Attachment, Regulation, and Competency

Mental Health In-home Parent Skill-Based Does Not Currently Meet Criteria

Attachment, Regulation and Competency (ARC) is a skills and competencies-focused program designed to serve children from birth to young adulthood who have experienced complex trauma and their caregivers. ARC aims to support children and their caregivers to build the skills and resilience to engage in the world in an empowered and future-oriented manner.  

 

ARC uses a flexible, components-based framework designed as both an individual-level clinical intervention for children and their caregivers and as a framework that supports organizations and systems serving children and families. In the individual-level model, providers assess children and their caregiving system (e.g., parents, foster parents, kin) and deliver program components to parents and children, tailored to specific family needs. In the organizational model, providers across mental health, medical, and educational settings receive training to apply ARC concepts within existing programs or caregiving systems. In this model, caregiving systems include milieu (e.g., residential and group homes) and organizational (e.g., teachers and youth leaders). 

 

The ARC framework has three core domains: (1) Attachment, (2) Regulation, and (3) Competency. In the Attachment domain, providers aim to strengthen the caregiving system by building adult caregivers’ skills to understand and manage their own emotional and psychological responses to trauma, enhance the child-caregiver relationship, and effectively respond to the child’s needs (which are often expressed as behavior). In the Regulation domain, providers focus on the child themselves developing self-awareness and skills to identify, understand, tolerate, and manage their internal experience. In the Competency domain, providers support child resilience through improving decision-making skills, exploring their sense of self and identity, and establishing and sustaining healthy relationships. 

 

Within each core domain, the ARC framework includes two to three building blocks (eight in total), which include key treatment targets and skills. Each has a rationale, key concepts, subskills, tools, and techniques. Providers use the framework to assess needs and select the relevant building blocks to apply during treatment. Throughout the treatment process, providers work towards the treatment targets to meet the overarching goal of helping participants integrate the trauma they’ve experienced into their lives.  


The Prevention Services Clearinghouse’s independent systematic review of ARC found that no studies of the program achieved a rating of moderate or high on design and execution.

 

As of December 2025, the ACF Assistant Secretary has final approval authority over the determination of the program or service rating. For more information, please visit the FAQ on the rating determination policy.


Date Last Reviewed by the Prevention Services Clearinghouse (Handbook Version 2.0): Mar 2026

Date Program or Service Description Last Updated: Mar 2026


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, the program or service developer’s website, 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, download the Handbook of Standards and Procedures, Version 2.0

Target Population

ARC is designed for children from birth through young adulthood who have experienced complex trauma and their caregivers. ARC focuses on trauma-related diagnoses including PTSD, behavioral disorders, depression, and anxiety.  

Dosage

ARC delivery is designed for flexibility, so frequency and duration reflect the setting and participants. Providers adapt the program based on individual-level or group needs. Providers can implement ARC with children and their caregivers individually, children and caregivers together, families together, groups of children and families, or groups of children and caregivers together.  

In the individual-level clinical intervention, providers may deliver ARC in inpatient or outpatient settings, weekly or more often. Program length varies depending on setting and family needs. For example, in an inpatient setting, ARC may last 6 weeks due to the length of stay, but in outpatient settings, duration often exceeds 6 months and even a year. In an organizational setting, providers can deliver ARC as determined by the length of the program, class, school year, or the needs of the group in treatment.  

Location/Delivery Setting
Recommended Locations/Delivery Settings

Providers can deliver ARC in inpatient treatment settings, residential care settings, outpatient settings, community-based settings, and in the home.  

Education, Certifications and Training

Mental health providers and clinicians implement ARC as well as practitioners within service systems, such as hospitals, residential programs, schools, foster care, shelters, etc. ARC training typically includes a 2- or 3-day intensive training program followed by tailored consultation to support the application of ARC concepts within specific practice settings or with specific populations. ARC trainers or consultants instruct providers on the foundations of ARC and how to use the framework. Training for providers in a clinical setting, such as an outpatient mental health center, involves instruction on how to use the ARC framework as a clinical intervention to treat children, adolescents, and families. Training for providers in a service system, such as a residential care setting, provides instruction on how to integrate the ARC framework into the service system as well as deliver the clinical intervention. 

Providers may also participate in a 1-day advanced training focused on a specific topic, a half-day residential applications module, or receive consultation from an ARC trainer or consultant to support ARC implementation.  

Program or Service Documentation
Book/Manual/Available documentation used for review

Blaustein, M. & Kinniburgh, K. (2018). Treating traumatic stress in children and adolescents: How to foster resilience through attachment, self-regulation, and competency (2nd ed.). Guilford Press. 

Available languages

The ARC manual is available in English, Japanese, Korean, and Dutch. 

Other supporting materials

What is ARC?  

Who is ARC Intended For? 

How was ARC developed? 

What does ARC training involve? 

For More Information

Website: https://arcframework.org/  

Phone: (781) 400-9173 

Email: info@centerfortraumatraining.org  


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 Attachment, Regulation, and Competency
Identified in Search 14
Eligible for Review 1
Rated High 0
Rated Moderate 0
Rated Low 1
Reviewed Only for Risk of Harm 0

Sometimes study results are reported in more than one document, or a single document reports results from multiple studies. Studies are identified below by their Prevention Services Clearinghouse study identification numbers. To receive a rating of supported or well-supported, the favorable evidence for a program or service must have been obtained from research conducted in a usual care or practice setting.


Studies Rated Low

Study 15226

Bartlett, J. D., Griffin, J. L., Spinazzola, J., Fraser, J. G., Noroña, C. R., Bodian, R., Todd, M., Montagna, C., & Barto, B. (2018). The impact of a statewide trauma-informed care initiative in child welfare on the well-being of children and youth with complex trauma. Children and Youth Services Review, 84, 110-117. https://doi.org/10.1016/j.childyouth.2017.11.015

Bartlett, J. D., Barto, B., Griffin, J. L., Fraser, J. G., Hodgdon, H., & Bodian, R. (2015). Trauma-informed care in the Massachusetts Child Trauma Project. Child Maltreatment, 21(2), 101-112. https://doi.org/10.1177/1077559515615700

Fraser, J. G., Griffin, J. L., Barto, B. L., Lo, C., Wenz-Gross, M., Spinazzola, J., Bodian, R.A., Nisenbaum, J. M., & Bartlett, J. D. (2014). Implementation of a workforce initiative to build trauma-informed child welfare practice and services: Findings from the Massachusetts Child Trauma Project. Children and Youth Services Review, 44, 233–242. https://doi.org/10.1016/j.childyouth.2014.06.016

Barto, B., Bartlett, J. D., Von Ende, A., Bodian, R., Rosa Noroña, C., Griffin, J., Goldman Fraser, J., Kinniburgh, K., Spinazzola, J., Montagna, C., & Todd, M. (2018). The impact of a statewide trauma-informed child welfare initiative on children’s permanency and maltreatment outcomes. Child Abuse & Neglect 81, 149-160. https://doi.org/10.1016/j.chiabu.2018.04.023

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 15225

Arvidson, J., Kinniburgh, K., Howard, K., Spinazzola, J., Strothers, H., Evans, M., Andres, B., Cohen, C., & Blaustein, M.E. (2011). Treatment of complex trauma in young children: Developmental and cultural considerations in application of the ARC intervention model. Journal of Child & Adolescent Trauma, 4(1), 34-51. https://doi.org/10.1080/19361521.2011.545046

This study is ineligible for review because it does not use an eligible study design (Handbook Version 2.0, Section 4.1.5)

Study 15227

Fehrenbach, T., Sax, R. M., Urban, T. H., Simon-Roper, L., Novacek, J., Aaby, D. A., & Hodgdon, H. B. (2022). Trauma treatment for youth in community-based settings: Implementing the Attachment, Regulation, and Competency (ARC) framework. Journal of Child and Family Studies, 31(2), 434-446. https://doi.org/10.1007/s10826-021-02096-x

This study is ineligible for review because it does not use an eligible study design (Handbook Version 2.0, Section 4.1.5)

Study 15228

Ford, J. D. & Blaustein, M. E. (2013). Systemic self-regulation: A framework for trauma-informed services in residential juvenile justice programs. Journal of Family Violence, 28, 665-677. https://doi.org/10.1007/s10896-013-9538-5

This study is ineligible for review because it does not use an eligible study design (Handbook Version 2.0, Section 4.1.5)

Study 15229

Hodgdon, H. B., Kinniburgh, K., Gabowitz, D., Blaustein, M. E., & Spinazzola, J. (2015). Application of the ARC model with adopted children: Supporting resiliency and family well being. Journal of Child and Adolescent Trauma, 9(1), 43-53. https://doi.org/10.1007/s40653-015-0050-3

This study is ineligible for review because it does not use an eligible study design (Handbook Version 2.0, Section 4.1.5)

Study 15230

Hodgdon, H., Kinniburgh, K., Gabowitz, D., Blaustein, M. & Spinazzola, J. (2013). Development and implementation of trauma-informed programming in residential schools using the ARC framework. Journal of Family Violence, 28, 679-692. https://doi.org/10.1007/s10896-013-9531-z

This study is ineligible for review because it is not a study of the program or service under review (Handbook Version 2.0, Section 4.1.9)

Study 15231

Holland, J., Begin, D., Orris, D., & Meyer, A. (2017). A descriptive analysis of the theory and processes of an innovative day program for young women with trauma-related symptoms. Occupational Therapy in Mental Health, 34(3), 228-241. https://doi.org/10.1080/0164212X.2017.1393369

This study is ineligible for review because it does not use an eligible study design (Handbook Version 2.0, Section 4.1.5)

Study 15232

Holmes, C., Levy, M., Smith, A., Pinne, S., & Neese, P. (2015). A model for creating a supportive trauma-informed culture for children in preschool settings. Journal of Child and Family Studies, 24, 1650-1659. https://doi.org/10.1007/s10826-014-9968-6

This study is ineligible for review because it is not a study of the program or service under review (Handbook Version 2.0, Section 4.1.9)

Study 15233

Naste, T. M., Price, M., Karol, J., Martin, L., Murphy, K., Miguel, J., & Spinazzola, J. (2018). Equine Facilitated Therapy for Complex Trauma (EFT-CT). Journal of Child & Adolescent Trauma, 11, 289-303. https://doi.org/10.1007/s40653-017-0187-3

This study is ineligible for review because it is not a study of the program or service under review (Handbook Version 2.0, Section 4.1.9)

Study 15234

Rishel, C. W., Tabone, J. K., Hartnett, H. P., & Szafran, K. F. (2019) Trauma-Informed Elementary Schools: Evaluation of school-based early intervention for young children. Children & Schools, 41(4), 239-248. https://doi.org/10.1093/cs/cdz017

This study is ineligible for review because it does not report program or service impacts on an eligible outcome (Handbook Version 2.0, Section 4.1.8)

Study 15235

Saint Gilles, M. P., & Carlson, J. S. (2020). A pilot study on the effects of a supplemental trauma intervention within a Head Start preschool program. Research and Practice in Schools, 7(1), 49–69.

This study is ineligible for review because it is not a study of the program or service under review (Handbook Version 2.0, Section 4.1.9)

Study 15236

Tabone, J. K., Rishel, C. W., Hartnett, H. P., & Szafran, K. F. (2020). Examining the effectiveness of early intervention to create trauma-informed school environments. Children and Youth Services Review, 113, Article 104998. https://doi.org/10.1016/j.childyouth.2020.104998

This study is ineligible for review because it does not report program or service impacts on an eligible outcome (Handbook Version 2.0, Section 4.1.8)

Study 15237

Tabone, J. K., Rishel, C. W., Hartnett, H. P., & Szafran, K. F. (2022). Trauma-informed intervention with children: Integrating the CANS assessment with the ARC framework in a clinical setting. Journal of Child & Adolescent Trauma, 15, 65-74. https://doi.org/10.1007/s40653-021-00357-x

Tabone, J. K., Rishel, C. W., Hartnett, H. P., Szafran, K. F., & Royse, R. (2022). Examining the effects of adverse childhood experiences and gender on trauma-informed intervention outcomes. Journal of Child & Adolescent Trauma, 16, 9-19. https://doi.org/10.1007/s40653-022-00456-3

This study is ineligible for review because it does not use an eligible study design (Handbook Version 2.0, Section 4.1.5)

Study 15238

Tweedie, M. G., Belanger, C., Rezazadeh, K., & Vogel, K. (2017). Trauma-informed teaching practice and refugee children: A hopeful reflection on welcoming our new neighbours to Canadian schools. BC TEAL Journal, 2(1), 36-45. https://doi.org/10.14288/bctj.v2i1.268

This study is ineligible for review because it does not use an eligible study design (Handbook Version 2.0, Section 4.1.5)