessons from programs based on sexual education curriculums. By addressing the challenges and building on the successes, we can create a more compassionate, supportive, and effective educational environment that empowers adolescents to make informed choices about their sexual health while recognising and addressing the impact of trauma.

 

 

References

  1. Davies AWJ, Brass J, Mendonca VM, O’Leary S, Bryan M, Neustifter R. Enhancing Comprehensive Sexuality Education for Students with Disabilities: Insights from Ontario’s Educational Framework. Sexes. 2023 Oct 17;4(4):522–35. Available from: https://doi.org/10.3390/sexes4040034
  2. Fava NM, Bay‐Cheng LY. Trauma-informed sexuality education: recognising the rights and resilience of youth. Sex Education:Sexuality, Society and Learning. 2013 Jul 1;13(4):383–94. Available from: https://doi.org/10.1080/14681811.2012.745808
  3. Panisch LS, Faulkner M, Fernández S, Fava NM. Exploring How Trauma is Addressed in Sexual Education Interventions for Youth: A scoping review. Health Education & Behavior [Internet]. 2020 Sep 8;47(6):880–93. Available from: https://doi.org/10.1177/1090198120954398
  4. Leung H, Shek DTL, Leung E, Shek EYW. Development of Contextually-relevant Sexuality Education: Lessons from a Comprehensive Review of Adolescent Sexuality Education Across Cultures. International Journal of Environmental Research and Public Health [Internet]. 2019 Feb 20;16(4):621. Available from: https://doi.org/10.3390/ijerph16040621
  5. Trauma [Internet]. https://www.apa.org. Available from: https://www.apa.org/topics/trauma
  6. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach | SAMHSA Publications and Digital Products. 2014. Available from: https://store.samhsa.gov/product/samhsas-concept-trauma-and-guidance-trauma-informed-approach/sma14-4884
  7. International technical guidance on sexuality education: an evidence-informed approach. In: UNESCO eBooks. 2018. Available from: https://doi.org/10.54675/uqrm6395
  8. Digital S. Girl Shine | Save the Children’s Resource Centre [Internet]. Save the Children’s Resource Centre. Available from: https://resourcecentre.savethechildren.net/document/girl-shine/
  9. Williams‐Butler A, Howard T, Anthony VWL, Duron JF. Adverse Childhood Experiences, sexual debut and substance use among Black justice-involved youth: The imperative of trauma-informed sexuality education. Children and Youth Services Review. 2023 Apr 1;147:106847. Available from: https://doi.org/10.1016/j.childyouth.2023.106847
  10. International Technical and Programmatic Guidance on Out-of-School Comprehensive Sexuality Education (CSE). United Nations Population Fund. Available from: https://www.unfpa.org/featured-publication/international-technical-and-programmatic-guidance-out-school-comprehensive
  11. Barr EM, Goldfarb ES, Russell SG, Seabert DM, Wallen M, Wilson K. Improving Sexuality Education: The Development of Teacher‐Preparation Standards. Journal of School Health. 2014 Apr 21;84(6):396–415. Available from: https://doi.org/10.1111/josh.12156
  12. Im H, Swan LET. Working towards Culturally Responsive Trauma-Informed Care in the Refugee Resettlement Process: Qualitative Inquiry with Refugee-Serving Professionals in the United States. Behavioral Sciences. 2021 Nov 7;11(11):155. Available from: https://doi.org/10.3390/bs11110155
  13. Starrs A, Ezeh A, Barker G, Basu A, Bertrand JT, Blum RW, et al. Accelerate progress—sexual and reproductive health and rights for all: report of the Guttmacher– Lancet Commission. The Lancet. 2018 Jun 1;391(10140):2642–92. Available from: https://doi.org/10.1016/s0140-6736(18)30293-9
  14. Lohan M, Brennan‐Wilson A, Hunter R, Gabrio A, McDaid L, Young H, et al. Effects of gender-transformative relationships and sexuality education to reduce adolescent pregnancy (the JACK trial): a cluster-randomised trial. The Lancet Public Health [Internet]. 2022 Jul 1;7(7):e626–37. Available from: https://doi.org/10.1016/s2468-2667(22)00117-7
  15. Çayır E, Spencer M, Billings DL, Messias DKH, Robillard AG, Cunningham T. “The only way we’ll be successful”: Organizational factors that influence Psychosocial Well-Being and Self-Care among advocates working to address Gender-Based violence. Journal of Interpersonal Violence. 2020 Jan 11;36(23–24):11327–55. Available from: https://doi.org/10.1177/0886260519897340