NRCAC supports evidenced-based treatment for child abuse victims and their non-offending family members. Quality mental health services are critical for the long term well-being and healing of children victimized by abuse. NRCAC is happy to provide information on the different evidenced-based treatment modalities and trainings offered. Please find some online resources and research for your review.
How Cac's Are Healing Kids, NCA Member Survey, 2016
NCA/NRCAC Mental Health Brochures
- Evidence Based Mental Health Treatments for Child Abuse Victims
- Ensuring Well Being of Children; A Comprehensive Approach to Trauma-Informed Care for CACs
- Helping your Child Heal from Abuse
California Evidence-Based Clearinghouse for Child Welfare (CBEC)
The mission of the California Evidence-Based Clearinghouse for Child Welfare (CEBC) is to advance the effective implementation of evidence-based practices for children and families involved with the child welfare system.
Children's Advocacy Center Directors' Guide to Quality Mental Healthcare
Children’s Advocacy Center (CAC) directors working to meet the National Children’s Alliance (NCA) Accreditation Standard for mental health need a resource to help them on their journey to deliver the highest quality care to children and families. Especially for non-clinicians, ensuring that mental health services meet the necessary quality threshold can be challenging. How do you make the decision to offer mental health services provided through linkage agreements, or in-house? How do you monitor the quality of mental health services when you’re not in the room? What’s the difference between screening and assessment? How do these guide service provision decisions and treatment? To help answer these questions, the NCTSN and NCA have developed a web-based training resource comprising ten modules geared to help non-clinicians understand, evaluate, and manage mental health service delivery for CACs. Each module contains an easy-to-understand overview of the topic, expert interviews that further drill down into the material, and links to practical tools and resources.
National Child Traumatic Stress Network Empirically Supported Treatments and Promising Practices
The fact sheets linked from this page offer descriptive summaries of some of the clinical treatments, mental health interventions, and other trauma-informed service approaches that the National Child Traumatic Stress Network (NCTSN) and its various centers have developed and/or implemented as a means of promoting the Network’s mission of raising the standard of care for traumatized youth and families. This list does not present a comprehensive list of all relevant interventions developed and available for treating child traumatic stress.
Substance Abuse and Mental Health Services Administration (SAMHSA) National Registry of Evidence-based Programs and Practices
NREPP is a searchable online registry of more than 400 substance use and mental health interventions. NREPP was developed to help the public learn more about evidence-based interventions that are available for implementation. NREPP does not endorse or approve interventions.
EVIDENCE BASED PROGRAMS
Alternatives for Families: A Cognitive Behavioral Therapy
Alternatives for Families: A Cognitive Behavioral Therapy (AF-CBT; Kolko et al. 2011) was developed for caregivers and children ages 6-adolescence who have a history of caregiver physical abuse or coercive parenting practices. Two randomized trials have shown it to be superior to routine community care for reducing children’s conduct and oppositional behaviors, as well as in reducing internalizing symptoms. Further, parents who receive AF-CBT demonstrate significantly greater decreases in the use of physical discipline and in anger at post-treatment as compared to those in routine community care. AF-CBT differs from TF-CBT in that it was developed specifically for families with histories of physical abuse and that it frequently includes the caregiver who engaged in physical abuse.
Parent-Child Interaction Therapy
Parent-Child Interaction Therapy (PCIT; Eyberg 2005) was developed for caregivers and children ages 2-7 who have disruptive behavior disorders. PCIT is an excellent treatment option for young children with predominantly externalizing symptoms. Over 50 randomized controlled trials support the effectiveness of PCIT in reducing parent stress levels and children’s behavioral problems in children with or without histories of maltreatment. PCIT has been used for children and caregivers with a history of physical abuse and has shown to be effective in lowering both caregiver abuse and risk for further abuse to occur.
Trauma-Focused Cognitive Behavioral Therapy
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT; Cohen, Mannarino & Deblinger, 2006) has the highest evidence base in reducing children’s internalizing symptoms and has been shown to have moderate effectiveness in reducing children’s externalizing symptoms. In randomized trials, TF-CBT has been directly compared and found to be more effective than routine community care, nondirective supportive therapy and child-centered therapy. TF-CBT is appropriate for children ages 3-18 and their non-offending caregivers. It was first developed for children with histories of sexual abuse or of witnessing domestic violence, and has been extended for use with children with related trauma symptoms.
Attachment, Regulation and Competency
The Attachment, Regulation and Competency (ARC) Framework is a flexible, components-based intervention developed for children and adolescents who have experienced complex trauma, along with their caregiving systems. ARC’s foundation is built upon four key areas of study: normative childhood development, traumatic stress, attachment, and risk and resilience. Drawing from these areas, ARC identifies important childhood skills and competencies which are routinely shown to be negatively affected by traumatic stress and by attachment disruptions, and which – when addressed – predict resilient outcome.
Child and Family Traumatic Stress Intervention
Child and Family Traumatic Stress Intervention (CFTSI: Berkowitz, Stover, & Marans, 2010) was developed specifically for children in the acute (45 days or less) time frame after a traumatic event occurred. It has shown to be helpful in preventing the development of PTSD.
Child Parent Psychotherapy
Child Parent Psychotherapy (Lieberman & Van Horn, 2004) is a treatment for young children (ages 0-5) and their caregivers. It has been shown to reduce externalizing symptoms and PTSD in children who have witnessed domestic violence.
Eye Movement Desensitization and Reprocessing
Eye Movement Desensitization and Reprocessing (EMDR; Shapiro, 2001), was originally developed for adults, and has now been used with children. To date, research has shown that for children who have experienced disasters or accidents (such as car accidents); EMDR is equally as effective as cognitive behavioral therapy. In one sample group, EMDR has also been shown to reduce PTSD symptoms in children ages 6-16 with histories of maltreatment.
Problematic Sexual Behavior Cognitive Behavioral Therapy for School Age Children
The Problematic Sexual Behavior Cognitive Behavioral Therapy for School Age Children is a treatment program is a family-oriented, cognitive-behavioral, psychoeducational, and supportive treatment group designed to reduce or eliminate incidents of problematic sexual behavior. This program is implemented by trainers at Oklahoma University Center on Child Abuse and Neglect (CCAN).
Prolonged Exposure for Adolescents
Prolonged Exposure for Adolescents (Foa et al., 2013) is a well-established treatment for adult PTSD, which recently has been applied to adolescents (ages 13-18) with histories of sexual abuse or assault, and shown to be more effective in reducing PTSD than supportive counseling. Prolonged exposure differs from TF-CBT in that it includes less of a focus on developing coping skills, and has an increased focus on processing trauma memories.
Risk Reduction through Family Therapy
Risk Reduction through Family Therapy (RRFT; Danielson, 2010 ) takes a systems-based approach to reducing negative outcomes among sexually abused adolescents. RRFT has been shown to reduce adolescent girls’ internalizing symptoms (including PTSD), while reducing the potential for risky behaviors. RRFT is unique from other treatments for child maltreatment victims in that it includes, and specifically targets, high risk behaviors such as substance abuse. Children with these types of problems are typically excluded from studies on other treatments.
- Trauma Symptom Checklist for Children (TSCC)
- Trauma Symptom Checklist for Young Children (TSCYC)
- Child Sexual Behavior Inventory (CSBI)
- Mood and Feelings Questionnaire (MFQ)
- Child PTSD Symptom Scale (CPSS)
- Strengths and Difficulties Questionnaire (SDQ)
- UCLA PTSD Reaction Index
PAR is a publisher of psychological assessment materials including TSCC and TSCYC.
YOUTH WITH PROBLEMATIC SEXUAL BEHAVIOR
- Problematic Sexual Behavior Fact Sheet – CACs; Where we Begin
- Problematic Sexual Behavior Fact Sheet – Caregivers; What Happens Now
- Problematic Sexual Behavior Fact Sheet – Overview; What we Can Do
Trauma-Informed Child Welfare Practice, Winter 2013
Consideration of childhood trauma from a complex trauma framework invites a subtle but pivotal paradigm shift: from the traditional premise that “traumatic stress” derives from exposure to one or more events that lead to specific manifestations of distress which in turn compromise certain aspects of a child’s otherwise normative functioning, to the recognition that under certain circumstances the fundamental elements of a child’s daily life can be characterized by violations so egregious or deficits so severe that these become primary determining factors shaping a child’s foundational capacities and overall development. Cumulative exposure to trauma exponentially increases the likelihood of revictimization. In turn, maladaptive coping strategies developed in effort to survive experiences overwhelming to the child—including running away, self- harm, aggression or substance abuse—can evolve into direct or vicarious traumatic experiences in and of themselves for the child, their caregiving system, and secondary victims. These patterns of trauma exposure, coping deficits, illness, and retraumatization form the building blocks of intergenerational trauma. As prevention, detection and response to precisely these deleterious childhood adversities is, for better or worse, its unique purview, the child welfare system seeking to become truly trauma-informed cannot afford to overlook complex trauma. After all, it has always been the heart of the matter.
SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach
Trauma is a widespread, harmful and costly public health problem. It occurs as a result of violence, abuse, neglect, loss, disaster, war and other emotionally harmful experiences. Trauma has no boundaries with regard to age, gender, socioeconomic status, race, ethnicity, geography or sexual orientation. It is an almost universal experience of people with mental and substance use disorders. The need to address trauma is increasingly viewed as an important component of effective behavioral health service delivery. Additionally, it has become evident that addressing trauma requires a multi-pronged, multi-agency public health approach inclusive of public education and awareness, prevention and early identification, and effective trauma-specific assessment and treatment.
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