Trauma Recovery and Empowerment Model (TREM)

The Trauma Recovery and Empowerment Model (TREM) is a fully manualized group-based intervention designed to facilitate trauma recovery among women with histories of exposure to sexual and physical abuse. Drawing on cognitive restructuring, psychoeducational, and skills-training techniques, the gender-specific 24-29 session group emphasizes the development of coping skills and social support. It addresses both short- and long-term consequences of violent victimization, including mental health symptoms, especially posttraumatic stress disorder (PTSD) and depression, and substance abuse. TREM has been successfully implemented in a wide range of service settings (mental health, substance abuse, criminal justice) and among diverse racial and ethnic populations.

The goal of this program is to facilitate trauma recovery among women with histories of exposure to sexual and physical abuse.

Studies demonstrated that TREM participants showed a significant reduction in severity of problems related to substance use from baseline to 12-month follow-up relative to the comparison group. Reduced trauma symptoms were also significantly greater for the intervention group than for the comparison group at 12-month follow-up. Furthermore, the intervention group had significantly reduced symptoms of psychological problems 1 year after the intervention.

Community Connections Trauma Education staff have provided training in TREM to clinicians in over 20 states. A study showed that both treatment and control groups had a significant reduction in drug addiction severity at 6- and 12-month follow-ups (p < 0.01) and remained significant after controlling for differences in baseline status. Both the intervention and comparison groups achieved significant improvement in alcohol addiction severity at 6- and 12-month follow-ups (p < 0.01). However, the difference was not significant after controlling for baseline differences.

In a different study, the intention-to-treat analyses showed significant differences over time between the TREM and the comparison groups on both the alcohol and drug composite scores, p = 0.008 and p = 0.0004, respectively. Mean scores of the TREM group showed a significant reduction in severity of problems related to substance use from baseline to 12-month follow-up compared to the comparison group.

In one study, reduced trauma symptoms were significantly greater for the intervention group (M = 15.6, SD = 13.7) than for the comparison group (M = 20.8, SD = 11.9) at 12-month follow-up, p = 0.029.

In another study, the intervention group had significantly improved outcomes compared to the usual-care condition on trauma-related symptoms at 6-month follow-up (feelings of dissociation, p = 0.007, effect size = 0.63; sense of personal safety, p = 0.03, effect size = 0.48), and at 12-month follow-up (feelings of dissociation, p = 0.007, effect size = 0.61; trauma coping, p = 0.003, effect size = 0.54; sense of personal safety, p = 0.030, effect size = 0.38).

In a third study, the intention-to-treat analyses showed significant differences over time between the TREM and comparison groups on trauma symptoms, p = 0.03. Mean scores of the TREM group decreased from baseline to 12-month follow-up relative to the comparison group.

Furthermore, one evaluation found significantly reduced symptoms of psychological problems among TREM participants 1 year after the intervention (p = .008).