Attachment, Regulation and Competency (ARC) Grow for Medically Complex Families

Attachment, Regulation and Competency (ARC) Grow for Medically Complex Families (MCF) is a skills and competencies-focused program designed to serve caregivers of children ages 6 months–18 years with a chronic or complex medical condition. ARC Grow MCF aims to support medically complex families to build caregivers’ skills and resilience to cope with the unique challenges of caring for a medically complex child or teen, navigate relationships within the family and with medical providers, and maintain meaningful connections with their children. 

ARC Grow MCF uses the ARC components-based framework and content specific to medically complex families. ARC Grow MCF facilitators deliver the program in a structured format to individual caregivers. The ARC framework has three core domains: (1) Attachment, (2) Regulation, and (3) Competency. ARC Grow MCF draws heavily from the Attachment Domain. In the Attachment domain, facilitators aim to strengthen the caregiving system to manage emotional and psychological responses to trauma and grief, enhance the child-caregiver relationship, and effectively respond to the child’s complex needs. In the Regulation domain, facilitators aim to support caregivers in developing tools and strategies for increasing child or adolescent regulation skills including the ability to identify, understand, tolerate, and manage their internal experience. In the Competency domain, facilitators support caregivers in building tools and strategies to improve caregiver decision-making skills, explore caregiver personal and family identity, and foster positive family connections.  

Facilitators begin each structured session with a check-in activity in which caregivers share their energy and stress levels before initiating a modulation activity designed to support regulation. Next, caregivers describe how they applied skills at home. Facilitators have caregivers complete an “All About Me Book” activity that aims to enhance their ability to reflect on their identity as an individual and parent. The facilitator then delivers key content from the ARC framework and shows how to apply core skills. Facilitators also assign Home Connection work to practice new skills in the home, outside of the session. The session concludes with another modulation activity and a check-out activity in which the caregiver reflects on their energy, comfort, and stress. 

Within each core domain, the ARC framework includes two to three key treatment targets (eight in total), also known as building block skills. Each has a rationale, key concepts, subskills, tools, and techniques. The building block skills for ARC Grow MCF are tailored to medically complex families, covering topics such as traumatic grief, self-monitoring, and managing extreme stress and traumatic reactions.

The Prevention Services Clearinghouse’s independent systematic review of ARC Grow MCF found that no studies met eligibility criteria for review.

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 and the program or service developer’s website.

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