The information in this program outline is provided by the program representative and edited by the CEBC staff. The Trauma Outcome Process Assessment Model (TOPA) program has been reviewed by the CEBC in the areas of: Sexual Behavior Problems in Children, Treatment of and Sexual Behavior Problems in Adolescents, Treatment of, but lacks the necessary research evidence to be given a Scientific Rating.

• Types of Maltreatment: Physical Abuse, Sexual Abuse, Physical Neglect, Emotional Abuse, Exposure to Domestic Violence
• Target Population: The TOPA treatment program focuses on two populations: (a) sexually abused children and adolescents; and (b) children and adolescents who have sexual behavior problems or manifest sexually abusive behavior. This includes males and females ages 4 to 19, including youths with low intellectual functioning.

The TOPA program is designed to help sexually abused and sexually abusive children/youths: (a) recognize how self-destructive and/or sexually abusive behaviors connect to past sexual abuse and other traumatic experiences (e.g., physical abuse, exposure to domestic violence); (b) take responsibility for maladaptive behaviors; and (c) make adaptive choices when current stressors trigger feelings or memories related to past traumas. Therapists take a directive role by creating a safe therapeutic environment, then implementing cognitive-behavioral interventions through experiential methods (art therapy, play therapy, sand tray, bibliotherapy, role play, drama, relaxation). Therapist also works with parents or caregivers to ensure that the home environment supports and maintains the child’s treatment gains.

The overall goals of the Trauma Outcome Process Assessment (TOPA) are to:

• Increase child’s self-awareness of feelings, thoughts, body sensations, motivations, and behaviors, as related to a traumatic experience or triggers related to the traumatic experience.
• Increase adaptive responses and decrease maladaptive responses (i.e., self-destructive behavior, sexual behavior problems, sexually abusive behaviors) to traumatic experiences or triggers related to traumatic experiences.

Treatment objectives – the child will:

• Take responsibility for self-destructive behaviors, sexual behavior problems, and/or sexually abusive behaviors.
• Demonstrate increased self-esteem and self-caring behaviors.
• Demonstrate increased empathy for others.
• Demonstrate improved social skills.
• Cease to engage in self-destructive behaviors, sexual behavior problems and/or sexually abusive behaviors.
• Utilize positive coping skills when confronted with stressful events reminiscent of past sexual abuse or other trauma.

Expected outcomes are that the child/youth will have increased self-awareness, decreased self-destructive and/or sexually abusive behaviors, and improved coping skills when confronted with feelings and/or memories associated with past sexual abuse or other traumas.