Programs

Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS)

Type of Approach:

  • Group
  • Individual

Provider Education Level:

  • Unspecified

Length:

  • Greater than 12 weeks
  • Less than 12 weeks

Trauma Type:

  • Child Abuse
  • Community Violence
  • Domestic Violence
  • Gang Violence
  • Homicide/Familicide
  • Multiple
  • Neglect
  • Other
  • Sexual Abuse
  • Substance Abusing Caregiver

Trauma Symptom:

  • Anxiety
  • Depression
  • Externalizing Behaviors
  • PTSD

Setting:

  • Correctional
  • Hospital-based
  • Other
  • Other Community Settings
  • Residential
  • School

Notes:

Type of services:

Group psychotherapy for adolescents that is a skill-based and present-focused intervention.
Developed for adolescents who may still be living with ongoing stress and may be experiencing problems in several areas of functioning including difficulties with affect regulation and impulsivity, self-perception, relationships, somatization, dissociation, numbing and avoidance, struggles with their own purpose/meaning in life, and seeing a future for themselves.

Type of provider:

Mental health professionals

Program setting:

Outpatient clinics, schools, group homes, residential treatment centers and facilities, juvenile justice centers, and foster care programs

Length of program/number sessions:

16-sessions; one-hour in length

Type(s) of trauma addressed:

Chronic interpersonal trauma

Additional Information:

Overall goals of the intervention include helping teens cope more effectively in the moment, enhancing self-efficacy, connecting with others and establishing supportive relationships, cultivating awareness, and creating meaning in their lives.
Core components which are learned and practiced during the group intervention include:

  • mindfulness practice
  • relationship building/communication skills
  • distress tolerance
  • problem-solving and meaning making
  • psychoeducation on stress, trauma, and triggers

Adaptations of SPARCS are being piloted and include: a 6-session Skills Training model (SPARC-ST) for use in short-term facilities (less than 6 weeks); two peer-led curricula (Taking Control; RAP Club), and SPARCS for use in individual therapy (SPARCS-I).

Unique/Innovative Characteristics

This group intervention is appropriate for traumatized adolescents with or without current/lifetime PTSD. SPARCS is specifically designed for teens living with ongoing stress and focuses on helping them to cope in their current situation.

Information for this summary was abstracted from the NCTSN publication, Trauma-Informed Interventions: Clinical and Research Evidence and Culture-Specific Information Project (pages 205-214) and Models for Developing Trauma-Informed Behavioral Health Systems and Trauma-Specific Services, 2007 Update by A. Jennings, K. Morford, and R. Tregerman, Center for Mental Health Services, National Center for Trauma-Informed Care (NCTIC).

Date Added/Updated:

6/15/12

Age:

  • 13-17 (Adolescent)
  • 18-25 (Young Adult)

Language:

  • English
  • Spanish

Ethnic Racial Group:

  • American Indian, Alaska Native, Other Indigenous
  • Black or African American
  • Hispanic or Latino
  • Immigrant or Refugee
  • White

Caregivers Included:

  • None

Population Adaptations:

Age range of children:

12 to 21 years old

Parent/adult caregiver included in intervention:

No

Ethnic/racial and other groups served:

SPARCS has been used with ethnically diverse groups including African American, Latino, Native American, LGBTQ, and refugee/immigrant populations. SPARCS has also been used with gang members, adolescents in rural settings, traumatized teens who are pregnant or parents of young children, youth in foster care and runaway/homeless youth living in shelters.

Specific cultural adaptations:

Has been adapted for use in Israel, Sri Lanka, Liberia, and Australia. Although SPARCS is a structured intervention, the training and manual are constructed to encourage clinicians to flexibly apply the material in a manner that meets the needs of their specific population while retaining fidelity to the core components of the curriculum.

Languages available:

English. Some of the handouts/worksheets given to group members have been translated into Spanish.

Foundation:

Theoretical basis:

Predominantly cognitive-behavioral and also draws upon Dialectical Behavior Therapy (DBT), Trauma Adaptive Recovery Group Education and Therapy (TARGET), and Trauma and Grief Components Therapy for Adolescents (TGCT-A).

Evaluation Studies:

According to summaries in the NCTSN and the NCTIC publications, pilot data indicated significant improvement in overall functioning during the 16-session treatment. Findings included:

  • significant changes on subscales measuring conduct problems, inattention/hyperactivity, and interpersonal relationships
  • significant reduction in PTSD symptoms with improvement in the overall severity of PTSD symptoms and criterion scores assessing symptoms related to re-experiencing, avoidance, and hyper-arousal

In an Evidence-Based Practices Pilot (EBPP) by the Illinois Department of Children and Family Services in conjunction with the Mental Health Services and Policy Program at Northwestern University, findings indicated that adolescents in foster care who received SPARCS compared to adolescents who received standard care:

  • were half as likely to run away
  • were one-fourth less likely to experience placement interruptions (arrests, hospitalizations, runaways etc.)
  • showed improvement in risk behaviors measured with the Child and Adolescent Needs and Strengths (CANS) instrument

For African-American adolescents (the primary group in the EBPP), compared to a comparison group, youth receiving SPARCS:

  • were less likely to drop out of treatment
  • improved significantly on the following CANS subscales “Traumatic Stress Symptoms,” “Life Domain Functioning,” and “Risk Behaviors”

Additional pilot data summarized from a variety of sources including local agencies, NCTSN Centers, and the Evidence-Based Practices Pilot indicated significant improvement in:

  • interpersonal coping and support-seeking behavior
  • overall functioning (as measured by the YOQ), as well as all of the subscales (social problems, behavioral dysfunction, relationships, intrapersonal distress, anxious/depressive symptomatology, somatic complaints, high risk behaviors).

Mental Health Services & Policy Program & Illinois Department of Children & Family Services. 2008. Final evaluation of the implementation of three evidence-based practices for the treatment of trauma among youth in child welfare. Unpublished report.
Weiner, D., Schneider, A., and Lyons, J. Evidence-based treatments for trauma among culturally diverse foster care youth: Treatment retention and outcomes. Children and Youth Services Review. 2009; 31:1199-1205.

Pilot or evaluation studies in progress:

Agencies implementing SPARCS typically track outcomes as part of their routine standard of care. The data is used to track change across time (e.g. evaluate clinical improvements), secure funding, and inform treatment decisions. Outcome measures vary according to the populations served by each agency (e.g. youth struggling with substance abuse versus juvenile justice or gang involvement). Although evaluation data is gathered by numerous agencies providing SPARCS, much of the information is used internally and is not published. SPARCS is currently being piloted in substance abuse treatment facilities. A peer-led adaptation of SPARCS is being formally evaluated for use with urban youth exposed to community violence.

Other publications about the program:

Habib, M., Labruna, V., & Newman, J. (invited paper-in preparation). Implementation of a Manually-Guided Group Treatment: A Phenomenological Approach to Treating Traumatized Adolescents in Residential Settings. Journal of Child and Adolescent Trauma.
DeRosa R & Pelcovitz D. Igniting SPARCS of Change: Structured psychotherapy for adolescents responding to chronic stress. In J. Ford, R. Pat-Horenczyk & D. Brom (Eds.). Treating Traumatized Children: Risk, Resilience, and Recovery. 2008. New York: Routledge.
Treating traumatized adolescent mothers: a structured approach. In Webb NB (Ed). Working with traumatized youth in child welfare (pp. 219-245). 2005. New York: Guilford Press.

Program replicated elsewhere:

Replicated with foster care youth as part of a project with the Department of Children and Family Services in Illinois. SPARCS has been provided as part of state-funded initiatives in other states as well (e.g. Mississippi, North Dakota). To date, groups have been conducted in more than a dozen states, with each agency collecting outcome data specific to their population
Much of this data is not published.

Rated/Reviewed by Evidence Based Registries:

California Evidence-Based Clearinghouse for Child Welfare
Evidence-Based Practices for Children Exposed to Violence: A Selection from Federal Databases
National Child Traumatic Stress Network Empirically Supportive Treatments and Promising Practices

Training Contact:

Contact Mandy Habib, Psy.D. at mhabib@nshs.edu or mhabib@sparcstraining.com or Victor Labruna, Ph.D. at vlabruna@nshs.edu or vlabruna@sparcstraining.com

Training Notes:

Training manuals/protocols:

Yes
DeRosa R, Habib M, Pelcovitz, D, Rathus J, Sonnenklar J, Ford J et al. (2006). Structured Psychotherapy for Adolescents Responding to Chronic Stress: A Treatment Guide. Unpublished manual.
Habib, M., & Sonnenklar, J. (2006). SPARCS Group Handouts for Youth. Unpublished workbook.
The professional printed manual and workbook are available for purchase by contacting Dr. Habib or Labruna (e-mail addresses below). Sample sessions from the manual can be e-mailed, free of charge, for review.

Training available:

Yes

Languages:

English, Some handouts are available in Spanish

Program Contact