TREM is a fully manualized 24- to 29-session group intervention for women who survived trauma and have substance use and/or mental health conditions. This model draws on cognitive–behavioral, skills training, and psychoeducational techniques to address recovery and healing from sexual, physical, and emotional abuse. TREM consists of three major parts. The first section, on empowerment, helps group members learn strategies for self-comfort and accurate self-monitoring as well as ways to establish safe physical and emotional boundaries. The second component of TREM focuses more directly on trauma experience and its consequences. In the third section, focus shifts explicitly to skills building. These sessions include emphases on communication style, decision-making, regulating overwhelming feelings, and establishing safer, more reciprocal relationships.
TF-CBT is a psychosocial treatment model designed to treat post traumatic stress and related emotional and behavioral problems in children and adolescents ages 3 to 18 years. Initially developed to address problems associated with childhood sexual abuse, TF-CBT has been modified and tested with children who have experienced a wide array of traumas, including domestic violence, traumatic loss, war, commercial sexual exploitation, and the often multiple and complex traumas experienced by children who are placed in foster care. TF-CBT is appropriate for use with children exposed to trauma whose parents or caregivers did not participate in the abuse.
The Safety, Mentoring, Advocacy, Recovery, and Treatment (SMART) model developed by a team of clinicians at the Kennedy Krieger Institute Family Center is a structured, phase-based, abuse-focused, treatment approach to address the emotional and behavioral needs of young children with a history of sexual abuse exhibiting problematic sexual behavior (PSB). A major premise of the model is that the PSB stems from emotional responses to the prior child sexual abuse causing the child to form cognitive distortions about themselves, others, and the world around them. A unique feature of the model is the formation of parallel narratives of the child’s experiences as a victim and as one who victimizes others. Children are supported to examine their roles and perceptions associated with each of these experiences. Clinicians guide children and their families through this process and provide the context for comparison leading to the integration of these experiences into a single narrative. The SMART model consists of three clinically essential phases: Safety and Stabilization, Triggers/Integration, and Re-Socialization. The SMART model utilizes individual, family, and group therapy simultaneously.
Risking Connection® teaches a relational framework and skills for working with survivors of traumatic experiences. The focus is on relationship as healing, and on self-care for service providers. It provides a comprehensive training curriculum for working with survivors of childhood abuse specially designed for staff in all mental health settings, including public systems. Risking Connection® emphasizes the concepts of empowerment and collaboration, three major goals serve as the main focus: (1) a theoretical framework to guide work with survivors of traumatic abuse, (2) specific intervention techniques to use with survivor clients, and (3) attention to the internal needs of trauma workers as well as clients. In addition, common concerns and skepticism about trauma treatment are addressed. Interspersed in this curriculum are client/clinician worksheets as well as assessment, self-reflection, group discussion, and clinical practice exercises.
Real Life Heroes was especially designed for children in child and family service programs who frequently lack safe, nurturing homes and secure relationships with caring and committed adults. The model can be used by programs and agencies as a prescriptive methodology to address primary goals including preventing placements, reuniting families, or finding alternate permanent homes for children who cannot return to biological parents.
Real Life Heroes (RLH) is based on cognitive behavioral therapy models for treating post traumatic stress disorder (PTSD) in school-aged youth. Designed for use in child and family agencies, RLH can be used to treat attachment, loss, and trauma issues resulting from family violence, disasters, severe and chronic neglect, physical and sexual abuse, repeated traumas, and post traumatic developmental disorder. RLH focuses on rebuilding attachments, building the skills and interpersonal resources needed to reintegrate painful memories, fostering healing, and restoring hope. These goals are accomplished using nonverbal creative arts, narrative interventions, and gradual exposure to help children process their traumatic memories and bolster their adaptive coping strategies.
PCIT is effective with single parents, cognitively limited parents, court-ordered parents, two-parent families, and foster parents. Cultural adaptations have been effective with Latino/Hispanic families, African American Families, and Native American families. PCIT has been disseminated internationally (e.g. Hong Kong, Norway, The Netherlands) and has been translated into different languages (e.g. Spanish and Mandarin). PCIT has been adapted for: Head Start classrooms;Group treatment; Home rather than office based sessions; Domestic violence shelters; Residential treatment centers.
Seclusion and restraint were once perceived as therapeutic practices in the treatment of people with mental and/or substance use disorders. Today, these methods are viewed as traumatizing practices and are only to be used as a last resort when less-restrictive measures have failed and safety is at severe risk.
For more information on alternatives to seclusion and restraint:
International Family, Adult, and Child Enhancement Services (FACES) provides comprehensive, community-based mental health services for refugee, asylee and asylum-seeking children, adults, and families suffering from trauma or emotional disorders. Services include individual and family counseling, assistance accessing benefits and entitlements, expressive therapies, linkages to primary and dental health care, and case management. International FACES staff respect each culture’s definition of family roles and recognize the importance of working with and strengthening the family structure. Services are offered in a linguistically and culturally appropriate manner, often conducted by staff from the same culture as the family or with trained interpreters. Outreach and engagement strategies help educate participants about the value of mental health services, as well as providing linkages to other specialized services.
Integrative Treatment of Complex Trauma (ITCT) was originally developed for use in school and clinic settings with culturally diverse clients, ages 3 to 21, and their families. Specific cultural groups include ethnic minorities (African American, Latino American, Asian American, and Pacific Islander American), low socioeconomic status, gender-specific child and adolescent groups, and immigrants from Mexico, Central America, Pacific Islands, and Southeast Asia. ITCT has also been adapted for use in urban schools in economically impoverished areas.
Child Parent Psychotherapy is a dyadic, relationship-based treatment for parents and young children (birth-5) that helps restore normal developmental functioning in the wake of violence and trauma by focusing on restoring the attachment relationships that are negatively affected by violence, establishing a sense of safety and trust within the parent-child relationship, and addressing the co-constructed meaning of the event or trauma shared by parent and child. Sessions focus on parent-child interactions to support and foster healthy coping, affect regulation, and increased appropriate reciprocity between parent and child. Parent guidance on development, behavioral management, crisis intervention, and case management are provided as needed in an unstructured way.