Trauma Recovery and Empowerment Model (TREM)

This is a group therapy program for the treatment of women with a history of physical and sexual violence victimization. Cognitive restructuring techniques, psychoeducation, skills training, and social support are used to facilitate recovery from trauma, depression, and substance use.
The intervention includes 18 to 29 sessions structured in five phases:
1) The first part addresses women’s empowerment needs and promotes skills development, such as defining physical and emotional boundaries, self-confidence, and self-esteem;
2) The second part addresses issues associated with trauma recovery and includes discussions of physical, sexual, and emotional abuse; the relationships between abuse and psychological or emotional symptoms; and the relationships between compulsive behaviors and trauma;
3) The third part includes aspects of family life; communication and decision making; guilt, acceptance, forgiveness, and personal healing;
4) The fourth part is dedicated to helping participants process their group experiences; and
5) The fifth (additional) part provides arrangements to serve women diagnosed with severe mental disorders, as well as those who are incarcerated, have children, and engage in risky behaviors.

Impact evaluations

One impact evaluation found that program participants showed a statistically significant improvement in trauma-related symptoms, excluding alcohol or drug abuse, compared with those who received treatment as usual not offered by the program [1].
Another study indicated that program participants showed greater reductions in alcohol and drug abuse severity, as well as in anxiety symptoms and stressful events, and an increase in perceived personal safety. No significant effects were observed on post-traumatic stress symptoms or general mental health symptoms, physical and mental health-related quality of life, or exposure to interpersonal abuse. Changes in trauma recovery skills were positively associated with gains in study outcomes for treatment group participants. [2]

Bibliographic reference

[1] Fallot, R. D., McHugo, G. J., Harris, M. & Xie, H. (2011). The Trauma Recovery and Empowerment Model: A Quasi-Experimental Effectiveness Study. Journal of Dual Diagnosis, 7(1-2), 74–89. https://doi.org/10.1080/15504263.2011.566056

[2] Toussaint, D. W., VanDeMark, N. R., Bornemann, A. y Graeber, C. J. (2007). Modifications to the Trauma Recovery and Empowerment Model (TREM) for substance-abusing women with histories of violence: Outcomes and lessons learned at a Colorado substance abuse treatment center. Journal of Community Psychology, 35(7), 879–894. https://doi.org/10.1002/jcop.20187

Information source

The California Evidence-based Clearinghouse