Programs

Notes:

Type of services provided:

TGCT-A is a modularized, assessment-driven, flexibly tailored treatment program for trauma-exposed and traumatically bereaved older children that can be delivered in individual or group sessions. Designed to meet the complex needs of youth to deal with the interplay between trauma and grief, TGCT-A is organized into four modules. Treatment modules and sessions within modules are selected according to a client’s needs, strengths, circumstances and informed wishes. The four modules are:

• Module I includes content on psychoeducation on traumatic stress and grief reactions, core skills for emotion regulation, dealing with trauma and loss reminders, social support

• Module II provides guidelines for facilitating narrative construction and sharing of trauma/loss experiences

• Module III provides a customized approach to grief based on assessment of a youth’s multidimensional grief profile; skill training and therapy are provided depending on the mix of separation distress, existential/identity distress or circumstance-related distress

• Module IV promotes developmental progression, planning for upcoming stressors and consolidates treatment progress

Program setting:

Community agency, hospital, outpatient clinic, residential care facility, school, juvenile justice settings

Length of program/number of sessions:

12-26 weeks of weekly sessions of 50-75 minutes

Type(s) of trauma/concerns addressed:

Community violence, traumatic bereavement, natural and man-made disasters, war/ethnic cleansing, domestic violence, witnessing interpersonal violence, medical trauma, serious accidents, physical assaults, gang violence, terrorist events

Symptoms addressed:

Posttraumatic stress, depression, anxiety, maladaptive grief, interruptions in developmental progression related to trauma or loss

Education level of providers:

Masters-level training in a mental health-related field

Additional information:

None

Unique/Innovative Characteristics:

Intervention for youth that addresses the intersections between grief and trauma

Date Added/Updated:

12/29/2017

Population Adaptations:

Age range of children served:

12 to 20 years of age

Are parent/adult caregiver(s) included in intervention?

Yes, there is guidance on how parents / caregivers can be engaged to support the work with the child.

Ethnic/racial and other groups served:

TGCT-A has been used in settings that serve diverse populations of youth in poor urban and suburban communities and with incarcerated youth. It was used across New York City in multi-racial/ethnic communities after 9/11. It has been implemented with a variety of socioeconomic and religious/cultural/ethnic groups.

Specific cultural adaptations:

TGCT-A has been used with Muslim, Croatian and Serbian youth in post-war Bosnia and Herzegovina.

Languages that service/resource is available:

English, Bosnian, plans to translate into Spanish

Foundation:

Goals of the program/services:

• Reduce posttraumatic stress disorder (PTSD)
• Reduce depression
• Reduce maladaptive grief
• Improve school behavior
• Resume developmental progression

Evaluation Studies:

Has there been any evaluation?

Yes

Key evaluation results:

Layne and colleagues (2008) conducted a randomized controlled trial with war-exposed and predominantly ethnic Muslim secondary students in Bosnia who reported severe symptoms of posttraumatic stress disorder (PTSD), depression or maladaptive grief and significant impairment in school or relationships. The group intervention was conducted in a school setting. Students in the intervention group received TGCT-A and a classroom-based psychoeducation and skills intervention while the comparison group received only the classroom-based intervention. Findings included:

• Only the treatment group (TGCT-A) experienced significant reductions in maladaptive grief reactions
• There were significant posttreatment reductions in PTSD symptoms for both the treatment and comparison groups

Cox and colleagues (2007) conducted semistructured focus groups to evaluate the effectiveness of TGCT-A with war-exposed youth in Bosnia and Herzegovina. Students overall perceptions of TGCT-A were positive. Key themes of outcomes and impact perceived by students and group leaders included:
• Acquisition of coping skills and attitudes
• Willingness to advocate for peers
• Improved interpersonal relationships
• Negative and positive impacts
• Impacts in the schools and on the group
• Logistics of the program
• Broader impacts on the perception of mental health in the community

Is there an evaluation currently in progress or planned?

Research is being conducted on cultural and religious/spiritual influences on the way bereaved children grieve and mourn which will help to inform this work.

Publications about the program:

There are numerous publications about TGCT-A. Listed below are two publications regarding evaluation:

Layne CM, Saltzman WR, Poppleton L, Burlingame GM, Pasalic A, Durakovic E, Music M, Campara N, Dap N, Arslanagic B, Steinberg AM, Pynoos RS. Effectiveness of a school-based group psychotherapy program for war-exposed adolescents: A randomized controlled Trial. Journal of American Academy of Child and Adolescent Psychiatry. 2008;47(9): 1048-1062.

Cox J, Davies DR, Burlingame GM, Campbell JE, Layne CM, Katzenbach RJ. Effectiveness of a trauma/grief-focused group intervention: a qualitative study with war-exposed Bosnian adolescents. International Journal of Group Psychotherapy. 2007;57(3)319-345.

Rated/Reviewed by Evidence Based Registries:

California Evidence-Based Clearinghouse for Child Welfare
National Child Traumatic Stress Network Empirically Supportive Treatments and Promising Practices

Training Contact:

None specified

Training Notes:

Training manuals/protocols:

Yes; there is also a workbook for youth

Availability of Training:

Yes

Languages that training/resource is available:

Not specified