1. UCLA Trauma-Grief Focused Treatment Program for Adolescents (TGFT) Christopher M. Layne William R. Saltzman Robert S. Pynoos
©2006

2. Implementation Sites to Date
Armenia (massive earthquake)
Post-War Bosnia (war)
Inglewood, California (school shooting)
Pasadena, California (community violence)
Columbine/Santee High Schools (school shootings)
World Trade Center (terrorist attack, community & domestic violence)
Florida (selected components; hurricane)
©2006

3. Empirical Evidence (Layne et al., 2001)
Significant pre-post reductions in:
PTSD symptoms
complicated grief symptoms
depression symptoms
Reliable improvement rates (RCI’s):
49% in PTSD scores
51.4% in complicated grief scores
35.2% in depression scores
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4. Program Characteristics
Ages: years old
Focus: Trauma (single or multiple exposure) & traumatic death/loss.
Setting: School or community clinic
Assessment-driven
Length of Treatment: sessions (modular design – varied length depending on which parts are used).
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5. Overview of Trauma/Grief-Focused Group Psychotherapy
Module I
(6 sessions)
Module II
(8-12 sessions)
Module III
(8 sessions)
Module IV
(4 sessions)
Group Phase
Opening
Working Through
Termination
Module
Title
Group Cohesion, Psychoeducation, and Basic Coping Skills
Working Through Traumatic Experiences
Coping with Traumatic Loss and Grief
Re-Focusing on the Present and Looking to the Future
Therape-utic Tasks
1: Welcome and introduction (program overview, barriers, group contract, posttraumatic stress, depression, and grief reactions)
2: Learning about trauma and loss reminders (how I react to, and cope with, reminders)
3: Learning coping skills
4: The event-thought-feeling link
5: Identifying and challenging distressing thoughts (“Three Steps to Taking Charge of Your Feelings”)
6: Support seeking (“Five Steps to Getting Support”)
First: Preparing for trauma narrative work (constructing the group narrative, constructing my personal trauma timeline)
Middle: Constructing the trauma narrative (prolonged therapeutic exposure; develop a vocabulary for communicating about the trauma)
Final: Exploring the worst moments (prolonged therapeutic exposure; using trauma reminders to understand the nature and personal meaning of traumatic experiences; cognitive restructuring cognitions associated with guilt and shame; exploring intervention fantasies)
1: Learning about grief (grief reactions, loss reminders, and grief processes / tasks)
2: Understanding grief reactions: Focus on anger
3: Understanding grief reactions: Focus on guilt
4: Remembering and reminiscing
5: Guided imagery: Retrieving a non-traumatic image of the deceased
6: Adjusting to a world in which the deceased is absent
7: Planning for difficult days (relapse prevention)
8: Saying goodbye in a good way
1: Resuming developmental progression
2: Problem-solving current life (“Three Steps to Solving a Problem”)
3: Dealing with problems that are not my job to fix
4: Saying goodbye in a good way
©2006

6. Trauma/Grief Focused Psychotherapy: Five Therapeutic Foci
Traumatic Experiences
Trauma & Loss Reminders
Post-Trauma Stresses & Adversities
Bereavement and the Interplay of Trauma & Grief Reactions
Developmental Impact
©2006

7. Intervention Strategies
Psychoeducation
Skills Training
Cognitive Interventions
Prolonged Therapeutic Exposure
Grief Processing/Facilitation
Social Network Interventions
Relapse Prevention
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10. My Timeline What was happening outside of me:
What was happening inside of me: (thoughts, feelings, bodily sensations)
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11. Construction Algorithm
Trauma Narrative
Construction Algorithm
Situations
Thoughts
Behaviors
Feelings
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12. Parts of my life I want or need to change to adjust to the loss
Practice Exercise:
Parts of my life I want or need to change
to adjust to the loss
Overall Change I Want/Need
First Steps I need to Take
Living situation and finances
Mealtimes/ time spent with family
School, homework, preparation for college
Choice of friends/ time spent with friends
Daily interactions with people
Favorite activities and hobbies
Chores and Responsibilities
Other (describe)____________
wellll
©2006