TARGET is a strengths-based approach to education and therapy for trauma survivors who are looking for a practical approach to recovery. The goal is to help trauma survivors to understand how trauma changes the body and brain's normal stress response into an extreme survival-based alarm response which can become "post-traumatic stress disorder" (PTSD), and to learn a practical 7-step approach (summarized by an acronym--"FREEDOM") to changing the PTSD alarm response into a positive approach to personal and relational empowerment that promotes real and lasting recovery from trauma.
Adults in the wake of acute traumatic violence, accidents, or disaster, including emergency responders and disaster recovery/relief workers (TARGET-AT).
Adults in outpatient or residential/inpatient treatment for acute or chronic mental illness (TARGET-RMI).
Adults in recovery from chronic substance abuse or addiction (TARGET-AR).
Adults in recovery from domestic violence (TARGET-DV).
Parents whose children have experienced acute or chronic traumatic stress (TARGET-P).
Adolescent and pre-adolescent trauma survivors with behavioral, psychosocial, or addiction problems (TARGET-T).
Individual psychotherapy for adult survivors of violence or abuse (TARGET-I)
TARGET can be adapted to assist people with a variety of types of trauma experiences throughout their lifetime in addressing "unfinished emotional business" that results in "maladaptive coping strategies." The model is being applied with a variety of populations and settings including:
TARGET has been translated and successfully used in Spanish, Hebrew, and Dutch, and has been adapted and successfully used by and for deaf individuals.
TARGET can be delivered in gender-specific or coed educational/support groups or on a one-to-one or family basis. The basic concepts can be taught by a qualified TARGET facilitator in a brief encounter or in a series of sessions ranging from a 3-session orientation to a 6+-month intensive program. Results of a randomized controlled effectiveness study of TARGET compared to trauma-informed outpatient addiction treatment have been reported most recently at the 2003 American Public Health convention (contact firstname.lastname@example.org for presentation summary) and are being prepared for publication by the study principal investigator, Dr. Linda Frisman. The findings indicated that TARGET and trauma informed usual services were equivalent in achieving reductions in depression, anxiety, post-traumatic stress, post-traumatic cognitions, and substance use which were sustained at an assessment 12-months following entry to the study, and TARGET was superior to trauma informed usual care in sustaining participants' self-efficacy related to addiction recovery. Results of open trials of TARGET with women in parenting, correctional diversion, residential addictions treatment, and outpatient psychiatry and community mental health programs, and with youths in juvenile justice programs, are being prepared for publication. Preliminary findings indicate a consistent reduction in PTSD symptoms, post-traumatic cognitions, and maladaptive coping, and improvement in self-efficacy and psychosocial functioning following TARGET group or individual treatment (by parent report as well as self-report for youths).
TARGET is being implemented with intensive training and a year of ongoing clinical consultation in 21 agencies in Connecticut and the Connecticut Coalition Against Domestic Violence. The statewide "Trauma Initiative" of the Connecticut Department of Mental Health and Addiction Services has sponsored most of these agencies. Clinicians and case managers who have completed these trainings are using TARGET in groups and individual services to assist trauma survivors in recovery from addiction, mental illness, co-occurring disorders, or domestic violence.
TARGET served as the education model for the training of more than 1000 behavioral health professionals and 200 prevention specialists in Connecticut's response to the tragedy of September 11, 2001, sponsored by the Center for Trauma Response, Recovery and Preparedness (www.CTRP.org).
The model is more commonly implemented in versions of different lengths: 3-5 session orientation, 12 session for groups in addiction treatment programs, and 26 sessions for groups in community mental health or inpatient/residential psychiatric programs, and 16 sessions for one-to-one outpatient psychotherapy.
Adaptations of the model have been implemented in Spanish, Dutch, and Hebrew, Deaf women and men, women in domestic violence shelters, women in prison and in community re-entry programs following incarceration, men and women in partial hospital treatment, men and women committed involuntarily to forensic inpatient programs, men and women following emergency medical care for acute assault or accidental injury, and pre-adolescents and adolescents and parents in community-based juvenile justice programs.