Program Goals

The goals of the Safety, Mentoring, Advocacy, Recovery, and Treatment (SMART) model are:

• Reduce/eliminate the problematic sexual behavior
• Address the dual-treatment needs of the child as a victim and one who victimizes others
• Establish stability and a sense of safety for the child and their family
• Increase the child's and family's awareness of personal and familial risk patterns and triggers
• Develop coping skills and strategies aimed at improving emotional and behavioral regulation across domains (home, school, and community)
• Build a strong resource structure that will support the family across the child's life trajectory

Logic Model

The program representative did not provide information about a Logic Model for Safety, Mentoring, Advocacy, Recovery, and Treatment (SMART).

Essential Components

The essential components of the Smart, Mentoring, Advocacy, Recovery, and Treatment (SMART) model include:

• Three clinically essential phases:
• Safety & Stabilization - The initial phase of treatment focuses on:
• Trauma Assessment of the child
• Risk Reduction Plan with a focus on safety
• Family and Community Engagement – Family engagement and the formation of a strong therapeutic relationship are critical.
• Trauma Integration & Recovery - The second phase of the model focuses on:
• Impulse Regulation – helping the child regulate his/her behavior
• Affect Modulation - Helping the child regulate his/her emotions
• Trauma Triggers - helping the child understand what might bring the unwanted behaviors and emotions back
• Cognitive Processing – helping the child develop coping and problem-solving skills
• Trauma Narratives – helping the child be able to talk about what happened
• Re-Socialization & Mastery - The final phase of the model focuses primarily on relapse prevention and supports the child and family to integrate all the skills learned into daily practice:
• Stress/Relaxation – learning to recognize stress and use relaxation skills to alleviate the stress
• Healthy Intimacy – learning to be comfortable with his/her own body
• Self-esteem – teaching the child about self-esteem and helping them acquire it
• Relapse Prevention – integrating above learned skills into daily practice
• Each phase contains content modules that must be mastered in order to move to the next phase of treatment. Each module includes specific activities and interventions.
• The SMART model includes a treatment guide that was developed as a mechanism to standardize and promote fidelity of the model and a specialized treatment workbook. The treatment guide offers indicators of mastery to inform and guide clinical practice.
• Key themes are interwoven within each phase including the use of psycho-education, safety contracting and monitoring, and skill building.

Program Delivery

Child/Adolescent Services

Safety, Mentoring, Advocacy, Recovery, and Treatment (SMART) directly provides services to children/adolescents and addresses the following:

• Problematic sexual behavior, placement instability, safety contracting, PTSD symptoms, feelings of shame, distorted beliefs about self and others, and symptoms of anxiety and depression

Parent/Caregiver Services

Safety, Mentoring, Advocacy, Recovery, and Treatment (SMART) directly provides services to parents/caregivers and addresses the following:

• Has a child with problematic sexual behavior (PSB) and failure to recognize familial patterns and communication that exacerbate the PSB; may also be experiencing trauma-related emotional distress

Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Family involvement is mandatory at least 2x per month. There are family activities included in the treatment workbook. Extensive safety planning and formal and informal resources are identified and hopefully developed to support the child and family at home, at school, and in the community.

Recommended Intensity:

Number of contacts per week is tailored to the specific needs of the family and is based on risk and family stability. The average length of sessions is 50 minutes.

Recommended Duration:

12-18 months; may vary with the number of contacts per week as needed by the family

Delivery Setting

This program is typically conducted in a(n):

• Outpatient Clinic

Homework

This program does not include a homework component.

Resources Needed to Run Program

The typical resources for implementing the program are:

• A trained clinician
• Confidential space to conduct sessions
• Treatment guide and workbook
• Therapeutic books and supplies
  
• Crayons, markers, and colored pencils
  

Manuals and Training

Prerequisite/Minimum Provider Qualifications

Master's Degree in Counseling, Psychology, or Social Work and training in the intervention. At least one year's experience working with children and families impacted by childhood sexual abuse and other childhood traumas.

Manual Information

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

Training Information

There is training available for this program.

Training Contact:

• Jennifer Weeks, LCPC
  www.kennedykrieger.org/patient-care/centers-and-programs/traumatic-stress-center/training/upcoming-training-consultation/special-populations/safety-mentoring-advocacy-recovery-treatment-smart-model-organizational-training-only
  weeksj@kennedykrieger.org
  phone: (443) 923-5965

Training Type/Location:

Training can be provided onsite at an agency, or at The Family Center at the Kennedy Krieger Institute.

Number of days/hours:

Initial 2-day didactic training prior to implementation, follow-up monthly consultation calls, and 1-day advanced training to be delivered approximately 6 months later

Relevant Published, Peer-Reviewed Research

Additional References

No reference materials are currently available for Safety, Mentoring, Advocacy, Recovery, and Treatment (SMART).