Trauma Recovery and Empowerment Model
The Trauma Recovery and Empowerment Model (TREM) is designed for women who have survived trauma and may have substance use or mental health conditions. The program aims to increase trauma recovery skills, improve mental health, and decrease substance use. TREM is a group intervention that uses strategies such as education about mental health issues, cognitive restructuring, skills training, and peer support.
Each session is structured as a conversation about a relevant topic and is led by two or three group leaders. Group leaders guide participants through questions and an experiential exercise in which participants complete an activity related to the topic, such as practicing safety precautions after discussing physical safety. Group leaders typically implement TREM topics in order. TREM content is split into four consecutive parts. Part 1 focuses on empowerment and explores 11 topics, including gender identity, sexuality, interpersonal boundaries, and self-esteem. Part 2 focuses on trauma recovery and explores 10 topics related to connections between sexual, physical, and emotional abuse and psychiatric symptoms, substance abuse, and current relationships. Part 3 focuses on advanced trauma recovery issues and explores nine additional trauma-related topics, including blame, responsibility, and the role of forgiveness in recovery. Part 4 provides closing rituals where participants explore how they have changed throughout the intervention.
Group leaders may conduct modified TREM sessions with women who have serious mental illnesses, incarcerated women, and men. Additionally, following the completion of TREM, group leaders may provide additional sessions for female trauma survivors who commit abuse or mothers who need parenting help.
Trauma Recovery and Empowerment Model does not currently meet criteria to receive a rating because no studies of the program achieved a rating of moderate or high on design and execution.
Date Research Evidence Last Reviewed: Sep 2024
Sources
The following sources informed the program or service description, target population, and program or service delivery and implementation information: the program or service manual, and the California Evidence-Based Clearinghouse for Child Welfare.
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 download the Handbook of Standards and Procedures, Version 1.0
Target Population
TREM is designed to serve women who have survived trauma and may have substance use or mental health conditions. Women who have serious mental illnesses, women who have committed abuse, incarcerated women, and men can participate in modified TREM sessions.
Dosage
Two to three group leaders typically deliver TREM in 33 weekly group sessions. Each session typically lasts 75 minutes, includes 8–10 participants, and covers one topic.
Location/Delivery Setting
Recommended Locations/Delivery Settings
Group leaders can deliver TREM in hospitals, outpatient clinics, community-based agencies, group or residential care, justice settings, or shelters.
Education, Certifications and Training
Group leaders can participate in an optional 2-day TREM training.
Program or Service Documentation
Book/Manual/Available documentation used for review
Harris, M., & The Community Connections Trauma Work Group. (1998). Trauma Recovery and Empowerment: A clinician's guide to working with women in groups. The Free Press.
Available languages
TREM materials are available in English and Spanish.
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 Trauma Recovery and Empowerment Model |
|---|---|
| Identified in Search | 11 |
| Eligible for Review | 1 |
| Rated High | 0 |
| Rated Moderate | 0 |
| Rated Low | 1 |
| Reviewed Only for Risk of Harm | 0 |
Studies Rated Low
Study 15137Fallot, R. D., McHugo, G. J., Harris, M., & Xie, H. (2011). The Trauma Recovery and Empowerment Model: A quasi-experimental effectiveness study. Journal of Dual Diagnosis, 7(1-2), 74-89. https://doi.org/10.1080/15504263.2011.566056
This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.Studies Not Eligible for Review
Study 15138
Fallot, R. D., & Harris, M. (2002). The Trauma Recovery and Empowerment Model (TREM): Conceptual and practical issues in a group intervention for women. Community Mental Health Journal, 38(6), 475-485. https://doi.org/10.1023/A:1020880101769
This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4)Study 15139
Fallot, R. D., & Harris, M. (2004). Integrated Trauma Services Teams for women survivors with alcohol and other drug problems and co-occurring mental disorders. Alcoholism Treatment Quarterly, 22(3/4), 181-199. https://doi.org/10.1300/J020v22n03_10
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 15140
Morrissey, J. P., Jackson, E. W., Ellis, A. R., Amaro, H., Brown, V. B., & Najavits, L. M. (2005). Twelve-month outcomes of trauma-informed interventions for women with co-occurring disorders. Psychiatric Services, 56(10), 1213-1222. https://doi.org/10.1176/appi.ps.56.10.1213
Cocozza, J. J., Jackson, E. W., Hennigan, K., Morrissey, J. P., Reed, B. G., Fallot, R., & Banks, S. (2005). Outcomes for women with co-occurring disorders and trauma: Program-level effects. Journal of Substance Abuse Treatment, 28(2), 109-119. https://doi.org/10.1016/j.jsat.2004.08.010
Morrissey, J.P., Ellis, A.R., Gatz, M., Amaro, H., Glover Reed, B., Savage, A., Finkelstein, N., Mazelis, R., Brown, V., Jackson, E.W., & Banks, S. (2005). Outcomes for women with co-occurring disorders and trauma: Program and person-level effects. Journal of Substance Abuse Treatment, 28(2), 121-133. https://doi.org/10.1016/j.jsat.2004.08.012
McHugo, G.J., Kammerer, N., Jackson, E.W., Markoff, L.S., Gatz, M., Larson, M.J., Mazelis, R., & Hennigan, K. (2005). Women, Co-occurring Disorders, and Violence Study: Evaluation design and study population. Journal of Substance Abuse Treatment, 28(2), 91-107. https://doi.org/10.1016/j.jsat.2004.08.009
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 15141
Johnstone, S., Dela Cruz, G. A., Kalb, N., Tyagi, S. V., Potenza, M. N., George, T. P., & Castle, D. J. (2023). A systematic review of gender-responsive and integrated substance use disorder treatment programs for women with co-occurring disorders. American Journal of Drug & Alcohol Abuse, 49(1), 21-42. https://doi.org/10.1080/00952990.2022.2130348
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 15142
Karatzias, T., Ferguson, S., Gullone, A., & Cosgrove, K. (2016). Group psychotherapy for female adult survivors of interpersonal psychological trauma: A preliminary study in Scotland. Journal of Mental Health, 25(6), 512-519. https://doi.org/10.3109/09638237.2016.1139062
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 15143
Masin-Moyer, M., Engstrom, M., & Solomon, P. (2020). A comparative effectiveness study of a shortened Trauma Recovery Empowerment Model and an attachment-informed adaptation. Violence Against Women, 26(5), 482-504. https://doi.org/10.1177/1077801219836730
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 15144
Masin-Moyer, M., Kim, J. C., Engstrom, M., & Solomon, P. (2022). A scoping review of the Trauma Recovery and Empowerment Model (TREM). Trauma, Violence & Abuse, 23(3), 699-715. https://doi.org/10.1177/1524838020967862
This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4)Study 15145
Molina, G., & Whittaker, A. (2022). Treatment of post-traumatic stress disorder and substance use disorder in adults with a history of adverse childhood experiences: A systematic review of psychological interventions. Drug and Alcohol Dependence Reports, 2, 100028. https://doi.org/10.1016/j.dadr.2022.100028
This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4)Study 15146
Paquin J., Kivlighan D., Drogosz L. M. (2013). Person-group fit, group climate, and outcomes in a sample of incarcerated women participating in trauma recovery groups. Group Dynamics: Theory, Research, and Practice, 17(2), 95-109. https://doi.org/10.1037/a0032702
This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4)Study 15147
Toussaint, D. W., VanDeMark, N. R., Bornemann, A., & Graeber, C. J. (2007). Modifications to the Trauma Recovery and Empowerment Model (TREM) for substance-abusing women with histories of violence: Outcomes and lessons learned at a Colorado substance abuse treatment center. Journal of Community Psychology, 35(7), 879-894. https://doi.org/10.1002/jcop.20187
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).