Attachment, Regulation and Competency



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 85th to 49th 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


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.


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. 


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