The Attachment, Regulation and Competency (ARC) Framework
Condition: Posttraumatic Stress Disorder; Developmental Trauma Disorder
MeSH terms: Stress Disorders, Post-Traumatic
Study type: Interventional

Summary: 
      This study evaluates the effectiveness of the Attachment Regulation and Competency (ARC)
      treatment framework in comparison to treatment as usual for reducing symptoms of PTSD and
      Developmental Trauma Disorder among children ages 8 to 16 with a history of exposure to
      multiple traumatic events.
    

Detailed description: 
      The primary goal of this project is to expand the knowledge base in the field of trauma
      informed interventions by addressing current gaps in the evidence base through: a) evaluation
      of the efficacy of an innovative intervention designed specifically for children who
      experience complex trauma and their caregivers, thereby evaluating strategies that are most
      effective, and b) examining how ARC promotes protective factors (self-regulation, caregiver
      wellness), thereby supporting the health and well-being of complexly traumatized children and
      their families. The overall purpose of the randomized controlled trial (RCT) is to examine
      the effectiveness of ARC on the range of developmental disruptions and clinical symptoms that
      represent complex trauma, as well as its utility for increasing the adaptive functioning of
      children and families. In particular it is necessary to determine: 1) if ARC will demonstrate
      effectiveness in reducing sequelae of complex trauma as determined by a scientifically
      rigorous randomized control trial study design; 2) the extent to which ARC positively impacts
      resiliency factors (self-regulation, executive functioning, caregiver wellness), thereby
      serving to moderate or mediate change in symptoms and functioning; and 3) the impact of ARC
      across multiple levels of the family ecology, including the child, the caregiver-child
      relationship (i.e., attachment) and caregiver stress and wellness.

      The specific objectives of this research project are the following:

        1. Recruit 182 children ages 8 to 16 with complex trauma and their adult caregivers, from
           clinical samples of children actively seeking treatment for mental health disorders and
           related difficulties from three community based outpatient clinics in the Commonwealth
           of Massachusetts.

        2. Conduct comprehensive, clinical interviews with participants and their caregivers to
           assess sequelae of complex trauma, to determine underlying resiliency factors and to
           gather information regarding trauma exposure history, over four study time points (pre-,
           mid-, and post-treatment and 6-month follow up).

        3. Deliver 24 sessions of once weekly ARC or TAU over a 6-month intervention period.

        4. Evaluate the efficacy of ARC and TAU using a variety of sophisticated statistical
           methods, such as growth curve modeling, multivariate analyses, and hierarchical linear
           regression analyses.

        5. Disseminate findings to: 1) the academic community via presentations at professional
           conferences and publications of data in peer reviewed journals; 2) the public, via the
           Trauma Center website, which received over 600,000 visitors in 2012, with 1,161,451
           downloads of our manuscripts and resources for providers, consumers and state service
           agencies; and 3) the National Child Traumatic Stress Network (NCTSN) and Complex Trauma
           Treatment Network (CTTN) at annual network meetings, via their websites and through
           ongoing collaborations with partner network sites across the country.
    

Intervention name(s): Attachment Regulation and Competency; Treatment as usual
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Trauma informed psychotherapy intervention for children with a history of exposure to trauma and their caregivers.; Supportive psychotherapy
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The Attachment, Regulation and Competency (ARC) Framework is an attachment focused model designed specifically for trauma-impacted children that incorporates principles of the following theoretical orientations: 1) developmental theory; 2) family systems theory; and 3) strengths-based approaches. The central goals of the ARC framework are to (a) support caregiving systems and enhance caregiver-child relationships ("Attachment"), (b) support children in developing the skills and tolerance for connecting to, identifying, and sharing internal experience and managing emotional and physiological states ("Regulation"), (c) build key capacities associated with resilience including the ability to engage in problem-solving and a positive / effective sense of self ("Competency"), and (d) process traumatic experiences.
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment