Clinical Model




Grandfather Home for Children is adopting the Evidence Based Practice of Attachment, Self-Regulation, and Competency (ARC).  ARC is recognized by the National Child Traumatic Stress Network as a highly efficacious treatment framework for working with children and their families struggling with complex trauma.

 

 

ARC Developed by: Kristine Kinniburgh, LICSW & Margaret Blaustein, Ph.D.

 

 

As many as one in four youth will experience a potentially traumatic exposure, and many of these will be multiple or prolonged. The impact of these stressors is far-reaching, and often repeats across generations as yesterday’s impacted children become tomorrow’s parents and caregivers. Establishing effective practice for this population is a priority, but is challenging, given their diverse histories, their varied presentations, the multifaceted contextual, cultural, and developmental influences which shape them, and the wide range of systems within which they seek care.

 

ARC (Kinnibrugh & Blaustein, 2005; Blaustein & Kinniburgh, 2010) draws from the fields of trauma, attachment, and child development, where the framework recognizes the importance of working with the child-in-context and is designed to be usable in a variety of settings.  ARC acknowledges the role of historical experiences and adaptive responses in current presentation, and aims to work with the surrounding environment – whether primary caregivers or treatment system – to support and facilitate the child’s healthy growth and development. Rather than identify manualized treatment intervention strategies, the framework identifies 10 key “building blocks”, or intervention targets, while encouraging the awareness of developmental and cultural considerations.

 

 

ARC Framework Outline

I.                    Attachment

a.       Caregiver modulation: Building caregiver capacity to manage and tolerate affect

b.      Caregiver-child attunement: Supporting caregivers in understanding and interpreting child behavior, and responding in a supportive manner

c.       Increasing consistent caregiver response: Increasing caregiver ability to appropriately respond to child behaviors with praise and reinforcement, as well as age-appropriate limit-setting

d.      Building routines and rituals: Increasing consistency/predictability through targeted development of family- and child-specific routines

II.                  Self-Regulation

a.       Affect identification: Ability to identify and label internal experience, and to connect emotion to thoughts, behaviors, physiological sensations, and experiences

b.      Affect modulation: Ability to regulate internal arousal and external manifestations

c.       Affect expression: Ability to communicate and share emotional experience

III.                Competency

a.       Building age-appropriate competence in relevant developmental domains

b.      Executive functions: Ability to plan, anticipate, problem-solve, and delay response

c.       Self-Development and Identity: Building positive and coherent sense of self and future orientation

IV.                Trauma Experience Integration

a.       Trauma Experience Integration: Building reflective process around historical life experiences, in order to support engagement in present life

 

All core clinical staff (Clinical Director, Director of Residential Services, campus based therapists, Unit Managers, Day Treatment service providers and community services Regional Directors) have been trained in the ARC framework.  Campus staff utilize the framework as the overarching treatment model for individual, group and family treatment.  Community services within the foster care regions utilize ARC in conjunction with the child/family independent therapists in child groups and multi family groups.

 

More information about ARC can be found here (Trauma Center at JRI).