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Trauma Recovery and Empowerment Model (TREM)

An Evidence-Based Practice

Description

The Trauma Recovery and Empowerment Model (TREM) is a fully manualized group-based intervention designed to facilitate trauma recovery among women with histories of exposure to sexual and physical abuse. Drawing on cognitive restructuring, psychoeducational, and skills-training techniques, the gender-specific 24-29 session group emphasizes the development of coping skills and social support. It addresses both short- and long-term consequences of violent victimization, including mental health symptoms, especially posttraumatic stress disorder (PTSD) and depression, and substance abuse. TREM has been successfully implemented in a wide range of service settings (mental health, substance abuse, criminal justice) and among diverse racial and ethnic populations.

Goal / Mission

The goal of this program is to facilitate trauma recovery among women with histories of exposure to sexual and physical abuse.

Impact

Studies demonstrated that TREM participants showed a significant reduction in severity of problems related to substance use from baseline to 12-month follow-up relative to the comparison group. Reduced trauma symptoms were also significantly greater for the intervention group than for the comparison group at 12-month follow-up. Furthermore, the intervention group had significantly reduced symptoms of psychological problems 1 year after the intervention.

Results / Accomplishments

Community Connections Trauma Education staff have provided training in TREM to clinicians in over 20 states. A study showed that both treatment and control groups had a significant reduction in drug addiction severity at 6- and 12-month follow-ups (p < 0.01) and remained significant after controlling for differences in baseline status. Both the intervention and comparison groups achieved significant improvement in alcohol addiction severity at 6- and 12-month follow-ups (p < 0.01). However, the difference was not significant after controlling for baseline differences.

In a different study, the intention-to-treat analyses showed significant differences over time between the TREM and the comparison groups on both the alcohol and drug composite scores, p = 0.008 and p = 0.0004, respectively. Mean scores of the TREM group showed a significant reduction in severity of problems related to substance use from baseline to 12-month follow-up compared to the comparison group.

In one study, reduced trauma symptoms were significantly greater for the intervention group (M = 15.6, SD = 13.7) than for the comparison group (M = 20.8, SD = 11.9) at 12-month follow-up, p = 0.029.

In another study, the intervention group had significantly improved outcomes compared to the usual-care condition on trauma-related symptoms at 6-month follow-up (feelings of dissociation, p = 0.007, effect size = 0.63; sense of personal safety, p = 0.03, effect size = 0.48), and at 12-month follow-up (feelings of dissociation, p = 0.007, effect size = 0.61; trauma coping, p = 0.003, effect size = 0.54; sense of personal safety, p = 0.030, effect size = 0.38).

In a third study, the intention-to-treat analyses showed significant differences over time between the TREM and comparison groups on trauma symptoms, p = 0.03. Mean scores of the TREM group decreased from baseline to 12-month follow-up relative to the comparison group.

Furthermore, one evaluation found significantly reduced symptoms of psychological problems among TREM participants 1 year after the intervention (p = .008).

About this Promising Practice

Organization(s)
Community Connections
Primary Contact
Community Connections
801 Pennsylvania Avenue, S.E., Suite 201
Washington DC 20003-2152
202-546-1512
http://www.ccdc1.org
Topics
Health / Mental Health & Mental Disorders
Health / Alcohol & Drug Use
Organization(s)
Community Connections
Source
SAMHSA's National Registry of Evidence-Based Programs and Practices (NREPP)
Date of publication
Dec 2006
Date of implementation
1997
For more details
Target Audience
Women