Trauma Model Therapy
About This Program
Target Population: Adults with severe childhood trauma and complex comorbidity; program has been used for other mental health disorders as well.
Program Overview
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
Logic Model
The program representative did not provide information about a Logic Model for Trauma Model Therapy.
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
Program Delivery
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
Recommended Intensity:
Inpatient – 25 hours of group therapy 3 hours individual therapy/week Partial hospitalization – 20 hours group therapy, 2 hours individual/week
Recommended Duration:
Maximum length of stay inpatient is 3 weeks, maximum length of stay partial hospitalization is 4 weeks, duration of outpatient therapy is years. This can be adapted to other settings.
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.
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.
Manuals and Training
Prerequisite/Minimum Provider Qualifications
The usual qualifications for a given setting – MD, MA, PhD, BA for technicians
Manual Information
There is a manual that describes how to deliver this program.
Training Information
There is training available for this program.
Training Contact:
- Tere Kole
www.rossinst.com
teresdesk@rossinst.com
phone: (972) 918-9588
Training Type/Location:
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 professional's program has no set duration and can be a half day to several weeks depending on the person.
Relevant Published, Peer-Reviewed 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 basic study design, measures, results, and 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 controlled 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 basic study design, measures, results, and 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 controlled 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 basic study design, measures, results, and 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 controlled 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 basic study design, measures, results, and 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 controlled 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 basic study design, measures, results, and 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 controlled postintervention follow-up: None.
Additional 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
- Colin A. Ross, MD
- Agency/Affiliation: The Ross Institute
- Website: www.rossinst.com
- Email: rossinst@rossinst.com
- 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
