Program Goals

The goals of the Trauma Resiliency Model (TRM)® for the target population are:

For Children/Adolescents:

• Learn to discern the difference between sensations of distress and sensations of well-being.
• Learn about the autonomic nervous system and how the body responds to stress.
• Learn the key concepts of the model that include the definition of the Resilient Zone, High Zone, and Low Zone, creating a common language for conceptualizing their experience of distress and well-being.
• Increase awareness of sensations of well-being by practicing the six self-help wellness skills.
• Increase well-being and reduce depressive symptoms, anxiety symptoms, somatic symptoms, and posttraumatic stress symptoms.
• Learn basic concepts about the neurobiology of trauma and resiliency, including organizing principles of the brain, survival responses, and memory.
• Understand common human responses to stressful and traumatic events through a lens of biology.
• Reduce feelings of shame and stigma.
• Pay attention to the sensations connected to the traumatic experience that can be reprocessed by present-moment awareness of paying attention to sensations of well-being and competing survival responses.
• Complete thwarted survival responses that were blocked as the result of a traumatic experience or a series of traumatic experiences, in order to bring the nervous system back to a state of balance.

For Parents/Caregivers:

• Learn to discern the difference between sensations of distress and sensations of well-being.
• Learn about the autonomic nervous system and how the body responds to stress.
• Learn the key concepts of the model that include the definition of the Resilient Zone, High Zone, and Low Zone, creating a common language for conceptualizing their experience of distress and well-being.
• Increase awareness of sensations of well-being by practicing the six self-help wellness skills.
• Increase well-being and reduce their own potential depressive symptoms, anxiety symptoms, somatic symptoms, and posttraumatic stress symptoms.
• Learn basic concepts about the neurobiology of trauma and resiliency, including organizing principles of the brain, survival responses, and memory.
• Understand common human responses to stressful and traumatic events through a lens of biology.
• Reduce feelings of shame and stigma.
• Pay attention to the sensations connected to the traumatic experience that can be reprocessed by present-moment awareness of paying attention to sensations of well-being and competing survival responses.
• Complete thwarted survival responses that may have been blocked as the result of a traumatic experience or a series of traumatic experiences, in order to bring the nervous system back to a state of balance.

Logic Model

The program representative did not provide information about a Logic Model for Trauma Resiliency Model (TRM).

Essential Components

The essential components of the Trauma Resiliency Model (TRM)® include:

• As an overview, the nine skills of TRM are designed to be delivered to clients by a TRM practitioner:
• The first six skills (i.e., the Community Resiliency Model (CRM)®) are self-help wellness skills to be used by the client both in session and in their activities of daily living. They are designed to increase confidence in managing and changing distressing sensations, thoughts, and feelings connected to the multisensory reminders of their traumatic experience.
• The remaining three skills -- Titration, Pendulation, and Completion of Survival Responses (i.e., adapted from the work of Peter Levine and other pioneers in the field of somatic therapy) – are used by the TRM Practitioner in session to help gently reprocess the traumatic experience.

• The parent is brought in with the child/adolescent for the wellness skills earning process. When the skills are taught to both parent and child, the parent can model the skills and, when balanced, be more effective in helping the child. As parents practice the skills, they ideally become more attuned to and are better able to read their child’s nervous system responses and redirect the child to use a skill when they observe the child escalating or withdrawing.
• Developmental factors and the child’s or adolescent’s comfort level need to be considered when determining whether or not the parent is present when the TRM Practitioner implements the three remaining trauma reprocessing skills with the client. If the parent is still present, the skills are taught in the family session just like the wellness skills. If the parent is not present, these skills can be taught in individual or group sessions.
• Optional workbooks have been developed for parents and youth to be used individually or together to help reinforce the skills.
• TRM content consists of:
• The first part of the intervention is to educate clients about the biology of trauma and resiliency. This is accomplished by psychoeducation, workbooks, and pocket cards.
• The key concepts of the Resilient Zone (also known as the “Okay Zone”), High Zone, and Low Zone are explained in simple terms to help individuals begin to self-monitor the sensations connected to their distress and most importantly sensations connected to their well-being.
• The primary core wellness skills of Tracking, Resourcing, and Grounding are taught. The client (and parent) is guided in practicing the three basic skills and are oriented to the Trauma Resource Institute’s (TRI’s) free iChill app (available online and for iOS and Android devices), which can be used outside of the therapeutic setting by older children and adolescents to help reinforce the learning of the skills, whether working individually, in families, or in groups.
• The wellness skills of Gesturing, Help Now!, and Shift and Stay are taught to the client to reinforce the self-management of the wellness skills. The iChill app is again reinforced for home practice of the first six skills to reinforce the clients’ ability to regulate their own nervous system during times of distress.
• Once the practitioner knows the client can sense neutral and pleasant sensations, the client may have the readiness to work on a particular traumatic event that has been shared.
• The practitioner uses the additional three trauma reprocessing skills of Titration, Pendulation, and Completion of Survival Responses to gently guide the client to ideally release the sensations connected to the traumatic experience, which restores balance to the nervous system.
• The client may experience common transient release sensations of the autonomic nervous system (e.g., tingling, heat, shaking) that help to restore balance within the body and mind. This results in a sense of relief in the body and mind.
• Throughout the therapeutic process, the child/adolescent is encouraged to practice the wellness skills of the model in order to strengthen their ability to bring attention to sensations of well-being in the present moment. Doing so helps reduce the impact of any distressing reminders of traumatic experiences that may arise and restores balance to the mind and body.

Program Delivery

Child/Adolescent Services

Trauma Resiliency Model (TRM) directly provides services to children/adolescents and addresses the following:

• Trauma/stress reactions, such as anxiety symptoms, depressive symptoms, disruptive behaviors, angry outbursts, insomnia, irritability, grief, and autonomic nervous system dysregulation

Parent/Caregiver Services

Trauma Resiliency Model (TRM) directly provides services to parents/caregivers and addresses the following:

• Parents/caregivers of children with trauma/stress reactions
• Parents/caregivers experiencing trauma/stress reactions with symptoms such as anger management challenges, anxiety, depression, hostility, and difficulty parenting

Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Family members and other supports can learn the wellness skills, the language of the model, and the neuroscience of trauma, stress, and well-being in order to provide a network of support for the child.

Recommended Intensity:

For individual/family sessions, 15- to 60-minute sessions at first with 1- to 1.5-hour sessions during the trauma reprocessing stage. For group sessions during the last 3 skills, they can range from 15- to 90-minute sessions.

Recommended Duration:

The number of sessions can vary greatly due to a number of factors (e.g., severity of symptoms, number of traumas, complexity of trauma, etc.), but it is typically 4 or more. There is great flexibility when learning the six wellness skills of of the model and for some, one 60-minute session learning the wellness skills coupled with the iChill app is sufficient. Once an agency is trained, the wellness skills for the model can be integrated organizationally creating a common language for supporting the client at all contact points, including those outside of the therapeutic session.

Delivery Settings

This program is typically conducted in a(n):

• Adoptive Home
• Birth Family Home
• Foster / Kinship Care
• Hospital
• Outpatient Clinic
• Community-based Agency / Organization / Provider
• Group or Residential Care
• Justice Setting (Juvenile Detention, Jail, Prison, Courtroom, etc.)
• Public Child Welfare Agency (Dept. of Social Services, etc.)
• School Setting (Including: Day Care, Day Treatment Programs, etc.)
• Shelter (Domestic Violence, Homeless, etc.)
• Virtual (Online, Telephone, Video, Zoom, etc.)

Homework

Trauma Resiliency Model (TRM) includes a homework component:

• It is best to practice the skills as the more practice, the better the person is able to stabilize the nervous system. Using the skills within the activities of daily living is encouraged.
• Clients are encouraged to use TRI’s free iChill app outside of the therapeutic setting. This app can be used by older children, adolescents, and adults to help reinforce the learning of the skills, whether working individually, in families, or in groups.
• It is currently available in English, Spanish, and Ukrainian.

Languages

Trauma Resiliency Model (TRM) has materials available in languages other than English:

Arabic, Diné Bizaad (Navajo), French, Hungarian, Khmer, Kinyarwandan, Kreyòl (Haitian Creole), Kurdish, Nepali, Russian, Simplified Chinese, Somali, Spanish, Swahili, Tagalog, Turkish, Ukrainian

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

Resources Needed to Run Program

The typical resources for implementing the program are:

Paper, pen, and a room or space. Computer is not necessary but can be used.

Manuals and Training

Prerequisite/Minimum Provider Qualifications

To become a Certified TRM Practitioner, one must be a licensed mental health professional in good standing.

Manual Information

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

Program Manual(s)

Manual details:

• Miller-Karas, E. (2023). Building resilience to trauma: The Trauma and Community Resiliency Models (2nd ed.). Routledge.

TRM Workbook (supplemental):

• Miller-Karas, E. (2021). Trauma Resiliency Model (TRM)® Workbook.
• Available (hardcopy or digitally) through the website store: https://www.traumaresourceinstitute.com/materials/trauma-resiliency-model-workbook

Training Information

There is training available for this program.

Training Contacts:

• Elaine Miller-Karas
  www.traumaresourceinstitute.com/trm-trainings
  emillerkaras@communitytri.com
  phone: (909) 626-4070
• Michael Sapp
  www.traumaresourceinstitute.com/trm-trainings
  msapp@communitytri.com
  phone: (909) 626-4070

Training Type/Location:

• On Zoom or in-person at location of trainee's organization.
• Periodic in-person public trainings hosted by TRI.

Number of days/hours:

• TRM Level 1: 3 days (23 hours)
• TRM Level 2: 3 days (23 hours)
• Certified TRM Practitioner: Must meet requirements as set forth in the certification document available online at https://www.traumaresourceinstitute.com/tri-certification

Relevant Published, Peer-Reviewed Research

Currently, there are no published, peer-reviewed research studies for Trauma Resiliency Model (TRM).

Additional References