Phase Model of Trauma-Informed Treatment

TI & CTI's research-supported trauma-informed phase model treatment approach is featured in its publications, training programs, and clinical practice. Within this treatment approach, trauma resolution is a late-stage intervention, only introduced once the client has been well prepared (in terms of understanding, motivation, stability, and coping skills) and is likely to be successful.

The phase model is considered the standard of care in trauma treatment. We use Dr. Greenwald's Fairy Tale phase model, so named because it is introduced with the telling of a fairy tale, in which each element of the story corresponds to one of the phases in treatment. For example, the hero's love for the princess (which moves him to try to slay the dragon) represents the treatment phase in which the client's motivation is identified and developed. The Fairy Tale model's phases of treatment are as follows:

  1. evaluation including learning about the client's strengths, resources, trauma/loss history, life situation, and presenting problems
  2. identification and enhancement of the client's goals and motivation
  3. trauma-informed case formulation and treatment contracting
  4. stabilization, potentially including case management, parent training, problem-solving, and strategic avoidance of high risk situations
  5. identification and enhancement of coping and affect tolerance skills
  6. resolution of trauma and loss memories
  7. consolidation of gains
  8. anticipation of future challenges

Our treatment approach is focused on helping clients to realize their potential and achieve their goals. This treatment approach includes the typical "peak performance" interventions plus others to overcome obstacles and enhance outcome.

Effective and Efficient

Despite the fact that this model includes numerous phases of treatment, it's an extremely efficient treatment approach, because:

  • Not every phase requires a lengthy intervention; it depends on what is needed to ensure that the relevant outcome has been achieved.
  • When the outcomes are achieved in order, this makes subsequent interventions more efficient and effective. For example, a client who is already highly motivated will work harder at self-management skills training, and thus be more successful.
  • The interventions used are effective and efficient.

Works With Many Problems

The phase model is considered the standard of care for trauma-focused therapy. However, this treatment approach is not limited to a trauma focus. Rather, because trauma (broadly defined to include loss etc.) is at the root of a wide range of problems, the treatment can be broadly applied. Trauma or loss is addressed in addition to using the most effective treatment approaches for the given problem.

Research Supported

This research-supported treatment approach uses a number of proven-effective interventions (as called for) to get the job done effectively and efficiently for the client and situation. For example:

  • Motivational Interviewing to help clients to identify and enhance investment/commitment in their goals.
  • Cognitive-Behavioral Training for self-management skills (including anger management, self-discipline, etc.).
  • Imaginal Rehearsal to practice (visualizing) effective behaviors
  • EMDR or PC for resolution of trauma or loss memories.
  • Relapse Prevention and Harm Reduction to help clients to anticipate future challenges and stay on track towards their goals.

Furthermore, the treatment approach maximizes the "common factors" (factors shared across treatment styles) that contribute to treatment success. The overall treatment approach has also been found to be effective in several studies.