Trauma Services
Pilot Studies of TREM Show Promising Outcomes - Roger D. Fallot, Ph.D.
Over the past several years, we have gathered pilot data on TREM group implementation and outcomes at several sites. Interviews, focus groups, and structured questionnaires addressed questions of TREM’s feasibility and replicability, its attractiveness to consumer-survivors, completion rates, safety and risks, and potential effectiveness. We were especially interested in exploring outcomes in several domains: service utilization, mental health symptoms, participant safety, recovery skill development, and consumer satisfaction.
A report is now being compiled summarizing the findings of these pilot projects. Preliminary outcomes are very promising. In terms of service utilization, rates of psychiatric hospitalization and emergency room use were lower for TREM participants in two studies. TREM completers, for example, averaged 0.23 days per month of psychiatric hospitalization in a post-group period while non-participants averaged 1.01 days per month. In a study involving incarcerated substance-abusing women, TREM group participation was related to longer community stays without arrest after release from prison.
In two studies, group members and/or clinicians reported decreases in a wide range of mental health symptoms, including depression and dissociation as well as anxiety-related symptoms, following TREM group participation. Clinicians using the Global Assessment Scale reported significant increases in participants’ overall level of functioning post-group. In addition, clinicians rated TREM completers’ personal safety higher than it was before the group. One project examined the eleven recovery skills (e.g., self-protection, self-soothing, emotional modulation, consistent problem-solving) included in the Trauma Recovery and Empowerment Profile (TREP). Clinicians in this study rated members’ post-group skill levels higher than their pre-group skills on each of the eleven dimensions.
Finally, we were particularly interested in understanding consumer-survivor satisfaction with the TREM groups. In one survey, 95% of the members reported that the group was helpful. They especially attributed their satisfaction to feeling support from other group members (95%), experiencing “more control over” their lives (95%), greater assertiveness (85%), and involvement in safer relationships (79%). At one site, a consumer satisfaction team asked 11 TREM participants to rate the group on a scale of 1 to 10 “with 10 being the highest score.” All of the respondents rated the TREM group a “10.”
These findings and others compiled from pilot projects help to answer important questions about the feasibility and possible effectiveness of TREM groups. They suggest using a diverse range of outcome measures in looking at TREM’s impact on recovery. And they support our plans to develop and carry out more experimental studies of TREM’s effectiveness.
An article describing these and other findings from TREM pilot studies has been submitted for publication. Copies of this draft article may be requested from Roger Fallot at rfallot@ccdc1.org.
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