Trauma Specific & Trauma Informed Models
What is Trauma-Informed, Gender-Responsive Care?
Which Trauma Model Should I Use
Psychological trauma refers to extreme stress that overwhelms an individual’s ability to cope. This can be caused by experiences such as violence, hate crimes, sexual abuse, and other traumatic events. High rates of trauma are often linked with an increase of substance use, mental health problems, disease, violence, abuse, and suicide.
Trauma-specific programs specifically treat trauma. Other models may not primarily treat trauma but still discuss trauma. We call these trauma-informed models. For example, a substance abuse group that addresses the impact of trauma on using alcohol would be trauma-informed.
Trauma models may use a combination of treatment strategies such as present-focused (coping skills, psychoeducational, symptoms management) or past-focused approaches (discussing the trauma story). For short term treatment, often present-focused approaches are more appropriate while past-focused approaches may be best used with those at a more stable time in their recovery.
Many groups that address trauma are all male or all female because they have encountered physical or sexual abuse differently. Curriculums that address gender differences among trauma are called gender-responsive. Research on women and trauma suggests that women are more than twice as likely to develop Post Traumatic Stress Disorder (PTSD), more likely to experience sexual assault, and are more likely to be harmed by a partner or lover rather than an enemy or stranger (www.ptsd.va.gov, 2013) (Kendall-Tackett, 2005). Other gender differences that affect care can include stigma for mothers and women, child care, financial stability, and criminal backgrounds.
It is important when you are looking for treatment or a model to know:
Whether you are looking for treatment in a group or as an individual
Whether you need treatment for trauma, trauma and mental health, trauma and substance use, or both (co-occurring)
If the service or group you’re seeking is designed for men, women, or is specific to the Lesbian, Bisexual, Gay, Transgender, Questioning, Intersex (LGBTQI) community
Some curricula were designed to be used with only men or women, for example Helping Women Recover
Curriculum may not be designed for one gender, for example Seeking Safety, but group participants are often the same gender because men and women often experience and discuss trauma such as sexual abuse or violence in very different ways.
Healing Trauma or Beyond Trauma- by Stephanie Covington with Eileen M. Russo is a manualized curriculum for women’s treatment groups and developed for use in residential, outpatient, correctional, domestic violence programs and mental health clinics that treat trauma, however, substance abuse is integrated throughout the curriculum. The curriculum includes psycho-educational aspects that teach about trauma and coping skills. This is a shorter 5 session version of Beyond Trauma. (More information can be found at www.stephaniecovington.com )
TREM - Trauma Recovery and Empowerment Model is a group intervention designed by Community Connections for women with histories of sexual and physical abuse. Drawing on cognitive restructuring, psychoeducational and skill building the 33 topics emphasizes coping skills and social support. It addresses short-term and long-term consequences of violence victimization, mental health, PTSD, depression and substance abuse. Led by trained women clinicians, each session takes about 75 minutes. It can be adapted for shorter-term residential and outpatient settings. (More information can be found www.communityconnectionsdc.org )
M-TREM - by Community Connections is a group intervention based on TREM but adapted for male trauma survivors. (More information can be found www.communityconnectionsdc.org )
EMDR - Eye Movement Desensitization and Reprocessing - developed by Francine Shapiro, is a psychotherapy that involves using rapid eye movement to reduce anxiety while recalling traumatic events to help with the treatment of PTSD. Treatment involves eight phases and three main concentrations: past memories, present disturbances, and future actions. No studies have been done with clients in substance abuse treatment. Training in EMDR is required for practitioners. (More information can be found www.emdr.com/)
Helping Women Recover: A Program for Treating Substance Abuse - is a manual-driven treatment by Stephanie Covington to reduce substance use for women. The trauma-informed treatment sessions are delivered by female staff. The curriculum uses a strengths-based approach with a focus on personal safety to help clients develop effective coping skills, build healthy relationships that foster growth, and develop a strong, positive interpersonal support network. The sessions use cognitive behavioral skills training, mindfulness meditation, experiential therapies psychoeducation, and relational techniques to understand the different forms of trauma, typical reactions to abuse, and how a history of victimization interacts with substance use. (More information can be found at www.stephaniecovington.com )
Helping Men Recover - by Stephanie Covington, Rick Dauer, and Dan Griffin, Helping Men Recover is a gender-responsive, trauma-informed treatment program for men. The facilitator guide and workbook are an ideal resource for drug and alcohol counselors, mental health professionals, and program administrators for outpatient, residential, and community-based treatment centers. The guide contains the theory, structure, and content needed to run effective groups. The participant's workbook is designed so that men can process, record, and refer back to their therapeutic experience. The program model is organized into four modules: self, relationships, sexuality, and spirituality. (More information can be found at www.stephaniecovington.com )
TARGET by Julian Ford is a strengths-based approach to education and therapy for trauma survivors who are looking for a practical approach to recovery. The goal is to help trauma survivors to understand how trauma changes the body and brain's normal stress response and to learn a practical 7-step approach called FREEDOM (focus, recognize triggers, emotion self-check, evaluate thoughts, define goals, options, and make a contribution) to changing the PTSD alarm response into a positive approach to personal and relational empowerment that promotes real and lasting recovery from trauma. TARGET can be delivered in gender-specific or educational/support groups, individual or family basis. (More information can be found www.ptsdfreedom.org )
Seeking Safety - by Lisa Najavits is a present-focused therapy to help people attain safety from trauma/PTSD and substance abuse. The treatment was designed for flexible use. It has been conducted in group and individual format; for women, men, and mixed-gender; using all 25 topics or fewer topics; in a variety of settings and for both substance abuse and dependence. It has also been used with people who have a trauma history, but do not meet criteria for PTSD. Seeking Safety consists of 25 topics and is available in several languages and a blind and/or dyslexic versions are available. Seeking Safety has shown positive outcomes on trauma symptoms, substance abuse and other domains. (More information can be found www.seekingsafety.org )
Most Common Trauma Specific Models in Connecticut
What is Happening in Connecticut
Many agencies throughout Connecticut are providing trauma treatment groups or individualized treatment. In Connecticut, the Department of Mental Health and Addiction Services (DMHAS) and The Connecticut Women’s Consortium (CWC) chair the Trauma and Gender Practice Improvement Collaborative (TAG Initiative) and promote best practices in trauma-informed, gender-responsive care. In April of 2010, DMHAS adopted a formal Trauma Policy to foster a health care system that employs and practices principles that are trauma sensitive and trauma informed. To see the policy visit www.ct.gov/dmhas/lib/dmhas/policies/chapter6.5.pdf .
The Connecticut Women’s Consortium helps support the TAG Initiative and trauma models through education and training. Many clinicians and therapists are trained in trauma treatment models are available in their biannual training catalog.
In addition, the TAG Initiative has other resources available. The TAG Agency Project is a two-year project where agencies apply and are selected to receive technical assistance and training around trauma-informed, gender-responsive care throught the CWC.