SPARCS
SM
Structured Psychotherapy for
Adolescents Responding to Chronic
Stress:
A Guide for Trauma-Focused Groups
Mandy Habib, Psy.D.
Ruth DeRosa, Ph.D.
North Shore-Long Island Jewish Health System
Adolescent Trauma Treatment Development Center
Manhasset, New York
[email protected]Still in the Middle of the Hurricane
Complex PTSD
Problems with
Regulation of Affect &
Impulses
Cognitive Functioning/
Dissociation
Somatization
Sense of Self
Relationships
Systems of Meaning
Development of the Manual
Adapted From
Dialectical Behavior
Therapy
for Adolescents
DBT
TARGET
Miller, Rathus & Linehan, in press
TARGET
Ford & Russo, 2006
UCLA Trauma/Grief
UCLA
PROGRAM
Group Psychotherapy
Layne, Saltzman, Pynoos, et al., 2000
5
SPARCS
Outpatient Clinics:
Collaborations
Childrens Institute Incorporated, LA, CA
The Village Family Services, North Hollywood, CA
Mental Health Center of Dane County, Madison, WI
Open Arms, Albany, GA
New York Foundling, NYC
Adolescent HIV Clinic, North Shore LIJ
Dept. of Children & Family Services, (foster care), Chicago,
Illinois
Residential & Day Treatment
Madonna Heights RTC & RTF, Dix Hills, NY
Andrus Childrens Center, Yonkers, NY
Dane County Group Home, Madison, WI
St. Marys Group Home, Boston, MA
Adolescent Substance Abuse Program, North Shore LIJ
School-based groups
St. Vincents, NYC
Safe Horizon, NYC
Center for Child and Family Health, Durham, NC
Teenage Parenting Program, Seaford, NY
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SPARCS:
Group Members
For adolescents between 12-19 years old
History of chronic (interpersonal) trauma
Designed for adolescents who may be living
with significant ongoing stressors
May or may never have met full criteria for
PTSD
Exhibit functional impairment
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SPARCS
16 Sessions (60 minutes per session)
Present-focused
No systematic exposure component
included
Strength-based
Broad Goals of the
Program
Enhance Resilience
The Cs:
Connect with others
(communicate)
Cope more effectively in the
moment
Cultivate awareness
Create meaning
SPARCS Core Skills
MAKE A LINK =
communication & connecting with
others
Let M Go =
meaning
problem-solving and creating
Distress Tolerance =
effectively in the moment
Mindfulness =
coping more
cultivating awareness
1
0
Session Structure
Check In
Mindfulness practice
Review of application of previous weeks
topics
Session-specific content
Activities: role plays, movie clips, projects
Snack
Check-out
1
1
Psychoeducation
re: Stress
Reactions
Bottle About to
Burst
1
2
Reactions to Trauma
Mental Shutdown (Dissociation)
People tell me Im spacing out a lot.
I fee like Im in a dream or dont know myself.
I feel like Im watching myself from outside,
Its like separate parts of me take control of my life.
Trying to Feel Safe/In Control
I wont let myself eat. I make myself throw up
because I
am afraid of losing control of my eating and gaining
weight.
I eat to feel better. I drink or drug to try to forget.
Extreme Risk-Taking or Self-Harm
I do dangerous things, hanging out where I could get
hurt.
I get relief by cutting, punching, or hurting my body.
1
3
Preliminary SPARCS
Outcome Data
All subjects:
Completed SPARCS group treatment
Had previous trauma
Had pre-treatment Youth Outcome
Questionnaire total scores in clinical
range, i.e.>47
Were female, mean age 15.46 years
1
4
YOQ (n=20)
Community
norm total:
10.6-37.2
*
*
*p<.05
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5