Mayerson Center for Safe and Healthy Children

You can download the Replication Cycle (60K) chart in portable document format (.pdf). You must have Adobe Acrobat Reader installed on your computer to read this file.

The Trauma Treatment Training Center / TTTC begins by selecting a model to disseminate. The TTTC looks at current evidence-based treatment models in the field. To be implemented successfully, treatments must:

• Have measurable positive clinical outcomes
• Be well-defined and teachable
• Be acceptable to clients, providers and payers
• Be fiscally and administratively manageable
• Be cost-effective and affordable

Once a model is selected, training materials are prepared and the first training session occurs. Upon completion of training, TTTC staff provide follow-up consultation to trainees until they reach competency. Not only does research inform practice, but practice informs practice. Trainees who take treatments back to their agencies and use them with their clients know what works and what does not and can help us understand why. These clinicians can also provide insight into how training could be improved or revised based on their clinical experiences with the model. Their feedback is integrated into the model for the next replication cycle and the process of preparation and training begins again.

Continuous quality improvement is embedded into every dissemination cycle in an effort to make each treatment model adaptable and usable in a variety of settings with a variety of client populations while remaining faithful to model fidelity.

In addition to training and providing follow-up consultation to clinicians, the TTTC works with agency supervisors to implement the model, maintain fidelity to the model and build training capacity within the agency. The TTTC collaborates with agency administrators around issues of billing and sustainability, as well as with third-party payers to recognize models as billable therapies to ensure agency reimbursement. This information offers insight about a model's impact in an agency at every level.

In collaboration with model developers and other practitioners in the field, this continuous quality improvement loop allows us to refine treatment models, and learn how these models are trained and implemented in real-world settings. This replication process is repeated until an Implementation Toolkit can be developed. Using this toolkit the TTTC then works with other centers to develop local training programs of their own.

The replication cycle allows us to better understand how to implement specific evidence-based treatment models in community agencies, while teaching us about the process of implementing evidence-based treatment models in general. When implementing any evidence-based treatment model, certain principles hold true across all models, while other principles are model-specific or may require adaptation based on agency-specific factors. Because of this, and because model dissemination is not an exact science, transferring evidence-based treatment models is, in essence, a co-creation among model developers, trainers, agency administrators and clinicians.

In the past, the TTTC primarily trained Parent-Child Interaction Therapy (PCIT). We have expanded the evidence-based treatment model trainings that we offer, including: Parent-Child Interaction Therapy, Child-Adult Relationship Enhancement (CARE), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Treating Traumatic Loss in Children (TTLC), Psychological First Aid, Child Forensic Interviewer Training, Specialized Child Forensic Interviewer Trainings and Cognitive Processing Therapy for Sexual Abuse (CPT-SA). Descriptions and registration information for all of these trainings can be found in the TTTC Training Catalog.