Abt Associates Inc. - Connecticut

1 Abt Associates Inc. Suite 800 North 4550 Montgomery Avenue Bethesda, MD 20814-3343 Models for developing trauma - informed behavioral Health Systems and trauma -Specific Services i Models for developing trauma - informed behavioral Health Systems and trauma -Specific Services Compiled by Ann Jennings, This report is an update of the 2004 technical report describing trauma - informed and trauma -specific service models identified by state behavioral health service systems and organizations. All models in this report are designed and used specifically to address trauma in the lives of children, their parents or caregivers, and adults. Acknowledgments This document was compiled by the exhaustive efforts of Ann Jennings with her dedication to promoting awareness to the prevalence and effects of trauma as well as her hope in healing and systems transformation to a trauma - informed community. Abt Associates Inc.

2 , the National Association of State Mental Health Program Directors (NASMHPD), and the National Center for trauma informed Care (NCTIC) gratefully acknowledge the many individuals and organizations that contributed to the development of this updated report. In particular, we would like to thank Terry Cline, Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA), A. Kathryn Power, , and Susan E. Salasin of the Center for Mental Health Services (CMHS) within SAMHSA for their time, effort and continuing commitment to this issue. Among the many individuals who contributed resources and time to this updated publication, we would like to especially thank those dedicated and talented people who created the trauma - informed and trauma -specific service models and treatment approaches contained in this report. Their response to our request for revised or new descriptions of their models according to a format easily reviewed by readers within state mental health and substance abuse service systems was generous and timely.

3 They patiently and carefully summarized key aspects of their models, indicating the status of research and evaluative findings, identifying the specific settings and individuals for whom each approach was designed and/or adapted, and providing contact information for readers to easily obtain more information and/or materials. Their commitment and continuing work in the field of trauma , especially with regard to the creation and research of models addressing the complex and deeply rooted types of childhood abuse trauma experienced by so many recipients of public mental health and addition services, has been essential to moving the field forward towards achieving the vision of recovery and transformation portrayed in the President s New Freedom Commission on Mental Health Final Report. We would also like to acknowledge the contributions of Gail Robinson, , Rebecca Tregerman, and Kenneth Morford of Abt Associates Inc.

4 For their invaluable assistance contributing to the preparation of this manual. Disclaimer The data collection method used to prepare this report did not include specific questions about a particular model s Approach, Intended Setting, or Special Focus, although many authors included such information in their descriptions. Authors were contacted to review the tables and to provide any missing information for the final publication of this report. ii Contents Disclaimer ..i 1 Data Collection Who Are the Models Designed For?..1 What Kinds of trauma are Experienced by Persons Who Develop Serious and Persistent Mental Illness and Addiction? ..2 Evolution of trauma - informed and trauma -Specific Services in State Mental Health Systems ..3 What Factors have Contributed to the Growth of trauma Awareness and Activity in State Mental Health Service Systems?..4 trauma - informed and trauma -Specific 9 Models for developing trauma - informed Service Systems and Organizations: Creating Cultures of trauma - informed Care.

5 11 Creating trauma informed Systems of Care: Facilitating Recovery in Mental Health Service Settings ..13 developing trauma - informed Organizations: A Tool Kit ..14 National Executive Training Institute for the Reduction of Seclusion and Restraint: Creating Violence Free and Coercion Free Mental Health Treatment Risking Connection : A Training Curriculum for Working with Survivors of Childhood Abuse ..15 Risking Connection in Faith Communities: A Training Curriculum for Faith Leaders Supporting trauma Survivors ..16 The Sanctuary model ..17 Women and Addiction: A Gender-Responsive Approach ..20 trauma - informed Service Models for 23 Domestic Violence Group Intervention ..23 Economic Success in Recovery ..23 trauma informed Addictions Group Intervention ..24 trauma Issues Associated with HIV Infection: A Group Intervention ..24 trauma -Specific Service Models for 27 Addictions and trauma Recovery Integration model (ATRIUM).

6 29 The Associative Skills model : Taking Charge of Change; The Trouble with Feelings; and Boundaries, Precious Boundaries ..30 Beyond trauma : A Healing Journey for Women ..31 Cognitive- behavioral Treatment for PTSD Among People with Severe Mental Eye Movement Desensitization and Reprocessing (EMDR) ..33 Growing Beyond Survival: A Self Help Toolkit for Managing Traumatic Helping Women Recover (HWR ): A Program for Treating Individual Cognitive- behavioral Treatment for PTSD in People with Severe Mental Integrated Substance Abuse Mental Health and trauma Treatment with Women: A Case Study Workbook for Staff Managing Traumatic Stress through Art: Drawing from the Center ..38 Prolonged Exposure (PE) The PTSD Psychoeducation Program for People with Severe Mental Illness ..40 Restoring Hope and Trust: An Illustrated Guide to Mastering Seeking Safety ..41 Spirituality and Recovery Curriculum.

7 42 Spirituality in trauma Recovery Group ..43 Symptom-Specific Group Therapy (SSGT) for Complex Post Traumatic Stress Disorder (CPTSD) ..43 trauma Affect Regulation: Guide for Education and Treatment (TARGET ) ..45 trauma , Addictions, Mental health And Recovery (TAMAR) trauma Treatment Group model ..46 trauma Recovery and Empowerment model (TREM) ..47 trauma Recovery and Empowerment Profile (TREP) and Menu of Strategies for Improving a Woman s trauma Recovery and Empowerment Profile ..49 The trauma Recovery Group: Group Cognitive- behavioral Treatment for PTSD in People with Severe Mental Illness ..49 trauma Resiliency model (TRM) ..50 trauma Safety Drop-In Group: A Clinical model of Group Treatment for Survivors of Models for developing trauma - informed behavioral Health Systems and trauma -Specific Services iii TRIAD Women s Group A Woman's Path to Recovery (Based on A Woman's Addiction Workbook).

8 52 Manualized Adaptations of trauma -Specific Service Models for 55 Cultural and Linguistic Adaptation and Expansion of trauma Recovery and Empowerment model : An Introduction to trauma Issues for Women on Inpatient or Short-Stay Men s trauma Recovery and Empowerment model (M-TREM): A Clinician s Guide to Working with Male trauma Survivors in Groups ..56 Models for developing trauma - informed Service Systems and Organizations: 59 Child Adult Relationship Enhancement (CARE) ..59 Child Development Community Policing Program (CD-CP)..60 Preventing Child Abuse Within Youth Serving Organizations: Getting Started on Policies and Stewards of Children: Adults Protecting Children from trauma informed Organizational Self trauma Systems Therapy (TST)..65 trauma -Specific Models for Impact of Early trauma on Parenting Nurturing Program for Families in Substance Abuse Treatment and Recovery, 2nd edition.

9 67 Parenting at a Distance ..68 Pathways to Family Reunification and Recovery (Caminos Para la Reunificacion y la Recuperacion): An educational group curriculum for women in Strengthening Multi-Ethnic Families and Communities: A Violence Prevention Parent Training Program ..69 trauma -Specific Service Models for Children and Family/ 71 Alternatives for Families: a Cognitive behavioral Therapy (AF-CBT) (Formerly Abuse-Focused Cognitive behavioral Therapy) Attachment, Self-Regulation, and Competency (ARC): A Comprehensive Framework for Intervention with Complexly Traumatized Youth ..74 Child-Parent Psychotherapy (CPP) ..74 Combined Parent-Child Cognitive behavioral Therapy: Empowering Families At-Risk for Physical Abuse to Develop Healthy Outlooks and Positive Environments ..75 International Family Adult and Child Enhancement Services (IFACES): A Comprehensive Service model for Refugee Children.

10 76 Parent-Child Interaction Therapy (PCIT)..77 Safety, Mentoring, Advocacy, Recovery, and Treatment (SMART)..79 trauma Focused Cognitive behavioral Therapy (TF-CBT) for Children and Parents; Cognitive behavioral Therapy for Childhood Traumatic Grief (CBT-CTG); Combined TF-CBT and Sertraline for Children ..80 trauma Systems Therapy ..81 trauma -Specific Service Models for 83 Assessment-Based Treatment for Traumatized Children: A trauma Assessment Pathway model (TAP) ..84 Cognitive behavioral Therapy for Childhood Traumatic Grief (CBT-CTG) ..86 Complex trauma Cognitive behavioral Culturally Modified trauma -Focused Treatment (CM-TFT) ..87 Group Intervention for Children of Mothers with Co-occurring Mental Health and Substance Abuse Disorders and Histories of Interpersonal Integrative Treatment of Complex trauma (ITCT) for Children and Adolescents ..88 Life Skills/Life Story ..89 Love and Life: trauma Recovery and Empowerment for Adolescent Girls and Young Women Ages 12-18 (G-TREM): A Clinician s Guide for Working with Adolescent Girls in Groups.