Attachment B: Trauma Treatment Models for Child-Serving Resident.pdf

ATTACHMENT B

Trauma Treatment Models for Child-Serving Residential Providers

This resource has been developed to assist QRTPs in implementing a trauma-informed treatment model for the population the facility serves and that addresses the youth’s clinical needs. This resource will also help SCDSS staff assessing applications for QRTP certification and in monitoring the implementation of the selected trauma-treatment.

Intervention/Program Name Brief Description Additional Information and Criteria

Acceptance & Commitment Therapy (ACT)

CEBH- Well supported by research evidence-medium child welfare relevance

NCTSN- not listed

Empirically based psychological intervention that uses acceptance and mindfulness strategies, together with commitment and behavior change strategies to increase psychological flexibility.

Psychological flexibility means contacting the present moment fully as a conscious human being, and based on what the situation affords, changing or persisting in behavior in the service of chosen values. Through metaphor, paradox, and experiential exercises clients learn how to make healthy contact with thoughts, feelings, memories, and physical sensations that have been feared and avoided. Clients gain the skills to recontextualize and accept these private events, develop greater clarity about personal values, and commit to needed behavior change.

There is no ACT certification process. ACBS, as a community, has decided to forego this, as it could create a hierarchical and closed process which would be antithetical to our values. Rather, we aim to foster an open, self-critical, mutually supportive community which, working together, builds a progressive psychology more adequate to the challenges of human suffering. There is no such thing as an officially certified ACT therapist.

ACT does not require certification. In fact, it defines itself as a psychological intervention. As such it can be utilized by those with a license (as a treatment modality) and those without a license (as an intervention).

There are two basic ways to begin learning about ACT: Reading up on it on your own or seeking out a community in which to network and broaden and deepen your knowledge of ACT

Recommended Intensity:

There is no recommended intensity. The number, frequency, and length of sessions can vary depending on the needs of the client or the practice of the treatment provider.

Recommended Duration:

There is no recommended duration. The overall duration of the intervention can vary depending on the needs of the client or the practice of the treatment provider.

Because individuals can read up on their own, see the following website for recommended readings and resources:

14 Must-Read Acceptance & Commitment Therapy Books (positivepsychology.com)

• Get Out of Your Mind and into Your Life;

Steven Hayes, PhD; New Harbinger Publications; 1st edition (November 1, 2005)

• ACT Made Simple: An Easy-to-Read Primer on Acceptance and Commitment Therapy;

Russ Harris; New Harbinger Publications;

2nd edition (2019)

• Acceptance and Commitment Therapy, Second Edition: The Process and Practice of Mindful Change; Steven Hayes, Kirk Strosahl, and Kelly Wilson; Guilford Press (2012)

There are no pre-implementation materials to measure organizational or provider readiness for Acceptance and Commitment Therapy (ACT).

Mandated state licensure to deliver psychotherapeutic services is required to become trained as an ACT therapist

Peer reviewed trainers are available and available through the Association for Contextual Behavior Science. Reviewed trainers are listed at:

Find an ACT Trainer | Association for Contextual Behavioral Science (contextualscience.org) https://positivepsychology.com/acceptance-and-commitment-therapy-books/ https://positivepsychology.com/acceptance-and-commitment-therapy-books/ https://contextualscience.org/civicrm/profile?gid=20&reset=1&force=1 https://contextualscience.org/civicrm/profile?gid=20&reset=1&force=1

Proof of training completion; core competencies experiential training workshops; accredited Acceptance and Commitment Therapy (ACT) training courses.

ACT Certification | Association for Contextual Behavioral Science (contextualscience.org)

ARC: Attachment, Self-Regulation, and Competency: A Comprehensive Framework for Intervention with Complexly Traumatized Youth

CEBCH- not able to be rated – high relevance to child welfare

NCTNS

Framework is designed to be adaptable to needs and real-life circumstances of clients (i.e., identifying culturally relevant caregiver supports, working with appropriate members of family or kinship system).

Framework specifically targets the child’s surrounding system (caregivers(s), treatment system, community). The approach is grounded in attachment theory and early childhood development and addresses how a child’s entire system of care can become trauma informed to better support trauma focused therapy. The approach provides a framework for both trauma informed and trauma specific therapeutic intervention.

Dependent on individualized implementation and modality. The number of sessions can range from 12 to greater than 52 sessions. ARC has multiple modalities including individual, group and family treatment; parent workshops; milieu/systems intervention; and a new home-based prevention program.

Prerequisite/Minimum Provider Qualifications

Integration of ARC into clinical intervention requires the appropriate education/licensure/certification of the provider in their profession.

Recommended Intensity:

Varies dependent on client and type of setting; the number of sessions can range from 12 to greater than 52 sessions.

Recommended Duration:

Varies dependent on client and type of setting

The standard foundational training is 2 days;

training in the in-home caregiver coaching curriculum is 3 days. The minimum suggested follow-up consultation is 12 hours or one year (1-2 hours/month) for clinical implementation.

Additional consultation to support development of infrastructure, supervisory skills and supports, and ongoing internal training is helpful and often recommended, depending on agency size/structure.

Proof of training; Designated lead ARC trainers/consultants; agency-specific supervisors https://contextualscience.org/act_certification https://contextualscience.org/act_certification and/or administrators; if/as appropriate, learning community colleagues

Implementation manual arc_fact_sheet.pdf (nctsn.org)

Child and Family Traumatic Stress Intervention

(CFTSI)

CEBCH – Promising research evidence – high relevance child welfare

NCTSN

Brief early intervention model for children and adolescent that is implemented soon after exposure to a potentially traumatic event or in the wake of disclosure of physical and sexual abuse developed at the Yale Child Study Center. Fills in the gap between acute responses/crisis intervention and evidence based, longer-term treatments designed to address traumatic stress symptoms and disorders that have become established. Goal of this family-strengthening model is to improve the caregiver’s ability to respond to and support a child who has at least one posttraumatic symptom.

Aims to reduce symptoms and prevent onset of PTSD. It is delivered to children aged 7-18 years, together with their parent or caregiver, after the child has experienced a potentially traumatic event

(PTE).

Children ages 7-18 recently exposed to a potentially traumatic event or having disclosed physical or sexual abuse and endorsing at least one symptom of posttraumatic stress

CFTSI is provided to children and adolescents who have experienced a Potentially Traumatic Event (PTE) within the past 30 days (including disclosure about prior sexual or physical abuse, or other PTEs that have only recently been revealed).

Recommended Intensity:

Session 1: Accomplished in 1-2 meetings each 1 hour in length Session 2a: 1 hour Session 2b: Accomplished in 1-2 meetings each 1 hour in length Session 3: 1 hour Session 4: 1 hour Additional sessions with child, caregiver or dyad are scheduled as necessary

Prerequisite/Minimum Provider Qualifications:

Master’s level trained therapists

Proof of training sessions are appropriate for supervisors and mental health providers with a master’s degree or higher (who will act as the primary CFTSI provider), as well as case managers (who will play a vital role in collaboration with the primary CFTSI provider).

https://www.nctsn.org/sites/default/files/interventions/arc_fact_sheet.pdf

Recommended Duration:

4-6 weeks

This program involves the family or other support systems in the individual’s treatment: Caregivers, including Foster Parents, participate together with the identified child in each CFTSI Session (except for Session 1 when the provider meets only with the caregiver and Session 2a when the provider meets only with the child alone prior to the first family session)

Training offered at a site of the agency choosing; 2 days for 12 total hours

CFTSI is provided by mental health professionals wo have received specialized training in this evidence-based treatment

Implementation manual

Additional information can be found at the Yale Childhood Violent Trauma Center

Child and Family Traumatic Stress Intervention < Child Study Center (yale.edu)

Child-Parent Psychotherapy (CPP)

CEBCH – Supported by research evidence – high child welfare relevance

NCTSN

Child Parent Psychotherapy is an intervention model for children aged 0-5 who have experienced traumatic events and/or are experiencing mental health, attachment, and/or behavioral problems.

The treatment is based in attachment theory but also integrates psychodynamic developmental, trauma, social learning, and cognitive behavioral theories. Therapeutic sessions include the child and parent or primary caregiver. A central goal is to support and strengthen the caregiver-child relationship as a vehicle for restoring and protecting the child’s mental health. Treatment also focuses on contextual factors that may affect the caregiver-child relationship (e.g., cultural norms and socioeconomic and immigration-related stressors). Targets of the intervention include caregivers’ and children’s maladaptive representations of themselves, each other, interactions, and behaviors that interfere with the child’s mental health. For children exposed to trauma, caregiver and child are guided over the course of treatment to create a joint narrative of

Dyadic intervention ages 0-5

The following organizations have conducted independent reviews of the research on CPP, have listed CPP as an evidence-based practice, and have posted summaries on their websites.

• The California Evidence-Based Clearinghouse for Child Welfare:

http://www.cebc4cw.org/program/child-parent-psychotherapy/

• Oregon.gov Addictions and Mental Health Approved Practices and Process:

Oregon Health Authority : Early Childhood Mental Health : Child and Family Behavioral Health : State of Oregon https://medicine.yale.edu/childstudy/services/community-and-schools-programs/yctsr/stress-intervention/ https://medicine.yale.edu/childstudy/services/community-and-schools-programs/yctsr/stress-intervention/ http://www.cebc4cw.org/program/child-parent-psychotherapy/ http://www.cebc4cw.org/program/child-parent-psychotherapy/ https://www.oregon.gov/oha/HSD/BH-Child-Family/Pages/Early-Childhood.aspx https://www.oregon.gov/oha/HSD/BH-Child-Family/Pages/Early-Childhood.aspx https://www.oregon.gov/oha/HSD/BH-Child-Family/Pages/Early-Childhood.aspx the traumatic event and to identify and address traumatic triggers that generate dysregulated behaviors and affect. Treatment is generally conducted by a master’s or doctoral-level therapist and involves weekly hour-long sessions.

Recommended Intensity:

Weekly 1 to 1.5-hour sessions

Recommended Duration:

52 weeks (one year)

Prerequisite/Minimum Provider Qualifications:

Practitioners: Master’s level training

Supervisors: Master’s degree plus minimum of 1-year training in the model

Proof of training; typically training involves an initial 3-day workshop and then quarterly (3 more times in a year) 2-day additional workshops. In addition, training involves bi-monthly telephone-based care consolation of ongoing treatment cases involving children aged 0-5 who have experienced a trauma.

There are several different training models. Training can be arranged through the Child Trauma Research Program by contacting Child Parent Psychotherapy, and may include CPP Agency Mentorship Program (CAMP), endorsed CPP 12-month internships, or through the Learning Collaborative model of the National Child Traumatic Stress Network. In general, training is tailored to the needs of the organization.

Child Parent Psychotherapy

HOME – Child-Parent Psychotherapy (childparentpsychotherapy.com) https://childparentpsychotherapy.com/ https://childparentpsychotherapy.com/

Cognitive Behavioral Therapy (CBT)

CEBCH

NCTSN

Society of Clinical and Adolescent Psychology

Cognitive behavioral therapy (CBT) for children and adolescents usually are short-term treatments (i.e., often between six and 20 sessions) that focus on teaching youth and/or their parents’ specific skills.

CBT differs from other therapy approaches by focusing on the ways that a child or adolescent’s thoughts, emotions, and behaviors are interconnected, and how they each affect one another. Because emotions, thoughts, and behaviors are all linked, CBT approaches allow for therapists to intervene at various points in the cycle. These treatments have been proven to be effective in treating many psychological disorders among children and adolescents, such as anxiety, depression, post-traumatic stress disorder (PTSD), behavior problems, and substance abuse.

Individual CBT solely on the child or adolescent and includes one therapist who teaches the child or adolescent the skills needed to overcome their challenges. This form of CBT has been proven effective in the treatment of child and adolescent depression and anxiety disorders, as well as substance abuse in adolescents. Group CBT includes not only the child or adolescent and therapist in therapy sessions, but also others outside of the child or adolescent’s social groups – usually new acquaintances who are also being treated for the same disorder. Those in the group therapy are often dealing with similar behavior issues and, unlike individual CBT, the group format allows helpful relationships to form, in addition to learning skills needed to change behavior.

Cognitive-behavioral therapy can exist as a distinct therapeutic technique. However, is often paired with other therapeutic approaches. The term “cognitive-behavioral therapy” is very general term for a classification of therapies with similarities.

Training requirements vary depending on additional therapy focus.

There is no licensing body for cognitive behavioral therapists, but most certifying institutes require you to hold a state license in your field of practice.

Before you can apply to a training program in cognitive behavioral therapy, most institutes require you to have a certain number of years of supervised experience providing cognitive therapy.

Person desiring to become cognitive behavioral therapist, must have a minimum of a master’s degree in mental health or a Master’s in a medical-related field

There is no requirement that participants have an active clinical practice, just that they have had training and supervised experience in the basics of counseling or psychotherapy for Clinical Practice of

CBT.

Training and CBT certification is available through the Beck Institute. CBT certification requires a terminal education degree with a behavioral or mental health specialization. This degree should prepare individuals to see clients and practice as a clinician; work /clinical experience; and, professional licensing documentation. Additional requirements can be found at Beck Institute | Home

Beck Institute also offers Beck Institute CBT Certified Master Clinician and Beck Institute Certified Supervisor

Beck Institute:

https://beckinstitute.org/

Collaborative Problem Solving (CPS)

CEBCH – Promising Research Evidence – medium child welfare relevance

NCTSN – not listed

CPS is an approach to understanding and helping children with behavioral challenges who may carry a variety of psychiatric diagnoses, including oppositional defiant disorder, conduct disorder, mood disorders, bipolar disorder, autism spectrum disorders, posttraumatic stress disorder, etc. CPS uses a structured problem-solving process to help adults pursue their expectations while reducing challenging behavior and building helping relationships and thinking skills. Specifically, the CPS approach focuses on teaching the neurocognitive skills that challenging kids lack related to problem solving, flexibility, and frustration tolerance. Unlike traditional models of discipline, this approach avoids the use of power, control, and motivational procedures and instead focuses on teaching at-risk kids the skills they need to succeed. CPS provides a common philosophy, language and process with clear guideposts that can be used across settings. In addition, CPS operationalizes principles of trauma-informed care.

Prerequisite/Minimum Qualifications:

There is no minimum educational requirement to become a provider. For a clinician or educator to become certified in the CPS model, they must participate in a 24-week CPS training program.

There is a manual that describes how to implement this program, and there is training available for this program.

Ranges from a 1-day introductory session to more intensive (2.5 day) advanced sessions as well as hourly coaching:

Introductory training: These in-person and online trainings provide a general overview exposure of the model including the overarching philosophy, the assessment, planning and intervention process.

Training can accommodate an unlimited number of participants.

Services involve Family/Support Structures:

This program involves the family or other support systems in the individual’s treatment: Caregivers in other settings may be involved in the problem-solving process if there are oppositional episodes in those settings.

Two-and-a-half day intensive trainings that provide participants in-depth exposure to all aspects of the model using didactic training, video demonstration, role play and breakout group practice. Tier 1 training is limited to 150 participants. Tier 2 training is limited to 75 participants.

Coaching sessions for up to 12 participants that provide ongoing support and troubleshooting in the model

Typically, family therapy (in which the youth is the identified patient, but the parents are heavily involved in the sessions, so they can get better at using the approach with their child on their own) occurs once per week for approximately 1 hour.

The approach can also be delivered in the home with greater frequency/intensity, such as twice a week for 90 minutes. Parent training group sessions occur once a week for 90 minutes over the course of 4 or 8 weeks. The approach can also be delivered by direct care staff in a treatment setting and/or educators in a school system, in which case delivery is not limited to scheduled sessions but occurs in the context of regular contact in a residence or classroom.

Recommended Duration:

Family therapy: 8-12 weeks; In-home therapy: 8-12 weeks; Parent training groups: 4-8 weeks

Proof of certification/training: certified trainers throughout North America who teach the model as well as systems that use the approach. The list is available at https://thinkkids.org/our-communities

Implementation manuals:

Treatment Manual: Greene, R. W., & Ablon, J.S.

(2005). Treating Explosive Kids: The Collaborative Problem-Solving Approach. Guilford Press.

Clinician Session Guide: Guides the clinician in all aspects of the treatment, from initial assessment to ongoing work. Can be obtained by contacting the Director of Research and Evaluation, Dr. Alisha Pollastri at apollastri@mgh.harvard.edu

CPS Coaching Guide: A guide specifically geared towards trainer individuals who are helping caregivers to implement the model over time.

Available to certified trainers.

Think:Kids provides implementation support in the form of ongoing coaching and fidelity and outcome monitoring.

https://thinkkids.org/our-communities mailto:apollastri@mgh.harvard.edu

Additional information can be found at: Think:Kids : Home (thinkkids.org)

Combined Parent-Child Cognitive Behavioral Therapy (CPC-CBT)

CEBCH – Promising research evidence – high relevance child welfare

NCTSN

Empowering families who are at risk for physical abuse; short-term (16-20 Sessions), strength-based therapy program in families where parents are engaged in a continuum of coercive parenting strategies. Families can include those who have been substantiated for physical abuse, those who have multiple unsubstantiated referrals, and those who fear they may lose control with the child.

Children may present with PTSD symptoms, depression, externalizing behaviors. Helps child heal from the trauma of physical abuse, empowers and motivates parents to modulate their emotions and use effective non-coercive parenting strategies, strengthens parent-child relationships while helping end cycle of violence

CPC-CBT directly provides services to children/adolescents and addresses the following:

• Children’s PTSD, depression, self-esteem, social skills, empathy skills, problem solving and behavioral problems, such as aggression and other acting out behaviors

CPC-CBT directly provides services to parents/caregivers and addresses the following:

• Parental lack of motivation and engagement, depression, anger, self-control, assertiveness, attributions about children’s behavior, empathy for children, positive parenting skills, family relationships, parent-child interactions, and parental trauma history.

This program involves the family or other support systems in the individual’s treatment: All

Children aged 3-17 and their parents/caregivers

Prerequisite/Minimum Qualifications:

Clinicians who implement CPC-CBT should have a master’s degree or higher in one of the mental health professions or be working towards one of these degrees under the supervision of a licensed mental health professional. Given that CPC-CBT is based on cognitive-behavioral principles, it is helpful but not necessary for clinicians to be well grounded in Cognitive-Behavioral Therapy. It is important for clinicians to prepare themselves to work in a supportive, nonjudgmental manner with parents who have harmed their children in some way.

https://thinkkids.org/ https://thinkkids.org/ caregivers, including grandparents, and all siblings are encouraged to participate

Recommended Intensity:

Individual: 900-minute sessions weekly; Group:

120-minute session weekly

Recommended Duration:

16-20 sessions

Proof of training; Varies depending on training program requested. CPC-CBT’s developers are utilizing National Center for Child Traumatic Stress (NCCTS) Learning Collaborative (LC) methodology to enhance the adoption and implementation of CPC- CBT. These are intended to help agencies gain the necessary clinical and implementation competence to incorporate and sustain CPC-CBT as a part of their current practices.

There are three CPC-CBT training options available to organizations. The first two training options listed incorporate LC methodology. The first is more intensive than the second.

The first training option involves a formal Learning Collaborative (LC). A LC consists of pre-work, three 2-day learning sessions spaced over the course of 8 to 12 months with consultation calls in the implementation of CPC-CBT occurring twice per month between the learning sessions.

Agencies may opt for the second training option that incorporates some of the LC methodology but is less intensive. This involves two full days of in-person training on the model which includes role-plays and performance feedback. Because the program is highly structured, ongoing consultation that occurs twice per month for at least one full cycle of therapy is recommended for clinicians as well. Feedback on audiotaped client sessions is highly recommended.

Two days of advanced training is also available after the initial training sessions to address advanced concepts and questions that arise after clinicians have implemented the model with multiple clients.

For agencies that are unsure whether they can commit to the above requirements or who need additional information about CPC-CBT to determine if it is feasible to implement the model, a third CPC- CBT training option is available. This option involves two days of introductory training in the model which includes role-plays and performance feedback, However, agencies should not expect staff to be able to fully implement CPC-CBT after a single training event.

There are pre-implementation materials to measure organizational or provider readiness for Combined Parent-Child Cognitive-Behavioral Therapy (CPC-CBT) as listed below:

A readiness package is provided to interested agencies. Administrators and clinicians are also asked to complete readiness survey through Survey Monkey.

Implementation manual

Additional information can be found at Rowan University, School of Osteopathic Medicine:

CPC-CBT | School of Osteopathic Medicine | Rowan University (rowanmedicine.com) https://centers.rowanmedicine.com/cares/services/mentalhealth/cpc-cbt.html https://centers.rowanmedicine.com/cares/services/mentalhealth/cpc-cbt.html

Dialectical Behavior Therapy – DBT – Adolescents

CEBCH – not listed

NCTSN – not listed

Although Dialectical Behavior Therapy (DBT) was originally developed for use with adults, it has since been adapted and found to be effective with adolescents (ages 12-18). DBT for adolescents includes the same treatment strategies and primary targets as DBT for adults, while also including parents in treatment and targeting difficult behavior patterns common to adolescents and their families. In addition, DBT for adolescents is typically briefer than DBT for adults, lasting 16-24 weeks. DBT for adolescents has been evaluated in randomized clinical trials with teens with repeated suicidal and self-harming behaviors, as well as teens with bipolar disorder.

Participants are expected to be mental health professionals who have attended DBT Intensive or Foundational training, have at least one year of experience delivering DBT, and currently work with pre-adolescent children.

The DBT-C training involves rigorous preparation, training, and homework. The course is deigned to model basic elements of the treatment in an experiential way. Just as DBT-C requires families to make a full commitment to treatment and to attend all sessions, DBT-C training requires participants to attend the entire training, do their best to learn the material, and to participate in a willing, committed manner.

Staff can implement DBT strategies without being certified. Staff are encouraged to attain DBT Certification

The applicant must meet the following education criteria (total minimum of 21 hours of continuing education):

• Complete a minimum of 18 education hours in Dialectical Behavior Training, including 6 hours specific to Dialectical Behavior Therapy skills training.

• Complete a minimum of 3 education hours in Suicide/Risk Assessment and Intervention

The applicant must attest that they have read the following:

• At least 2 practitioner books on the practice of Dialectical Behavior Therapy (i.e., not texts focused on Dialectical

Behavior Therapy skills, but focused on Dialectical Behavior Therapy as a theoretical orientation).

• At least two Dialectical Behavior Therapy Skills training manuals

Proof of certification (2 years); training manual;

implementation manual; recertification is required

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Dialectical Behavior Therapy for Children – DBT-C

CEBCH – not listed

NCTSN – not listed

DBT-C retains the theoretical model, principles, and therapeutic strategies of standard DBT and incorporates almost all of the adult DBT skills and didactics into the curriculum. However, the presentation and packaging of the information are considerably different to accommodate for the developmental and cognitive levels of pre-adolescent children. Further, DBT-C adds an extensive parent training component to the model.

DBT-C teaches parents everything their child learns (e.g., coping skills, problem-solving, didactics on emotions), plus effective contingency management techniques. DBT-C maintains that parental modeling of adaptive behaviors, reinforcement of a child’s skills use, ignoring of maladaptive responses, validation, and acceptance are key to lasting changes in a child’s emotional and behavioral regulation.

Participants are expected to be mental health professionals who have attended DBT Intensive or Foundational training, have at least one year of experience delivering DBT, and currently work with pre-adolescent children.

The DBT-C training involves rigorous preparation, training, and homework. The course is deigned to model basic elements of the treatment in an experiential way. Just as DBT-C requires families to make a full commitment to treatment and to attend all sessions, DBT-C training requires participants to attend the entire training, do their best to learn the material, and to participate in a willing, committed manner.

While there isn’t a set duration for DBT, there is a rough outline that is followed. A full course of dialectical behavior therapy takes around 6 months to complete. There are four main modules in DBT, mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness

The applicant must meet the following education criteria (total minimum of 21 hours of continuing education):

• Complete a minimum of 18 education hours in Dialectical Behavior Training, including 6 hours specific to Dialectical Behavior Therapy skills training.

https://behavioraltech.org/about-us/

• Complete a minimum of 3 education hours in Suicide/Risk Assessment and Intervention

The applicant must attest that they have read the following:

• At least 2 practitioner books on the practice of Dialectical Behavior Therapy (i.e., not texts focused on Dialectical Behavior Therapy skills, but focused on Dialectical Behavior Therapy as a theoretical orientation).

• At least two Dialectical Behavior Therapy Skills training manuals

Proof of certification (2 years); training manual;

implementation manual; recertification is required

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Eye Movement Desensitization and Reprocessing (EMDR) [Trauma Treatment - Client-Level Interventions (Child & Adolescent)]

CEBCH - Well-Supported by Research Evidence – medium child welfare relevance

NCTSN – not listed

EMDR therapy is an 8-phase psychotherapy treatment that was originally designed to alleviate the symptoms of trauma. During the EMDR trauma processing phases, guided by standardized procedures, the client attends to emotionally disturbing material in brief sequential doses that include the client’s beliefs, emotions, and body sensations associated with the traumatic event while simultaneously focusing on an external stimulus. Therapist directed bilateral eye movements are the most used external stimulus, but a variety of other stimuli including hand-tapping and audio bilateral stimulation are often used

This program is typically conducted in a(n):

Community Agency; Hospital; Outpatient Clinic;

Residential Care Facility; School

Prerequisite/Minimum Provider Qualifications

Qualifying individual providers must be either fully licensed mental health professionals or be enrolled in a Master's or Doctorate level program in the mental health field (Social Work, Counseling, Marriage Family Therapy, Psychology, Psychiatry, or Psychiatric Nursing) currently involved in the practicum and/or internship portion of the program they are enrolled in (first year students not eligible) and on a licensing track working under the supervision of a fully licensed mental health professional.

https://behavioraltech.org/about-us/

Usually one 50- or 90-minute session per week

Recommended Duration:

Length of treatment is impossible to predict and is dependent upon the severity of the trauma, etc.

Often major gains are apparent within a few weeks ranging from 3-12 sessions. Length of treatment is dependent on level of dissociation

The basic training consists of two 3-day training modules. In addition, 10 hours of case consultation are required to learn to implement the protocol.

For In-Person Trainings: Participants must complete the entire training (including 10 hours of case consultation) within 24 months from the initial start date.

For Virtual Online Zoom Trainings: Participants must complete the entire training (including 10 hours of case consultation) within 12 months from the initial start date.

Training should be provided by a training organization approved by EMDRIA

Certification is not required for a clinician to practice EMDR therapy. If trained, can use EMDR therapy under one’s professional license. EMDR Certification is an option that many therapists have wanted because of Managed Care concerns and hospital privileges.

To become certified means that you have attained the level of mastery needed to meet the requirements set out by the EMDR International Association (EMDRIA). Becoming a certified EMDR therapist ensures that one is knowledgeable in current research, and one attends advanced trainings and conferences to maintain skill level and certification.

EMDR Institute Welcome to EMDR.com - EMDR Institute - EYE

MOVEMENT DESENSITIZATION AND

REPROCESSING THERAPY

https://www.emdr.com/ https://www.emdr.com/ https://www.emdr.com/

I Feel Better Now! Trauma Intervention Program

CEBCH – Not able to be rated – medium child welfare relevance

NCTSN – not listed

Comprehensive trauma intervention program modified from original SITCAP program; 10-session group program designed specifically for at-risk traumatized children ages 6-12; integrates cognitive strategies with sensory/implicit strategies. Designed to alter the iconic memories of trauma to allow children the opportunity to achieve successful cognitive reordering of their traumatic experiences. Supports victim to survivor thinking and changes in negative behaviors and allows traumatized children to become more resilient

Prerequisite/Minimum Provider Qualifications

Minimum 2-day training from Starr Commonwealth required

Minimum 1-year group experience with elementary school aged children

Supervision provided by a master’s Level Starr Certified Trauma and Loss trainer

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Recommended Intensity:

One 60-minute session per week

Recommended Duration:

Eight to ten sessions in length

Proof of training; implementation manual

I Feel Better Now! Trauma Intervention Program;

William Steele, Pamela Lemerand, Deanne Ginns- Gruenber, Caelan Soma; Publisher, Starr Commonwealth, 1998

I Feel Better Now!

I Feel Better Now! Trauma Intervention Program - Starr Commonwealth

Starr Commonwealth Starr Commonwealth - Driven to Heal https://starr.org/product/i-feel-better-now-program/ https://starr.org/product/i-feel-better-now-program/ https://starr.org/

Integrative Treatment of Complex Trauma for Adolescents - ITCT-A

CEBCH – Not able to be rated – high child welfare relevance

NCTSN – not listed

ITCT-A is a flexible multicomponent therapy for multiply traumatized adolescents and young adults. It involves semi-structured protocols, treatment tools and interventions that are customized to the specific issues, social context, and capabilities of each client. An important component of ITCT-A is tis continuous monitoring of treatment effects over time. This involves initial and periodic psychometric and interview-based evaluation of the adolescent’s symptomology, as well as assessment of their socioeconomic status, culture, ongoing level of support systems and coping skills, family and caretaker relationships, attachment issues and functional self-capacities.

Especially focuses on social and cultural issues.

Attention is paid to the use of culturally appropriate treatment resources, and the focus and context of treatment is adapted to the adolescent’s sociocultural environment.

Unlike most structured trauma treatment approaches for children and adolescents, ITCT-A does not have a pre-established number of sessions to be applied for every client. Instead, therapy may range from several months to year or more, although most clients appear to require an average of approximately six to eight months of treatment.

Prerequisite/Minimum Provider Qualifications

Master’s degree (or equivalent) that includes clinical training in a mental health-related field. This may be in the fields of psychiatry, psychology, social work, marriage and family therapy, counseling, etc.

Trainings are conducted at the USC Adolescent Trauma Training Center in Torrance, CA, onsite at trainee organizations, and at local and national conferences.

Education and Training Resources

There is a manual that describes how to deliver this program, and there is training available for this program.

A national ITCT-A Clinician Certification program is available. There is no cost associated with trainings offered by the USC-ATTC or the Clinician Certification program

Proof of training; proof of certification;

implementation manual

Keck School of Medicine; University of Southern California About ITCT-A | Adolescent Trauma Training Center

(USC-ATTC)

Download ITCT-A Guides and Resources | Adolescent Trauma Training Center (USC-ATTC) https://keck.usc.edu/adolescent-trauma-training-center/about-itcta/ https://keck.usc.edu/adolescent-trauma-training-center/about-itcta/ https://keck.usc.edu/adolescent-trauma-training-center/download-itct-a-guides-and-resources/ https://keck.usc.edu/adolescent-trauma-training-center/download-itct-a-guides-and-resources/

Motivational Interviewing – MI

NCTSN – not listed

Title IV-E Preventions Services Clearinghouse

Motivational Interviewing (MI) is often recommended as an evidence-based approach to behavior change. However, definitions of MI vary widely, including out of date and inaccurate understandings. “MI is a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for and commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion.” (Miller & Rollnick, 2013, p. 29) Key qualities include: MI is a guiding style of communication, that sits between following (good listening) and directing (giving information and advice); designed to empower people to change by drawing out their own meaning, importance and capacity for change; based on a respectful and curious way of being with people that facilitates the natural process of change and honors client autonomy.

Originally designed to support adults coping with substance use issues, MI has since been successfully adapted for other fields as an effective method for engaging non-voluntary or reluctant clients in making positive life changes by exploring and resolving their ambivalence toward change.

The Title IV-E Prevention Services Clearinghouse now rates MI as a “well-supported” program in the category of substance abuse programs and services

There are no minimum qualifications for MI providers. MI can be used by a variety of different professionals. The Motivational Interviewing Network of Trainers (MINT) does not recommend specific trainings. However, they provide online training resources, contact information for MI trainers, and information about public trainings by MINT members.

Proof of training; manual

Training Expectations | Motivational Interviewing Network of Trainers (MINT)

Individual study and self-training; Introduction to MI (1 hour to 1 day); Introduction to MI (Intro workshop 2-3 days)

Intermediate and advanced training (2-3 days); MI Supervisor training ( 2-3 Days)

Miller, W. R., & Rollnick, S. (2012). Motivational Interviewing: Helping people change (3rd ed.).

Guilford Press https://motivationalinterviewing.org/training-expectations https://motivationalinterviewing.org/training-expectations

Welcome to the Motivational Interviewing Website! | Motivational Interviewing Network of Trainers (MINT)

Understanding Motivational Interviewing | Motivational Interviewing Network of Trainers

(MINT)

NM - Neurosequential Model

NCTSN – not listed

The Neurosequential Model is a developmentally informed, biologically respectful approach to working with at-risk children. The Neurosequential Model is not a specific therapeutic technique or intervention; it is a way to organize a child’s history and current functioning. The goal of this approach is to structure assessment of a child, the articulation of the primary problems, identification of key strengths and the application of interventions (educational, enrichment and therapeutic) in a way that will help family, educators, therapists, and related professionals best meet the needs of the child.

Prerequisite/Minimum Provider Qualifications for individual certification:

At least a master’s degree in social sciences or equivalent (e.g., psychology, education, social work, nursing, OT/PT, etc.); A current license (e.g., LPC, LMFT, LMSW, etc.) or similar designation (if outside of US); Current practice working with children, youth, adults, or families; Participation in at least 1 NMT Case-based Training Series (10 sessions). For those who have not completed an NMT Case-based Series but want to enroll in the Certification Program, a Pre-Requisite Series will be added to their training package at no additional cost.

Requirements for the NMT Site Certification Process: Organizations are considered for Site Training Certification if seven or more employees or affiliated professionals are seeking Certification.

The NMN will work with sites to determine whether Individual or Site Training Certification is most appropriate. While the full Site Certification process includes two phases of training, an organization may choose to enter Maintenance after Phase I. No internal training is possible in this case.

https://motivationalinterviewing.org/ https://motivationalinterviewing.org/ https://motivationalinterviewing.org/ https://motivationalinterviewing.org/understanding-motivational-interviewing https://motivationalinterviewing.org/understanding-motivational-interviewing https://motivationalinterviewing.org/understanding-motivational-interviewing

Type 1: NMT Online Training Series NMT Online Courses | NMnetwork (neurosequential.com)

Type 2: NMT Training Certification: Phase I, Phase II & Mentor Certification NMN_SiteCert_Overview_9_2021 (filesusr.com)

Site Certification Process

Organizations are considered for Site Training Certification if seven or more employees or affiliated professionals are seeking Certification.

The NMN will work with sites to determine whether Individual or Site Training Certification is most appropriate. While the full Site Certification process includes two phases of training, an organization may choose to enter Maintenance after Phase I.

Proof of certification

Information can be found at:

NMT | NMnetwork (neurosequential.com)

Parent Child Interaction Therapy

CEBCH - Well supported by research evidence – medium child relevance

NCTSN

Parent-child interaction therapy (PCIT) is an evidence-based behavior parent training treatment for young children with emotional and behavioral disorders that places emphasis on improving the quality of the parent-child relationship and changing parent-child interaction patterns.

Children and their caregivers are seen together in PCIT. Specifically, parents are initially taught relationship enhancement or discipline skills that they are going to be practicing in session and at home with their child. In subsequent sessions, most of the session time is spent coaching caregivers in the application of specific therapy skills.

Based on well-controlled randomized controlled trials, PCIT has been categorized as a probably efficacious treatment for 3- to 6-year-olds with disruptive behavior (Eyberg, Nelson, & Boggs, 2008).

PCIT has been rated as Promising by Blueprints for Healthy Youth Development as a treatment for young children with emotional and behavioral problems. The Parent-Child Interaction Therapy – Blueprints for Healthy Youth Development (blueprintsprograms.org) for PCIT lists additional information about PCIT including a Fact Sheet, https://www.neurosequential.com/nmt-online https://www.neurosequential.com/nmt-online https://8968bc28-f174-409f-949e-5f60ff828648.filesusr.com/ugd/3edded_cec3a203d6a94f23bd081411bb43c90c.pdf https://www.neurosequential.com/nmt https://www.blueprintsprograms.org/parent-child-interaction-therapy/ https://www.blueprintsprograms.org/parent-child-interaction-therapy/ https://www.blueprintsprograms.org/parent-child-interaction-therapy/

PCIT outcome research has demonstrated statistically and clinically significant improvements in the conduct-disordered behavior of preschool age children: after treatment, children’s behavior is within the normal range. Studies have documented the superiority of PCIT to wait list controls and to parent group didactic training. In addition to significant changes on parent ratings and observational measures of children’s behavior problems, outcome studies have demonstrated important changes in the interactional style of the fathers and mothers in play situations with their children.

Program Costs, Funding Strategies, and a Detailed Evaluation Abstract.

In terms of the use of PCIT for a child welfare population, there is a nice review of the literature from Parent-Child Interaction Therapy With At-Risk Families (pcit.org)

Prerequisite/Minimum Provider Qualifications:

A firm understanding of behavioral principles and adequate prior training in cognitive-behavior therapy, child behavior therapy, and therapy process skills (e.g., facilitative listening) is required.

For training in this treatment protocol outside an established graduate clinical training program, the equivalent of a master's degree and licensure as a mental health provider is required.

It is recommended that the 40 hours of intensive skills training be followed by completion of two supervised cases prior to independent practice. For within program supervisors, it is recommended that they complete a minimum of 4 prior cases and complete a within program trainer training.

Recommended Intensity:

One or two 1-hour sessions per week with the therapist

Recommended Duration:

The average number of sessions is 14 but varies from 10 to 20 sessions. Treatment continues until the parent masters the interaction skills to pre-set

Training Type/Location:

On-site and off-site

Number of days/hours:

5 days for a total of 40 hours; follow-up consultation through the completion of two cases

Proof of training; implementation manual http://www.pcit.org/uploads/6/3/6/1/63612365/pcit_overview_child_welfare.pdf http://www.pcit.org/uploads/6/3/6/1/63612365/pcit_overview_child_welfare.pdf criteria and the child's behavior has improved to within normal limits.

PCIT International Find a Trainer (pcit.org)

Psychological First Aid

CEBCH – not able to be rated – medium relevance child welfare

NCTSN

PFA is an evidenced-informed intervention designed to be put into place immediately following disasters, terrorism, and other emergencies, and has received wide usage worldwide. PFA is comprised of eight core helping actions: contact and engagement, safety and comfort, stabilization, information gathering, practical assistance, connection with social supports, information on coping support, and linkage with collaborative services

Disasters, terrorism, and acute trauma, post-disaster adversity, displacement

PFA online includes a 6-hour interactive course

Proof of training; implementation manual

National Childhood Traumatic Stress Network (NCTSN) – currently, all NCTSN Learning Center courses for CEs are FREE. Users must register with NCTSN Learning Center NCTSN Learning Center for Child and Adolescent Trauma: Log in to the site

Mental Health Preparedness - Training - Johns Hopkins Public Health Preparedness Programs - Johns Hopkins Bloomberg School of Public Health (jhsph.edu)

Sanctuary Model

CEBCH – promising research evidence – medium child welfare relevance

NCTSN

The aims of the Sanctuary Model are to guide an organization in the development of a trauma-informed culture with seven dominant characteristics all of which serve goals related to recovery from trauma spectrum disorders while creating a safe environment for clients, families, staff, and administrators with measurable goals:

Culture of Nonviolence; Culture of Emotional Intelligence; Culture of Inquiry & Social Learning;

Culture of Shared Governance; Culture of Open Communication; Culture of Social Responsibility;

and, Culture of Growth and Change

Sanctuary implementation is typically a three-year process

Prerequisite/Minimum Provider Qualifications: The minimum qualifications for an organization to participate are a fundamental readiness to engage in trauma-informed practices at the organizational level to include a trauma component in their work or to complement and enhance other trauma specific treatment interventions. The resources for implementation vary by organization, but should include release time for employee training and core http://www.pcit.org/find-a-trainer.html https://learn.nctsn.org/login/index.php https://learn.nctsn.org/login/index.php https://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-center-for-public-health-preparedness/training/online/mental-health-trainings.html https://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-center-for-public-health-preparedness/training/online/mental-health-trainings.html https://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-center-for-public-health-preparedness/training/online/mental-health-trainings.html…