The Impact of Child Trauma Therapy Training
on Participants

Ricky Greenwald, Psy.D.

Child Trauma Institute, Greenfield, MA

B. Hudnall Stamm, Ph.D., Debra Larsen, Ph.D., & Kelly Griffel, B.A.

Institute of Rural Health & Department of Psychology, Idaho State University

Citation: Greenwald, R., Stamm, B. H., Larsen, D., & Griffel, K. (2003, October). The impact of child trauma therapy training on participants. Poster session presented at the annual meeting of the International Society for Traumatic Stress Studies, Chicago.

Address correspondence to: Ricky Greenwald, Psy.D., rg@childtrauma.com, Child Trauma Institute, PO Box 544, Greenfield, MA 01302.

Abstract

Research on effective treatment for child trauma is considerably ahead of practice, and the interventions with the best empirical support have not been widely used in the field. Since dissemination is urgent, child trauma treatment training programs are proliferating, but data is rarely reported on the impact of such training, either on participants or on their clients. Such data, if gathered and reported, could help to identify promising/effective training methods. This paper reports on the impact of the 5-day "Child Trauma Institute" training program for school-based mental health professionals in NYC following 9/11. In the fist study, seventy-one participants completed an early version of the Compassion Satisfaction and Fatigue (CSF) screening form, as well as a form assessing their child trauma treatment attitudes and practices, at the beginning and again at the end of the training. In the second study, this procedure was repeated with 35 new participants, using the current version of the CSF. The training appeared to have a significant positive impact on participants' Compassion Satisfaction, with non-significant trends towards reductions in Compassion Fatigue and Burnout. The training also appeared to produce significant gains (with large effect sizes) on many of the competency items. These findings provide preliminary support for the value of this training program.

Introduction

Research on effective treatment for child trauma is considerably ahead of practice, and the interventions with the best empirical support have not been widely used in the field. Since dissemination is urgent, child trauma treatment training programs are proliferating. Unfortunately, data is rarely reported on the impact of such training, either on participants or on their clients. Such data, if gathered and reported, could help to identify promising/effective training methods.

This paper reports on the impact of the 5-day “Child Trauma Institute” training program for school-based mental health professionals in NYC following 9/11. This is an experiential program delivered in a small-group setting (max of 30). Content is empirically based, reflecting what is known to be effective in child trauma treatment (see Cohen, Berliner, & March, 2000). Additional content focusing on therapeutic relationship and therapist self-care was adapted from an adult-oriented curriculum (Saakvitne, Gamble, Pearlman & Tabor Lev, 2000). Training modules include an overview of child/adolescent trauma and treatment, therapeutic relationship, therapist self-care, and skills training for a series of interventions in a systematic treatment approach.

Questions:

•          Can participation in the training course reduce perceptions of compassion fatigue and burnout?

•          Can participation increase reported knowledge and competence re child trauma treatment?

Methods

Participants

•          New York City school-based mental health professionals (guidance counselors, social workers and psychologists) following 9/11.

•          71 participants in Year 1, 35 participants in Year 2.

Instruments

•          Compassion Satisfaction & Fatigue Short form (all subscales 0 to 5, higher scores greater amount of characteristic reported; compassion satisfaction, burnout, compassion fatigue); Subscale Alphas = .87-.90 (Stamm, 2000).

•          Trauma Expertise Scale (knowledge and competence re child trauma treatment, -2 to +2, higher scores indicate higher reported knowledge and competence); new for this study, alpha for this sample = .78 Yr 1; .57 Yr 2.

Procedures

Measures were taken at the beginning and at the end of the 5-day “Child Trauma Institute” training program. The program was delivered over a 2-month period, so there was some opportunity to practice some of the methods prior to post-test.

Analysis

•          Year 1: in an effort to be sensitive to participant privacy issues, a group pre-post test design was used.

•          Year 2: because it was clear that data lacked specificity due to lack of matching from pre to post-test, in year 2, a matched pre-test, post-test design was used.

•          SPSS: Reliabilities were calculated with alpha routine. Year 1, ANOVA group pre-test, post-test; Year 2, paired t-test.

Results & Discussion

    Year One Group Pre-test, Post-test

                                                                                                     Scale   df        F         sig

                                                                                                     CSat    1,141   10.56   <.01

                                                                                                     Brnt    1,141    1.42   =.25

                                                                                                     CFat    1,141    0.82   =.37

                                                                                                     TES    1,141   87.65   <.01

                                                                                                    Year Two Paired t-tests

                                                                                                    Scale   df        t          sig

                                                                                                    CSat    1,35     -4.17   <.01

                                                                                                    Brnt    1,35      3.12    <.01

                                                                                                    CFat    1,35      1.12    =.27

                                                                                                    TES    1,35     5.07     <.01

The results of these data suggest that people do feel better about their work, and report more knowledge and competency, after the training than they did before. At post-test the training did not appear to affect perceived compassion fatigue/secondary traumatic stress associated with the school personnel’s work.

In both years, participants reported increased knowledge and competence re child trauma treatment. This may be in part attributed to participant interest. Across both years, at least 75% of the participants chose to attend the training and over 50% of participants were “very interested in learning trauma skills.” The reported desire to be in the training was higher in year 1 than year 2 (90% vs. 65%). The interest in learning trauma skills was constant across the two years, at 97%.

In Year 1, the school-based mental health professionals reported being more satisfied with their work after the training. This result also appeared in Year 2. In Year 2, participants reported reduced perceptions of burnout from the pretest to the posttest.

Without further data, it is difficult to understand why the participants perceived their work more positively, and (for the year 2 participants) felt less burnout after the training than before. It is possible that the participants’ sense of increased efficacy in their work may have impacted both the satisfaction and burnout scales. The specific training focus on therapist self-care may have also contributed to these outcomes.

The results from this project suggest that the training has the potential to both increase the school personnel’s perception of efficacy and their perception of the positive aspects of their work.

Future studies should follow up after the training to see if the changes reported to have occurred have longevity. In addition, it would be useful to learn if these changes translate into improved outcomes for the children served.

References

Cohen, J. A., Berliner, L., & March, J. S. (2000). Treatment of children and adolescents. In E. B. Foa, T. M. Keane, & M. J. Friedman (Eds.), Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies (pp. 106-138). New York: Guilford.

Stamm, B. H.. (2000). Compassion Satisfaction and Fatigue Test, short form. Retrieved May 1, 2001, from the World Wide Web: http://www.isu.edu/~bhstamm/tests.htm

Saakvtne, K. W., Gamble, S. Pearlman, L. A. & Tabor Lev, B. (2000). Risking Connection. Baltimore, MD: Sidran Institute.

Acknowledgments

The delivery of training in this project was sponsored by the Child Trauma Institute, the Sidran Institute for Traumatic Stress Education and Advocacy, the Philip Morris Companies, and the NYC Department of Education.

The Compassion Fatigue and Satisfaction Test, and the data analysis for this project, is supported in part by grant # 1 D1B TM 00042-01 from the Department of Health and Human Services (DHHS) Health Resources and Services Administration, Office for the Advancement of Telehealth. The contents are the sole responsibility of the authors and do not necessarily represent the official views of DHHS.