Trauma Affect Regulation: Guide for Education and Therapy (TARGET)

Placement on the Continuum of Evidence Promising Download icon Download PDF
Target Population: 
Adolescents, Adults
Sector: 
Community-Based
Topic: 
Anger, Anxiety, Emotional Competency, Life Stress, PTSD, Relationships, Social Competency
Target Audience 

This program is for adult and adolescent survivors of physical, sexual, psychological, and emotional trauma.

Summary 

Trauma Affect Regulation: Guide for Education and Therapy (TARGET), a community-based intervention, is designed to treat Post-Traumatic Stress Disorder (PTSD) symptomatology in participants by helping them identify and utilize their strengths to normalize severe stress, control recollection of traumatic situations, increase feelings of self-worth, and create and maintain positive relationships.  

Evidence 

Several randomized controlled trials evaluating TARGET's effectiveness were identified.  One study of trauma-exposed mothers with young children revealed findings that were consistently positive with regard to significant decreased PTSD symptomatology and increased affect regulation skills at post-treatment and up to 6 months after program completion compared to another active treatment group and a wait-list control group.  This suggests that this program may be a promising treatment for PTSD in adult women.  Another study with a sample of delinquent girls showed some similar results for reductions in trauma symptoms but was less clear with regard to increases in affect regulation skills.  Sustainability was not assessed in this study.

Components 

Therapists facilitate this program and work with participants to help them re-frame PTSD symptoms as normal, healthy reactions to harsh and difficult circumstances.  Participants learn strategies to manage their feelings and handle situations.  The program includes three main features.

  • Provides skills to help participants cope with psychological, relational, and work or school problems;
  • Identifies differences between normal and extreme stress; and
  • Implements the Seven FREEDOM Steps.

The Seven FREEDOM Steps include the following:

  1. Focus - Concentrate on one thought that reveals your true self by slowing down, orienting, and self-checking;
  2. Recognize the trigger - Acknowledge triggers and learn to differentiate between actual hazards and reminders of trauma;
  3. Emotional self-check - Distinguish between reaction emotions, such as fear and anger, and main emotions, such as calmness and confidence, and learn to balance them;
  4. Evaluate thoughts - Identify reactive or alarm thoughts and discover within them the main thoughts that represent core beliefs;
  5. Define goals - Create goals that focus on personal values;
  6. Options - Make choices that align with your true self; and
  7. Make a contribution - Realize the value you make to the world when you manage your stress in a constructive way.

The program can be delivered as individual, couple, or group therapy.

Previous Use 

TARGET has been used in the juvenile justice system in Connecticut, Florida, and Maine and among adult and child mental health and addiction agencies.  Since 2000, over 20,000 individuals have participated in this program at over 120 sites.

Training 

Training for facilitators is required.  Group therapy is conducted by bachelor-, master's-, or doctoral-level facilitators; individual therapy and couple therapy are conducted by master's- or doctoral-level clinicians.  Advanced Trauma Solutions, Inc., (ATS) provides several options for on-site training in the United States and Canada.  For international organizations, on-site training and off-site training at the ATS Training Center are available.  Introductory and Advanced trainings are 3 to 5 days each,  and train-the-trainer options are customized based on an organization's goals.  On-going consultation is provided.  Please contact Judith Ford by email judy@advancedtrauma.com or by using the phone number in the Contact section for more information.  

Considerations 

Considerations for implementing this program include recruiting and obtaining buy-in from participants, finding facilitators who have a suitable educational background, ensuring facilitators receive training, and acquiring space to hold sessions.

The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

Implementation 

If you are interested in implementing TARGET, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu

Time 

Weekly sessions are held for 50 minutes for individual and couple therapies or 60 to 90 minutes for family or group therapy.  Program duration is 1 month for brief therapy, 3 to 4 months for time-limited therapy, or 6 or more months for extended therapy.  

Cost 

Information on implementation costs was not located.

Evaluation Plan 

To move the TARGET program to the Effective category on the Clearinghouse Continuum of Evidence at least one external evaluation must be conducted that demonstrates sustained, positive outcomes. This study must be conducted independently of the program developer.

Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

Contact 

Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email: Clearinghouse@psu.edu

You may also contact Advanced Trauma Solutions, Inc., by mail 11 Melrose Drive, Suite 200, Farmington, Connecticut 06032, phone 1-860-269-8663, email support@advancedtrauma.com, or visit www.advancedtrauma.com/Evidence---Research.html

References
References - Used For Placement 

Ford, J. D., Chang, R., Levine, J., & Zhang, W. (2013). Randomized clinical trial comparing affect regulation and supportive group therapies for victimization-related PTSD with incarcerated women. Behavior Therapy, 44, 262-276.

Ford, J. D., Steinberg, K. L., Hawke, J., Levine, J., & Zhang, W. (2012). Randomized trail comparison of emotion regulation and relational psychotherapies for PTSD with girls involved in delinquency. Journal of Clinical Child and Adolescent Psychology, 41, 27-37.

Ford, J. D., Steinberg, K. L., & Zhang, W. (2011). A randomized clinical trial comparing affect regulation and social problem-solving psychotherapies for mothers with victimization-related PTSD. Behavior Therapy, 42, 560-578.

*Resources and associated costs reflect those identified at the time of fact sheet publication.