TARGET-A: Trauma Affect Regulation: Guidelines for Education and Therapy for Adolescents and Pre-Adolescents
Type of Approach:
Provider Education Level:
Type of services:
Individual or group counseling adapted for preadolescents and adolescents for the prevention and treatment of Post Traumatic Stress Disorder (PTSD). TARGET uses a strengths-based approach that teaches a set of seven skills. The acronym for the seven skills is FREEDOM—Focus, Recognize triggers, Emotion self-check, Evaluate thoughts, Define goals, Options, and Make a contribution. Trauma survivors learn how to use these skills to regulate extreme emotion states, manage intrusive trauma memories, promote self-efficacy, and achieve lasting recovery from trauma.
Can be provided in individual, conjunct family, parent-child, group, residential and school settings, and as a case management intervention.
Type of service provider:
Clinicians, case managers, rehabilitation specialists, or teachers.
Length of program/number sessions:
Usually offered in 10 to 12 individual or group counseling/psychoeducational sessions. Readily adapted as a four session approach for settings where youth or families enter and leave service rapidly.
Type(s) of trauma addressed:
Physical abuse, domestic violence, emotional abuse and sexual abuse
TARGET was initially developed for adult survivors of trauma and has been adapted for adolescents.
Can serve as phase one intervention to other trauma interventions by helping youth and adults to self-regulate so they can use other skills such as anger management
Provides practical strategies for teens and their families to manage symptoms associated with PTSD.
Information for this summary was abstracted from the NCTSN publication, Trauma-Informed Interventions: Clinical and Research Evidence and Culture-Specific Information Project, the www.nrepp.samhsa.gov website, the California Evidence-based Clearinghouse for Child Welfare (www.cebc4cw.org) and other publications.
Ethnic Racial Group:
Age range of children:
10 to 18 years of age
Parent/adult caregiver included in intervention:
May include parent-child therapy component
Ethnic/racial and other groups served:
Native American, Latino, and African American families in U.S. and Canada; also African, Southeast Asian, and eastern European immigrant families. Being used in Israel, the Netherlands, and France. Has been implemented with urban and rural populations, usually lower socioeconomic status.
Canadian Indian youth
English, Spanish, Hebrew, Dutch and French
Cognitive behavioral therapy
TARGET was initially developed for and evaluated with adult trauma survivors. The NCTSN review (see reference at end of this summary) and SAMHSA’s National Registry of Evidence-based Programs and Practices (NREPP) indicate that manuscripts of evaluation studies of TARGET with youth study populations are in progress. One of the evaluation studies, funded by the U.S. Department of Justice involved girls and boys in juvenile detection programs in the State of Connecticut:
Ford JD, Hawke J. (in preparation). Demonstration of a promising evidence-based multimodal trauma recovery intervention (TARGET) for girls and boys in juvenile detention programs.
Results from a small pilot trial (24 subjects) with predominantly Latino and African American juvenile probation clients (10-18 years old) indicated reductions in PTSD avoidance/numbing, reductions in self-related post-traumatic thoughts, decreases in negative coping by self- and parent-reports, and increased hope/self-efficacy.
A randomized effectiveness study was conducted with adult clients being treated at outpatient clinics for psychological trauma and PTSD symptoms in the past month. While the study was initially designed as a randomized controlled trial it transitioned to a group cohort study to address waiting time concerns with forming intervention groups. Clients who participated in gender-specific men’s and women’s TARGET groups were compared to clients who received “trauma-sensitive care” (TSU). Results indicated that both interventions were effective in reducing post-traumatic stress, anxiety, depression, and substance abuse and sustaining these effects at 12-months after entry to the study. TARGET was superior in helping clients to maintain their self-efficacy regarding substance use abstinence following treatment.
Frisman L, Ford J, Hsiu-Ju L, Mallon S, Chang R. Outcomes of trauma treatment using the TARGET model. Journal of Groups in Addiction & Recovery. 2008;3(3-4):285-303.
Evaluations in progress:
According to the NREPP: SAMSHA’s National Registry of Evidence-Based Programs and Practices website, four evaluations of TARGET are underway; the website did not indicate what age the study populations are in these evaluation studies.
Other publications include:
Ford JD, Russo E. Trauma-focused, present-centered, emotional self-regulation approach to integrated treatment for post-traumatic stress and addiction: Trauma Adaptive Recovery Group Education and Therapy (TARGET). American Journal of Psychotherapy. 2006; 60:335-355.
Program replicated elsewhere:
Replicated in a variety of settings including with delinquent girls and low income mothers with PTSD.
Target has been adopted in statewide trauma initiatives in a wide range of settings in Connecticut and Florida including juvenile justice detention centers, probation offices, and residential and community programs.
Rated/Reviewed by Evidence Based Registries:
Yes; Available at www.advancedtrauma.com
English, Spanish, Hebrew, and Dutch