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Research findings suggest that one in four children in the United States are exposed to at least one potentially traumatic event by age sixteen; and, many experience multiple or repeated traumas (Costello, Erkanli, Frank & Angold, 2002). Given the prevalence of childhood trauma, social work students need to learn effective treatment interventions for working with children and families impacted by trauma. In 2010, Simmons School of Social Work joined a collaborative effort between Fordham University Graduate School of Social Service and Hunter College School of Social Work to “build workforce capacity by increasing the ability of schools of social work to provide trauma-informed education and training” (Katz, 2010).
This initiative is spearheaded by the National Center for Social Work Trauma Education and Workforce Development, a member of the National Child Traumatic Stress Network (NCTSN). It is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). As a partner in the coalition of social work schools, Simmons School of Social Work created the Trauma Project in 2010 to implement the Center’s program for training students to treat childhood trauma.
The goal of the Simmons School of Social Work’s Trauma Project is to train MSW students and their field instructors in one of two evidence-based interventions, either the Child Parent Psychotherapy (CPP) method, or the Attachment, Self-Regulation and Competency (ARC) method. The CPP model focuses on the effect of trauma on the relationship between young children and their families or caregivers. The model attends to complex trauma and to variables such as the families’ cultural and spiritual beliefs and values, immigration experiences and parenting practices (The National Child Traumatic Stress Network, 2008).The ARC model, originated by Blaustein and Kinniburgh, is a framework for intervention with youth and families/caregivers that have experienced multiple and/or prolonged traumatic stress. ARC identifies three core domains–attachment, self-regulation and competency–that are frequently disrupted among traumatized youth. (The Trauma Center, 2007).
The first step to implementing the Trauma Project was the adaptation by the Director of the MSW program of a standardized syllabus developed by the National Child Traumatic Stress Network. The new syllabus was used as the framework to teach a course titled, “A Cased-Based Approach to Learning Treatment of Trauma with Child & Adolescents.” The course was offered as an advanced elective. The course introduced students to evidence-based methods of child trauma treatment through a case-based approach to learning. The main focus of case-based learning is to foster self-directed learning. The course was organized around five “ill-structured” cases, and students were divided into teams. The teams were initially given pieces of case information, with questions to answer through dialogue, readings and a literature search. After the teams debriefed their initial understanding of the cases, they were given additional information about the cases, invited to reconsider initial conclusions and to seek to answer newly surfaced questions. An additional requirement of the course was the completion of an online course on trauma-focused cognitive behavioral therapy.
Students gave positive feedback about the way that the course encouraged participation and fostered critical thinking. One student evaluated the course by stating,
The course provided me with an introduction to trauma work and new knowledge of materials used in the treatment of complex traumatic stress disorder. It also helped me to effectively develop strategies, supported by compelling evidence, to work with families of diverse backgrounds. The impact of this course served as an excellent exposure to the work I would be expected to carry out in my field placement. I felt confident with the understanding of treatment options I offered to the children and families recovering from traumatic events in their lives.
The second step was the recruitment of field instructors and agencies to participate in the training. In their manual, The “Upstream Model” Field Implementation Guide (Katz, 2010), the Center provided detailed instructions about how to effectively recruit field instructors. The coordinator of the Trauma Project, who holds a faculty position in the field department in the MSW Program at Simmons, contacted fifty field instructors who expressed an interest in participating. To participate, field instructors were expected to attend a two- or three-day training and to have monthly consultation calls with the trainer. They also agreed to carry a caseload of at least two clients who could receive the trauma-informed treatment the supervisors were learning. In addition, they were also expected to supervise a second-year social work intern the year following the training. Another major determinant of a field instructor’s ability to join the project was the availability of appropriate clients for the intern(s). Implementation of the training project required that interns treat child or adolescent clients for weekly sessions over the nine month field placement. Agencies that could not meet this requirement were screened out.
Twenty of the fifty supervisors contacted by the school qualified to be field instructors for the Trauma Project. Those field instructors were offered training in one of the two models. Not surprisingly, the CPP method appealed to only seven of the field instructors because few Simmons’ placement agencies treat toddlers and preschoolers. The ARC method was chosen by thirteen field instructors. The field instructors gave positive, preliminary feedback about the workshops. One field instructor was particularly enthusiastic about the ARC method’s attention to ten “building blocks”: caregivers affect management, attunement, consistent response and routines/rituals as part of Attachment; affect identification, modulation and expression under Self-Regulation; and developmental tasks, executive functions and self-development under Competency. She said, “Thinking about my clients in the context of the blocks breaks down their very complicated experiences into manageable chunks.” After the field instructors attended the training sessions, they participated in conference calls with the trainer. The trainer and field instructors decided to increase the frequency of the calls to twice a month. These calls have continued for the purpose of supporting the field instructors’ ability to teach the method to their students.
The third step was recruitment of students to participate in the Trauma Project. The project coordinator and the director of the MSW Program held two information sessions for potential interns in which they introduced the project and outlined the requirements for the project in addition to the trauma course: participation in two or three days of trauma treatment training, and treating at least two children using the method. After the information sessions, the coordinator conducted individual interviews with twenty-five prospective students. Those who did not opt to join the project gave several reasons: the time commitment was too great, they did not want the available agencies as a placement and/or they realized that trauma work was not appropriate for them. Three agencies did not think the intern was an appropriate match. In the end, eighteen students were matched with agencies.
The cohort of eighteen students is presently being trained, and the Center will evaluate the outcomes of the training from the perspective of the student and field instructor. The Trauma Project has proven its worth to the Simmons School of Social Work in many ways. The syllabus offered by the National Child Traumatic Stress Network fostered the development of the case-based learning approach, which promoted self-directed and collaborative learning about trauma. The Trauma Project strengthened the alliance between the School and its affiliated agencies by offering needed training to field instructors–training which presented evidence-informed models of trauma practice and encouraged integration of theory and practice in supervision. Most importantly, social work students are learning to apply evidence-informed theories in the field in a way that also encourages initiative and critical thinking. With proper funding, the Trauma Project will surely succeed in its mission to develop a trauma-trained workforce of graduating social workers.
Blaustein, Margaret E., & Kinniburgh, Kristine M. (2010). Treating Traumatic Stress in Children and Adolescents: How to Foster Resilience Through Attachment, Self-Regulation, and Competency. New York: The Guilford Press.
Costello, E., Erkanli, A., Fairbank, J. A., & Angold, A. (2002). The Prevalence of Potentially Traumatic Events in Childhood and Adolescence. Journal of Traumatic Stress, 15(2), 99. Retrieved from EBSCOhost.
Katz, Laura. (2010). The “Upstream Model” Field Implementation Guide. New York: National Center for Social Work Trauma Education and Workforce Development. Unpublished manuscript.
National Child Traumatic Stress Network. (2008). CPP: Child-Parent Psychotherapy. In Trauma-Informed Interventions. Retrieved from http://www.nctsn.org/content/treatments-children-and-families
The Trauma Center. (2007). Attachment, Self-Regulation and Competency (ARC) Clinical Services. Retrieved from http://www.traumacenter.org/research/ascot.php