The Attachment, Self-Regulation, and Competency (ARC) (Blaustein & Kinniburgh, 2010; Kinniburgh & Blaustein, 2005) treatment framework is a components-based model that was designed to be flexibly applied with children across demographic and treatment settings, and ranging in age from early childhood through late adolescence / early adulthood. It was specifically designed to be applicable with children in the range of caregiving settings, including substitute care, and has been successfully applied in five countries, in urban and rural settings, with various cultural groups, and by a wide range of providers and provider systems. The framework was developed to target the needs of children and families exposed to complex trauma, and addresses the core areas of complex trauma impact and necessary intervention identified by experts in the field. Outcomes with youth and families indicate reductions in negative behavioral and emotional indicators, and increases in adaptive behaviors.
ARC targets 8 core skills within the three primary domains identified above, with a primary unifying goal of trauma experience integration. Core components framework designed to be adaptable to the range of child and family serving systems. Components operate on a dual level, incorporating both an organizational frame as well as clinical intervention strategies.
Theoretical basis:
The ARC framework targets the needs of children who have experienced complex trauma by targeting multiple levels relevant to outcomes for this population:
The framework focuses on strengthening the caregiving system surrounding children through enhancing supports, skills, and relational resources for adult caregivers. Caregiver functioning has a significant impact on mental health outcomes for trauma-impacted children, and in the case of families at risk for inadequate caregiving will impact placement stability and risk for further victimization. It is anticipated that caregiving systems receiving intervention will demonstrate improved mental health status, decreased incidence of removal, and decreased reports of stress related to parenting.
The framework addresses a core driving factor in negative outcomes among youth who have experienced complex trauma – namely, dysregulation of emotion, physiology, and behavior. Through targeting awareness and skill in managing internal experience, it is anticipated that youth will demonstrate decreased pathology and improved behavioral functioning.
The framework addresses key factors associated with resilience in stress-impacted populations, including executive function / problem-solving skills and sense of identity. A goal of intervention utilizing this framework is to go beyond pathology reduction, and to increase positive / resilient outcomes among youth receiving intervention.
Program setting:
The framework has been integrated into a wide range of child- and family-serving settings, including outpatient treatment, inpatient treatment, day programs, residential and group care, foster care, schools, early intervention / Head Start, in-home parenting support, and family shelter programs.
Length of program/number of sessions:
Length varies by application and treatment setting, and has ranged from very short-term adaptations (2 week intensive treatment settings) to long-term residential care. Given the complex population, the expectation is that treatment is typically at least 6-12 months in length.
Type(s) of trauma/concerns addressed:
Designed to target complex trauma in children and families.
Types of service providers:
Core concepts of the framework have been taught to and applied by a wide range of service providers, from family partners with lived experience to licensed mental health clinicians. Method of using the intervention framework varies by role and setting.
Age range of children served:
Birth to young adulthood, along with their caregiving systems.
Parent/adult caregiver(s) included in intervention:
The caregiving system is a primary target of intervention.
Ethnic/racial and other groups served:
The framework has been used broadly within the United States in varying contexts, including rural / urban / suburban settings; with varied socioeconomic status; and with families from widely diverse racial and ethnic background. Lead trainers and consultants work with systems implementing the framework to adapt concept delivery to meet the needs of the population served by the system.
Specific cultural adaptations:
Languages that service/resource is available: Primary manual / text is available in English and Dutch; a Turkish translation is anticipated in late 2015. Limited Spanish language materials are available.