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Workshop

April 2017

THE ATTACHMENT,
SELF-REGULATION
AND COMPETENCY
(ARC) MODEL

Delphine Collin-Vézina, PhD
Director, Centre for Research on Children and Families
Nicolas Steinmetz and Gilles Julien Chair in Social Pediatrics
in Community
Tier II Canada Research Chair in Child Welfare
Associate Professor, School of Social Work & Associate
Member, Department of Pediatrics
McGill University

Formation sur le trauma et le
modèle d’intervention ARC

1

Workshop

April 2017

Youth in Out-of-Home Care

• Data from the National Survey on Child and Adolescent

Well-Being showed that 43% of teenagers in out-of-home
care reported at least one mental health problem:
depression, anxiety, substance abuse, suicidality, ADHD(1)

• Among 9,942 children and youth in residential care

settings (mean age 10.4)(2)
– 92% of youth reported at least 2 traumatic events.
– 80% were rated as having behaviour problems, 70% had

attachment issues, 65% had academic difficulties, and 42% had
substance use problems.

– As the number of traumas increased, functional impairment

increased.

(1) Heneghan et al., 2013
(2) Briggs et al., 2012

Formation sur le trauma et le
modèle d’intervention ARC

2

Workshop

April 2017

Youth in Residential Care: A Quebec Study

Gender

45

Girls

Boys

55

N = 53

Age

20.8

22.6

30.2

26.4

14

15

16

17

Racial Group

20.8

17

18.9

39.6

Aboriginal or
1st Nations
Black

White or
European
Other

Collin-Vézina et al, 2011

Youth in Residential Care: A Quebec Study

Childhood Trauma Questionnaire

None or
minimal

Low to
moderate

Moderate
to severe

Severe to
extreme

38%

32%

19%

26%

62% (none)

6%

45%

15%

41.5%

24.5%

9%

9%

9%

15%

17%

34%

32%

23%

25%

17%

62%

68%

38%

55%

59%

Type of
Abuse

Physical
abuse

Emotional
abuse

Sexual
abuse

Physical
neglect

Emotional
neglect

Formation sur le trauma et le
modèle d’intervention ARC

3

Workshop

April 2017

Youth in Residential Care: A Quebec Study

Compounded maltreatment:
• 83% of the sample reported at least one form of

maltreatment.

• 76% of the youth reported MULTIPLE (2 or MORE)

forms of maltreatment.

• 64% of the youth reported 3 forms of maltreatment.
• 40% of the youth reported 4 forms of maltreatment.
• 19% of the sample experienced ALL 5 TYPES of child

maltreatment.

Youth in Residential Care: A Quebec Study

However, the reasons these 53 youth were taken into child
protection care (3 sub-sections) were poorly reflective of
the traumas experienced:

• 83,0% behaviour problems
• 26,4% neglect
• 5,7% sexual abuse,
• 5,7% abandonment
• < 5% emotional abuse • < 5% physical abuse Milne & Collin-Vézina, 2014 Formation sur le trauma et le modèle d’intervention ARC 4 Workshop April 2017 Adolescent male who is… Aggressive to people Deceitful Not receptive to feedback Easily frustrated Belittling Quick to anger A young person who is suffering Formation sur le trauma et le modèle d’intervention ARC 5 Workshop April 2017 NTCSN: Principles of Trauma-Informed Care Partner with Other Agencies and Systems Broader Child-Serving System Child Welfare System Family Child Partner with Child and Family Enhance Staff Well-Being and Resilience Maximize Physical and Emotional Safety Identify Child and Family’s trauma- Related Needs Enhance Family Well- Being and Resilience Enhance Child Well-Being and Resilience NCTSN Child Welfare Committee , 2012 Formation sur le trauma et le modèle d’intervention ARC 6 Workshop April 2017 ARC: A Systemic Approach to Trauma Of the handful of trauma- informed interventions, to our knowledge, only one presents a multi-systemic design that allows for implementation among direct-care staff. Targets the 3 core resiliency domains: A Attachment R Regulation C Competency Blaustein & Kinniburgh, 2010 ARC: A Systemic Approach to Trauma • Evidence- and practice-informed treatment • Grounded in trauma theory, attachment, and child development. • As a whole, these theories highlight the importance of: – Working with the youth-in-context, – Recognizing that the youth’s current adaptive responses are linked to historical experiences, – Promoting intervention within the immediate environment – whether primary caregivers or treatment systems – to support the youth’s growth and development. • Recognized as a promising practice by the NCTSN and SAMHSA Formation sur le trauma et le modèle d’intervention ARC 7 Workshop April 2017 THE ATTACHMENT, SELF-REGULATION AND COMPETENCY (ARC) MODEL ARC: A Systemic Approach to Trauma Flexible application according the intervention context: Individual, family, and group therapy; children, parents, milieux Trauma-impacted CHILD Formation sur le trauma et le modèle d’intervention ARC 8