Advertisement
1 / 34

Assessment-Based Treatment for Traumatized Children: A Trauma Assessment Pathway Model (TAP) PowerPoint PPT Presentation


  • 243 Views
  • Uploaded on 27-01-2012
  • Presentation posted in: General

Assessment-Based Treatment for Traumatized Children: A Trauma Assessment Pathway Model (TAP). Presented by: Alicia Gilbert, PhD Robyn Igelman, PhD. Chadwick Center for Children and Families . Chadwick Center Programs Trauma Counseling Forensic and Medical Services Family Support - PowerPoint PPT Presentation

Download Presentation

Assessment-Based Treatment for Traumatized Children: A Trauma Assessment Pathway Model (TAP)

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Assessment based treatment for traumatized children a trauma assessment pathway model tap l.jpg

Assessment-Based Treatment for Traumatized Children: A Trauma Assessment Pathway Model (TAP)

Presented by:

Alicia Gilbert, PhD

Robyn Igelman, PhD


Chadwick center for children and families l.jpg

Chadwick Center for Children and Families

Chadwick Center Programs

Trauma Counseling

Forensic and Medical Services

Family Support

Professional Education

Research Linkage

Child & Adolescent Services Research Center

(funded by the NIMH)


Trauma counseling program l.jpg

Trauma Counseling Program

  • Assessment-based individual, group and family therapy for children who have experienced

    traumatic events.

  • Therapy and advocacy to domestic violence victims and their children at the Family Justice Center.

  • School-based counseling services.

  • Parent-child interaction therapy.

  • Medication & psychological assessments.

  • Crisis intervention, advocacy, information and referrals.


Tap model overview l.jpg

TAP Model Overview

  • A treatment manual for traumatized children ages 2 to 18 years

  • Incorporates assessment data, clinical interview, and observation to create a Unique Client Picture

  • Includes specific components of trauma-specific treatment described by the Trauma Wheel

  • Draft completed and undergoing revisions


What is assessment based treatment abt l.jpg

What Is Assessment Based Treatment (ABT)?

Development of clinical assessment-based treatment refers to the “development of an integrated plan of prioritized interventions, that is based on the diagnosis and psychosocial assessment of the client, to address mental, emotional, behavioral, developmental and addictive disorders, impairments and disabilities, reactions to illnesses, injuries, and social problems.” (Social work, consolidated laws, effective Sept. 1, 2004)


Clinical pathways l.jpg

Clinical Pathways

  • A sequence or path that clinicians follow in making assessment, triage, and clinical decisions.

  • Found increasingly useful within the medical field.

  • Evaluation of UCLA’s Asthma Pathway showed substantial cost effectiveness and adherence to medical standards (Chest, 1998)

  • Rady Children’s Hospital developed over 40 pathways, starting with Asthma in 1994, domestic violence in 2001, and TAP in 2005.

  • TAP includes a pathway that directs triage, assessment, referrals, and clinical interventions.


Chadwick s philosophy of trauma treatment l.jpg

Chadwick’s Philosophy ofTrauma Treatment

  • The therapeutic goal is to resolve the impact of a single or series of traumatic experiences to the child and their family.

  • Therapeutic decisions emerge from clinical and standardized assessment.


3 components of tap l.jpg

3 Components of TAP

  • Assessment

    Creating a Unique Client Picture

  • Triage

  • Treatment


Assessment l.jpg

Assessment:

Is the client appropriate for your Center and for the TAP Model?


To get the full rich unique client picture gather information via l.jpg

To get the full rich unique client picture, gather information via:

  • Clinical Interviews

  • Behavioral Observation

  • Standardized Measures


Standardize your assessment choices what measures exist to help you know your client l.jpg

Standardize your Assessment ChoicesWhat measures exist to help you know your client?


Measurement considerations l.jpg

Psychometric Properties

Reliability and Validity

Clinical Cutoffs

Sensitivity to Change

Feasibility Issues

Time to administer

Staff training

Costs of using measures

Language

Multiple vs. Single Informants

Real World Validity

Clinical Utility

Measurement Considerations


Assessment pathway process l.jpg

Assessment Pathway Process

Core measures administered

Problem areas identified

Other measures are administered to probe more deeply


Slide16 l.jpg

Guiding Therapists via Assessment

Pathways integrated into assessment measures


Therapists use of assessment measures l.jpg

Therapists’ Use of Assessment Measures:

Guiding the assessment and providing feedback.


How to make sense of assessment results l.jpg

How to make sense ofassessment results:

  • Know what each measure assesses and applicable populations

  • Have a general understanding of each subscale

  • Examine the validity scales (if any)

  • Use assessment results as an adjunct to your clinical interview

  • Clarify inconsistencies between assessment results and clinical impressions


How to make sense of assessment results cont l.jpg

How to make sense of assessment results (cont.):

  • Involve the parents and children in your interpretive process

  • Integrate results with clinical impressions & think about how the results can be used to plan treatment

  • Don’t discount your clinical judgment!!


Problem solving what happens when the measures clinician don t agree l.jpg

Problem Solving: What Happens When the Measures & Clinician Don’t Agree?


Slide21 l.jpg

Critical Items


How do you discuss feedback with your clients l.jpg

How do you discuss feedback with your clients?


Parent and client feedback dos don ts l.jpg

Parent and client feedback:Dos & Don’ts

DO:

  • Allow one therapy session to discuss results and give feedback

  • Elicit client feedback and impressions regarding assessment results

  • Discuss results with parent and child to confirm clinical impressions

  • Address areas of concern not initially revealed through clinical interview

  • Most important: Engage them in the process!


Parent and client feedback dos don ts cont l.jpg

Parent and client feedback:Dos & Don’ts (cont.)

DON’T:

  • Avoid discussing results with your clients

  • Act like the assessments are a waste of time (because your clients will too!)

  • Be afraid to share written feedback and printouts with parents and children

  • Underestimate the ability of your clients to understand and appreciate your feedback


How to form your clinical hypothesis l.jpg

How to form your clinical hypothesis

  • Consider all assessment feedback

  • Which family members need to be included in treatment? What are the dynamics in the family?

  • Family and client buy in

  • Consider the cause of distress


Heuristics of using the clinical pathway l.jpg

Heuristics of Using theClinical Pathway

  • One skill builds upon another.

  • All spokes of the Trauma Wheel will be addressed at some point during treatment.

  • The length of time and intervention type depend upon the unique client picture.

  • The wheel is fluid – you move back and forth between spokes of the wheel.


Slide27 l.jpg

The Trauma Wheel

Relationship Building

Addressing Maladaptive Cognitions

Affect

Regulation

Child Development

Systemic Dynamics

Skill Building

&

Psychoeducation

Trauma Integration

Culture


Case example l.jpg

Case Example:

Referral Information

Interview with Child & Family

Standardized Assessment Results

Consider family buy-in & needs before making treatment decisions

Re-Assess


On going re assessment l.jpg

On-going Re-assessment

  • Weekly interviews/updated goals

  • Progress notes

  • Supervision

  • Follow-up standardized measures

    • Must use the same measures for each time period (to measure change over time)

    • Can add measures over time (once added must continue to administer added measure to assess change over time).


Slide30 l.jpg

Symptom Change

Over Time


Slide31 l.jpg

Trauma Assessment Pathway Model (TAP): At a Glance

Initial Screening Process

Triage

Refer out

Assessment:

Clinical Interview and Standardized Measures

Integrate Assessment Information

Form Unique Client Picture

Narrow the Clinical Focus Select Symptom Domains Hypotheses/Prioritize

Refer to a specialized program if needed

Establish Treatment Goals

Treatment Pathway

Guides treatment decisions and the use of the Trauma Wheel

Trauma Wheel

Reassess:

Weekly interviews, update goals

Supervision

Follow-up standardized measures

Continue Treatment

Following the Treatment Pathway

Termination


You re the experts l.jpg

You’re the Experts

  • What are some basic assumptions you may have about traumatized clients?

  • How have you validated those assumptions?

  • What is your experience with using assessment measures?


Resources l.jpg

Resources

  • www.ChadwickCenter.org (Chadwick)

  • www.nctsn.net (National Child Traumatic Stress Network)

  • www.musc.edu/cvc/ (TF-CBT on-line and OVC guidelines)

  • www.cachildwelfareclearinghouse.org


Contact information l.jpg

Contact Information

Alicia Gilbert, PhD

858-966-8682

agilbert@rchsd.org

Robyn Igelman, PhD

858-576-1700, ext. 3211

rigelman@rchsd.org