The National Child Traumatic Stress Network (NCTSN) and its various centers have developed and implemented a range of clinical treatments, mental health interventions, and other trauma-informed service approaches as a means of promoting the Network’s mission of raising the standard of care for traumatized youth and families.
Individuals who wish to know the evidence supporting an intervention may search online databases such as the National Registry of Evidence-Based Programs and Practices (NREPP) and the California Evidence-Based Clearinghouse for Child Welfare (CEBC). These websites offer a rigorous review of interventions—and the evidence supporting them—for a variety of child and adolescent mental health problems. Those searching for an intervention to best match the needs of the populations they serve are encouraged to consider other interventions than those summarized here.
Three Types of Fact Sheets
Intervention Fact Sheets include basic descriptive information about the intervention, the target population for which it was developed, essential components, and a summary of research evidence.
For some interventions, additional fact sheets are also available:
- Culture-specific Fact Sheets describe how the intervention engages children and families from diverse populations and has been successfully modified for use with different groups.
- Training Guidelines describe minimum training requirements, including preparation and case completion requirements, as well as prerequisites needed to supervise or train on the intervention
How to Use the Fact Sheets
- Consider not only the levels and types of evidence that support the use of the intervention in general, but also its appropriateness for a given community and target population. For example, does it address the types of trauma and losses that are prevalent within that population? Does it address their typical consequences, such as mental distress, functional impairment, risky behavior, or developmental disruption?
- More generally, the needs, values, available resources, demographic characteristics, and informed preferences of a provider's service population also influence the type of intervention needed. Factors to consider include these:
- Local culture and values of the clientele and the surrounding community
- Developmental factors, including age, cognitive, and social domains
- Socioeconomic factors
- Logistical and other barriers to help-seeking
- Availability of individual/family/community strength-based resources that can be therapeutically leveraged
- Setting in which services are offered (school, residential, clinic, home)
- Also consider such factors as training requirements, feasibility of adoption and implementation, and potential for sustainability. Readers should gather additional information on adoption readiness through discussions with the treatment developers and other sites that have implemented the practices.
- The NCTSN has developed a position statement on Prerequisite Clinical Competencies for Implementing Effective, Trauma-informed Intervention that agency leaders, clinicians, trainers, and others can use to guide optimal service provision to children and families affected by trauma. This statement delineates the clinical knowledge and skills recommended prior to training in or implementing an evidence-based treatment (EBT) both within and outside of the NCTSN.
Core Components of Interventions
Many existing trauma-focused interventions overlap in their content and approaches. These areas of overlap are termed “core components.” Core components can be conceptualized as intervention objectives (what the therapist intends to achieve by intervening) or practice elements (actions the therapist undertakes toward achieving the intervention objective). Providers should consider whether a given intervention targets the desired intervention objectives (outcomes valued by the clients), and whether the practice elements used in the intervention can be realistically implemented by the therapist. Taken together, clinicians should evaluate both intervention objectives and practice elements in terms of their "fit" with the specific needs and preferences of the population the agency serves. Interventions that do not include needed core components may be inappropriate for the population or may require substantial adaptation.
The core components of trauma-focused interventions include:
- Motivational interviewing (to engage clients)
- Risk screening (to identify high-risk clients)
- Triage to different levels and types of intervention (to match clients to the interventions that will most likely benefit them/they need)
- Systematic assessment, case conceptualization, and treatment planning (to tailor intervention to the needs, strengths, circumstances, and wishes of individual clients)
- Engagement/addressing barriers to service-seeking (to ensure clients receive an adequate dosage of treatment in order to make sufficient therapeutic gains)
- Psychoeducation about trauma reminders and loss reminders (to strengthen coping skills)
- Psychoeducation about posttraumatic stress reactions and grief reactions (to strengthen coping skills)
- Teaching emotional regulation skills (to strengthen coping skills)
- Maintaining adaptive routines (to promote positive adjustment at home and at school)
- Parenting skills and behavior management (to improve parent-child relationships and to improve child behavior)
- Constructing a trauma narrative (to reduce posttraumatic stress reactions)
- Teaching safety skills (to promote safety)
- Advocacy on behalf of the client (to improve client support and functioning at school, in the juvenile justice system, and so forth)
- Teaching relapse prevention skills (to maintain treatment gains over time)
- Monitoring client progress/response during treatment (to detect and correct insufficient therapeutic gains in timely ways)
- Evaluating treatment effectiveness (to ensure that treatment produces changes that matter to clients and other stakeholders, such as the court system)