Trauma Model Therapy

Scientific Rating:
NR
Not able to be Rated
See scale of 1-5
Child Welfare System Relevance Level:
Low
See descriptions of 3 levels

About This Program

The information in this program outline is provided by the program representative and edited by the CEBC staff. Trauma Model Therapy has been reviewed by the CEBC in the area of: Trauma Treatment (Adult), but lacks the necessary research evidence to be given a Scientific Rating.

Target Population: Adults with severe childhood trauma and complex comorbidity; program has been used for other mental health disorders as well.

Brief Description

Trauma Model Therapy is a structured therapy that involves a blend of cognitive-behavioral, systems, psychodynamic and experiential principles. The program can be delivered in individual or group therapy in an in-patient or out-patient setting. The program focuses on the problem of attachment to the perpetrator; the locus of control shift; just saying ‘no’ to drugs; addiction is the opposite of desensitization; and the victim-rescuer-perpetrator triangle. Trauma Model Therapy is designed to address all phases of a three-stage trauma recovery.

Program Goals:

The goals of Trauma Model Therapy are:

  • Remission of Axis I and II disorders
  • Reduction in symptoms
  • Decrease in mental health care utilization
  • Decrease in psychotropic medications
  • Increase in independence and function
  • Resolution of trauma

Essential Components

The essential components of Trauma Model Therapy include:

  • A focus on the following subjects:
    • Attachment to the perpetrator
    • A locus of control shift
    • Just say ‘no’ to drugs
    • Addiction is the opposite of desensitization
    • Victim-rescuer-perpetrator triangle
  • These are delivered in a structured therapy that involves a blend of cognitive-behavioral, systems, psychodynamic and experiential principles.
  • Model can be delivered in groups with between 10-18 participants or individually.
  • Treatment model can be adapted for any setting and level of care including private practice, and across all phases of a three-stage trauma recovery
  • Good professional boundaries and ethics
  • Self-responsibility and a focus on recovery from clients – they are not excluded if they are lacking in commitment to recovery, but if they are, this becomes a focus of the treatment
  • A focus on trauma resolution and recovery

Adult Services

Trauma Model Therapy directly provides services to adults (regardless of whether they are parents or caregivers) and addresses the following:

  • Experienced traumatic events; suicidal and homicidal ideation; severe anxiety, depression, substance abuse, dissociation; inability to function on an outpatient basis
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Family therapy in person or on speaker phone if the family is out-of-state

Delivery Setting

This program is typically conducted in a(n):

  • Hospital

Homework

Trauma Model Therapy includes a homework component:

A variety of structured homework assignments are given focusing on the reasons for admission, goals of the admission, specific tasks that need to be worked on, and specific strategies for accomplishing the goals. There is no one set homework sheet but there is a standard handout called a Therapeutic Assignment that is used when there is acting out or a lack of focus on treatment – it covers the above plus a section on what the acting out was, what its purpose was, and a detailed plan for how to deal with the feelings or conflict without acting out.

Languages

Trauma Model Therapy does not have materials available in a language other than English.

Resources Needed to Run Program

The typical resources for implementing the program are:

Typical hospital facilities and staff for inpatient and partial hospitalization. Could be run in a standard group format in an outpatient setting with sufficient staff, or can be adapted to intensive outpatient or private practice – the resources are those typical of the setting and level of care and are not specific to Trauma Model Therapy.

Minimum Provider Qualifications

The usual qualifications for a given setting – MD, MA, PhD, BA for technicians

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:
Training is obtained:

It is a set of books, papers, DVDs and a CD that can be purchased online for Trauma Model Therapy Certification – there are 30 hours of CEUs attached to it. Also, professionals can visit the hospital in Dallas and sit in on groups and attend treatment team meetings at no cost.

Number of days/hours:

30 hours of CEUs for Trauma Model Therapy Certification – the visiting professionals program has no set duration and can be a half day to several weeks depending on the person.

Relevant Published, Peer-Reviewed Research

This program has been reviewed and it was determined that this program lacks the type of published, peer-reviewed research that meets the CEBC criteria for a scientific rating of 1 – 5. Therefore, the program has been given the classification of "NR - Not able to be Rated." It was reviewed because it was identified by the topic expert as a program being used in the field, or it is being marketed and/or used in California with children receiving services from child welfare or related systems and their parents/caregivers. Some programs that are not rated may have published, peer-reviewed research that does not meet the above stated criteria or may have eligible studies that have not yet been published in the peer-reviewed literature. For more information on the "NR - Not able to be Rated" classification, please see the Scientific Rating Scale.

Child Welfare Outcomes: Not Specified

Show relevant research...

Ross, C. A., & Ellason, J. W. (1997). Millon Clinical Multiaxial Inventory-II follow-up of patients with dissociative identity disorder. Psychological Reports, 78, 707-716.

Type of Study: One group pretest-posttest
Number of Participants: 35

Population:

  • Age — Not specified
  • Race/Ethnicity — Not specified
  • Gender — Not specified
  • Status — Participants were individuals with Dissociative Identity Disorders

Location/Institution: Charter Behavioral Health System of Dallas

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study is part of a two-year follow-up assessment of patients who were clinically diagnosed with Dissociative Identity Disorders. Treatment for these patients was based on the Trauma Model Therapy. Measures utilized include the Million Clinical Multiaxial Inventory-II. Results indicate significant improvement was evident for scores on the self-defeating, borderline, paranoid, anxiety, somataform, dysthymia, alcohol dependence, and drug dependence.

Length of postintervention follow-up: None.

Ross, C. A., & Ellason, J. W. (1997). Two-year follow-up of inpatients with dissociative identity disorder. The American Journal of Psychiatry, 2(2), 103-112.

Type of Study: One group pretest-posttest
Number of Participants: 54 (Initially 113 subjects were included)

Population:

  • Age — Mean=39 years
  • Race/Ethnicity — Not specified
  • Gender — 48 Women and 17 Men
  • Status — Participants were individuals with Dissociative Disorders.

Location/Institution: Charter Behavioral Health System of Dallas

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This purpose of this study is to monitor outcomes of individuals with Dissociative Identity Disorders. Treatment for these patients was based on the Trauma Model Therapy. Measures utilized include the Dissociative Disorder Interview Schedule and Dissociative Experiences Scale, Institute of Mental Health Diagnostic Interview Schedule, Structured Clinical Interview for DSM-III-R, the Beck Depression Inventory, and the Hamilton Depression Rating Scale. Results indicate there was significant improvement on substance abuse, depression, and symptoms that mimic psychosis, while simultaneously reducing their number of antidepressant and antipsychotic drugs. Limitations include selection bias, nonrandomization of subjects, attrition bias, sample size, and reporting bias.

Length of postintervention follow-up: 2 years.

Ross, C. A., & Ellason, J. W. (2001). Acute stabilization in an inpatient trauma program. Journal of Trauma & Dissociation, 2(2), 103-112.

Type of Study: One group pretest-posttest
Number of Participants: 50

Population:

  • Age — 20-52 years
  • Race/Ethnicity — Not specified
  • Gender — 48 women and 2 men
  • Status — Participants were individuals with Dissociative Disorders.

Location/Institution: Private psychiatric hospital in Grand Rapids, MI

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This purpose of this study is to examine the short-term treatment response of patients with dissociative disorders and other trauma-related disorders admitted to an inpatient trauma program. Treatment for these patients was based on the Trauma Model Therapy. Measures utilized include the Dissociative Disorder Interview Schedule, Self-Report Version, the Symptom Checklist-90 Revised (SCL-90-R), the Beck Depression Inventory, the Beck Scale for Suicidal Ideation, the Beck Hopelessness Scale, and the Dissociative Experiences Scale. Results indicate there was no significant correlation between length of stay and changes on scores for any of the measures in the study. Limitations include selection bias, non randomization of subjects, sample size, reporting bias, lack of follow-up and lack of control group.

Length of postintervention follow-up: None.

Ross, C. A., & Haley, C. (2005). Acute stabilization and three-month follow-up in a trauma program. Journal of Trauma & Dissociation, 5(1), 103-112.

Type of Study: One group pretest-posttest
Number of Participants: 46

Population:

  • Age — 20-52 years
  • Race/Ethnicity — Not specified
  • Gender — 44 Women and 2 Men
  • Status — Participants were individuals with Dissociative Disorders.

Location/Institution: Private psychiatric hospital in Grand Rapids, MI

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This purpose of this study is to replicate the data of Ross and Ellason (2001) in a second set of inpatients, and to extend the study by providing data on a three-month follow-up of discharged patients. Treatment for these patients was based on the Trauma Model Therapy. Measures utilized include the Dissociative Disorder Interview Schedule, Self-Report Version, the Symptom Checklist-90 Revised (SCL-90-R), the Beck Depression Inventory, the Beck Scale for Suicidal Ideation, the Beck Hopelessness Scale, and the Dissociative Experiences Scale. Results indicate continued improvement of self-reported measures scores after discharge as well as continued improvement and individuals did not relapse. Limitations include selection bias, non randomization of subjects, sample size, reporting bias, and lack of control group.

Length of postintervention follow-up: 3 months.

Ross, C. A., & Burns, S. (2007). Acute stabilization in a trauma program: A pilot study. Journal of Psychological Trauma, 6(1), 21-28.

Type of Study: One group pretest-posttest
Number of Participants: 11

Population:

  • Age — 19-63 years
  • Race/Ethnicity — Not specified
  • Gender — 93 Women and 18 Men
  • Status — Participants were individuals with Borderline Personality Disorder.

Location/Institution: Private psychiatric hospital in Grand Rapids, MI

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study measured scores at admission and discharge from inpatient treatment at a hospital-based trauma program in Michigan utilizing Trauma Model Therapy. Measure utilized was the Beck Depression Inventory. Results indicate that the admission scores at discharge were lower. Limitations include lack of control or comparison group, selection bias, nonrandomization of subjects and lack of follow-up.

Length of postintervention follow-up: None.

References

Ross, C. A. (2008). Group therapy for dissociative disorders and addiction. Journal of Groups in Addiction and Recovery, 3, 323-346.

Ross, C. A. (2007). Trauma Model Therapy. A solution to the problem of comorbidity in psychiatry. Richardson, TX: Manitou Communications.

Ross, C. A., & Halpern, N. (2009). Trauma Model Therapy. A treatment approach for trauma, dissociation and complex comorbidity. Richardson, TX: Manitou Communications.

Contact Information

Name: Colin A. Ross, MD
Agency/Affiliation: The Ross Institute
Website: www.rossinst.com
Email:
Phone: (972) 918-9588
Fax: (972) 918-9069

Date Research Evidence Last Reviewed by CEBC: June 2015

Date Program Content Last Reviewed by Program Staff: June 2015

Date Program Originally Loaded onto CEBC: June 2013