UCLA Trauma-Grief Focused Treatment

Program for Adolescents

(TGFT)
Christopher M. Layne
William R. Saltzman
Robert S. Pynoos

2006

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

Empirical Evidence
(Layne et al., 2001)

Significant pre-post reductions in:

PTSD symptoms
complicated grief symptoms
depression symptoms

Reliable improvement rates (RCIs):

49% in PTSD scores
51.4% in complicated grief scores
35.2% in depression scores
2006

Program Characteristics
Ages: 11-20 years old
Focus: Trauma (single or multiple
exposure) & traumatic death/loss.
Setting: School or community clinic
Assessment-driven
Length of Treatment: 10-24 sessions
(modular design varied length
depending on which parts are used).
2006

Overview of Trauma/Grief-Focused Group Psychotherapy

Module I
(6 sessions)
Group
Phase

Opening

Module
Title

Group Cohesion,
Psychoeducation,
and Basic Coping
Skills

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-thoughtfeeling link
5: Identifying and
challenging distressing
thoughts (Three Steps to
Taking Charge of Your
Feelings)
6: Support seeking (Five
Steps to Getting Support)

Module II
(8-12 sessions)

Module III
(8 sessions)

Working Through
Working Through
Traumatic Experiences
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)

Coping with
Traumatic Loss and
Grief
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

2006

Module IV
(4 sessions)
Termination
Re-Focusing on
the Present and
Looking to the
Future
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

Trauma/Grief Focused Psychotherapy:

Five Therapeutic Foci
1)
2)
3)
4)

Traumatic Experiences
Trauma & Loss Reminders
Post-Trauma Stresses & Adversities
Bereavement and the Interplay of
Trauma & Grief Reactions
5) Developmental Impact
2006

Intervention Strategies

Psychoeducation
Skills Training
Cognitive Interventions
Prolonged Therapeutic Exposure
Grief Processing/Facilitation
Social Network Interventions
Relapse Prevention
2006

2006

2006

My Timeline
What was happening outside of me:

What was happening inside of me: (thoughts, feelings, bodily sensations)

2006

10

Trauma Narrative
Construction Algorithm
Situations

Thoughts

Behaviors

Feelings

2006

11

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)____________
2006

12