Introduction
For this project, I created this Student Mission Toolbox website for the student missionaries from Southern Adventist University. I was a student missionary in 2021 through Southern at Familia Feliz, an orphanage-style boarding school in Bolivia. While I was a student missionary, I found myself with a lot of questions about childcare and feeling at a loss to help kids process and work through trauma-related behavior issues. Since returning to school and completing youth-focused internships, I have been exposed to many helpful ideas, concepts, and training that I wish I could have used to help the kids I worked with at Familia Feliz.
To help share this information, I collaborated with the Student Mission Department at Southern Adventist University and presented on Trauma-Informed attitudes to the outgoing missions class in Spring 2024. I had conversations with the student mission director in the fall semester, interviewed a doctorate candidate who researched Southern’s student missions program for their thesis in January, prepared a presentation and presented in the spring, and developed and released an online toolbox in the summer of 2024.
Social Issue
The student mission training class at Southern Adventist University is tasked with covering a wide range of information to a group of young adults headed out for a vast diversity of volunteer positions in a 7 week course meeting just once a week, and a four day exit retreat. Training includes Introduction to Student Missions (SM) Life, Spiritual Growth and Practices, Mental Health and Emotional Well-being, Cultural Competence and Sensitivity, Practical Skills for Missionaries, and Interpersonal Relationships and Communication. While training covers key elements, due to time constraints there is no way to cover all of the information that outgoing student missionaries need due to the wide variety of roles they will be filling in the field. Due to this limitation, student missionaries often have to rely on on-the-job training from on-site volunteers and staff. On the site training is more applicable as staff/volunteers have more direct experience with the population and situation at hand and can provide guidance in real-time and mentorship/supervision in difficult situations. Some of these organizations, however, are understaffed, and this can leave student missionaries relying disproportionately on informal sources of support, such as calling friends and family for advice. To assist student missionaries in need of more support, and provide more resources to all of the outgoing student missionaries, I initiated this resource website under the supervision of my field instructor and with guidance from the Student Mission Director.
Interventions
The mission for this project was to equip student missionaries with essential skills to work more effectively with kids. To reach that mission there were two main goals identified:
- Increase trauma-informed attitudes among student missionaries.
- Increase access to relevant ethical theoretical models on working with kids.
To do that, two interventions were developed: a trauma-informed attitudes presentation and an SM Toolbox website to help student missionaries on the go.
In conversations with the student missions director, and a researcher looking at Seventh-day Adventist Student Missions departments, it was brought up that focus groups were conducted with student missionaries at Southern Adventist University and reported that they wanted shorter presentations in class, closer to 10 instead of 30 minutes (I. Goya, personal communication, January 8, 2024). Due to this feedback, the presentation that was developed was only 10-15 minutes long and contained only the most basic description of Trust-based relational intervention theoretical foundation (Purvis, et al., 2013) while more information would be able to be accessed by them and referred to in the website they would have access to. To assess the trauma-informed attitudes, we used the brief version of the trauma-informed care beliefs scale (Beehag et al., 2023), assessing their beliefs before and after the presentation.
Trust-based relational intervention was selected due to the high number of children who have experienced trauma and toxic stress at student mission locations, and the evidence-based results demonstrating a decrease in behavioral problems and trauma symptoms through using TBRI as an intervention strategy.
Review of the literature
Trust-based relational intervention is an ethical framework that focuses on meeting kids’ physical and psychological needs of safety, nourishment, and attachment first and prioritizing connection with the child as a prerequisite for changed behavior (Purvis et al., 2013). A trauma-informed approach, it has demonstrated positive results in multiple studies, showing decreased behavioral problems and trauma symptoms in multiple two-group, pre-post intervention designs, with both in-person (Purvis et al., 2015), and web-based trainings (Razuri, et al., 2016) and has also shown increases in pro-social and attachment behaviors in case studies (Purvis et al., 2014).
Theoretical Perspectives
By utilizing the theoretical perspectives of trauma-informed care and attachment theory through Trust-based Relational Intervention and by including cultural competence and sensitivity as a section on the student mission toolbox, this project integrates relevant theories and social work values of competence, integrity, dignity, and worth of a person and the importance of human relationships.
Results
36 student missionaries heard the trauma-informed attitudes presentation, 24 of these students took both the pre and post-test as some students came in late and/or choose not to complete one of the surveys. Utilizing the Trauma-Informed Care Beliefs Scale (Beehag et al., 2023), a pre-assessment and post-evaluation was completed, with students being given an opportunity to sign up for an email notification when the resources website went live.
| Statistic | Pre-Test | Post-Test |
| Mean | 65.46 | 68.50 |
| Mode | 70 | 70 |
| Median | 66.50 | 70 |
| Standard Deviation | 3.93 | 2.72 |
| Number of Students | 24 | 24 |
| T-statistic | -4.81 | |
| P-Value | 0.000075 |
The results indicate a statistically significant improvement in trauma-informed attitudes among the student missionaries. The mean score increased from 65.46 to 68.50 after the presentation, showing an improvement in trauma-informed beliefs among the student missionaries. The median score increased from 66.5 to 70, meaning that the central tendency of the scores improved. The standard deviation decreased from 3.93 to 2.72, suggesting that the post-test scores were more closely clustered around the mean, meaning there was less difference among the scores of the students after the intervention. The t-statistic of -4.81 indicates a significant difference between the pre-test and post-test scores, with the post-test scores being significantly higher than the pre-test scores. The p-value of 0.000075 is less than the statistical significance level of 0.05, indicating that the improvement in trauma-informed beliefs after the intervention is statistically significant.
Conclusions
One of the limitations of implementing this project were that I could not conduct long-term outcome assessments to see if the website impacted student missionaries’ confidence and competence in the field. Another limitation was financial in that I used the free version of WordPress, limiting the website in functionality and design. Another limitation was human resources as there was just me me working on this project under supervision. One thing that could have been done better is creating the website before the presentation to the Student Mission class to explain its purpose and design in the presentation. The website could have been better by having interviewed previous and current student missionaries to assess what resources would be most useful. Some unexpected outcomes from this project was complications in the website designing process resulting in increased wordpress proficiency for myself. Otherwise, there were no unexpected outcomes. The results indicated that the presentation significantly increased the trauma-informed beliefs of the student missionaries in the participating class, and I am looking forward to seeing as current student missionaries utilize the contact information on the website to contribute their own resources and hope that this project can be a good starting place for a community of resources to grow.
Competency 1
This project allowed me to bring social work values into an interdisciplinary collaboration with the student mission department and increasingly integrate ethical frameworks into the student mission training. By getting the concepts of Trust-based Relational Intervention, crisis prevention, and suicidal ideation/behavior screeners, I brought helpful information into an accessible and easily navigable resource student missionaries can access while in the field. I was able to grow in my ability to impact practice at the macro level with policy in the department, mezzo level working with the group of the student mission class, and on the micro level as student missionaries utilize these skills individually with the people they serve. I grew in my ability to responsibly utilize technology to advance the social work values of competence and integrity through developing skills in website development, powerpoint presentation, and the use of online assessment tools. I grew professionally through ongoing conversations with my field instructor and the student mission director about what would be most helpful for the department, and allow me to demonstrate all nine competencies. It was challenging to grow in my professional verbal and written communication in presenting ethical evidence-based frameworks for the analysis of complicated situations via a short talk and the website. Ultimately this special project increased my professionalism in integrating ethics in an evidence-based way through an interdisciplinary collaboration.
Competency 2
Creating this website gave me the opportunity to develop leadership skills by implementing evidence-based practice strategies with the student mission department at Southern Adventist University. This website advances human rights on all applicable levels by providing psychoeducational resources on working with kids to outgoing and current student missionaries. The individual rights of the child are being advanced by increasing the competence of the student missionaries, families’ rights are advanced by promoting the importance of children living with their families, or in a family-style environment, organizational rights are advanced through the empowering of the non-profits we partner with through equipping them with more prepared volunteers, community rights are advanced through the emphasis on cultural humility and respecting the culture of the community student missionaries are working in, and research and policy is being advanced by starting a trend towards trauma-informed attitudes within the student mission department.
Competency 3
Student missionaries are not the only group of expatriate volunteers that can become aware of cultural insensitivity regarding external agencies they work for and feel helpless in promoting culturally responsive and “localized approaches” in their development work (Lucas & Jeanes, 2020). It is important to understand the social values of the dominant culture (Penner, 2000) and to be culturally sensitive (Novak & Kumar, 2022) in our work and training in the social work and mission fields. To this end I developed a section on cultural humility that included a description of why taking a learner’s approach to different cultures is important, a summary of key cultural differences in the primary countries that Southern sends student missionaries to. The locations that the student missionaries go to are very diverse, and they are often faced with poverty, difficulty in accessing healthcare, and differences in power, privilege and values between them and the people they work alongside. By acknowledging people as the experts on their own lived experience student missionaries can help people achieve their own goals instead of assuming their goals are in line with an American viewpoint, and letting ethnocentricism hinder engagement and effectiveness.
Competency 4
Both interventions required critically reviewing the literature to identify evidence-based practices that were effective for this population of student missionaries, most specifically those working with children. I reviewed best practices to improve the policy and programs of the student mission training and to improve the practice of the student missionaries themselves. The review of this literature is spread out over this webpage as I explain why Trust-based relational intervention was chosen as an ethical framework, the scale selected, the importance of cultural humility in student missions, and on each page of the student mission website, I created as resources and references are cited on each entry. Reviewing this literature with the goal of directly applying this to student missions’ experience for their benefit helped me develop skills in applying research to practice in practical ways.
Competency 5
In developing this project, I worked with the Student Mission Director to implement trauma-informed training. Last fall, I started exploring options with the student mission director for a local organization then called Orphanwise, now called CareEQUIP by Orphanwise, to explore training option packages they had that would fit the needs of the student mission department. Due to the time, they needed to go over even their shortest presentation being more extended than what the department could fit into their schedule, and not having extra room in the budget to pay a speaker, getting the complete training was not an option. I instead advocated still including this training with the director by presenting a shortened version myself in the upcoming student mission class. By developing and implementing this plan, I advocated for a change in the student mission training.
Competency 6
I developed the competency of engagement through my presentation with the student mission class. Using my personal experience as a student missionary meant utilizing my first-hand experience to have practice-informed research and, at the same time, setting firm boundaries on how much of my personal experience to share in a professional setting. I used empathy, reflection, and interpersonal skills to navigate the conversation with the class so they could connect the concepts we discussed to situations they had already experienced in working with kids to help them understand and retain the information better. I examined evidence-based practice systems in selecting the framework to go over of TBRI and in talking with the student mission director and researcher to understand that the student mission classes generally wanted shorter presentations to grab their attention.
Competency 7
As was previously mentioned, to assess the trauma-informed attitudes of the student mission class before the presentation, I used the brief version of the trauma-informed care beliefs scale (Beehag et al., 2023). I selected this scale for its reliability and accessibility as there are other trauma-informed scales, but they have been developed for institutional uses and have to be purchased. While I have developed macro organizational/community assessments in classes and implemented individual assessments in my internship, this special project was a unique opportunity to formulate and conduct an assessment in a mezzo level setting in a classroom. This assessment found that the class already scored fairly high on having trauma-informed beliefs which is a positive sign, but could have been due in part to self-report bias. By collecting and organizing this data, and critically analyzing it I was able to use this assessment to inform the website creation.
Competency 8
My intervention component to this project was two-fold, a PowerPoint presentation on principles of trauma-informed care and a website providing a variety of information specific to the three stages of student mission deployment, preparation, being in the field, and re-entry. I integrated a macro-level intervention of psychoeducational with the community of student missionaries and the department, and provided resources to clinical evidence-based interventions to help student missionaries learn essential skills to work more effectively with kids. Working with the missions department on this intervention gave me insight into how important interdisciplinary communication is as we got to pull strengths and insights from both a missions and a social work perspective.
Competency 9
To evaluate the efficacy of the intervention of presenting on principles of trust-based relational intervention with the student mission class I had them repeat the same trauma-beliefs scale to note any differences in their belief. I was encouraged to see a significantly positive change in their beliefs, meaning that the way they understand how trauma impacts individuals and can influence certain problem behaviors in children has also been impacted. Some of the items were, “Knowing the impact of trauma on young people helps me to understand their challenging behaviors.” and “When I am stressed from caring for the young person in my care, it’s important to talk to someone about it.” and “Young people with trauma histories often blame themselves for the bad things that have happened to them.”. By selecting an evidence-based strategy for evaluating their beliefs with a reliable scale and evaluating the practice outcome across the system of this student missions class I developed evaluation skills that will be essential as I continue my social work practice.
References
Beehag, N., Dryer, R., McGrath, A., Krägeloh, C., & Medvedev, O. (2023). Design and development of the trauma informed care beliefs scale-brief. Children and Youth Services Review, 153, 107087. https://doi.org/10.1016/j.childyouth.2023.107087
Lucas, R. & Jeanes, R. (2020). Ethnographic reflections of the role of global north volunteers in sport-for-development. International Review for the Sociology of Sport, 55(7), 953–974. https://doi-org.ezproxy.southern.edu/10.1177/1012690219854650
Novak, M., Drummond, K., & Kumar, A. (2022). Healthcare professionals’ experiences with education in short term medical missions: An inductive thematic analysis. BMC Public Health, 22(1), 1–12. https://doi-org.ezproxy.southern.edu/10.1186/s12889-022-13349-9
Penner, L. A. (2000). Promoting prosocial actions: The importance of culture and values. Journal of Social Philosophy, 31(4), 477–487. https://doi-org.ezproxy.southern.edu/10.1111/0047-2786.00068
Purvis, K. B., Cross, D. R., Dansereau, D. F., & Parris, S. R. (2013). Trust-Based Relational Intervention (TBRI): A Systemic Approach to Complex Developmental Trauma. Child & Youth Services, 34(4), 360–386. https://doi-org.ezproxy.southern.edu/10.1080/0145935X.2013.859906
Purvis, K., McKenzie, L., Becker Razuri, E., Cross, D., & Buckwalter, K. (2014). A Trust-Based Intervention for Complex Developmental Trauma: A Case Study from a Residential Treatment Center. Child & Adolescent Social Work Journal, 31(4), 355–368. https://doi-org.ezproxy.southern.edu/10.1007/s10560-014-0328-6
Purvis, K., Razuri, E., Howard, A., Call, C., DeLuna, J., Hall, J., & Cross, D. (2015). Decrease in Behavioral Problems and Trauma Symptoms Among At-Risk Adopted Children Following Trauma-Informed Parent Training Intervention. Journal of Child & Adolescent Trauma, 8(3), 201–210. https://doi-org.ezproxy.southern.edu/10.1007/s40653-015-0055-y
Razuri, E. B., Hiles Howard, A. R., Parris, S. R., Call, C. D., DeLuna, J. H., Hall, J. S., Purvis, K. B., & Cross, D. R. (2016). Decrease in Behavioral Problems and Trauma Symptoms Among At-Risk Adopted Children Following Web-Based Trauma-Informed Parent Training Intervention. Journal of Evidence-Informed Social Work, 13(2), 165–178. https://doi-org.ezproxy.southern.edu/10.1080/23761407.2015.1014123