Interventions for Children, Youth & Their Caregivers

Complex Trauma Interventions for Children, Youth & Their Caregivers

Attachment, Regulation & Competency (ARC)

Are you ready to shift from a focus on reducing symptoms of posttraumatic stress to promote future resiliency with a flexible framework that addresses important childhood competencies negatively impacted by trauma?

What sets intervention apart:

ARC is a component-based intervention developed to support youth and their caregiving systems move beyond survival-based coping toward an empowered, future-oriented engagement in the world.

ARC is designed to be applied flexibly, as both an individual level clinical intervention and as an organizational framework that can be used in a wide variety of systems-- for example, schools, family shelters and daycare centers-- to guide trauma-informed care.

ARC is organized around three primary domains of intervention with eight underlying treatment targets. Focus is given to strengthening the caregiving system by supporting:

• parents,
• providers and
• others who care for or mentor youth

to manage their personal reactions to challenging youth behaviors, enhance their own resources and support systems, and build more effective responses to youth.

ARC is based on the realization that difficulties regulating feelings, thoughts and physical sensations that stem from experiences of complex trauma underlie many of the challenges seen in youth referred to services, such as problematic behaviors and emotional outbursts.

ARC helps youth and their adult supports:

• cultivate increased awareness of self and others,
• develop the capacity to tolerate and manage experiences, and
• build skills and tolerance for relational connections.

ARC moves beyond a traditional therapy focus on symptom reduction to promote future resilience by:

• increasing opportunities for choice and empowerment,
• exploring self and identity within clients, and
• building coherence through the development of a narrative around life experiences.

Woven throughout ARC is an emphasis on promoting three strategies with adult caregivers:

• psychoeducation to increase understanding of youth behaviors and needs;
• engagement to increase adult motivation to undertake this often challenging work, maintain hopefulness, recognize progress, and keep sight of what is most important; and
• routines to increase consistency and predictability for youth and to provide structure for youth and their caregiving system to put more effective ways of coping and communication into regular practice.

Population served:

ARC was developed for children, adolescents, and their caregiving systems. ARC is adaptable with caregiver goals designed to translate across different caregiving systems including:

• primary (biological, kin and foster families),
• milieu (residential, group home), and
• organizational systems of care.

Due to its adaptability, ARC is offered in a variety of settings. ARC has also been used extensively with youth with:

• developmental or cognitive impairment,
• transitional-aged youth,
• young mothers and their children in family shelters and group homes, and
• adults struggling with trauma and addictions.

Given its component-based structure and complex trauma focus, intervention length varies depending on setting and treatment goals. Outpatient ARC therapy is typically six months or more in length.

Dyadic Developmental Psychotherapy (DDP)

Are you interested in enhancing your child’s sense of safety and promoting healthy attachment by learning trauma-informed ways of relating to and engaging with each other?

What sets this intervention apart:

DDP is a two-phased treatment intervention aimed at supporting children in developing and maintaining attachment-based relationships with their parents or primary caregivers.

DDP uses the caregiver-child dyad as the foundation for healing. Prior to engaging the child in treatment, the therapist provides education about trauma-informed parenting to set the foundation for healthy dyadic interactions.

The PACE technique supports a child’s sense of safety by:

• emphasizing playfulness in communication and interactions,
• acceptance of the child’s present state of being,
• non-judgmental curiosity about the child’s experience, and
• empathy.

The therapist helps model and guide the adult in dyadic sessions to assist the child with managing their emotions through:

• co-regulation and regulation techniques,
• creating a coherent narrative of life experiences, and
• enhancing interpersonal skills.

Throughout treatment the caregiver is aided by the therapist to support the child in exploring and processing themes that may emerge, such as loss or abandonment.

Population served:

DDP was initially developed for children birth to five and their foster or adoptive parents. DDP, however, can serve young children and any form of caregiving system, which can include but is not limited to:

• kin,
• biological family,
• foster family, and
• adoptive family.

DDP is offered through outpatient treatment centers and private practice settings.

Real Life Heroes

Has the child in your care struggled to make sense of and cope with past experiences? Are you seeking a creative, playful treatment intervention that targets the core components of complex trauma to assist families in learning, healing, and growing together?

What sets this intervention apart:

Real Life Heroes supports a shared journey for caregivers and children toward one primary goal: healing and recovery.

Real Life Heroes is resiliency-focused, using the metaphor of a hero’s journey to build on the innate strength of clients and their caretakers who have overcome overwhelming adversity to restore hope and develop trust in an emotionally supportive relationship.

Real Life Heroes uses immersive activities such as:

• creative arts,
• music, and
• movement-based techniques

to accentuate the natural strengths of clients, provide education and awareness of trauma’s impact, and provide opportunities to practice new perspective taking and regulation skills.

Real Life Heroes uses teamwork and collaboration within each activity to:

• repair or build trust between child and caregiver,
• enhance sense of safety, and
• promote attunement within the relationship

to set the foundation needed to integrate trauma memories into a coherent life narrative. Clients are empowered to create a three-chapter life story:

• moving through painful memories,
• making sense of trauma and life adversity, and
• incorporating recognition of client strengths and positive family experiences to construct a meaningful, future oriented narrative.

Population served:

Real Life Heroes targets youth six to 19 years old and their caregiver(s).

Caregivers can be any adult in a meaningful relationship with the child such as:

• biological family members,
• adoptive or foster families,
• residential caretakers, and
• long-term adult connections such as
  • coaches,
  • mentors or
  • clergy.

Real Life Heroes has a standard, 12-session intervention that can be offered in a variety of settings and provided individually or in a group format.

Sensory Motor Arousal Regulation Therapy (SMART)

Would a child in your care benefit from increasing feelings of safety and regulation through active movement and present focused play?

What sets this intervention apart:

SMART is a bottom-up intervention acknowledging a person’s need to improve somatic or body-based regulation capacities in order to access the cognitive functioning and emotional stability required for processing trauma.

Complex trauma impacts a person biologically and cognitively. In children, this can often present as a:

• lack of balance or coordination,
• difficulties with attention and focus,
• problems with sensory integration or overstimulation,
• poor behavioral control, and
• challenges safely expressing emotions.

Drawing on occupational therapy techniques, SMART incorporates sensory and tactile equipment into a comprehensive complex trauma intervention framework. Through sensorimotor, movement and play activities, and with emphasis on repetition and mastery building, clinicians assist clients in:

• creating an awareness of feelings and sensations,
• establishing safety,
• building natural and healthy ways of tolerating and modulating levels of arousal,
• restoring natural body rhythms, and
• engaging in present experiences.

When serving children and their caregivers, SMART enhances attunement and provides opportunities for reciprocity and connection, supporting the attachment system as a protective factor.

SMART was the first somatic regulation-focused intervention to be recognized as an evidence-based practice in the United States.

Population served:

SMART serves children and youth aged two to 21. SMART can be delivered individually or for children and their caregiver(s). SMART is often provided in outpatient or residential treatment settings but has also been adapted for use in home-based therapy and daycare settings.