Real Life Heroes (RHL)
Type of Approach:
Provider Education Level:
RLH is a structured curriculum, based on cognitive behavioral therapy models, designed to treat posttraumatic stress disorder (PTSD) in school-age youth. RHL has developed an activities-based workbook that uses creative arts and life story work that integrates a child’s family and cultural heritage. RLH engages children and caring adults to rebuild attachments, build the skills and interpersonal resources needed to reintegrate painful memories, foster healing, and restore hope.
Variety of settings that range from home-based family interventions to mental health clinics to residential treatment. RHL has been used in child welfare programs and with children who have had multiple placements.
Length of program/number of sessions:
6 to 18 months of weekly therapy sessions; length varies depending on client’s needs
Type(s) of trauma/concerns addressed:
Physical abuse, sexual abuse, neglect, exposure to domestic violence, abandonment, disasters, terrorism or war; RHL is noted as being especially relevant for complex trauma.
Type of service provider:
Psychologists and social workers with Master’s level degrees
Activities and tools drawn on a child’s and families’ strengths, community resources, cultural heritage and stories of overcoming adversity, faith, ties to religious organizations, and spirituality.
The RLH model assists therapists and family members to recover and increase family and cultural strengths and promote safety planning, affect management, social skill building, attachments, and trauma processing.
Activities-based workbook built around the metaphor of heroes that are culturally relevant to treat PTSD in school-aged children.
Information for this summary was abstracted from the NCTSN publication, Trauma-Informed Interventions: Clinical and Research Evidence and Culture-Specific Information Project and other publications.
Ethnic Racial Group:
Age range of children served:
6 to 17 years old
Are parent/adult caregiver(s) included in intervention?
Yes; RLH can be used when a child does not have a caring, committed, nonoffending parent or guardian and/or a safe, secure home.
Ethnic/racial and other groups served:
RHL was pilot tested at the Latin American Institute in Boston, MA with a Hispanic population and with a rural population in Wisconsin.
Languages that service/resource is available:
Real Life Heroes focuses on three primary components for strengthening resiliency skills and resources: Relationships, Emotional Self and Co-Regulation, and Life Story Integration. These components frame developmentally-based assessments, service planning, session structure, fidelity, and evaluation measures.
Has there been any evaluation?
Key evaluation results:
A pilot test (no comparison group) was conducted with 41 children (ages 8 to 15 years old) who were enrolled in a program for high risk, home-based family counseling or an outpatient mental health clinic program. The children were primarily from low, socioeconomic backgrounds, were mixed urban-rural, and had trauma histories. The majority of children (74%) had three or more traumas.
From baseline to four months, children demonstrated significant reductions in child-reported trauma symptoms and problem behaviors reported on caregiver checklists. Twelve months after the intervention, child trauma symptoms decreased as a function of the number of chapters completed in the workbook.
Kagan R, Douglas AN, Hornik J, Kratz SL. Real Life Heroes pilot Study: Evaluation of a treatment model for children with traumatic stress. Journal of Child and Adolescent Trauma. 2008;1(1):5-22.
Publications about the program:
Kagan R. Real Life Heroes: A Life Storybook for Children. (2nd ed.). Binghamton, NY. The Haworth Press, Inc.
Rated/Reviewed by Evidence Based Registries:
National Child Traumatic Stress Network Empirically Supportive Treatments and Promising Practices
NREPP: SAMSHA’s National Registry of Evidence-Based Programs and Practices
California Evidence-Based Clearinghouse for Child Welfare
Richard Kagan, 418 426-2600 ext. 2725
Yes. The Real Life Heroes Practitioner Manual.
Availability of Training:
Languages that training/resource is available: