Research

There is a growing body of research highlighting the benefits of ARC when working with trauma-impacted youth.

The Research at a Glance

Analysis of child outcomes in two residential schools employing ARC with youth ages 12 to 18 over a 6-month period demonstrated clinically significant reductions in PTSD symptoms (UCLA PTSD Reaction Index) and internalizing and externalizing behavior (Child Behavior Checklist). Further, significant (48-68%) decreases in restraints were observed in comparison to non-ARC residential treatment facilities, who evinced either a small (1%) decrease or large increase (81%) in restraint use over the same time period.  Residential implementation supports its efficacy for problem reduction for youth in residential treatment.¹

In a sample of culturally diverse (high percentage Native American and Alaskan Native) child welfare-involved, multiply maltreated children ages 3-12 years, ARC treatment completers demonstrated a marked reduction in CBCL behavioral problems (from 85^th to 49^th percentile), and increased placement permanency: 92% versus the state average of less than 40% within 1 year.²

In a study of 481  adopted children with histories of complex trauma, treated children showed improvement in both child and caregiver functioning. After sixteen sessions of individual and 6 child- and caregiver-group based ARC treatment sessions, children showed reductions in internalizing, externalizing, posttraumatic stress, depression, anxiety, and dissociative symptoms from pre-to post treatment. In addition to improvement in child functioning, the study also showed a decrease in reported maternal stress, as well as other indicators of caregiver distress.³

The Massachusetts Child Trauma Project demonstrated that ARC was one of three utilized treatments that, as a group, demonstrated efficacy for a large sample of child-welfare involved children and families from pre- to post-treatment. Of note were clinically significant decreases in PTSD symptoms and behavior problems.⁴

Results of initial implementation of ARC within Juvenile Justice settings, which included clinical groups, staff training and support, and milieu intervention, demonstrated a 45% decline in restraints compared to a 131% increase in comparable Juvenile Justice programs during the same period, suggesting both a decrease in negative youth behaviors and increase in staff skill and capacity to provide alternative supports.⁵

Upcoming

A randomized control trial (RCT) examining the effects of ARC treatment is currently underway, where ARC is being compared to a trauma informed Treatment as Usual (TAU) control group. Study participants include 112 youth ages 8-16 who meet both of the following criteria: 1) a history of complex trauma, defined as a minimum of two types of trauma exposure at least one of which must be interpersonal in nature (i.e. physical, sexual or psychological maltreatment by a primary caretaker, neglect, abandonment, or impaired caregiving); and 2) diagnosis of Developmental Trauma Disorder as defined by the DTD interview developed by the Trauma Center. The intervention sample will be selected to include substantial representation of Hispanic/Latino, African American, and Asian American backgrounds.

For a complete list of articles, chapters, and texts relevant to the ARC framework, please click here.

Footnotes

¹ Hodgdon, H. B., Kinniburgh, K., Gabowitz, D., Blaustein, M. E., & Spinazzola, J. (2013). Development and implementation of trauma-informed programming in youth residential treatment centers using the ARC framework. Journal Of Family Violence, 28(7), 679-692.

² Arvidson, J., Kinniburgh, K., Howard, K., Spinazzola, J., Strothers, H., Evans, M., … & Blaustein, M. E. (2011). Treatment of complex trauma in young children: Developmental and cultural considerations in application of the ARC intervention model. Journal of Child & Adolescent Trauma, 4(1), 34-51.

³ Hodgdon, H. B., Blaustein, M., Kinniburgh, K., Peterson, M. L., & Spinazzola, J. (2016). Application of the ARC model with adopted children: supporting resiliency and family well being. Journal of Child & Adolescent Trauma, 9(1), 43-53.

⁴ Bartlett, J. D., Barto, B., Griffin, J. L., Fraser, J. G., Hodgdon, H., & Bodian, R. (2015). Trauma-informed care in the Massachusetts child trauma project. Child maltreatment, 1077559515615700.

⁵Gabowitz, D. & Spinazzola, J. (2007, November).  Partnering with other systems.  Paper presented at the New Grantee Orientation of the National Child Traumatic Stress Network, Richmond, VA.