Trust-Based Relational Intervention® – Caregiver Training
Trust-Based Relational Intervention® – Caregiver Training (TBRI-Caregiver Training) is an intervention for caregivers of children who have faced abuse, neglect, and/or other trauma. This program is designed to be highly interactive and is delivered in-person by certified practitioners. TBRI-Caregiver Training uses an attachment-based and trauma-informed approach. It aims to provide parents and caregivers with the tools needed to meet the needs of these children. The training emphasizes three core principles: (1) TBRI Connecting Principles, which focus on building trust and positive relationships between caregivers and children; (2) TBRI Empowering Principles, which focus on addressing children’s physical and environmental needs and building children’s self-regulation skills; and (3) TBRI Correcting Principles, which focus on building children’s social competencies.
TBRI – Caregiver is rated as a promising practice because at least one study achieved a rating of moderate or high on study design and execution and demonstrated a favorable effect on a target outcome.
Date Research Evidence Last Reviewed: Dec 2020
Sources
The program or service description, target population, and program or service delivery and implementation information was informed by the following sources: The California Evidence-based Clearinghouse for Child Welfare, the program or service developer’s website, the program or service manual, and the studies reviewed.
This information does not necessarily represent the views of the program or service developers. For more information on how this program or service was reviewed, visit the Review Process page or download the Handbook.
Target Population
TBRI-Caregiver Training is designed for parents and/or caregivers of children between the ages of 0 to 17 years old who have experienced adversity, early harm, toxic stress, and/or trauma.
Dosage
TBRI-Caregiver Training typically includes four in-person group sessions that last for 6 hours each.
Location/Delivery Setting
Recommended Locations/Delivery Settings
TBRI-Caregiver Training is delivered by certified practitioners in homes, schools, and community-based settings.
Location/Delivery Settings Observed in the Research
- University
Education, Certifications and Training
TBRI-Caregiver Training is delivered by certified practitioners who have completed TBRI Practitioner Training. Practitioner training consists of two phases. First, practitioners complete an online component that involves nine units of coursework and an interpersonal interview. This component is completed online over ten weeks. Second, practitioners complete five days of intensive on-site training. This training focuses on the application and implementation of TBRI. Practitioners who complete this training receive the TBRI Caregiver Training Package, which includes standardized presentations, manuals, and workbooks for delivering TBRI Caregiver Trainings in their organizations.
Program or Service Documentation
Book/Manual/Available documentation used for review
The TBRI Practitioner Training Notebook and Resource Manual is used in conjunction with the TBRI Practitioner Instructor Workbook and the TBRI slide deck.
Karyn Purvis Institute of Child Development. (2020). TBRI practitioner training notebook and resource manual. Karyn Purvis Institute of Child Development.
Purvis, K., Cross, D. R., & Hurst, J. R. (2013). Trust-Based Relational Intervention® Caregiver Training: TBRI practitioner instructor workbook. Karyn Purvis Institute of Child Development.
Karyn Purvis Institute of Child Development (n.d.). Trust-based Relational Intervention [PowerPoint slides].
Available languages
English, Spanish
Other supporting materials
For More Information
Website: https://child.tcu.edu/
Phone: (817) 257-7415
Email: child@tcu.edu
Note: The details on Dosage; Location; Education, Certifications, and Training; Other Supporting Materials; and For More Information sections above are provided to website users for informational purposes only. This information is not exhaustive and may be subject to change.
| Results of Search and Review | Number of Studies Identified and Reviewed for Trust-Based Relational Intervention® – Caregiver Training |
|---|---|
| Identified in Search | 3 |
| Eligible for Review | 1 |
| Rated High | 0 |
| Rated Moderate | 1 |
| Rated Low | 0 |
| Reviewed Only for Risk of Harm | 0 |
| Outcome | Effect Size
 and Implied Percentile Effect
|
N of Studies (Findings) | N of Participants | Summary of Findings |
|---|---|---|---|---|
| Child well-being: Behavioral and emotional functioning |
0.21
8 |
1 (13) | 96 |
Favorable:
1 No Effect: 12 Unfavorable: 0 |
Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group.
| Outcome | Effect Size
and Implied Percentile Effect
|
N of Studies (Findings) | N of Participants | Summary of Findings |
Months after treatment when outcome measured
|
|---|---|---|---|---|---|
| Child well-being: Behavioral and emotional functioning |
0.21
8 |
1 (13) | 96 |
Favorable:
1 No Effect: 12 Unfavorable: 0 |
- |
| Study 10924 - TBRI-CT vs. Waitlist (Purvis, 2015 - Not conducted in a usual care or practice setting) | |||||
| Strengths & Difficulties Questionnaire: Emotional Problems |
0.37
14 |
- | 96 | - | 0 |
| Strengths & Difficulties Questionnaire: Conduct Problems |
0.27
10 |
- | 96 | - | 0 |
| Strengths & Difficulties Questionnaire: Hyperactivity |
0.42
*
16 |
- | 96 | - | 0 |
| Strengths & Difficulties Questionnaire: Peer Problems |
0.01
0 |
- | 96 | - | 0 |
| Strengths & Difficulties Questionnaire: Prosocial Behavior |
0.31
12 |
- | 96 | - | 0 |
| Strengths & Difficulties Questionnaire: Total Problems |
0.38
14 |
- | 96 | - | 0 |
| Trauma Symptom Checklist for Young Children: Anxiety |
0.29
11 |
- | 96 | - | 0 |
| Trauma Symptom Checklist for Young Children: Depression |
0.33
12 |
- | 96 | - | 0 |
| Trauma Symptom Checklist for Young Children: Posttraumatic Stress (Intrusion) |
-0.18
-7 |
- | 96 | - | 0 |
| Trauma Symptom Checklist for Young Children: Posttraumatic Stress (Arousal) |
0.34
13 |
- | 96 | - | 0 |
| Trauma Symptom Checklist for Young Children: Posttraumatic Stress (Total Score) |
0.19
7 |
- | 96 | - | 0 |
| Trauma Symptom Checklist for Young Children: Dissociation |
0.02
0 |
- | 96 | - | 0 |
| Trauma Symptom Checklist for Young Children: Sexual Concerns |
0.04
1 |
- | 96 | - | 0 |
*p <.05
Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group. Effect sizes and implied percentile effects were calculated by the Prevention Services Clearinghouse as described in the Handbook of Standards and Procedures, Section 5.10.4 and may not align with effect sizes reported in individual publications.
Only publications with eligible contrasts that met design and execution standards are included in the individual study findings table.
Full citations for the studies shown in the table are available in the "Studies Reviewed" section.
The participant characteristics display is an initial version. We encourage those interested in providing feedback to send suggestions to preventionservices@abtassoc.com.
The table below displays locations, the year, and participant demographics for studies that received moderate or high ratings on design and execution and that reported the information. Participant characteristics for studies with more than one intervention versus comparison group pair that received moderate or high ratings are shown separately in the table. Please note, the information presented here uses terminology directly from the study documents, when available. Studies that received moderate or high ratings on design and execution that did not include relevant participant demographic information would not be represented in this table.
For more information on how Clearinghouse reviewers record the information in the table, please see our Resource Guide on Study Participant Characteristics and Settings.
| Characteristics of the Participants in the Studies with Moderate or High Ratings | ||||||
|---|---|---|---|---|---|---|
|
Study Location
|
Study Year
|
Age or Grade-level
|
Race, Ethnicity, Nationality
|
Gender
|
Populations of Interest*
|
Household Socioeconomic Status
|
| Study 10924 - TBRI-CT vs. Waitlist | ||||||
| Characteristics of the Children and Youth | ||||||
| United States of America | -- | Average age: 8 years |
42% White/Caucasian 27% Black/African American 19% Asian 8% Other 2% Native American 2% Hispanic/Latino |
63% Male 38% Female |
73% Experienced neglect, 27% Experienced physical abuse, 15% Experienced sexual abuse | -- |
| Characteristics of the Adults, Parents, or Caregivers | ||||||
| United States of America | -- | Average age: 44 years |
98% White/Caucasian 2% Hispanic/Latino |
94% Female 6% Male |
100% Parents of children who were domestically or internationally adopted and had resided in the adoptive home for at least one year |
25% Income: $150,000+ 31% Income: $100,000-$150,000 19% Income: $75,000-$99,999 13% Income: $50,000–$74,999 8% Income: $35,000-$49,999 4% Income: $25,000-$34,999 |
“--” indicates information not reported in the study.
* The information about disabilities is based on initial coding. For more information on how the Clearinghouse recorded disability information for the initial release, please see our Resource Guide on Study Participant Characteristics and Settings. The Clearinghouse is currently seeking consultation from experts, including those with lived experience, and input from the public to enhance and improve the display.
Note: Citations for the documents associated with each 5-digit study number shown in the table can be found in the “Studies Reviewed” section below. Study settings and participant demographics are recorded for all studies that received moderate or high ratings on design and execution and that reported the information. Studies that did not report any information about setting or participant demographics are not displayed. For more information on how participant characteristics are recorded, please see our Resource Guide on Study Participant Characteristics and Settings.
Studies Rated Moderate
Study 10924Purvis, K., Razuri, E., Howard, A., Call, C., DeLuna, J., Hall, J., & Cross, D. (2015). Decrease in behavioral problems and trauma symptoms among at-risk adopted children following trauma-informed parent training intervention. Journal of Child & Adolescent Trauma, 8(3), 201-210. https://doi.org/10.1007/s40653-015-0055-y
Some contrasts that received a moderate or high design and execution rating in this study were not from research conducted in a usual care or practice setting (Handbook Section 6.2.2) [see Individual Study Findings section above for additional information on contrasts that did or did not meet this criterion]Studies Not Eligible for Review
Study 10918
Howard, A. R., Parris, S. R., Nielsen, L. E., Lusk, R., Bush, K., Purvis, K. B., & Cross, D. R. (2014). Trust-Based Relational Intervention® (TBRI®) for adopted children receiving therapy in an outpatient setting. Child Welfare, 93(5), 47-64.
This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).
Study 10922
Purvis, K. B., Cross, D. R., Dansereau, D. F., & Parris, S. R. (2013). Trust-Based Relational Intervention (TBRI): A systemic approach to complex developmental trauma. Child & Youth Services, 34(4), 360-386. https://doi.org/10.1080/0145935X.2013.859906
This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).