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Mother and Child

Building Resilience in SBHC Patients through Primary Care

This toolkit intends to assist school-based health centers (SBHCs) in using trauma-informed approaches to foster resilience in youth, especially those who present with adverse childhood experiences (ACEs). A recommendation of this toolkit is to create a team-based plan to implement universal ACEs screening in SBHCs.  The resources in this toolkit are intended to support all SBHC staff members. This toolkit provides resources to support that shift, drawing on the science behind ACEs and the work being done on resilience building to mitigate the impact of ACEs.  This toolkit also recognizes limitations of a trauma-informed approach and heeds caution expressed around focusing solely on individual brain science without considering systemic factors outside of the individual. Healing Centered Engagement and Healthy Outcomes through Positive Experiences (HOPE) frameworks are recommended to support the need to address the presence and impact of ACEs in communities and respond through empowerment, advocacy, and the engagement of community members and stakeholders as extensions of this work. 

See Toolkit Goals below for more information.

School Hallway

This section provides contextual information on adverse childhood experiences (ACEs) and their relationship to health. It also provides an overview of foundational project concepts including trauma-informed care with a focus on healing centered engagement, and the Healthy Outcomes through Positive Experiences (HOPE) framework for building resilience. 

A Girl Looking at a Physics Model

SBHCs are well positioned to assess for and respond to adversity in their patients. Learn more about screening rationalACEs screening tools, workflows, and resources to support this process. 

Boy Playing with Blocks

There are many ways to respond to adversity. This section goes into detail on how to do so through the lens of building resilience. Learn more about how to apply trauma-informed approaches, with special attention to healing centered engagement and HOPE frameworks. 

Students in Cafeteria

Browse links and handouts to support your SBHC in responding to ACEs and building resilience. 

Children Embracing in Circle

Toolkit Goals

The goal of this toolkit is to provide SBHC staff with knowledge and resources to inform their work with patients in a manner that recognizes the lifelong impact that exposure to ACEs can have on health outcomes and to mitigate those negative outcomes while increasing resilience among the youth they serve. This is difficult work. It involves self-reflection and change as well as organizational reflection and change. This toolkit includes resources for SBHC staff related to how they approach patients experiencing ACEs and it is important to explore resources for addressing burnout and secondary trauma. Self-care is a necessary element of a trauma-informed and healing centered organization. The University of Buffalo’s School of Social Work has an excellent Self-care Starter Kit for reference.


To successfully implement trauma-informed care requires organizations and individuals to first do the internal work of becoming trauma-informed themselves and learn how to participate in Healing Centered Engagement. Healing work is a bilateral exchange and requires transformational rather than transactional relationships, within an organization, between peers, and with the youth served. At times, this work may be uncomfortable. Working through this discomfort using the resources provided will allow SBHC staff to meet patient needs on a more holistic, culturally responsive, and impactful level. This is a paradigm shift that requires time to internalize rather than a curriculum to be applied or a panacea to be given to others. This toolkit is intended to help you start that work. 

Toolkit Goals
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