How Was ARC Developed?
ARC was co-developed by Kristine Kinniburgh and Margaret Blaustein, and initially grew out of the work our agency, the Trauma Center at JRI, was doing within the National Child Traumatic Stress Network (NCTSN), a United States based consortium of sites dedicated to improving services for children and families who have experienced traumatic stress. As part of our work in the NCTSN, the Trauma Center emphasized the importance of expanding the capacity of community-based agencies to provide trauma-informed services. In our process of working with agencies to develop these services, we found ourselves needing to step back and examine the question: What is it, exactly, that we do? In other words: When we talk about “trauma treatment,” what does that mean for youth and families, particularly those who have experienced complex and chronic traumatic stress?
The initial origins of ARC came in our attempt to define core aspects of trauma treatment, and particularly those that are relevant not just in the office, but in the community, in the home, and in large systems of care. This process led to the development of ARC as a core components framework, which identifies 8 “building blocks”, or key treatment targets, within the three core domains of attachment (building safe relationships); self-regulation (supporting child and adolescent capacity to regulate physiological and emotional experience); and competency (supporting those capacities which facilitate resilient youth development). The final domain, Trauma Experience Integration, is identified as the ultimate goal of treatment, building upon the integration and application of the skills targeted throughout treatment, and with an emphasis on supporting youth capacity to engage purposefully in the present.
ARC was developed as a “flexible framework.” What this means is that rather than providing a single manualized protocol, ARC identifies core concepts of intervention which translate across service settings; breaks each of these core concepts down into key skills and targets; and works with implementing agencies and providers to apply these concepts within their clinical work or organizational setting. For instance, the first attachment “block” of ARC is “Caregiver Affect Management,” which emphasizes the importance of supporting the caregiving system in understanding and managing its own emotional responses. Sub-skills include validation / normalization of emotional experience; provision of psychoeducation; building self-monitoring skills; development of concrete coping strategies; and enhancing supports and resources. A clinician might work with a primary caregiver to develop these skills, while simultaneously tuning in to his or her own emotional responses to the child and/or the caregiver. Within a school setting, the administration might target support of teachers in recognizing and understanding their emotional responses to students. In a residential program, the staff often play the role of caregivers, and building appropriate supports for them becomes the target of intervention. Thus, the concepts will apply across settings and across role, but the focus and format of intervention will differ.
ARC was designed with the goal of not only allowing for, but embracing the inherent creativity and art of the clinical process, recognizing that strategies and approaches will necessarily differ across clients, across providers, and across settings. Trauma work is complex, and an attempt to apply the same strategy at all times, with all families, and within all settings is likely to fall short. However, while specific strategies may necessarily differ, there is now considerable agreement within the complex trauma field as to the core impacts of trauma, as well as core targets of intervention. ARC is strongly grounded in the theoretical and research literature, drawing in particular from the fields of trauma, attachment, and child development, and anchoring in the research on resilience.
The ARC framework has been in development since 2003, with the first version of the ARC manual completed in 2004, quickly followed by a revised edition in 2005. It has gone through a number of revisions since that time, culminating in the publication of the text, “Treating Traumatic Stress in Children and Adolescents: How to Foster Resilience through Attachment, Self-Regulation, and Competency” in March 2010 by Guilford Press. During this time, we have had the privilege of working with numerous agencies and programs (over 300 and growing) within the United States and internationally, in settings including (among others) outpatient centers, residential programs, juvenile justice systems, schools, foster care settings, group homes, domestic violence shelters, early intervention programs, inpatient hospitals, and more. The feedback and real-life application of these programs has made important contributions to the refinement of the framework, which is grounded as strongly in on-the-ground work as it is in theory.