TAP Background

The Chadwick Center for Children and Families, formerly known as the Center for Child Protection, is a branch of San Diego’s Rady Children’s Hospital that specializes in the evaluation and treatment of trauma victims. The center has been providing trauma counseling to victims of physical, sexual and emotional abuse, as well as to minors exposed to domestic violence and other forms of trauma since 1985. In the early 1990s, Chadwick leadership initiated efforts to objectively evaluate the efficacy of the treatment provided in its mental health program. These early efforts evolved into a formal treatment outcome program, in which clients and their parents were administered a battery of standardized assessment measures before, during, and upon completion of treatment. The measures captured a variety of clinical domains, including many specific to trauma, and assessed parental and family functioning. The assessment results were used in many ways, foremost of which was to assist in tracking client progress and directing treatment goals.

Over the years, the assessment protocol has been modified based on the needs of therapists and clients. New measures were adopted as additional needs were identified, and measures that were not clinically useful were discontinued. The resulting protocol proved to be valuable in many ways that were not initially foreseen. For example, the information gathered assisted staff in justifying the Center’s services to funding sources, helped direct program planning and staffing needs, and identified potential referral sources. The plethora of data obtained has become a powerful and empowering tool for therapists and clients, as well as for the administrative staff and the research team.
 
In 2002, the Chadwick Center became a member of the National Child Traumatic Stress Network (NCTSN). The Substance Abuse and Mental Health Services Administration (SAMHSA, Grant # 1 U79 SM54289-01) funds activities related to the NCTSN. It is an unprecedented collaboration among over 54 child trauma organizations across the country, with a mission “to raise the standard of care and improve access to services for traumatized children, their families and communities throughout the United States.” The grant provided an opportunity for the Chadwick Center to capture its existing assessment-based treatment model in a replicable format, refining and standardizing procedures, and ultimately sharing this model with other trauma counseling sites across the country.
 
The TAP model manual is the result of extensive discussions, planning and work discussions among clinicians, researchers and administrators in the Trauma Counseling Program at the Chadwick Center for Children and Families. As the manual model was developed, several predictable debates occurred. One of these was over the relative significance of research and clinical efforts in the development of the manual. An additional debate occurred regarding the utilization of only evidence-based treatments compared with a process that allowed for more choices among therapeutic interventions. As these dialogues were resolved, the TAP model evolved. In this adaptation of the manual, into one in which the clinician is able to select from among evidence-based and evidence-informed interventions and as well as promising practices.