Violence Against Teachers: Case Studies From The APA Task Force

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Violence Against Teachers: Case Studies from the APA Task Force

Article  in  International Journal of School & Educational Psychology · October 2013


DOI: 10.1080/21683603.2013.837019

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Violence Against Teachers: Case Studies from the APA


Task Force
a b c d
Linda A. Reddy , Dorothy Espelage , Susan D. McMahon , Eric M. Anderman , Kathleen
e f g h
Lynne Lane , Veda Evanell Brown , Cecil R. Reynolds , Abraham Jones & Jaclyn Kanrich
a

a
Graduate School of Applied and Professional Psychology, Rutgers University , Piscataway ,
New Jersey , USA
b
Department of Educational Psychology, University of Illinois , Champaign , Illinois , USA
c
Department of Psychology, DePaul University , Chicago , Illinois , USA
d
Department of Educational Studies, The Ohio State University , Columbus , Ohio , USA
e
Department of Special Education, University of Kansas , Lawrence , Kansas , USA
f
National Alliance of Black School Educators , Washington, DC , USA
g
Texas A&M University, Emeritus , College Station , Texas , USA
h
National Education Association , Washington, DC , USA
Published online: 04 Dec 2013.

To cite this article: Linda A. Reddy , Dorothy Espelage , Susan D. McMahon , Eric M. Anderman , Kathleen Lynne Lane , Veda
Evanell Brown , Cecil R. Reynolds , Abraham Jones & Jaclyn Kanrich (2013) Violence Against Teachers: Case Studies from the
APA Task Force, International Journal of School & Educational Psychology, 1:4, 231-245, DOI: 10.1080/21683603.2013.837019

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International Journal of School & Educational Psychology, 1, 231–245, 2013
Copyright q International School Psychology Association
ISSN 2168-3603 print/ISSN 2168-3611 online
DOI: 10.1080/21683603.2013.837019

Violence Against Teachers: Case Studies


from the APA Task Force
Linda A. Reddy
Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey, USA

Dorothy Espelage
Department of Educational Psychology, University of Illinois, Champaign, Illinois, USA

Susan D. McMahon
Downloaded by [Jaclyn Kanrich] at 13:24 06 December 2013

Department of Psychology, DePaul University, Chicago, Illinois, USA

Eric M. Anderman
Department of Educational Studies, The Ohio State University, Columbus, Ohio, USA

Kathleen Lynne Lane


Department of Special Education, University of Kansas, Lawrence, Kansas, USA

Veda Evanell Brown


National Alliance of Black School Educators, Washington, DC, USA

Cecil R. Reynolds
Texas A&M University, Emeritus, College Station, Texas, USA

Abraham Jones
National Education Association, Washington, DC, USA

Jaclyn Kanrich
Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey, USA

Violence directed toward teachers has been understudied despite significant media and
empirical investigation on school violence, such as student-to-student victimization and
bullying. To date, there are relatively few published studies scattered across many countries. To
address this void, the American Psychological Association, in collaboration with the National
Education Association, created the first Violence Directed Against Teachers Task Force. Task
Force recommendations and results from the Task Force U.S. national survey on teacher
victimization are presented, together with teacher-reported case studies. The case studies are
used to illustrate the range of educators, reported incidents, resulting actions by educators and
schools, and stress faced by teachers. Implications for research and practice are discussed.
Keywords: Teachers, teacher violence, victimization, school safety

Today’s educators are under tremendous pressure and stress


Submitted May 10, 2013; accepted July 29, 2013. related to high demands for instructional accountability,
Correspondence should be addressed to Linda A. Reddy, Graduate
student academic outcomes, and increasingly diverse
School of Applied and Professional Psychology, Rutgers University,
152 Frelinghuysen Rd, Piscataway, NJ 08854-8085, USA. E-mail: learners in the classroom. Teacher stress has been
lreddy@rci.rutgers.edu exacerbated by violence in schools, and specifically
232 REDDY ET AL.

violence against teachers, which has become a significant, or actual experience of violence in school systems. Whereas
multisystemic, national problem (Espelage et al., 2013). there has been significant media and empirical investi-
Stress has been defined as “environmental events or chronic gations on school violence, such as student-to-student
conditions that objectively threaten the physical and/or victimization and bullying (e.g., Espelage, 2012; Kondra-
psychological health or well-being of individuals of a suk, Greene, Waggoner, Edwards, & Nayak-Rhodes, 2005;
particular age in a particular society” (Grant et al., 2003, Türküm, 2011), violence directed toward teachers has been
p. 449). Grant et al.’s (2003) theoretical model provides a understudied. Having more information about the preva-
useful framework for examining teacher stress and lence of teacher victimization and the nature and range of
victimization. Applying the basic tenets of the model, teacher victimization experiences is essential for under-
victimization is an environmental stressor that contributes to standing school dynamics, reducing teacher stress, devel-
negative psychological outcomes among teachers. Within oping appropriate strategies and interventions, as well as
this model, moderators influence the relation between promoting positive school and classroom climates, student
victimization and psychological outcomes. Moderators learning, and recruitment and retention of highly qualified
include individual characteristics and environmental con- teachers into the education profession.
texts, such as gender, coping styles, administrative support, To address this void, the American Psychological
school climate, teacher training, and classroom manage- Association (APA), in collaboration with the National
ment skills. Mediators such as cognitive attributions, Education Association, created the first Violence Directed
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coping, symptoms, and school processes explain the relation Against Teachers Task Force. This article is derived from
between stressors and outcomes—that is, stressors trigger the work of the Task Force and has three objectives. First,
changes in biological, social, or psychological processes we offer a brief synthesis of the international and U.S.
that account for the relation between stressors and outcomes research on violence directed toward teachers. Second, we
(Grant et al., 2006). This model also suggests that there is outline the recommendations from the APA Task Force and
specificity in the relations among stressors, moderators, summarize some key findings on the nature and extent of
mediators, and psychopathology (McMahon, Grant, Compas, teacher victimization in the United States based on the Task
Thurm, & Ey, 2003), and relations among stressors, Force’s survey of U.S. teachers. Finally, we present three
moderators, mediators, and psychopathology are reciprocal teacher-reported case examples from the Task Force
and dynamic (Grant & McMahon, 2005; Grant, McMahon, national survey to illustrate a sampling of teacher
Carter, & Carleton, in press). This model allows for careful victimization.
examination of the complex processes that unfold when
teachers are victimized.
Teacher stress is not new. During the past 4 decades, RESEARCH ON TEACHER VIOLENCE
research has examined the relation of stress to educators’
work commitment, performance, support, and job burnout Violence directed toward teachers has been documented as a
(e.g., Cherniss, 1980; Klassen, 2010; Lambert, McCarthy, national and international concern. In the American 2009
O’Donnell, & Wang, 2009). However, changing and Institute of Education Sciences School Principal Survey on
uncertain state-level teacher evaluation practices (including Crime and Safety, approximately 17% of school principals
the increased use of value-added assessments) have placed reported that students were verbally abusive to their middle
unique demands on teachers without a concomitant increase and high school teachers (Dinkes, Kemp, & Baum, 2009).
in resources to manage these performance expectations The Indicators of School Crime and Safety Report (National
(Reddy, Kettler, & Kurz, 2013). Various factors related to Center for Education Statistics [NCES], 2012) found that
teacher stress have been examined, including perceptions of during the 2009 through 2010 school year, 9% of schools
demands, coping strategies, role conflict, role ambiguity, reported that student disrespect for teachers occurs on a
resource restriction, constraints on autonomy, workload, daily or weekly basis, and 5% of schools reported that
self-efficacy, and administrative and collegial support and student verbal abuse toward teachers occurs at least once per
supervision (e.g., Dworkin, Haney, & Telschow, 1988; week (Robers, Kemp, Truman, & Snyder, 2013). The
Helms-Lorenz, Slof, Vermue, & Canrinus, 2012; Lambert, Indicators of School Crime and Safety Report (NCES, 2008)
McCarthy, O’Donnell, & Wang, 2009; Shernoff, Mehta, found that 7% of teachers (253,100) nationally surveyed in
Atkins, Torf & Spencer, 2011; Smylie, 1999). Collectively, 2007 through 2008 were threatened or assaulted by students
scholars have recognized that these and many other work- in schools (Dinkes, Cataldi, Lin-Kelly, & Synder, 2007).
related factors must be examined within a system context Approximately 7% of primary education teachers and 8% of
that includes person-environment-interaction perspectives secondary education teachers were threatened with injury,
(e.g., Cherniss, 1980; Dworkin et al., 1998; Gottfredson, and approximately 6% of kindergarten through 12th grade
Gottfredson, Payne, & Gottfredson, 2005). teachers (K – 12) were physically attacked in schools
An important aspect of teacher stress that has received (Dinkes et al., 2007). Similar results were reported by the
surprisingly limited attention is educators’ perceived threats NCES in 2003 through 2004, where 12.7% of public school
VIOLENCE AGAINST TEACHERS 233

teachers and 3.3% of private school teachers rated verbal investigations reported low return rates, with the exceptions
abuse of teachers as occurring daily. In addition, 20.9% of of Chen and Astor (2009), Gregory, Cornell, and Fan (2012),
public school teachers and 6.5% of private school teachers and Gregory et al. (2010).
rated student disrespect for teachers as occurring daily. The Among the nine studies conducted in the United States,
NCES reported that 1.3 million nonfatal crimes (including a total of 14,316 teachers reported usable information (see
473,000 violent crimes) were committed against America’s Table 1). The teacher samples were predominately White
teachers from 1997 through 2001 (Kondrasuk et al., 2005). women (approximate age range from middle to upper 30s)
According to NCES 2003 data, teachers are three times who had 10 or more years of teaching experience. The
more likely to be victims of violence, as there were 21 sample included public and private schools located in urban,
incidents per 1,000 teachers versus 7 incidents per 1,000 suburban, and rural areas. Data were obtained from teachers
students (Kondrasuk et al., 2005). The U.S. Department working at elementary, middle, and high schools, as well as
of Education cited that from 1995 –1999, approximately vocational schools and 4-year colleges. Approximately 50%
20% of public school teachers reported being verbally held bachelor’s or master’s degrees. Comparable teacher
abused, 8% reported being physically threatened, and 2% characteristics were reported in the 12 international studies
reported being physically attacked in schools (e.g., (see Table 2). A total of 11,021 teachers reported usable
Kondrasuk et al., 2005; U.S. Department of Education, information and two studies included student informants
2000). only (Chen & Astor, 2009; Khoury-Kassabri, Astor, &
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To further build on these reports, we conducted a Benbenishty, 2009). Teacher participants were primarily
comprehensive literature search on studies that included White women (approximate age range from the middle 20s
empirical findings related to teacher victimization in schools to upper 30s) who had 10 or more years of teaching
worldwide. Several methods were used to assure a complete experience. There was a range of demographics among
review. First, a computerized search was conducted using international studies, which included public and vocational
the key words teacher stress, violence, school, teacher schools of both primary and secondary levels located in
victimization, teacher wellbeing, teacher effectiveness, urban, suburban, and rural areas. Students included those
survey, school climate, delinquency, and school disorder from low, middle, and high socioeconomic statuses.
with two databases (i.e., ERIC and PsycINFOw) and a Participants were proficient in English, Spanish, French,
search engine (i.e., Googlee Scholar) from 1988 to 2013. or Hebrew, from diverse cultural backgrounds, and tended
Second, the initial pool was reduced by systematically to be from the countries in which the studies were
reviewing the title, abstract, and method section of each conducted.
article so that only studies meeting our inclusion criteria Across the 21 U.S. and international studies, student
were incorporated. Studies published in non-peer reviewed verbal aggression was the most common form of violence
journals were omitted to focus our review on only those reported by teachers directed toward them. Special
investigations critiqued by independent reviewers and thus education teachers reported experiencing more physical
hopefully reflecting rigorous scientific methodologies. and nonphysical violence compared to general education
Third, reference sections of retrieved studies were examined teachers (Tiesman, Konda, Hendricks, Mercer, & Amandus,
for possible additional studies for inclusion. Finally, a hand 2013). Other types of violence noted are perceived threats,
search was conducted of major journals (i.e., British Journal assault, bullying, and harassment. Perpetrators of aggression
of Educational Psychology, Journal of Educational toward teachers included supervisors, co-workers, parents
Psychology, Journal of Interpersonal Violence, Journal of of students, and extended relatives of students (Fox &
Research in Crime and Delinquency, and Professional Stallworth, 2010; Gerberich et al., 2011; Ozdemir, 2012).
Psychology: Research and Practice). The title, abstract, and Students reported acting aggressively toward their teachers
method section of each potential article were reviewed for as a result of a teacher’s unreasonable requirements, a
possible inclusion. The search resulted in a total of 21 U.S. teacher’s unfair treatment, and disagreements with teachers.
and International studies1 from 20 journals. (See Table 1 and Other reasons included being punished, feeling upset,
Table 2 for a complete list of journals.) Nine studies were standing up for friends, and being provoked by teachers
conducted in the United States, and 12 studies were (Chen & Astor, 2009). Teachers believed that they were
conducted in nine countries outside of the United States assaulted by students because of their physical appearance,
(i.e., Belgium, Canada, Israel, Luxembourg, Netherlands, gender, religion, being a member of a minority group, work
Slovakia, Spain, Taiwan, and Turkey). Overall teacher outcomes, or disciplinary action (Mooij, 2011). In addition,
victimization information was collected through closed- research has shown that some of the most common
ended questionnaires, surveys (mailed or online), single circumstances associated with physical assaults include
items or scales, and semi-structured interviews. Most disciplining a student, working with special education
students, and breaking up a fight (Tiesman et al., 2013).
1. Studies included in the review are denoted with an asterisk in the Findings generally suggested that teachers’ perceived
reference list. victimization in schools was found to be related to fear,
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234
TABLE 1
Characteristics of U.S. Studies (N ¼ 9)

Study Journal Location Sample Method Results

Dworkin, Haney, & Journal of Houston, Texas N ¼ 291 teachers from urban Measure on stress, victimization, and fear of Teachers who have experience as victims of
Telschow (1988) Organizational public schools violence violence reported significantly higher
Behavior levels of stress than non-victims
Fox & Stallworth Human Relations N ¼ 779 teachers and Surveys assessing experience of violence and Results indicated that 64.8% of respondents
(2010) principals in an urban social support, including the Michigan reported being targets of pervasive
public school system Organizational Assessment Scale, Job- bullying, primarily by supervisors.
Related Affective Well-Being Scale, Experience of violence was associated
Physical Symptom Inventory, Oldenburg with increased negative emotion, burnout,
Burnout Inventory, and the Workplace and physical symptoms, as well as
Bullying Checklist decreased job satisfaction and attachment
Gerberich et al. Journal of Minnesota N ¼ 5,038 licensed educators Comprehensive survey including Results showed that 95% of physical assaults
(2011) Occupational and (Grades K–12); 33% demographic and work-related and nonphysical violence against
Environmental return rate information and information on work- educators were perpetuated by students.
Medicine related physical and nonphysical violent Most commonly reported symptoms and
events feelings from violent experiences
included frustration, anger, fear, anxiety,
stress, sadness, fatigue, difficulty
sleeping, and irritability
Gottfredson, Gottfredson, Journal of Research in N ¼ 254 public, secondary, Scales on teacher and student victimization, Higher residential crowding was linked with
Payne, & Gottfredson Crime and and non-alternative student delinquency, school climate, and more teacher victimization. Schools with
(2005) Delinquency elementary, middle, and exogenous structural variables greater perceived fairness and rule clarity
high schools in urban, had lower rates of student delinquency
suburban, and rural areas and victimization, and schools with more
positive psychosocial climates had lower
rates of teacher victimization
Gregory, Cornell, & American Journal N ¼ 7,318 ninth-grade Online surveys assessed teacher and student Results indicated that the most common
Fan (2012) of Education students; 2,780 ninth- perceptions of school climate. The survey threatening experience was verbal.
grade teachers from 280 included the Help Seeking Scale and Schools where teachers perceived greater
schools Experience of Rules Scale. The teacher structure and support had lower rates of
survey also included the Teacher teacher-reported victimization
Victimization Scale
Gregory, et al. (2010) Journal of N ¼ over 7,300 ninth-grade Online surveys assessing teacher and student Structure and support (school climate) are
Educational students; 2,900 teachers perceptions of school climate associated with less bullying and
Psychology from 290 high schools victimization in this study. Both structure
and support contribute to school safety for
adolescents
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Kondrasuk, Greene, Education Portland, Oregon N ¼ 139 administrators from Questionnaires addressing topics of school The majority of respondents to the survey
Waggoner, Edwards, & public and private schools; violence (86%) indicated feeling “very safe” in
Nayak-Rhodes (2005) 17% return rate their schools, and 80% of schools had a
“zero tolerance” policy against school
violence. Perceived causes of violence
against employees included substance
abuse, gang involvement, access to
weapons, school location, and ineffective
school discipline
Shernoff, Mehta, Atkins, School Mental Health Midwest City N ¼ 14 teachers from high- Semi-structured interviews were conducted Teachers reported limited resources as the
Torf, & Spencer poverty urban with teachers most prominent source of stress. Teachers
(2011) neighborhoods (Grades also indicated high-school level
K–8) disorganization due to lack of
administrative support. In addition to
these factors, frequent community
violence and safety issues contributed to
teacher physical and emotional problems,
problematic personal relationships, and
impacted work performance
Tiesman, Konda, Journal of Safety Pennsylvania N ¼ 2,514 teachers, school Survey on school variables and experience of The majority of those who reported
Hendricks, Mercer, & Research staff, and administrators; violence in school experiencing physical and nonphysical
Amandus (2013) 39% return rate violence noted students as the
perpetrators. Special education teachers
had the highest prevalence rates for
physical assaults and nonphysical
violence

235
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TABLE 2

236
Characteristics of International Studies (N ¼ 12)

Study Journal Location Sample Method Results

Alonso, Lopex- Perceptual and Galicia, Spain N ¼ 616 primary and Self-report teacher Data suggests verbal aggression is the most
Castedo, & Motor Skills secondary teachers questionnaire common form of violence used. Self-
Juste (2009) reports indicated teacher desire for more
effective response to violence
Cemaloglu Social Behavior Turkey N ¼ 385 elementary school Negative Acts Questionnaire Almost 50% of teachers expressed exposure
(2007) and Personality teachers to bullying within the previous 6 months.
There was no significant difference on
exposure to bullying based on gender,
marital status, or age
Chen & Astor Journal of School Taiwan N ¼ 14,022 students in Structured self-report Data showed that 30.1% of students reported
(2009) Violence Grades 4–12; 98% questionnaire on violent being involving in at least one aggressive
return rate behavior in schools act against their teachers in the last year,
the majority of which were purposely
opposing teachers to cause psychological
harm. The majority of students indicated
engaging in violent behavior as a result
from teachers’ unreasonable requirements
Dzuka & Dalbert European Slovakia N ¼ 364 teachers from rural Self-report questionnaires on Teachers who experienced more violence
(2007) Psychologist and urban areas; 108 experience of violence and also more often experienced negative
teachers from vocational subjective wellbeing affect, less often experienced positive
schools affect, and had less life satisfaction
Galand, Lecocq, & British Journal Belgium N ¼ 487 teachers in Questionnaire on school Experiences of school violence, including
Philippot (2007) of Educational secondary schools leadership, relationships student misbehavior, perceived violence,
Psychology (Grades 7 –12) with colleagues, verbal and verbal victimization, were strongly
victimization, students’ related to teacher reports of anxious,
misbehavior, perceived depressive, or somatic symptoms. As a
violence, and impact of result of this violence, 14% of teachers
experiences reported intent to leave teaching
Khoury-Kassabri, Journal of Israel N ¼ 16,604 students in Survey based on victimization Students with a positive perception of school
Astor, & Interpersonal Grades 7–11 and assessed students’ use policy, student –teacher relationships,
Benbenishty Violence of violence toward peers student participation in decision-making,
(2009) and staff and effective interventions by principal
and homeroom teacher on dealing with
violence reported less violence
perpetration in school. Results showed
that school-level variables explained the
majority of the variance in reports of
student violence toward peers and
teachers.
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Mooij (2011) Teachers and Netherlands N ¼ 5,148 teachers; 80,770 Questionnaire about social Results demonstrated that verbal violence is
Teaching: Theory students; 1,749 support safety in schools and the most common type of violence against
and Practice staff; and 629 members experiences of violent teachers and students. Teachers reported
of school management in behavior more incidents in which they were victims
secondary schools of verbal and mild physical violence,
compared to students. In addition,
whereas teachers reported low
percentages as perpetrators of violence,
students reported percentages as offenders
that were similar to percentages as victims
Ozdemir (2012) Journal of Kirikkale, Turkey N ¼ 902 teachers (Grades Instrument, survey, and semi- Emotional violence (intimidation & property
Instructional 6–12); 38.7% return rate structured interviews on destruction) was the most common type of
Psychology experience of violence violence reported against teachers
Steffgen & Ewen International Journal Luxembourg N ¼ 399 secondary school Questionnaire on school The highest percentage of teachers reported
(2007) on Violence and teachers; 48.5% return culture, professional being the victim of verbal attacks. Results
Schools rate strain, and violent indicated that class-oriented strain, time
behavior against teachers pressure, and quality of school
environment significantly contributed to
prediction of victimization
Türküm (2011) Children and Youth Turkey N ¼ 360 teachers from low, Two-part questionnaire: Results indicated that teachers faced violent
Services Review middle, and high demographics and behaviors from students more pervasively
socioeconomic statuses experiences of school than from other teachers or
violence administrators. Regarding social support
preferences, teachers do not prefer to
share experiences with school
administrators or counselors
Wilson, Douglas, & Journal of British Columbia, Canada N ¼ 731 public school tea-
Lyon (2011) Interpersonal chers from Grades K–12
Violence
Self-report survey on Data showed that 80% of
experience of participants had experienced
violence and impact school-related violence at
of violence one point in their careers,
with personal insults most
often reported. Experiences
of violence predicted teacher
functioning, as well as
emotional or psychological
and physical effects. Those
who had experienced
violence were more likely to
report fear at school than
those who reported never
experiencing violence
Zeira, Astor, & School Psychology Israel N ¼ 15,000 students in National survey; self-report Results indicated that verbal attacks are the
Benbenishty International Grades 4–11; 1,521 questionnaire on school most frequent type of student violence
(2004) teachers in primary, violence against teachers. Despite high rates of
junior, and high schools victimization, many teachers do not
consider school violence a major problem

237
238 REDDY ET AL.

physical and emotional symptoms, impaired personal APA TASK FORCE SUMMARY
relationships, work performance, and burnout (e.g., Dzuka
& Dalbert, 2007; Fox & Stallworth, 2010; Kondrasuk et al., Recommendations
2005; Shernoff et al., 2011; C. M. Wilson, Douglas, & Lyon,
Despite the available data, there remains a dearth of
2011). In particular, teacher reports of anxiety, depressive,
information specific to violence directed against teachers,
and somatic symptoms were associated with lower
and such systematic collection and documentation efforts
professional functioning, lower efficacy in the classroom,
are sorely needed. The APA Task Force report included
and lower emotional or physical well-being (e.g., Dzuka &
recommendations for such research and data acquisition
Dalbert, 2007; Galand, Lecocq, & Philippot, 2007; C. M.
(Espelage et al., 2013):
Wilson et al., 2011). Further, findings suggested some
teachers may not report victimization experiences, under-
. Establish a descriptive national registry of incidents of
scoring the need for increased administrative recognition of
violence against teachers that includes demographic
teacher violence and targeted supports for teachers at-risk
information but not teacher or student names.
for violence or those who have experienced violence (e.g.,
. Conduct additional research to understand the
Cemaloglu, 2007; Dzuka & Dalbert, 2007; Türküm, 2011;
magnitude of and possible causes of violence toward
Zeira, Astor, & Benbenishty, 2004).
other adults in the schools setting (e.g., educational
In addition to individual factors related to violence, the
support staff).
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findings point to environmental risk factors including


. Conduct treatment-outcome efficacy studies to ident-
disorganized school structures, negative school climates,
ify best practices for primary, secondary, and tertiary
lack of administrative and collegial social supports, high
preventions.
residential crowding, time pressure, class-oriented strain,
and the quality of the school environment. On the other
hand, lower rates of teacher-directed violence were In addition to a series of recommendations for the study of
associated with balanced school organizational structures violence directed against teachers, the Task Force
and support systems, clear school disciplinary policies and summarized its work by noting that psychologists can play
rules, and positive school relationships (e.g., Dworkin et al., a significant role in improving conditions related to school
1988; Gottfredson et al., 2005; Gregory et al., 2012; violence through their expertise in research and curriculum
Steffgen & Ewen, 2007). Therefore, research suggests that development, prevention science, race relations, multi-
teachers who were least prepared, more psychologically cultural competencies, and stress management. However,
vulnerable, and worked in high risk environments were there must be a research agenda that focuses on an accurate
most likely to experience some level of work-related assessment of the types of violence teachers experience.
violence. In future research, these types of individual and Next, research should evaluate the individual, classroom,
environmental risk factors should be examined as school, community, institutional, and cultural factors that
moderators of the relations between victimization stressors are predictive of the prevalence of teacher violence.
and teachers’ psychological, social, and professional It follows that prevention and intervention strategies must
outcomes. be implemented at multiple levels. It is imperative that
Collectively, educators’ perceived threats of violence, violence directed toward teachers be considered as a
as well as lack of support services, classroom behavioral gendered violence, given that 75% of U.S. teachers are
management and stress management training may impact women.
their psychological and professional well-being and Careful operational definitions of violence and aggres-
performance. Similarly, several researchers found teachers sion against teachers will need to be established and agreed
consistently reported a lack of support services and upon so that research outcomes can be compared across
training for preventing and managing school violence (e. research teams as well as sites if these data are to be used to
g., Alonso, Lopez-Castedo, & Juste, 2009; Daniels, maximize our ability to develop best practice approaches.
Bradley, & Hays, 2007; Kondrasuk et al., 2005). In sum, Measures of fidelity of the prevention programs as carried
the research highlights many problematic issues within out at the schools should be mandatory for all such studies,
schools that are associated with higher rates of teacher- and data on fidelity of implementation collected by third
directed violence. There is a need to work toward parties who are independent of the implementation of the
comprehensive systemic school changes that include prevention efforts should likewise be de rigueur in such
administrator awareness of staff safety issues and policies studies. Without information on the extent to which
that support and train school personnel and reduce prevention programs are implemented as intended, it is
violence and stress. The APA Task Force was assembled not possible to draw accurate conclusions regarding
to begin to examine these issues in the United States and intervention outcomes (Lane, Kalberg, & Menzies, 2012).
make recommendations for moving the research agenda Teacher training programs were also recommended to
forward. play a major role in reducing the likelihood of violence
VIOLENCE AGAINST TEACHERS 239

directed toward teachers. Teacher educators must consider whereas African American teachers were less likely to
the importance of providing preservice teachers with the report victimization. These quantitative data illustrate the
knowledge, classroom management skills, and confidence high rates of teacher-directed victimization in our national
to establish engaging classroom environments (Lane et al., sample.
2012). Concurrently, preparation programs need to
reinforce the behaviors and skills of novice teachers to Teacher-reported case studies. The following case
respond both with warmth and with confidence in their examples are drawn from the national survey to provide an
abilities to intervene effectively. illustration of the range of teachers, types of teacher
victimizations, and range of actions taken that may occur in
Task Force National Survey Study the United States. All case identifying information has been
changed.
The APA Task Force on Violence Directed Against
Teachers, in cooperation with the National Education
Association, conducted a national, anonymous, Web-based TEACHER VICTIMIZATION CASE EXAMPLES
survey that examined the overall rate of victimization
among teachers, as well as the rates of victimization by The Case of Dana
offense type, perpetrator, and teachers’ gender, race/
Dana is a 38-year-old White woman who has been teaching
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ethnicity, and community setting (McMahon et al., in


press). In addition, some open-ended questions were for 13 years. She is currently teaching sixth grade in a
included to provide more descriptive information regarding private middle school located in a suburban community in
teachers’ experiences with victimization. Participants Florida. Dana is a general education teacher who has a
included 2,998 K –12 teachers from 48 states in the United master’s degree and a certificate in biology for K –12 and a
States. On average, teachers were 46.5 (SD ¼ 11.2) years certificate in Special Education for first through ninth grade.
old, were women (83.5%), and taught for 16.9 (SD ¼ 10.5) Dana was married for 11 years, but was recently divorced 3
years. The majority of teachers were Caucasian (81.2%), months ago. Dana is obese and has a 6-year-old daughter
followed by African American (9.3%), Latino (4.4%), and with her ex-husband.
“other/multiracial” (5.1%). The majority of teachers worked
in a traditional public school setting (94.1%), and the History of victimization. Dana has experienced several
remainder of teachers worked in a public magnet or charter forms of victimization over numerous occasions during her
school (5.1%) or private school (0.8%). Also, 22.5% of teaching career. For example, students and parents have
teachers worked in high schools and the remainder of intimidated and verbally threatened her. She has received
teachers worked in Grades K –8. Participating teachers obscene remarks, gestures, and inappropriate e-mails and
worked in urban (44.5%), suburban (36.8%), and rural text messages from students, parents, and colleagues. Dana
(18.7%) settings (McMahon et al., in press). reported that students have thrown objects at her, stolen
Participants were asked, “Have any of the following from her, and damaged her personal property. She also
happened to you personally this year or last year at your indicated a colleague (teacher) stole her personal property
school? If yes, please check all the individuals that may (e.g., food, pens, and classroom preparation materials).
have been involved.” Eleven forms of victimization were
then listed: obscene remarks, obscene gestures, verbal Most upsetting incident and impact. Dana reported
threats, intimidation, cyber/Internet violence, theft of two recent incidents that occurred approximately 1 month
personal property, damage to personal property, objects apart in the Fall of 2009, one involving a parent and one
thrown, physical attack not resulting in a visit to a physician, involving a colleague. She reported, “A parent sent several
physical attack resulting in a visit to a physician, and threatening e-mails and Facebookw messages to me. She
weapon pulled. McMahon and colleagues (in press) found accused me of terrible things and told me that all the other
that 80% of teachers reported at least one victimization, and students were not returning to our school unless I quit my
of these teachers, 94% reported being victimized by job.” Dana also described another incident, where “a former
students. Nearly three-fourths of all teachers experienced at teacher is posting unprofessional things about me online and
least one harassment offense, followed by over one-half telling staff that she and another teacher were trying to get
experiencing property offenses, and 44% reporting physical me fired.” Dana was extremely distraught over these
attacks. Next, logistic regression analyses were conducted messages. The colleague’s verbal attacks continued
for each offense to determine how demographic character- throughout the school year. Because these messages are
istics contributed to the likelihood that teachers were ongoing, the emotions Dana felt continued to affect her
victimized. Findings suggest that teacher and community wellbeing. When Dana first read the threats online from the
characteristics are associated with higher likelihood of parent, she initially began to “cry and then became very
victimization—namely, men and teachers in urban settings, anxious.” The parent was the mother of one of Dana’s
240 REDDY ET AL.

favorite students, and the colleague was a senior female History of violence. Jason has described receiving
teacher in her school whom Dana barely knew. However, verbal and nonverbal threats from students, intimidation,
Dana knew both the student and the parent well, and was damage to his personal property at work, personal items
subsequently disappointed and upset the mother did not stolen, and inappropriate e-mails. Also, Jason has had small
speak to her in person to resolve her issues with Dana more objects (papers and pencils) thrown at him during class.
appropriately.
When Dana was asked why she thought the parent- Most upsetting incident and impact. When Jason was
incident happened, she stated, “The mother was having an asked to describe the most upsetting incident that happened
emotional break-down and was terrified for her son. Any to him as a teacher, he reported that in May 2010, he
indication that he was not the perfect child caused her to received “three messages on my home phone threatening
attack others.” Dana added she believed the parent verbally that students were going to jump me and a note left at school
attacked her through the Internet because she is “attention that said ‘you should die, faggot’!” Jason recognized the
seeking, impulsive, and generally unhappy” with some of male student’s voice on his home answering machine and
Dana’s decisions. assumed the note was left by the same student. When Jason
When Dana was asked why she thought the colleague- was asked why he thought these threats were made,
incident occurred, she reported, “She thinks her way of he stated, “[T]his male student had a chair pulled from under
teaching is the only way that is correct. She dislikes my him by a female student and I had her removed for hurting
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teaching philosophy and personal style.” Overall, Dana felt him. I think he was embarrassed.” Jason also reported being
bullied and disrespected by her colleague. She stated that concerned that this student was “out to get him” because he
her colleague knows she “won’t fight back.” was particularly “homophobic.” After receiving these
Dana felt quite overwhelmed by both incidents. She threats, Jason felt furious and a little violated. Jason became
described feeling sad and extremely angry, as well as sorry much more cautious both in and out of school, and described
for the mother. Dana did develop a strong desire to “get losing sleep because he was always “sleeping with one eye
even” with the parent and colleague. Dana also began open.” He was concerned for himself and his partner. He
blaming herself (i.e., believed that she “let this happen and regrets that he disclosed his sexual orientation to one
could have handled it better”). particular colleague.

Action taken after incident. Dana spoke privately to Action taken after incident. Initially, Jason did not
another teacher at a different school about both incidents, report the incident to anyone at school. Eventually, he told a
and then followed up with her principal. Unfortunately, close colleague (a teacher) at work who encouraged Jason to
Dana reported that “the administration was not at all talk with the principal. Jason had never discussed his
supportive” in dealing with these incidents. She tried to personal life with the principal before. To Jason’s surprise,
ignore the situations, but her emotions worsened. Dana the principal was very supportive and upset by the phone
began losing sleep, eating more, and grew increasingly calls and note. The principal also disclosed to Jason
irritable. When Dana was asked how these online attacks privately that he had a gay adult child. Because it was
affected her view of her current teaching position, she difficult to accurately identify who left the phone messages
reported, “You can’t trust administrators. It is always about and note, Jason took no further action. However, the school
favoritism, politics, and money. It has shown me that principal did discuss diversity and privacy issues at the
I should not take parent criticism personally, although following faculty meeting. When Jason was asked how this
I always seem to do that. It has made me continue to look for incident impacted his current view of teaching, he reported,
a new position, with the intention of leaving teaching if “I am now more cautious about boy and girl interactions in
possible.” As of now, Dana is still looking for a different class and stop them early if I can.” Jason has tried not to let
profession. the threats influence his teaching strategies, but it has
changed the way he thinks and feels about work.
The Case of Jason
The Case of Janelle
Jason is a 29-year-old multiracial man who has been
teaching for 5 years. He is currently teaching ninth grade in Janelle is a 52-year-old White woman with 27 years of
a public high school located in a suburban community. teaching experience. Janelle is currently teaching 9th-
Jason is a general education teacher who has a master’s through 12th-grade classes in a public high school located in
degree and certification in General Science, Chemistry, and a quiet, rural town. She has taught middle school during her
Environmental Science. Jason is a gay man who lives with career as well. She has a master’s degree in education, and
his partner of 8 years. He has not disclosed his sexual has many roles in the high school where she teaches. She
orientation to his students; however, he was “out” with some holds Grades K –12 certifications in General Education,
of his colleagues at work. Health, Physical Education, Special Education Severe/
VIOLENCE AGAINST TEACHERS 241

Profound/Multi-Handicapped, Special Education Resource Action taken after incident. On the day of the assault by
Room, and Special Education Direct Service/Self-Con- the female student, Janelle informed her principal and told a
tained Room. Janelle has been married to her husband for 30 colleague. Surprisingly, Janelle’s colleague asked her a
years, and has one daughter and one son. series of questions about what she did to provoke the incident
and she felt that the colleague was not very supportive. She
left work and went to her primary care physician. She also
History of victimization. Janelle reported several reported the incident to her union representative. The union
incidents of victimization from her students, both in middle representative was supportive, but pushed her to press legal
and high schools. For example, she has had her personal charges. Janelle reluctantly filed charges with the school
property damaged on several occasions, received obscene police against the student and her parents. Janelle reported
remarks and gestures, verbally threatened (e.g., “I will get that the school police officer filed the paperwork and no
you,” and “Watch your back”), and objects (i.e., pencils, additional action was taken. Janelle reported:
markers, paper, and a small book) thrown at her in class.
In addition, she has had three separate incidents in which I realize that I cannot count on the school police officer ever
she was physically attacked by students. She sought again. My principal was more supportive than the school
physician care for one incident. police officer. I ended up filing a report at the police
department and complaining about the school police officer.
I will call the police directly next time.
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Most upsetting incident and impact. For the most


upsetting incident, Janelle reported “Being jumped upon Although Janelle felt she handled the situation well overall,
and beaten during class by an explosive female student . . . the assault affected her current view of teaching. She stated,
on another occasion, a male student made disgusting “I feel that the female student should never have been
sexually explicit remarks towards me in front of my class.” placed in our school. I don’t know what became of the
When the female student attacked her, she was left with student. The student is no longer enrolled.” Janelle indicated
severe bruising on her arms and stomach, as well as one she is more cautious as a teacher, and her trust is
black eye. She was so stunned by the assault that she could compromised with most students.
not even attempt to get the student off her. Janelle reported
feeling that she was “shaking inside” and her “heart was Integration of Case Examples
beating excessively.” She was attacked in March 2010, and
continues to suffer some distress from the incident 1 year In sum, these case examples illustrate the surrounding
later. Prior to the assault by the female student, Janelle had individual and environmental context of the victimization
thought of the school as a safe and quiet place despite experiences reported by three particular teachers. They also
previous incidents, and was quite surprised by the severity highlight victimization as a stressor, suggest potential
of the attack. Janelle knew the student very well. moderators and mediators, and reveal the significant impact
When Janelle was asked why she thought this incident these stressors have on teachers’ personal and professional
happened, she stated, “The female student has anger issues lives (e.g., Janelle’s compromised trust of students). One
and has been moved from several schools.” Janelle believed theme that emerged across the three case studies is
the student physically attacked her because she learned educators’ suggested external locus of control of violence
violent and aggressive behaviors at home, lacks self-control, in schools. In these examples, organizational structure and
comes from a “bad neighborhood,” needs attention, lacks administrative and collegial supports are emerging as
self-esteem, is impulsive, and does not like school. Janelle important predictors and buffering factors to reduce violence
also reported that the student was unhappy with Janelle’s against teachers. However, much work is needed to better
grading and became angry when she received bad grades equip administrators and educators on their interpersonal
(i.e., Ds) in class. Janelle felt the student wanted to “get approaches to students, parents, and other school personnel.
revenge” against her. After the attack, Janelle was In addition, occurrences of violence against teachers have
extremely furious and frightened for her life. Her colleagues the potential to dramatically affect the teacher workforce.
and husband indicated she was not herself for some time
(i.e., more quiet and withdrawn) at work and at home.
When the male student made the “sexually explicit DISCUSSION
remarks” to her, she felt ashamed, embarrassed, and disgusted.
This incident occurred in class on two occasions and lasted for In looking at the multiple demands placed on today’s
several minutes, disrupting the flow of her class during educators, which include increasingly high expectations for
September 2008. Janelle believed the male student made these student performance, diverse student learning abilities, few
remarks to her because “he had apparently been successful at school resources, and violence perpetrated by students,
bullying others and that is how he deals with his own failures.” parents, and colleagues, it is not surprising they are
242 REDDY ET AL.

experiencing high rates of stress. In this article, we explored demographics), the context of the incident (environmental
an important facet of teacher stress—perceived threats or and individual), and the nature of the incident and outcomes
actual experiences of violence in the school setting. By is needed. This registry would be helpful in terms of
better understanding the extent and context of teacher promoting systematic and consistent measurement and
victimization as well as the factors that are associated with assessment of stressors, moderators, mediators, outcomes,
victimization, the research and teaching communities can and reciprocal and dynamic processes associated with
move forward in finding solutions to prevent and address teacher victimization. The goal would be to study these
this type of stress. phenomena descriptively, gaining essential information to
Violence against teachers is a larger problem than many inform intervention efforts (Shavelson & Towne, 2002).
individuals realize. Whereas the media regularly covers Indeed, there is a need to acquire the information necessary
stories about violence perpetrated against students (e.g., the to (a) prevent violence against teachers and (b) respond
cases of Columbine High School and Sandy Hook more efficiently and effectively when such incidences do
Elementary School), the focus is often on the effects of occur. The cost of even one such incident—emotionally,
these and other violent acts on the students and not on the physically, and fiscally—is too much. As such, evidence-
teachers. As we have reviewed in this article, the prevalence based interventions in these arenas are critical.
of violence perpetrated against educators is great. Violence Once data are systematically collected indicating the
against teachers is broad in scope, with the most common prevalence and nature of these incidents, educators and
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form of violence consisting of verbal assaults (Dinkes et al., policymakers will be in better positions to improve
2009), followed by threats and physical attacks (e.g., Dinkes prevention efforts. First, systematic data would be available
et al., 2007), each of which is illustrated in the provided to present to legislators and policymakers, so that funds could
illustrations. The case examples we described are consistent potentially be made available for infusion into future
with the range of violent incidents identified in the few research efforts. Second, although prevention strategies
extant survey-based studies (C. M. Wilson et al., 2011), and specifically aimed at educators are minimal, the development
offer poignant depiction of the impact of violence against of such efforts could be made cost-effective if they can be
teachers. It is particularly disheartening given the multiple guided by specific data on the prevalence and nature of the
demands placed on today’s school teachers who are charged problem on a national level. For example, there is little
with one of the most honorable—and challenging—tasks: research available indicating the relation between violence
educating all of our children, including those with and homophobia; if cases such as “Jason’s” are found to be
significant emotional and behavioral disorders. prevalent through the establishment of a national registry, then
The stress that is associated with violence against teachers prevention and educational efforts aimed at homophobia-
also is significant, and serves as an additional impetus for the induced violence could be developed and implemented.
involvement of the psychological community in research on The Task Force also advocates research on the
the prevalence and prevention of such acts. Teachers are magnitude of violence perpetrated against other adults
charged with the formidable task of meeting exceptionally who work in school settings. In addition to teachers,
high standards of academic excellence for all students; personnel in schools include administrative staff, clerical
distilling the core qualities of citizenship, character, and staff, custodial staff, cafeteria staff, hall monitors, social
social competencies; and serving an increasingly diverse workers, school psychologists, coaches, and numerous other
group of students in inclusive settings. Yet, schools are often individuals. Whereas research on violence against teachers
not well equipped to provide teachers with the necessary is minimal, research on violence against other school
supports that they need to cope with violence that is personnel is nearly nonexistent. The same stressors that
perpetrated against them amidst all these commitments. teachers are faced with as a result of verbal and physical
Recall the case of “Janelle,” who reported the incident that aggression also may be equally stressful for these other
she experienced to several individuals (including a colleague important school personnel.
and a union representative), but was merely asked about how
she provoked the situation (by the colleague), and was
encouraged to press charges (by the union); little support was CONCLUSION
provided for her to be able to make sense of the incident and
process this difficult experience. Much additional research is needed on teacher victimization
The APA Task Force made several recommendations and the potential impact it has on school systems, school
based on the limited current extant research. First and personnel, student learning, and the future of education.
foremost, the Task Force argued for the need for a national Violence against teachers is prolific, varied, and has lasting
registry of occurrences of violence against educators. Such a effects on many individuals. Thus, a national call for
registry would not need to include identifying information research, policy, and practice is urgently needed (Espelage
of either victims or perpetrators. A registry that contains et al., 2013). To date, only 21 studies have been published
information about both victims and perpetrators (including on teacher violence. Investigations have primarily used self-
VIOLENCE AGAINST TEACHERS 243

report measures (e.g., Kondrasuk et al., 2005; Zeira et al., violence and victimization is warranted to design effective
2004) and, in some cases, a single item or question (e.g., prevention and intervention programming and policies to
Dzuka & Dalbert, 2007; C. M. Wilson et al., 2011) or small enhance our educational system for all.
set of items (Gregory et al., 2012) to capture the predictors of
this multifaceted problem. Collectively, the generalizability ABOUT THE AUTHORS
of the 21 studies are limited due to the low return rates and
sample-specific settings (i.e., specific provinces, counties, Linda A. Reddy, PhD, is an Associate Professor of School
states, or regions of a country). Whereas examinations of U.S. Psychology at Rutgers University. Her research interests include
classroom assessment, attention deficit hyperactivity disorder
and international findings are informative, it is important to assessment and intervention, and test development and validation.
note the structure and context of schooling varies She is currently the principle investigator of two school
considerably both across and within countries, thus improvement grants focused on evaluation, targeted professional
precluding definitive conclusions being drawn across studies. development and improved student learning and behavior. She is a
Despite these inherent limitations, findings from extant Fellow of the American Psychological Association (APA) and the
President-Elect of APA Division 16 (School Psychology).
literature point to alarming rates of violence against teachers,
and immediate attention is warranted. As noted by Daniels, Dorothy Espelage, PhD, is a Professor at University of Illinois,
Bradley, and Hays (2007) and Zeira et al. (2004), there is a Champaign. She has conducted research on bullying, homophobic
teasing, sexual harassment, and dating violence for two decades.
need for school administrators at all levels to increase their She has over 120 research publications. She is PI on two CDC-
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knowledge and awareness regarding teachers’ exposure to funded Second Step randomized clinical trial to prevent violence in
violence and potential impact on their professional 50 middle schools. National Science Foundation funds her work to
functioning. Likewise, it is important that school personnel develop better observational methods to assess bullying among
recognize that teachers can be victims, perpetrators, and adolescents. NIJ and NIH are funding her longitudinal and social
network studies of these behaviors.
witnesses of school violence (Mooij, 2011). As illustrated in
the three case examples, the type of teacher and kind of Susan D. McMahon, PhD, is a Professor of Clinical and
teacher victimization that occurs come in many forms. Community Psychology at DePaul University. Her research
interests include school-based prevention, intervention, and
Teachers reported experiencing violence from students, evaluation, violence and aggression among teachers and youth,
parents, and colleagues, suggesting that students are not the and the interplay between individual and contextual factors among
only individuals that need to be included in violence directed urban, at-risk youth. She is currently Department Chairperson and
toward teacher prevention efforts. Further, violence is not a Fellow of the American Psychological Association Division 27.
limited to the school hours; teachers report being targeted at Eric M. Anderman, PhD, is Chair of the Department of Educational
home and through the Internet. As the Internet and social Studies and Professor of Educational Psychology at The Ohio State
media grow in popularity and are being used to perpetuate University. His area of research is academic motivation, with a
aggression and violence among students (Espelage, Rao, & particular focus on academic cheating, and HIV and pregnancy
prevention. Dr. Anderman, who is a Fellow of both the American
Craven, in press), it is not surprising that teachers are being Psychological Association and the American Educational Research
targeted through technology. Association, received the American Psychological Association’s
Future research should focus on the effectiveness of Early Career Achievement Award in Educational Psychology in
violence policies and prevention strategies as they relate to 1999. His research on cheating and motivation have been featured
teacher victimization in schools. Currently there is by numerous media outlets, including Dateline NBC, MSNBC,
CBS News, The New Yorker, CNN, The Huffington Post, and
extensive literature on intervention programs for preventing numerous other outlets. His research has been funded by the
and intervening with school violence and general work National Institutes of Health, the U.S. Department of Education,
place violence, with an emphasis on positive behavior and the Spencer Foundation. He has published over 90 books,
interventions and supports (e.g., Lane, Menzies, Oakes, & articles and chapters on academic motivation.
Kalberg, 2012; S. J. Wilson, Lipsey, & Derzon, 2003). Kathleen Lynne Lane, PhD, is a Professor at the University of
However, to our knowledge there is no research focused on Kansas in the Department of Special Education. Her research focus
systematic prevention strategies and approaches for teacher is on designing, implementing, and evaluating comprehensive,
victimization specifically for school personnel and students. integrated, three-tiered (CI3T) models of prevention with an
emphasis on systematic screenings for behavior challenges.
Research is also needed on the possible mediators and
moderators associated with negative teacher – student and Veda Evanell Brown, PhD, National Alliance of Black School
teacher – school personnel interactions that lead to teacher Educators, Washington, DC, USA.
victimization. Also, research on environmental and Cecil R. Reynolds, PhD, Texas A&M University, Emeritus,
psychological factors that identify educators at risk for Distinguished Professor of Educational Psychology and Neuro-
violence is warranted, as is research on how school science.
psychologists and school personnel can help teachers to Abraham Jones, EdD, National Education Association, Washing-
cope with the aftermath of violent events. A better ton, DC, USA.
understanding of the system, classroom, and individual Jaclyn Kanrich, BA, is a graduate student in the school psychology
level factors contributing to the likelihood of teacher program at the Graduate School of Applied and Professional
244 REDDY ET AL.

Psychology at Rutgers University. She has assisted on several national study of delinquency prevention in schools. Journal of Research
research projects that have addressed working with children with in Crime and Delinquency, 42, 412–444.
Attention Deficit Hyperactivity Disorder, consulting with teachers, Grant, K. E., Compas, B. E., Stuhlmacher, A. F., Thurm, A. E., McMahon,
and translating research to practice. S. D., & Halpert, J. A. (2003). Stressors and child and adolescent
psychopathology: Moving from markers to mechanisms of risk.
Psychological Bulletin, 129, 447–466.
Grant, K. E., Compas, B. E., Thurm, A. E., McMahon, S. D., Gipson, P. Y.,
Campbell, A., & Krochock, K. (2006). Stressors and child and adolescent
psychopathology: Evidence of moderating and mediating effects.
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