Exploring Trauma+: A Brief Intervention for Men and Gender-Diverse People (ET+)

Adults who experience the world from a male perspective and have experienced trauma

Exploring Trauma+: A Brief Intervention for Men and Gender-Diverse People is the 2nd edition of the Exploring Trauma curriculum. This edition reflects the expanded definition of gender responsive to include the experiences of transgender and nonbinary people. This new material has inclusive pronouns, as well as examples of traumatic events and focus questions specific to this group. The facilitator guide and participant workbook are on a flash drive which allows for easy duplication. There are introductory materials for the facilitator and then detailed instructions (specific lesson plans) for the sessions. The session topics include: the process of trauma, the Adverse Childhood Experiences (ACE) questionnaire, power and abuse, grounding and self-soothing, the risk of victims becoming victimizers, understanding shame, and healthy relationships. There is a strong emphasis on grounding skills. This material can also be used for training staff on the gender-responsive issues related to trauma.

Stephanie S. Covington, PhD

• Title: LCSW
• Agency/Affiliation: Covington Training Institute and Center for Gender and Justice
• Website: www.stephaniecovington.com/training/trainings-and-workshops/
• Email: sc@stephaniecovington.com
• Phone: (858) 454-8528

The goals of Exploring Trauma+: A Brief Intervention for Men and Gender-Diverse People (ET+) are:

• Increase understanding of trauma
• Increase in psychological well-being (mental health)
• Decrease in trauma symptoms
• Decrease in depression and anxiety
• Decrease in anger and aggression
• Decrease posttraumatic stress disorder (PTSD)

The essential components of Exploring Trauma+: A Brief Intervention for Men and Gender-Diverse People (ET+) include:

• This can be conducted as a group intervention with 6-10 people who experience the world from a male perspective with one facilitator per group or can be used in individual work.
• Specific topics for each of the 6 sessions:
• Session 1: Welcome and Introduction (3 activities)
• Session 2: Exploring Trauma (3 activities)
• Session 3: Thinking, Feeling, and Acting (3 activities)
• Session 4: Beyond Guilt, Shame, and Anger (5 activities)
• Session 5: Healthy Relationships (4 activities)
• Session 6: Love, Endings, and Certificates (5 activities)
• Content includes:
• Educating participants on the process of trauma
• Education on typical responses to trauma including PTSD
• Helping them to identify both maladaptive beliefs and behaviors
• Teaching coping skills and grounding activities
• Providing between session activities to reinforce information from group and to be able to practice skills
• Workbook in English and Spanish
• Materials are on a flash drive for ease of duplication

Adult Services

Exploring Trauma+: A Brief Intervention for Men and Gender-Diverse People (ET+) directly provides services to adults (regardless of whether they are parents or caregivers) and addresses the following:

• Symptoms of abuse including anxiety, depression, PTSD, and emotional dysregulation) and risk of perpetration

Recommended Intensity

One or two 2-hour long sessions per week

Recommended Duration

6 sessions – approximately 3-6 weeks

Delivery Settings

This program is typically conducted in a(n):

• Community-based Agency / Organization / Provider
• Group or Residential Care
• Justice Setting (Juvenile Detention, Jail, Prison, Courtroom, etc.)
• Outpatient Clinic
• Shelter (Domestic Violence, Homeless, etc.)

Homework

Participants have a workbook to process their group experience and practice skills.

Languages

Exploring Trauma+: A Brief Intervention for Men and Gender-Diverse People (ET+) has materials available in the following languages other than English:

• Spanish

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed in this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

• Flash drive which contains the facilitator’s guide and participant workbook
• Flip chart
• Room with chairs in a circle or at a table
• A group facilitator
• Art supplies for collage work

Prerequisite/Minimum Provider Qualifications

Counselor with experience in the field or an experienced group facilitator are the typical qualifications. It can be used with peer facilitation, as well as for individual work.

Manual Information

There is a manual that describes how to deliver this program.

Program Manual(s)

Manual information:

• Covington. S., Pugh, S., & Rodriguez, R. (2021). Exploring Trauma+: A Brief Intervention for Men and Gender-Diverse People. Hazelden.

The flash drive with facilitator guides and workbooks can be purchased online, please contact kim@stephaniecovington.com or go to https://www.stephaniecovington.com and select “Bookstore.”

Training Information

There is training available for this program.

Training Contact

Training Type/Location:

Training can be provided onsite or virtually. There are also trainings available at various sites in California and other parts of the U.S.

For more information see, https://www.stephaniecovington.com (select “Training”) and https://www.centerforgenderandjustice.org

Number of days/hours:

Generally 1 day onsite, or 2 days (4 hours per day) virtually

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Exploring Trauma+: A Brief Intervention for Men and Gender-Diverse People.

Formal Support for Implementation

Formal support for implementation in addition to the written facilitator guide can be provided via consultation to include onsite observations, Zoom meetings, email communication, and telephone calls. Consultation and TA are optional and can be contracted for a specific period of time depending on the needs of the agency. Formal support can include implementation issues, facilitator refresher courses, use of fidelity measures (see below), leadership coaching, and trouble-shooting any challenges the agency is having regarding implementation. Information on consultation is provided upon request. Please contact the program representative listed at the bottom of this page for more information.

Fidelity Measures

The Fidelity Instrument and Implementation Guidelines can be used in a variety of ways: a self-report checklist; a self-report checklist to compare with a checklist completed by an observer; checklist used with video recordings. Fidelity Instrument and Implementation Guidelines are available upon request. Please contact the program representative listed at the bottom of this page for more information.

Established Psychometrics

There are no established psychometrics for Exploring Trauma+: A Brief Intervention for Men and Gender-Diverse People.

Fidelity Measures Required

No fidelity measures are required for Exploring Trauma+: A Brief Intervention for Men and Gender-Diverse People.

Implementation Guides or Manuals

The Facilitator Guide provides complete directions and implementation guidelines.

Implementation Cost

There are no studies of the costs of Exploring Trauma+: A Brief Intervention for Men and Gender-Diverse People.

Research on How to Implement the Program

Research has not been conducted on how to implement Exploring Trauma+: A Brief Intervention for Men and Gender-Diverse People.

Child Welfare Outcome: Child/Family Well-Being

"What is included in the Relevant Published, Peer-Reviewed Research section?"

• Messina, N. (2023) An experimental study of the effectiveness of a trauma- specific intervention for incarcerated men. Journal of Interpersonal Violence, 38(3-4), 3088–3112. https://doi.org/10.1177/08862605221104526

  Type of Study: Randomized controlled trial

  Number of participants: 221

  Population:

  • Age — Mean=37 years
  • Race/Ethnicity — 44% Latino/Hispanic and 22% Black
  • Gender — 100% Male
  • Status — Participants were men incarcerated in a prison housed on a security classification risk Level III yard.

  Location/Institution: California

  Summary:

  The purpose of the study was to assess the effectiveness of the trauma-specific intervention, Exploring Trauma: A Brief Intervention [now called Exploring Trauma+: A Brief Intervention for Men and Gender-Diverse People (ET+)] among men incarcerated for violent offenses. Participants were randomized into Exploring Trauma or a waitlist control group. Measures utilized include a modified index of perpetration and victimization history from the Conflict Tactics Scales, a modified index of perpetration and victimization history of the Abuse Behavior Inventory, the Patient Health Questionnaire Depression Subscale, the Patient Health Questionnaire Anxiety Subscale, The Trauma Symptom Checklist – 40 (TSC40), the Kessler Psychological Distress Scale (K6), the State-Trait Anger Expression Inventory—2 (STAXI-2), and the Revised Instrumental and Expressive Representation Scales. Results indicate that significant improvement was found for Exploring Trauma compared with the control group on 11 of the 13 trauma-related outcome measures. The largest effect sizes ranged from .46 for mental health functioning, .42 for trait anger measures, and .40 for anxiety. Limitations include that the study sample may not be representative of male prison populations nationally; the potential for a biased estimation resulting from sample attrition; the inability to compare the two groups on outcomes from official records data, as the control group was offered the program immediately after completing the final survey; and post-release outcomes were not obtained due to the lengthy sentences of the incarcerated populations in California for serious violent crimes.

  Length of controlled postintervention follow-up: None.

• Gajewski-Nemes, J., & Messina, N. (2021). Exploring and healing invisible wounds: Perceptions of trauma-specific treatment from incarcerated men and women. Journal of Trauma & Treatment, 10, Article 5. https://www.hilarispublisher.com/open-access/exploring-and-healing-invisible-wounds-perceptions-of-traumaspecific-treatment-from-incarcerated-men-and-women.pdf

• Messina, N. P., & Burdon, W. B. (2021, Winter). Evaluation of a violence- and trauma-prevention program in secure housing units. Journal of Community Justice, 30(2), 7–12(6). https://www.civicresearchinstitute.com/online/article_abstract.php?pid=9&iid=1565&aid=9775

• Messina, N., & Schepps, M. (2021). Opening the proverbial 'can of worms' on trauma‐specific treatment in prison: The association of ACEs to treatment outcomes. Clinical Psychology & Psychotherapy, 28(5), 1210–1221. https://doi.org/10.1002/cpp.2568