Consultation and Training

TREM Questions and Answers

Q: How do I know that I am leading TREM groups in the way they were originally designed?

A: Roger Fallot, Ph.D. and Maxine Harris, Ph.D. developed a TREM Group Intervention Fidelity Scale, which can be used to evaluate your faithfulness to the TREM approach. The measure includes two sections: context items and group items.

The context items measure areas such as training, assessment, referral, and support (e.g. to what extent have all clinicians in an agency been trained in areas of trauma assessment and related support). The group items examine the frequency of the use of thirteen types of leader behaviors: structure, training, content, control, activity, question/comment ratio, session structuring comments, general psycho-educational comments, trauma-specific educational comments, empowering/affirming comments, positive problem solving comments, leader style, and goals for the session.

The fidelity measure lists key data sources for each item to be measured. These cue the fidelity rater to the type of data sources (e.g., audiotape review of session, clinical director interview, or clinical record review) to use to measure that point on the fidelity scale. The measure also provides specific anchors to rate the extent of compliance for each item (e.g., how many times a leader made a psycho-educational statement during the group).

Community Connections can provide consultation in TREM fidelity; we can train you to measure fidelity or can measure your fidelity via taped group sessions. To receive more information about fidelity training or to receive a copy of the fidelity measure please contact Rebecca Wolfson Berley, MSW, Training Coordinator at (202) 608-4735 or at rwolfson@ccdc.org.