Trauma Services
A New Tool for Clinicians and Survivors: The Trauma Recovery and Empowerment
Profile (TREP) and The TREP Menu of Strategies: Skill Building Exercises
to Address Specific Needs By Lori Beyer, MSW and Rebecca Wolfson Berley,
MSW Summer 2002
Clinicians working within the Trauma Recovery and Empowerment Model (TREM)
have come to realize that survivors of abuse often lack basic skills necessary
for healthy living. Since skill development is a major focus of the work
in TREM, we have expanded on that focus with a new clinical tool, the Trauma
Recovery and Empowerment Profile (TREP) and a companion menu of skill building
exercises to increase skill acquisition.
Clinicians at Community Connections developed a list of eleven core skill
dimensions: self-awareness, self-protection, self-soothing, emotional modulation,
relational mutuality, accurate labeling of self and others, sense of agency
and initiative taking, consistent problem solving, reliable parenting, possessing
a sense of purpose and meaning, and judgment and decision and making. A
work group of clinicians led by Maxine Harris and Roger Fallot then worked
to define the domains so that clinicians could accurately assess a survivor's
skill level. The work group developed markers to help codify what behaviors,
thoughts, or perceptions might rate a woman at a "1" compared to at a "3"
or "5" on TREP's 5 point likert scale. For example, a woman who is at a
"1" in her self- awareness "is unaware of her motivation and the causes
of her behavior and moods," a woman who is at a "3" is "able to identify
how she feels but remains unaware of any triggers for her actions," and
a woman who is at a "5" is "aware of her needs and wants, able to articulate
them, and follows through on attending to them." These markers of behaviors,
thoughts, and perceptions help the clinicians and the survivors to think
more specifically about the survivors' many strengths and also those areas
in which she might benefit from more concentrated work. The markers also
give concrete examples to ensure consistency no matter who does the rating.
Clinicians can then work with trauma survivors to determine a rating in
each of the eleven skill dimensions, and together they can decide on a few
areas where more extensive work might be most beneficial.
Once the rating scale was developed, clinicians then set about the task
of identifying specific skill building exercises designed to enhance a woman's
skills in particular domains. Eight exercises were conceived for each of
the eleven skill dimensions; four beginning level and four intermediate
level strategies. The strategies vary in their method of skill development.
Some of the strategies rely on journaling, others on developing guided imagery
skills, while others encourage survivors to think more deeply about situations
in order to come up with solutions that are "outside of the box." Clinicians
and consumers should consider which techniques best suit the individual's
abilities and preferences.
The response to the TREP and the companion menu of strategies has been very
positive. JoAnn, a trauma clinician at Community Connections says, "I find
the TREP exercises very helpful when a consumer comes in with a problem
and wants immediate help. We look over a few exercises and choose one or
two that would help in the moment." Karen, another trauma clinician spoke
about the TREP's more long-term utility saying, "I have found the TREP scale
and exercises most helpful for women who are really ready for and committed
to their recovery work. When they have energy, focus and dedication they
can work with the exercises on their own as well as when we meet together."
Other agencies have begun to express interest in the TREP and corresponding
menu of strategies. Community Connections has developed a three-hour training
for clinicians, case managers, supervisors, and any members of teams responsible
for treatment planning and clinical work with consumers/survivors in the
use of the TREP and TREP Interventions Menu. Clinicians in Rumford, Maine
were introduced to the TREP last fall, and a group of mental health clinicians
and domestic violence advocates in Chicago, Illinois were trained in the
use of the TREP in May, 2002. The next TREP training will be in July at
Sweetser in Brunswick, Maine.
Ultimately, we hope that the TREP and corresponding interventions menu can
serve as an additional clinical tool to help survivors feel a renewed sense
of hope that the skills they want to develop are not out of reach, but rather
can be learned and mastered. The TREP and TREP Menu of Strategies can be
ordered from the publications page of this website.
Click here for more information and order form
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