Child and Adolescent Trauma Treatment and Training Institute


 

Child Adolescent Trauma Treatment Training Institute

The Child and Adolescent Trauma Treatment and Training Institute (CATTTI) is a multidisciplinary, University-Community collaboration housed at the University of Kentucky's Center on Trauma and Children. CATTTI has been a member of the National Child Traumatic Stress Network (NCTSN) since 2007.   

The mission of CATTTI is to facilitate child and family recovery from psychological trauma through statewide service delivery, and to increase the capacity of the mental health community to provide services that are empirically-based and culturally relevant. This mission is undertaken in partnership with the Cabinet for Health and Family Services, the judiciary and community stakeholders. This project builds on an already nationally-recognized child assessment and treatment center in Kentucky, and is the clinical nucleus for clinical training and dissemination of trauma-informed evidence-based practices (TI-EBPs).

In addition to providing training and dissemination of TI-EBPs throughout the state, the CATTTI project provides trauma assessments and numerous interventions appropriate for youth ages 3-18, including Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Trauma Affect Regulation: Guide for Education and Therapy (TARGET), Parent Child Interaction Therapy (PCIT), Child and Family Traumatic Stress Intervention (CFTSI), and Trauma Informed Parenting Skills 4 Resource Parents (TIPS 4 RP). These interventions were selected due to the exposure profile of at-risk children in the state, the majority of whom are suffering from exposure to interpersonal (e.g. child maltreatment), family and community based violence. A more in-depth description of each trauma-informed intervention is provided below.

The CATTTI clinic also works with Clinical Associates throughout the state. These Clinical Associates are trained using a Breakthrough Collaborative Model and are regional partners in the delivery of clinical services to underserved areas of the State. These Clinical Associates provide a reciprocal service to UK CTAC by functioning as colleagues, referral sources, and "best practices ambassadors" in Kentucky, thereby positively influencing the project's effectiveness across the state. These formal and personal links are promising for ongoing dissemination and intellectual investment in the provision of trauma-informed care.

Trauma-Informed Interventions Available

Trauma-focused Cognitive Behavioral Therapy (TF-CBT)

TF-CBT is a phase-based trauma-focused intervention appropriate for youth ages 3-18 who are experiencing traumatic-stress related symptoms. TF-CBT uses gradual exposure to distressing thoughts and feelings connected to traumatic events and focuses on building coping skills to manage stressful emotional content, decrease avoidance, address negative alterations in cognition and mood, and reduce levels of arousal and reactivity. The intervention also facilitates the processing of traumatic and negative life events and any related cognitions and emotions. Caregivers are considered an important part of treatment and are included in sessions so that they can help youth to practice acquired skills at home, develop trauma-informed parenting skills, and support the emotional well-being of their child. TF-CBT is supported by a robust empirical base that has demonstrated its ability to decrease traumatic-stress related symptoms in trauma-exposed youth. TF-CBT uses the PRACTICE acronym to outline the components of treatment:

Psychoeducation and Parenting Skills

Relaxation

Affect expression and modulation  

Cognitive coping and processing I and II

Trauma Narrative

In Vivo mastery of trauma reminders

Conjoint caregiver-child sessions

Enhancing safety and future development

Trauma Affect Regulation: Guide for Education and Therapy (TARGET)

TARGET is a phase-based trauma-focused treatment for school-aged youth and families that can be delivered in an individual, family, or group format. TARGET was developed for youth who have experienced complex trauma, and is particularly appropriate for youth who struggle with daily stressors and affect regulation. TARGET provides a 7 step sequence of skills—the FREEDOM steps—that are designed to help youth understand and gain greater control of trauma- and stress-related reactions that may be triggered by daily life stressors. The FREEDOM steps were developed around the following components:

Focus

Recognize triggers

Emotion self-check

Evaluate thoughts

Define goals

Options

Make a contribution

Parent Child Interaction Therapy (PCIT)

PCIT is an evidence-based treatment model that is a combination of play therapy and behavioral therapy for children, 2-12 years of age, and their parents or caregivers.  PCIT is designed to promote a positive parent-child relationship while reducing disruptive behaviors. Children and their caregivers are seen together in PCIT.

PCIT teaches caregivers play-therapy skills to improve the parent-child interactions, and problem-solving skills to manage maladaptive and challenging behaviors.  Parents are taught and practice communication skills and behavior management with their children in a playroom while being coached by a therapist. These skills are summarized by the PRIDE acronym:

Praise appropriate behavior

Reflect appropriate talk

Imitate appropriate play

Describe appropriate behavior

Enthusiasm

When practiced consistently, these skills and techniques can instill more confidence, reduce anger and aggression, and encourage better individual and interactive behavior in both the caregiver and child. The goals of PCIT are supported by research that indicates when PCIT is successfully completed there is an improvement in the quality of the parent-child relationship, a decrease in child behavior problems with an increase in prosocial behaviors, an increase in parenting skills (including positive discipline), and a decrease in parenting stress. Overall, PCIT can help improve family dynamics by working to reduce negative behavior and interactions within the family as well as improving communication and positive interactions.  

Child and Family Traumatic Stress Intervention (CFTSI)

CFTSI is an evidence-based, short-term therapy for children and adolescents, 7-18 years old, who were exposed to, experienced, or disclosed a potentially traumatic event within the past 30 days. The goal of CFTSI is to decrease post-traumatic stress reactions and the onset of Post-Traumatic Stress Disorder (PTSD).  Potentially traumatic events might include: physical abuse, sexual abuse, domestic violence, bullying, severe neglect, death of a significant person.

Prevention of PTSD is addressed through increasing communication between the child and their caregivers about feelings, symptoms, and behaviors associated with the potentially traumatic event thereby increasing caregiver support of the child. Also, the caregivers and child are provided with specific behavioral skills to help in coping with traumatic stress-related symptoms.

As an evidence-based early intervention, CFTSI fills the gap between standardized acute interventions and evidence-based, longer-term treatment required to deal with on-going post-traumatic stress-related reactions.

Trauma-Informed Parenting Skills 4 Resource Parents (TIPS 4 RP)

TIPS 4 RP is a phase-based intervention for resource parents caring for trauma-exposed youth that is currently in the development and piloting phase. The intervention rests upon the premise that caregivers—and their relationship with the child—is often the most productive vehicle for healing and change. TIPS 4 RP has four key learning components:

  1. Trauma Awareness
  2. Interpersonal Relationships Matter
  3. Positive Parenting to Increase Adaptive Child Coping
  4. Safety as the Context for Healing and Recovery.

The intervention grew out of the Caring for Children Who Have Experienced Trauma: A Workshop for Resource Parents curriculum developed by the NCTSN. TIPS 4 RP is appropriate for any resource parent—a relative, foster or foster-adoptive caregiver—and caregivers may be new or experienced in their role. TIPS 4 RP may be delivered to multiple adult caregivers in the family, or to a single caregiver who may share the information with others.  This intervention can serve as a follow-up to Caring for Children Who Have Experienced Trauma: A Workshop for Resource Parents, but that course is not required for participation in TIPS 4 RP. 

TIPS 4 RP is appropriate to address caregiver needs for children of any age who are placed in out of home care. The intervention may be used with children who have a history of any type of trauma exposure, and is particularly relevant for children who may have experienced familial maltreatment and the consequent effects on attachment relationships.  TIPS 4 RP may be provided regardless of the child’s current engagement in mental health treatment services, including those that include caregivers in the treatment as TIPS 4 RP will be congruent with other trauma informed interventions for children.  Children and adolescents who are engaged in treatment should continue with that intervention—TIPS 4 RP is not necessarily a replacement for other trauma-focused interventions.  TIPS 4 RP is also appropriate for caregivers of children with a range of mental health concerns and is not predicated on any particular diagnosis of the child. 

CATTTI Referral Form