What Makes TGCTA Unique? Six Strengths:
TGCTA has six strengths that set it apart as a cutting-edge intervention for traumatized, bereaved, and traumatically bereaved adolescents. These include:
- Specialized focus on older childhood and adolescence. TGCTA addresses the developmental needs, strengths, risks, challenges, tasks, and life circumstances of older children and adolescents. Practitioners can flexibly select from a range of discussion topics, therapeutic activities, and sketches depending on each client’s life stage, developmental tasks, and current life challenges and opportunities.
- Capacity to therapeutically address trauma, bereavement, and traumatic bereavement. TGCTA can be tailored to focus on trauma, bereavement, and the interplay between posttraumatic stress and grief reactions that can arise in cases f traumatic bereavement. TGCTA treatment elements align with the latest diagnostic and treatment considerations for trauma and bereavement.
- Balanced, wellness-focused approach to bereavement and grief. Based on a balanced, wellness-focused approach (multidimensional grief theory) to conceptualizing and addressing a broad range of grief reactions, TGCTA is uniquely positioned to address Prolonged Grief Disorder as it appears in either DSM-5-TR or ICD-11. The TGCTA grief module (Module 3) contains many different engaging exercises and sketches that allow practitioners to custom-tailor their intervention depending on each youth’s grief assessment profile. These exercises varyingly focus on grief psychoeducation, promoting adaptive grief reactions, allowing maladaptive grief reactions to recede, and helping bereaved youth to move forward with their lives while retaining a sense of connection to the deceased.
- Individual or group-based format. Evidence from multiple evaluation studies indicate that TGCTA is effective when delivered in either an individual or group-based format. In contrast to other treatments that originated as individual or classroom-based modalities and were later adapted for group settings, TGCTA was originally designed for use with teens in a school-based group setting. There is strong evidence that groups are generally as effective as, and more efficient than, individual treatment for many problems, and that groups offer additional therapeutic tools not found in individual treatment. These tools include positive group norms and expectations, group cohesion, and member to member sharing (Davies, Burlingame, & Layne, 2006).
- Multi-tiered intervention. TGCTA’s flexibly-tailored format allows it to support multi-tiered mental health and wellness interventions. These include Tier 1 (basic classroom-based intervention, such as psychoeducation and coping skills training), Tier 2 (specialized therapeutic services delivered at school by trained school professionals), and Tier 3 (referral of severe cases to community-based mental health organizations for specialized therapeutic services). Multi-tiered interventions are especially valuable in high-risk, high-need, low-resource settings because they help service providers to create a continuum of care that can assist many youth and families while reserving specialized services for those at highest risk.
- Modularized, assessment-driven, custom-tailored intervention. TGCTA’s modularized format supports assessment-driven, flexibly-tailored intervention. TGCTA’s four modules can be used in flexible ways to match the needs of the particular population and setting, clients’ presenting problems, and time available. These modules and their potential applications include:
Module | Module Title | Potential Applications and Recommendations |
1. | Building Cohesion and Coping Skills | TGCTA intervention should always begin with Module 1, either used alone or in combination with other modules (e.g., 1 and 4; 1, 2, and 4; 1, 3, and 4, etc.). |
2. | Trauma Processing | Designed for youth with significant trauma histories who are experiencing significant current trauma-related distress. |
3. | Grief Processing | Designed for youth with significant bereavement histories who are experiencing loss-related distress (e.g., Prolonged Grief Disorder reactions). Module 3 components focus on both facilitating adaptive grief reactions and helping maladaptive grief reactions to recede. |
4. | Promoting Adaptive Developmental Progression | Designed for youth with significant trauma or loss histories who are experiencing significant difficulties with functional impairment, risky behavior, and/or developmental disruption. Although brief, Module 4 is powerful and rewarding to implement and should not be overlooked. |
A field evaluation (Davies et al., 2007) and a randomized controlled trial (Layne et al., 2008) found significant improvements in youth outcomes among youth who received Module 1 and 4 components alone (psychoeducation, cognitive restructuring, and coping skills training) in a classroom setting as implemented by trained school counselors. The randomized controlled trial also found that youth who received a full course of TGCTA (Modules 1, 2, 3, and 4) in a small group treatment setting showed significantly more therapeutic benefit than their peers who participated in classroom-based Module 1 and 4 elements alone. These findings suggest that Modules 1 and 4 can be implemented in a classroom-based setting with moderate staff training and support while producing significant benefit. However, to produce maximum therapeutic benefit, a full course of TGCTA (Modules 1, 2, and 4 for traumatized youth; Modules 1, 3, and 4 for bereaved youth; and Modules 1, 2, 3, 4 for traumatized and bereaved or traumatically bereaved youth) is recommended.