National Child Traumatic Stress Network Empirically Supported Treatments and Promising Practices

The fact sheets linked from this page describe some of the clinical treatment and trauma-informed service approaches implemented by National Child Traumatic Stress Network centers, with the common goal of reducing the impact of exposure to traumatic events on children and adolescents.

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Page Contents:

How the Fact Sheets Were Developed

These fact sheets were developed as part of the NCTSN Trauma-Informed Interventions: Clinical and Research Evidence and Culture-Specific Information Project, a joint venture undertaken by the NCTSN and the National Crime Victims Research and Treatment Center at the Medical University of South Carolina. This project aims to evaluate the extent to which clinical and research evidence exists to support the use of trauma-informed treatment interventions with diverse cultural groups (as defined by such factors as race, ethnicity, sexual orientation, socioeconomic status, spirituality, disability, and geography).

These documents were produced in close consultation with the developer of each treatment or service approach, and they replace a similar set of fact sheets developed by the NCTSN in 2005. The new materials below include more up-to-date information, and the previous emphasis on published research findings is balanced by more detailed information pertaining to culturally-relevant features of each intervention. In cases in which the fact sheets were not updated for NCTSN Trauma-Informed Interventions: Clinical and Research Evidence and Culture-Specific Information Project, we continue to list the original fact sheets below.

How to Use the Fact Sheets

The approaches described in the fact sheets are interventions being implemented by centers within the National Child Traumatic Stress Network. Please note that these interventions do not represent all relevant practices available for treating child traumatic stress. Where appropriate, sites searching for an intervention that is most relevant for their population(s) should consider additional interventions beyond those summarized here.

In recognition of the diverse needs of the child and adolescent populations served by NCTSN sites across the country, the interventions and treatments listed below span a continuum of evidence-based interventions, ranging from rigorously evaluated interventions to promising practices and newly emerging practices. Readers should review and consider these practices based not only on their levels of evidence but also on their appropriateness for a given community and target population, training requirements, feasibility of adoption and implementation, and potential for sustainability. Readers are encouraged to gather additional information on adoption readiness through discussions with the treatment developers and other sites that are implementing the practices.

The needs, values, and preferences of a provider's service population should also influence the type of intervention needed. Factors to consider include:

Prevalence of types of trauma and traumatic bereavement to which the population(s) is exposed
Associated types and rates of mental distress and associated behavioral and functional impairment
Cultural background(s) 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
Setting in which services are offered (school, residential, clinic, home)

Core Components of Interventions

Many existing trauma-focused interventions overlap in their content and approaches. These areas of overlap are termed "core components." Providers are encouraged to consider (1) whether and how specific interventions include desired intervention components, (2) how, if included, these components are carried out (e.g., specific skills-acquisition activities, homework, role-play, games), and (3) how well these components "fit" with the specific needs and preferences of the population the agency serves. For example, does the intervention emphasize acquiring the appropriate coping skills? If so, are the activities in which skills are acquired appropriate for the developmental level, cultural background, and geography of the population served? Interventions that do not include needed core components may be inappropriate for the population, or may at least require substantial adaptation in order to be considered appropriate. Examples of core components might include:

Screening and triage
Systematic assessment, case conceptualization, and treatment planning
Psycho-education
Addressing children and families' traumatic stress reactions and experiences
Trauma narration and organization
Enhancing emotional regulation and anxiety management skills
Facilitating adaptive coping and maintaining adaptive routines
Parenting skills and behavior management
Promoting adaptive developmental progression
Addressing grief and loss
Promoting safety skills
Relapse prevention
Evaluation of treatment response and effectiveness
Engagement/addressing barriers to service-seeking

Intervention Descriptions

Click on each intervention to download a detailed fact sheet that provides a description of the intervention as well as where to obtain additional information. Interventions are listed in alphabetical order.

Name of Intervention	Targeted Populations	Modality	Culture-Specific Fact Sheet
Adapted Dialectical Behavior Therapy for Special Populations (DBT-SP) [1] (2012) (PDF)	8-21; both males and females; for youth experiencing a wide range of traumas	individual	Yes [2]
Alternatives for Families - A Cognitive Behavioral Therapy (AF-CBT) [3](2012) (PDF)	School-age children; for youth experiencing a wide range of traumas	individual, family	Yes [4]
Assessment-Based Treatment for Traumatized Children: Trauma Assessment Pathway (TAP) [5] (2012) (PDF)	0-18; both males and females; for children who have experienced a wide range of traumas	individual, family, systems	Yes [6]
Attachment and Biobehavioral Catch-up (ABC) [7](2012) (PDF)	Birth – 24 months; both males and females; for low-income families who have experienced neglect, abuse, domestic violence, placement instability	individual, family	No
Attachment, Self-Regulation, and Competence (ARC): A Comprehensive Framework for Intervention with Complexly Traumatized Youth [8](2012) (PDF)	2-21; both males and females; for children, caregivers, and systems that have experienced a wide range of traumas	individual, family, systems	Yes [9]
Child Adult Relationship Enhancement (CARE) [10] (2008) (PDF)	Children of all ages and their caregivers; both males and females	family, systems	Yes [11]
Child and Family Traumatic Stress Intervention (CFTSI) [12] (2012) (PDF)	7-18; both males and females; for parents and children who may have complex trauma histories	individual, family, systems	No
Child Development-Community Policing Program [13] (2007) (PDF)	0-18+; both males and females; for children and families in the aftermath of crime and violence.	individual, family, systems	No
Child-Parent Psychotherapy [14] (CPP) [14] (2012) (PDF)	0-6; both males and females; for youth who have experienced a wide range of traumas and parents with chronic trauma	individual, family, systems	Yes [15]
Cognitive Behavioral Intervention for Trauma in Schools (CBITS) [16](2012) (PDF)	10-15; both males and females; for children who have experienced a wide range of traumas	individual, family, systems	Yes [17]
Combined Parent Child Cognitive-Behavioral Approach for Children and Families At-Risk for Child Physical Abuse (CPC-CBT) [18] (2009) (PDF)	4-17; both male and female; for families with a history of physical abuse and inappropriate physical discipline/coercive parenting strategies	individual, group, family	Yes [19]
Combined TF-CBT and SSRI Treatment [20](2007) (PDF)	10-18; females	individual, family	No
COPE - Community Outreach Program - Esperanza [21] (2007) (PDF)	4-18; both males and females; for traumatized children who are presenting with behavior or social-emotional problems	individual, family	No
Culturally Modified Trauma-Focused Treatment (CM-TFT) [22](2008) (PDF)	4-18; both males and females; Latino/Hispanic; for youth who have experienced a wide range of traumas	individual, family	Yes [23]
Family Advocate Program [24](2005) (PDF)	18-70; both males and females; for youth who present with anxiety, depression, PTSD symptoms, and/or traumatic loss	family	No
Forensically-Sensitive Therapy [25](2005) (PDF)	4-17; predominantly female; for youth presenting problems ranging from anxiety and depression to risk-taking behaviors and functional impairment. Program is designed for a mental health clinic.	individual, family	No
Group Treatment for Children Affected by Domestic Violence [26] (2007) (PDF)	5-no upper limit; both males and females; for children and their nonoffending parents who have been exposed to DV	group, family, systems	No
Honoring Children, Making Relatives [27](2007) (PDF)	3-7; both males and females; for American Indian and Alaska Native children	individual, family	No
Honoring Children, Mending the Circle [28](2007) (PDF)	3-18; both males and females; for American Indian and Alaska Native children	individual	No
Honoring Children, Respectful Ways [29](2007) (PDF)	3-12; both males and females; for American Indian and Alaska Native children	individual	No
Integrative Treatment of Complex Trauma (ITCT-C, ITCT-A) [30] (2008) (PDF)	2-21; both males and females; for Hispanic-American, African-American, Caucasian, Asian-American; for youth who may have complex trauma histories	individual, family, systems	Yes [31]
International Family Adult and Child Enhancement Services (IFACES) [32](2012) (PDF)	6-12; both males and females; for refugee and immigrant children who have experienced trauma as a result of war or displacement	individual	Yes [33]
Parent-Child Interaction Therapy (PCIT) [34](2008) (PDF)	2-12; both males and females	individual, family, systems	Yes [35]
Psychological First Aid (PFA) [36] (2012) (PDF)	0-120; both males and females; for individuals immediately following disasters, terrorism, and other emergencies	individual	Yes [37]
Real Life Heroes (RLH) [38] (2012) (PDF)	6-12, plus adolescents (13-19) with delays in social, emotional or cognitive functioning; both males and females; for children who have experienced a wide range of traumas	individual, family, systems	Yes [39]
Safe Harbor Program [40](2007) (PDF)	6-21; both males and females; provided in schools for children and adolescents exposed to trauma and violence who may present with a range of problems and symptoms	individual, group, family, systems	No
Safety, Mentoring, Advocacy, Recovery, and Treatment (SMART) [41] (2012) (PDF)	3-11; both males and females; to date the model has been effectively used with primarily African-American children; majority of families are low income	individual, family, systems	No
Sanctuary Model [42] (2008) (PDF)	4-no upper limit; both males and females; evidence-supported template for system change based on the active creation and maintenance of a nonviolent, democratic, productive community to help people heal from trauma	systems	Yes [43]
Sanctuary Model Plus (IRIS Project) [44](2005) (PDF)	Children and adolescents placed in residential treatment centers and their families	group, systems	No
Skills for Psychological Recovery (SPR) [45](2012) (PDF)	5-120; both males and females	individual, family	Yes [46]
Skills Training in Affective and Interpersonal Regulation/Narrative Story-Telling (STAIR/NST) [47] (2005) (PDF)	12-21; for females who have experienced sexual/physical abuse and a range of additional traumas, including community violence, domestic violence, and sexual assault	individuals, group	No
Southeast Asian Teen Village [48] (2005) (PDF)	adolescents; females, Southeast Asian (mostly Hmong)	group	No
Streetwork Project [49] (2007) (PDF)	13-23; both males and females; harm reduction program good with a wide variety of ethnic/racial groups, religious group, and the LGBTQ community	individuals, group, system	No
Strengthening Family Coping Resources [50] (SFCR) (2008) (PDF)	0-no upper limit; both males and females; for families experiencing economic hardship	family	No
Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS) [51](2012) (PDF)	12-21; both males and females; for adolescents with Complex Trauma, e.g. adolescents exposed to chronic interpersonal trauma (such as ongoing physical abuse) and/or separate types of trauma (e.g. community violence, sexual assault).	group	Yes [52]
Trauma Adapted Family Connections (TA-FC) [53] (2012) (PDF)	0-18; both males and females; who reside in the household; families experiencing complex development trauma, at risk of neglect	individual, family, group	No
Trauma Affect Regulation: Guidelines for Education and Therapy (TARGET) [54] (2012) (PDF)	10-18+; both males and females; for children and caregivers experiencing traumatic stress; very frequently with single parents or with families whose children have limited contact with biological parents (e.g., foster kids, residential placements), and diversity of religious affiliations	individual, group, family, systems	Yes [55]
Trauma and Grief Component Therapy for Adolescents (TGCT) [56] (2008) (PDF)	12-20; both males and females; for trauma-exposed or traumatically bereaved older children and adolescents	individual, group, family, systems	Yes [57]
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) [58] (2012) (PDF)	3-21; both males and females; for children with Posttraumatic Stress Disorder (PTSD) or other problems related to traumatic life experiences, and their parents or primary caregivers	individual, family	Yes [59]
Trauma-Focused Coping in Schools (TFC) (AKA: Multimodality Trauma Treatment Trauma-Focused Coping-MMTT) [60] (2012) (PDF)	6-18; both males and females; for children exposed to single incident trauma and targets posttraumatic stress disorder (PTSD) and collateral symptoms of depression, anxiety, anger, and external locus of control	individual, group	Yes [61]
Trauma-Informed Organizational Self-Assessment [62] (2008) (PDF)	6-19; both males and females; for children who have experienced a wide range of traumas	individual, family, systems	Yes [63]
Trauma Systems Therapy (TST) [64] (2008) (PDF)	6-19; both males and females; for youth who have experienced a wide range of traumas	systems	Yes [63]