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Trauma-informed approaches (TIAs) were developed as an organizational change process to help social service agencies serve clients. Rooted in mental health and public health, TIAs are popular in preK-12 but are challenging to operationalize and failing to transform the status quo. This qualitative case study examines spread to understand these implementation issues. It explores 1) how TIAs spread across the fields of mental health and public health into preK-12 education, and 2) what form of TIAs spread. It is grounded in organizational theory and theory of racialized organizations (Ray, 2019). Archival data from government agencies, professional organizations, academic journals, and news articles are analyzed. The study is critical given the prevalence of trauma and the challenges of public education.