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Development and Implementation of Trauma-Informed Programming in Youth Residential Treatment Centers Using the ARC Framework


This project describes application of an evidenced-based, trauma-informed treatment framework, Attachment, Regulation and Competency (ARC), with complexly traumatized youth in residential treatment. The processes of implementing the ARC model into clinical and milieu programming at two residential treatment programs are described. Particular attention is paid to system-level processes and strategies for embedding ARC in a sustainable manner. Pilot data demonstrated a significant relation between use of ARC and reductions in PTSD symptoms, externalizing and internalizing behaviors, and the frequency of restraints used across programs. Preliminary findings contribute to an emerging empirical basis for the ARC model and are supportive of its clinical utility as a practice in the residential context. Next steps include: a) expanding the study findings by conducting controlled efficacy research, b) examining system level variables as mediators of change, and c) describing the full operation stage of implementation of the ARC framework.

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This project was funded in part by grant number 5U79SMO56175 from the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. The authors thank the National Child Traumatic Stress Network’s Core Data Set team at Duke Clinical Research Institute for their seminal work in developing the database from which data for the present study were drawn; Johanna Greeson and Ernestine Briggs from the National Center for Child Traumatic Stress at Duke University for assistance with data coding and extraction; and Dr. Michael Suvak for assistance with statistical analyses and consultation. We acknowledge the staff of Glenhaven Academy, Cohannet Academy, Walden Street School and the Susan Wayne Center for their collaboration in developing, implementing, evaluating and refining trauma-focused residential programming for youth impacted by complex trauma. We express our special gratitude to Kari Beserra, Douglas Brooks, Liz Carrigan, Mia DeMarco, Stacey Forrest, Rick Granahan, Brian Lary, Jenn Miguel, Sean Rose, and above all to Andrew Pond, for their unwavering openness, ingenuity, insight, and perseverance in partnering with us to advance trauma-focused residential systems of care.

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Correspondence to Hilary B. Hodgdon.

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Hodgdon, H.B., Kinniburgh, K., Gabowitz, D. et al. Development and Implementation of Trauma-Informed Programming in Youth Residential Treatment Centers Using the ARC Framework. J Fam Viol 28, 679–692 (2013).

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  • Traumatized youth
  • Trauma-informed care
  • Residential services
  • Complex trauma
  • Evidence-based treatment