Trust-Based Relational Intervention (TBRI) - Online Caregiver Training

Scientific Rating:
3
Promising Research Evidence
See scale of 1-5
Child Welfare System Relevance Level:
High
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. Trust-Based Relational Intervention (TBRI) - Online Caregiver Training has been rated by the CEBC in the area of: Parent Training Programs that Address Behavior Problems in Children and Adolescents.

Target Population: Parents (e.g., birth parents, foster parents, kinship parents, adoptive parents, etc.) and caregivers of children who come from ‘hard places,’ such as maltreatment, abuse, neglect, multiple home placements, and violence

For parents/caregivers of children ages: 0 – 17

Brief Description

TBRI Online Caregiver Training is a program available via 18 modules on a website that can be accessed in the home or any other location with Internet availability. The training presents the Trust-Based Relational Intervention, a holistic approach that is multidisciplinary, flexible, and attachment-centered. It is a trauma-informed intervention that is specifically designed for children who come from ‘hard places,’ such as maltreatment, abuse, neglect, multiple home placements, and violence, but can be used with all children. TBRI consists of three sets of harmonious principles: Connecting, Empowering, and Correcting Principles. These principles have been used in homes, schools, orphanages, residential treatment centers and other environments. They are designed for use with children and youth of all ages and risk levels. By helping caregivers understand what should have happened in early development, TBRI principles guide children and youth back to their natural developmental trajectory.

Program Goals:

The goals of Trust-Based Relational Intervention (TBRI) - Online Caregiver Training are:

  • Create an environment of physical, social, and psychological safety
  • Recognize and meet children's physiological needs (e.g., hydration)
  • Structure experiences to enhance emotional and behavioral self-regulation
  • Enhance caregivers' mindful awareness and mindful caregiving
  • Build and strengthen secure attachments between caregivers and children
  • Build and strengthen resilience in caregivers and children
  • Help caregivers master the use of proactive strategies for behavioral change
  • Help caregivers master the IDEAL Response (Immediate, Direct, Efficient, Active, Leveled at behavior, not child)
  • Help caregivers master Levels of Response (Playful, Structured, Calming, Protective)

Essential Components

The essential components of Trust-Based Relational Intervention (TBRI) - Online Caregiver Training include:

  • TBRI® Connecting Principles
    • Connecting Principles help children build trust and meaningful relationships. These include:
      • Engagement Strategies, which connect with children nonverbally, such as with eye contact, behavior matching, and playful engagement.
      • Mindfulness Strategies, which involve parents and caregivers being aware of what they bring to interactions with their children, such as being conscious of their own relationship histories.
  • TBRI® Empowering Principles
    • Empowering Principles help children learn important skills like self-regulation. There are two types of Empowering strategies:
      • Physiological Strategies, which focus on the internal physical needs of the child. These include things like hydration, blood sugar, and sensory needs.
      • Ecological Strategies, which focus on the child’s external environment and guide children toward learning self-regulation skills. Ecological Strategies include things like transitions, scaffolding (guided support appropriate to a child’s level that facilitates learning), and daily rituals.
  • TBRI® Correcting Principles
    • Correcting Principles help children learn behavioral and social competence so that they can better navigate the social world they live in. Correcting Principles include:
      • Proactive Strategies, which are designed to teach social skills to children during calm times.
      • Responsive Strategies, which provide caregivers with tools for responding to challenging behavior from children.
  • Includes 18 modules with topics such as:
    • TBRI Overview
    • Daily Transitions
    • Mindfulness
    • Brain Chemistry
    • Life Value Terms
  • The content of each module consists of 20-40 minutes of direct instruction on a TBRI principles and/or strategy
  • Many modules also include video examples and demonstrations.

Parent/Caregiver Services

Trust-Based Relational Intervention (TBRI) - Online Caregiver Training directly provides services to parents/caregivers and addresses the following:

  • Caregivers' lack of mindfulness, and associated deficits (e.g., inability to remain calm and recognize children's needs)
  • Caregivers' lack of awareness about their own caregiving history, and its impact on their own ability to provide care
  • Caregivers who have children that experience the following:
    • Inability to give and/or receive nurturing care
    • Hyper-vigilance and lack of felt safety
    • Inability to regulate their own emotions and/or behavior
    • Problem behavior, including both internalizing and externalizing behaviors
    • Sensory related deficits, including, for example, hypersensitivity and/or hypo-sensitivity to touch
    • Poor social skills (e.g., doesn't know how to appropriately ask for their needs)
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: TBRI involves all individuals involved in providing care for children including biological parents, adoptive parents, foster parents, caseworkers, teachers, coaches, therapists, counselors, social workers, child advocates, and direct care staff. Caregivers can share specific modules with other relevant people in a child’s life, (e.g., teachers, caseworkers, counselors, etc.).

Delivery Settings

This program is typically conducted in a(n):

  • Adoptive Home
  • Birth Family Home
  • Foster/Kinship Care
  • Online via Website

Languages

Trust-Based Relational Intervention (TBRI) - Online Caregiver Training does not have materials available in a language other than English.

Resources Needed to Run Program

The typical resources for implementing the program are:

On-line Whiteboard Modules (on-line video lectures with quizzes), Internet connection, and computer

Minimum Provider Qualifications

No service providers are used in this intervention.

Education and Training Resources

There is not a manual that describes how to implement this program, and there is not training available for this program.

Implementation Information

Since Trust-Based Relational Intervention (TBRI) - Online Caregiver Training is rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

Show implementation information...

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Trust-Based Relational Intervention (TBRI) - Online Caregiver Training.

Formal Support for Implementation

There is no formal support available for implementation of Trust-Based Relational Intervention (TBRI) - Online Caregiver Training.

Fidelity Measures

There are no fidelity measures for Trust-Based Relational Intervention (TBRI) - Online Caregiver Training.

Implementation Guides or Manuals

There are no implementation guides or manuals for Trust-Based Relational Intervention (TBRI) - Online Caregiver Training.

Research on How to Implement the Program

Research has not been conducted on how to implement Trust-Based Relational Intervention (TBRI) - Online Caregiver Training.

Relevant Published, Peer-Reviewed Research

This program is rated a "3 - Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list study) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. Please see the Scientific Rating Scale for more information.

Child Welfare Outcomes: Not Specified

Razuri, E. B., Howard, A. R., Parris, S. R., Call, C., DeLuna, J., Hall, J. S., … Cross, D. R. (2016). Decrease in behavioral problems and trauma symptoms among at-risk adopted children following trauma-informed web-based trauma-informed parent training intervention. Journal of Evidence-Informed Social Work, 13(2), 165-178. doi:10.1080/23761407.2015.1014123

Type of Study: Randomized pretest-posttest design with a control group
Number of Participants: 256

Population:

  • Age — Children: 5-12 years, Adults: 42-43 years
  • Race/Ethnicity — 101 White/Caucasian ,71 Black/African American, 44 Asian, 30 Hispanic/Latino, 3 Native Americans, 7 other (children); Adults: 247 White/Caucasian, 2 Hispanic/Latino, 2 Asian, 1 Black/African American, 1 Native American, 3 other
  • Gender — 50% Male and 50% Female, Adults: 93.8% Female, 6.38% Male
  • Status — Participants were adopted children with histories of early maltreatment and neglect.

Location/Institution: Texas Christian University

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The current study evaluated the effectiveness of a web-based version of Trust-Based Relational Intervention (TBRI) [now called Trust-Based Relational Intervention - Online Caregiver Training (TBRI)] in reducing behavioral problems and trauma symptoms in at-risk adopted children. Reported here are results for the 128 participants in the TBRI group who completed 75% or more of the online modules and 128 participants in a matched sample control group. Measures utilized include the Strengths and Difficulties Questionnaire (SDQ) and Trauma Symptoms Checklist for Young Children (TSCYC). Results indicated that children of parents in the TBRI group demonstrated significant decreases in behavioral problems on the SDQ and significant decreases in trauma symptoms on the TSCYC after intervention. Scores for children in a matched-sample control group did not change. Limitations include lack of full randomization, reliance on self-reported measures and lack of follow-up.

Length of postintervention follow-up: None.

References

Purvis, K. B., Cross, D. R., & Pennings, J. S. (2009). Trust-Based Relational Intervention: Interactive principles for adopted children with special social-emotional needs. Journal of Humanistic Counseling, Education, and Development, 48, 3-22.

Purvis, K. B., Cross, D. R., Dansereau, D. F., & Parris, S. R. (2013). Trust-Based Relational Intervention (TBRI): A systematic approach to complex developmental trauma. Child & Youth Services, 34(4), 1-28.

Purvis, K. B., Parris, S. R., & Cross, D. R. (2011). Trust-Based Relational Intervention: Principles and practices. In E. A. Rosman, C. E. Johnson, & N.M. Callahan (Eds.), Adoption Factbook V (pp. 485-489). Alexandria, VA: National Council for Adoption.

Contact Information

Name: Casey Call, PhD
Agency/Affiliation: Karyn Purvis Institute of Child Development, TCU
Email:
Phone: (817) 257-4283
Fax: (817) 257-0630

Date Research Evidence Last Reviewed by CEBC: June 2017

Date Program Content Last Reviewed by Program Staff: February 2017

Date Program Originally Loaded onto CEBC: June 2016