D.C. Mun. Regs. tit. 22, r. 22-A6348

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 22-A6348 - SPECIALTY SERVICE: TRAUMA RECOVERY AND EMPOWERMENT MODEL

6348.1

Trauma Recovery and Empowerment Model ("TREM ") is a structured group therapy intervention designed for clients who have survived trauma and have substance use disorders and/or mental health conditions. TREM draws on cognitive restructuring, skills training, and psychoeducational and peer support to address recovery and healing from sexual, physical, and emotional abuse.

6348.2

A curriculum for each model outlines the topic of discussion, a rationale, a set of goals, and a series of questions to be posed to the group in addition to an experiential exercise for each session. The components are:

(a) Therapy sessions focused on empowerment, self-comfort, and accurate self- monitoring, as well as ways to establish safe physical and emotional boundaries;

(b) Therapy sessions focused on the trauma experience and its consequences; and

(c) Therapy sessions focused on skills building, including emphases on communication style, decision-making, regulating overwhelming feelings, and establishing safer, more reciprocal relationships.

6348.3

Each TREM group is population specific and on average consists of eighteen (18) to twenty- four (24) sessions, with each session at least seventy-five (75) minutes in duration. Population-specific groups include:

(a) TREM for women;

(b) TREM for men;

(c) TREM for girls twelve (12) to eighteen (18) years of age;

(d) TREM for boys twelve (12) to under eighteen (18) years of age; or

(e) TREM for individuals who are lesbian, gay, bisexual, transgender, or questioning (groups for either individuals under eighteen (18) or individuals eighteen (18) years of age and over).

6348.4

Due to the sensitive nature of the discussions, TREM requires at least two (2) facilitators to be assigned to every group to ensure the safety and continuity of the group. At least one (1) facilitator must be a qualified practitioner licensed to practice independently. A team approach is required to: address situations that may arise within the group; decrease burnout; provide continuity if one facilitator is absent; and to lend additional therapeutic support to the group. Qualified practitioners working as facilitators must have completed Department-approved, population-specific TREM training.

6348.5

Qualified Practitioners of TREM are:

(a) Psychiatrists;

(b) Psychologists;

(c) LICSWs;

(d) APRNs;

(e) LMFTs;

(f) LPCs;

(g) LISWs;

(h) LGSWs;

(i) LGPCs; or

(j) Psychology Associates.

6348.6

Recovery Coaches, Certified Peer Specialists, and CACs I and II who have successfully completed a TREM group and Department-approved TREM training shall be authorized to support TREM services under the supervision of the two group facilitators.

6348.7

TREM shall be provided at the SUD treatment provider's site or in a residential facility of sixteen (16) beds or less unless otherwise stated by the Department.

D.C. Mun. Regs. tit. 22, r. 22-A6348

Final Rulemaking published at 62 DCR 12056 (9/4/2015); amended by Final Rulemaking published at 67 DCR 11585 ( 10/9/2020 ).