Training Programs on Traumatic Stress & Complex Trauma; Social Worker CE Credits
Real Life Heroes® (RLH) provides therapists with easy-to-use tools including a life storybook, manual, 24 CE credit asynchronous training program, multi-dimensional assessment guide, multi-sensory creative arts activities and psycho education resources to promote engagement of children, adolescents and parents/caregivers in assessment-driven, evidence-supported therapy for complex trauma and Developmental Trauma Disorder (DTD). RLH is focused on ‘Relational Healing for Relational Traumas’ and was developed for use in hard-pressed treatment centers to expand and sustain engagement of youths & families who have experienced multi-generational adversity, historical traumas, and on- going risks & stressors. Therapists can use RLH to reframe referrals based on pathologies and blame into a shared ‘journey’, a ‘pathway’ to strengthening (or building) emotionally supportive and enduring relationships and promoting development of self & co-regulation skills for youths, parents, extended family members and other caregivers. Creative arts, mindfulness, movement activities, ‘improv’ & shared life story work provide a flexible means for youths & families to develop the security, attunement and regulation skills needed for re-integration of traumas and development of strength-based identities linked to their cultural heritage.
¨ RLH engages children, adolescents and families from diverse communities utilizing principles of 'the hero’s journey' (Campbell, 1968) and tools that highlight youth, family and cultural strengths and elicit a youth and family’s caring, heritage and yearning to make things better.
¨ RLH books (The Real Life Heroes Life Storybook, Real Life Heroes Toolkit, The Hero’s Mask (middle grade novel & guidebook) and Wounded Angels, Inspiration from Children in Crisis, engage youths and parents/caregivers to expand perspectives about what can help them develop positive identities despite chronic traumas.
¨ RLH focuses on the developmental needs of children ages 6-12 and adolescents with Complex Trauma and Developmental Trauma Disorder who experienced traumas beginning before age 12 and have delays in their social, emotional or cognitive development.
¨ RLH expands the reach of evidence-supported treatment programs by broadening inclusion criteria and helping therapists connect with troubled youths and families.
o RLH can be used with youths and families who have experienced chronic traumas.
o RLH can be used with youths and parents/caregivers who have not been able or willing to participate in trauma-focused treatments including youths with suspected traumas that have not been acknowledged or validated, youths who have had frequent hospitalizations or placements, youths with aggressive behavioral reactions to trauma reminders, youths whose parents or caregivers have not been able or willing to work in trauma-focused treatment or youths who lack the language or cognitive skills for cognitive-based therapies.
¨ RLH has been successfully utilized in a wide range of programs from home-based to residential treatment and psychiatric hospitals in rural to urban environments, with justice-involved youths, with refugee youths, with youths living in birth, foster, kinship and adoptive families and residential programs and in school-based programs.
¨ RLH On-Demand helps programs provide training at times that best match therapists’ schedules any time during the year at a low cost and can be combined with live video-streamed training and consultation. Grant-funding is currently available for programs in the U.S. serving youths with complex trauma/DTD.
¨ RLH provides therapists with tools to overcome what is often cited as the greatest challenges in trauma treatment with youths and families, to increase and sustain engagement especially with highly stressed youths and parents/caregivers.
o RLH provides strategies for therapists and programs to avoid common pitfalls leading to families not being able or willing to participate, not showing up, or dropping out of evidence-based treatments.
o RLH utilizes messages and assessment-service planning tools that respect youths’ and parent/caregivers’ needs to protect themselves from chronic traumas and the importance of each family’s cultural heritage including discrimination, racism, religious persecution and other historical traumas.
¨ RLH includes a workbook and session rituals which provide a flexible, easy-to-learn, highly adaptable and transferable structure that promotes sustained participation in therapy.
o The RLH Life Storybook and Toolkit enable youths, parents, and other caregivers to continue trauma treatment if they move between programs or therapists.
o RLH highlights primary roles for birth, foster, kinship or adoptive parents, residential counselors, behavioral health specialists, and other caring adults.
o RLH promotes collaborative treatment planning.
o 24 CE credit training is ASWB-approved for asynchronous, video-streamed or hybrid training programs.
¨ The RLH Toolkit and fidelity measures can be used to assure implementation of all ‘best practice’ components for treatment of complex trauma and trauma-informed child welfare services recommended by the National Child Traumatic Stress Network (NCTSN).
¨ RLH tools can be used with other evidence-supported trauma treatments to promote and sustain engagement, strengthen interventions or overcome obstacles to treatment.
¨ The RLH Life Storybook, Toolkit and asynchronous training increase sustainability within programs and implementation with diverse youths and families.
¨ RLH has demonstrated efficacy in pre-post research studies with youths and families in highly stressed child welfare, behavioral health and school-based programs with an ‘all practitioner’ training model that can be replicated in a wide-range of programs.
“I have so many more people in my life that can help me now. I am not alone anymore.” - 12-year old boy in foster family care
“Heroes has inspired me to be something I did not think I could be 10 months ago. I thought I was going to give up, fall into a hole, have kids (young) and be like my mother. . . . I am my own hero . . . And now I will be someone and I hope to inspire others!" -15-year old girl in a home-based prevention of placement program who was helped to return to family living after living with a family friend and placement in two group care programs.
"I really like the centering activities . . . I have used them in my own recovery, and I have noticed a big difference they have made in my son's anger.“ --Parent at a child and family guidance clinic
"I gave her (the foster care clinician) a hard time about doing it (Real Life Heroes) in the beginning, but once I did it, I really liked it!" -Birth parent in a foster family cCare program.
“This has been the most successful implementation of any treatment model we’ve offered.” -Director of Training and Quality Improvement for a state-wide child welfare and behavioral health care agency
“It’s not one more thing. It’s the thing.” -Home-based intensive case management program director
“I have heard nothing but wonderful things about RLH from the staff! Sometimes a training may be well received, but it still isn’t something you see implemented very consistently. So it is especially wonderful to know that the staff are utilizing RLH.” -Clinic Director
Real Life Heroes® is listed in the National Registry of Evidence-based Programs and Practices by the Substance Abuse Mental Health Services Administration (SAMHSA), the SAMHSA National Center for Trauma-Informed Care "Models for Developing Trauma-Informed Behavioral Health Systems and Trauma-Specific Services," and as one of the National Child Traumatic Stress Network’s (NCTSN) Empirically Supported Treatments and Promising Practices. RLH is also listed as ‘High’ in Child Welfare System Relevance by the California Evidence-based Clearinghouse for Child Welfare. The 2007 RLH Practitioner’s Manual was rated as addressing 8 of 9 core domains identified as essential Intervention Objectives and Practice Elements developed by the NCTSN Core Curriculum on Childhood Trauma Task Force (Strand, Hansen, & Layne, 2012). The only domain missing, Therapist Self-Care, has been included in RLH training programs since 2007. The RLH model has been successfully pilot tested in home-based and placement child welfare services, and behavioral health care (Kagan,Douglas, Hornik, & Kratz, 2008) and utilized in a wide range of child and family service agencies in the U.S. and Canada. The HEROES Project, a SAMHSA-funded community practice site of the NCTSN, evaluated use of Real Life Heroes in seven child and family service programs and found significant reductions in traumatic stress and behavioral problems on standardized measures. This study involved training all staff, rather then just selected practitioners, and did not exclude children with aggressive or self-abusive behaviors, children who lacked validation for traumas or children who lacked caregivers who were able and willing to participate in treatment. Children receiving RLH in this study did not have placements or psychiatric hospitalizations (Kagan, Henry, Richardson, Trinkle & Lafrenier, 2014).
In my work as a clinical psychologist, children have shared with me traumatic experiences that ripped their families apart and shattered their sense of trust and belonging. These same children have also shared with me a yearning to be loved and the courage to change. I have been inspired by how children recovered from losses of the family members they loved, emotional, physical and sexual abuse, family violence, neglect, and abandonments. I have also seen how many children remained mired in the nightmares of their lives and appeared to relive their greatest fears day after day. Many children appeared cut off from emotionally supportive relationships with caring adults and appeared to repeat the abuse and violence they had experienced in their own behaviors. Dangerous behaviors led to referrals to child welfare services, juvenile justice programs or mental health treatment centers.
My job as a psychologist was to engage these children and their families and to find a way to understand what had happened and what could be done to help them. Rather than viewing these children as helpless victims or frightening aggressors, I learned to listen and watch for clues to what made these children smile and what led to dangerous behaviors. From these children, their parents, caregivers, and my colleagues, I learned lessons about what could be done to transform their lives. I also learned how their stories of trauma and recovery could inspire all of us.
Each child and family I have worked with has taught me a lesson of how ordinary people can rise up to surmount tragedies. Working with children and families who have experienced traumas has broadened my understanding of the impact of traumatic stress and what is possible for everyone. Very often, the worst traumas involved the breakdown of a child’s trust in parents, guardians, and other adults to keep themselves and their families safe. Many children appeared cut off from emotionally supportive relationships with caring adults and appeared to repeat the abuse and violence they had experienced in their own behaviors. Parents, grandparents, teachers, counselors and other caring adults often felt threatened by children’s behavioral reactions after multiple traumas. Caring adults often felt disempowered and unable to re-connect with troubled children. At the same time, troubled children often felt increasingly alone and desperate with little hope.
I developed the Real Life Heroes treatment model to expand the reach of evidence-supported trauma treatment programs and to provide tools that practitioners can use to engage hard-to-reach children and parents/caregivers. I wrote my most recent books, The Hero’s Mask novel and The Hero’s Mask Guidebook (Routledge, 2020) to create openings for parents, teachers, therapists, and other caring adults to encourage children to share what may be hidden from adults--what leads to their joy, what they yearn for, who they admire, and what drives their fears. These books build on what I have learned from children, families, and colleagues, my own experience with grief, and ten previously published professional and trade books: Families in Perpetual Crisis with Shirley Schlosberg (Norton, 1989), Turmoil to Turning Points; Building Hope for Children in Crisis Placements (Norton, 1996), Wounded Angels; Lessons from Children in Crisis (Child & Family Press, 2003); Rebuilding Attachments with Traumatized Children; Healing from Losses, Violence, Abuse, and Neglect (Routledge,2004), the Real Life Heroes Life Storybook 1st, 2nd and 3rd editions (Routledge, 2004, 2007, 2017), the Real Life Heroes Practitioner’s Manual (Routledge, 2004), the Real Life Heroes Toolkit for Treating Traumatic stress in Children and Families (Routledge, 2017), and Wounded Angels; Inspiration from Children in Crisis (Routledge, 2017). I have also published 35+ articles, chapters, and papers and media recordings on practice and research issues in trauma therapy, child welfare, foster care, adoption, training implementation, program evaluation, and quality improvement in family service and behavioral health treatment programs.
Wounded Angels; Inspiration from Children in Crisis, 2nd ed. (Routledge, 2017), is a book about what we can learn from children who have moved beyond tragedies to fight for what they, their siblings, and their parents need. Their stories highlight the role that courage and caring can play for people of all ages and circumstances- and the rich forces in our lives that have the potential to promote healing for all of us. The children, caregivers, and practitioners I have met led me to develop Real Life Heroes, a resiliency-focused treatment program for traumatic stress.
Real Life Heroes® (RLH) is a practitioner-developed and evidence-supported treatment program that has been successfully implemented in a wide range of child and family service, educational, and mental health treatment programs for over 15 years. RLH provides practitioners with easy-to-use tools including a life storybook, practitioner’s manual, multi-sensory creative arts activities, and psycho education resources to engage children and caregivers in evidence-supported trauma treatment. RLH helps practitioners reframe referrals based on pathologies and blame into a shared ‘journey,’ a ‘pathway’ to healing and recovery. The RLH Toolkit for Treating Traumatic Stress in Children and Families, 2nd Ed (2017) includes assessment, service and session planning guidelines that promote integrated treatment and teamwork focused on restoring (or building) emotionally supportive and enduring relationships and promoting development of affect regulation skills for children and caregivers. Creative arts, movement activities, and shared life story work provide a means for children and caregivers to develop the safety and attunement needed for re-integration of traumatic memories.
The 3rd Edition of the Real Life Heroes Life Storybook (2017) includes three new chapters, a revised chapter organization, and revised workbook activities based on research findings, suggestions from children and caregivers, and recommendations from practitioners. The 3rd Edition engages children and caregivers with therapeutic activities which promote self and co-regulation, trauma and resiliency psycho-education, increased mind-body awareness, and trauma memory integration. Used together, the Real Life Heroes Life Storybook and the Real Life Heroes Toolkit for Treating Traumatic Stress in Children and Familiesfacilitate implementation of recommended ‘best practice’ components of treatment for traumatic stress and Complex Trauma. Both books highlight how practitioners and treatment programs can successfully engage and assist children and families with traumatic stress to transform their lives.
My publications and training programs have been enriched by my experience in non-profit child and family services as Director of Professional Development, QI, Research, and Psychological Services at Parsons Child and Family Center and Northern Rivers in Albany, New York, and Principal Investigator for two SAMHSA-funded National Child Traumatic Stress Network (NCTSN) grants. In the NCTSN, I have been an active member of the NCTSN Steering Committee, the NCTSN Affiliate Advisory Board, the Complex Trauma, Parent Trauma and Child Welfare Committees and the Trauma-Informed Organizational Assessment Advisory Group. I founded and co-chaired the NCTSN Resource Parent Committee and co-led development of the NCTSN curriculum, Caring for Children Who Have Experienced Traumatic Stress which has been used in child welfare programs across the United States.
I am currently writing as well as providing consultation and training on traumatic stress and complex trauma treatment. My training programs, presentations, articles, and books highlight practical and innovative approaches that therapists, caregivers, programs, and clinics can utilize to help children and families strengthen resilience and reduce traumatic stress.
Real Life Heroes Training and Consultation Programs have been developed and tested for effective dissemination and implementation in behavioral health, school-based, refugee and child and family service agencies with limited time and funding for training programs. Training programs typically utilize a program-centered ‘All-practitioner’ model of training which is adapted for each sponsoring organization to meet their goals. Current programs highlight hybrid training models utilizing combinations of asynchronous training and live video streamed consultation groups to maximize impact and minimize costs for programs.
Training programs build on organizational strengths, previous trauma treatment training, and staff expertise. Use of the Real Life Heroes Toolkit, 2nd ed. and the RLH Life Storybook, 3rd ed. enables practitioners to learn and implement materials quickly and ensures implementation of National Child Traumatic Stress Network (NCTSN) recommended components of evidence-supported treatment for Complex PTSD and child welfare services. Fidelity is promoted with tools provided in the RLH Toollkit and supported through consultation with supervisors and directors and development of program-centered procedures and policies and a trauma-informed learning community.
Training Programs have successfully engaged and trained practitioners and programs with limited time for training and a wide range of skills and previous training. Follow- up surveys have found high rates of practitioner use and sustainability after training in child welfare and behavioral health programs serving high risk youths who have experienced multiple types of traumas. Training programs are offered through on line platforms, e.g. zoom, during the Covid pandemic. Video-streamed programs can be adjusted for organizations of all sizes with reduced rates to make these viable for small groups and organizations. Post-covid, training programs will again be provided on site and can be adjusted for a wide range of programs.
RLH On-Demand is now available at a low cost to match the resources of hard-pressed therapists and treatment centers, especially those with high turn-over rates and limited training funding and where sustaining trauma-informed treatment has been difficult. RLH On-Demand helps programs to provide training for new staff at any time during the year and at times that best match their schedules. RLH On-Demand includes video presentations, slide presentations, demonstration videos, practice activities, application to the therapist's clients, downloadable resource tools, reflections, quizzes, and feedback surveys. On-Demand training can be supplemented by 10 months of small group clinical consultation and supervsory
consultation to increase the effectiveness of training programs.
Real Life Heroes Fundamentals: Resiliency-focused Therapy for Children and Families with Complex Trauma, Course #5323, is approved by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program to be offered by Training Programs on Traumatic Stress as an individual course. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE course approval period: 11/21/2023 - 11/21/2025. Social workers completing this course receive 24 clinical continuing education credits.
NCTSN grant funding is available to cover training costs for a limited number of programs, therapists, supervisors and program directors in the United States. Priority will be given to non-profit organizations and state-funded facilities providing services to youths and families with Complex Trauma/DTD who demonstrate a commitment to implementation and a willingness to provide feedback on this training program. Priority will also be given to programs serving trauma-exposed youths in urban and rural high-risk schools, justice-involved youths, and refugee/asylum-seeking youths.
To learn more about RLH Training Programs and grant funding, please click the link below.
To register for RLH On Demand, please see: https://reallifeheroes.thinkific.com/courses/real-life-heroes-fundamentals-resiliencyfocused-therapy-for-complex-traumas
Kagan, R. (2021). The Hero’s Mask. London: Routledge Press.
Kagan, R. (2021). The Hero’s Mask Guidebook; Helping Children with Traumatic Stress. London: Routledge Press.
The Hero’s Mask novel traces an 11-year old girl’s discovery of strengths within herself, her family and her friends and how she is inspired by a new teacher who helps her learn the secrets of heroes. The novel engages middle grade readers and their parents/caregivers to uncover mysteries and illustrates how parent-child relationships can wither when families experience hard times and how they can be renewed or rebuilt. This is a book about overcoming fears and healing the wounds separating a mother and daughter, both scarred by traumatic grief. The Hero’s Mask and The Hero’s Mask Guidebook; Helping Children with Traumatic Stress provide a two-part resource that illustrates how a resiliency-focused understanding of toxic stress can be utilized to bring children and caring adults back together and what schools and other organizations can do to promote healing.
Available from Routledge Press: https://www.routledge.com/The-Hero-s-Mask--Helping-Children-with-Traumatic-Stress-A-Resource/Kagan/p/book/9780367474287
Also available from Amazon.com and other booksellers.
Kagan, R., Pressley, J., Espinoza, R., Lanktree, C., Henry, J., Knoverek, A., Duffy, S., Labruna, V., Habib, M.,. Blaustein, M., & Spinazzola, J. (2023). Development of a Differential Assessment Guide to Improve engagement with Youths & Families Living with Chronic Trauma. Journal of Child and Adolescent Trauma. 16: 145-159. A free full-text, view-only version is available at: https://rdcu.be/cWtg0
Kagan, R. (2017). Real Life Heroes Life Storybook, 3rd Edition. New York, NY: Routledge: https://www.routledge.com/Real-Life-Heroes-Life-Storybook/Kagan/p/book/9780415518048
Kagan, R. (2017). Real Life Heroes Toolkit for Treating Traumatic Stress in Children and Families, 2nd Edition. New York, NY: Routledge: https://www.routledge.com/Real-Life-Heroes-Toolkit-for-Treating-Traumatic-Stress-in-Children-and/Kagan/p/book/9781138963474
Kagan, R. (2017). Wounded Angels; Inspiration from Children in Crisis, 2nd Edition. New York, NY: Routledge: https://www.routledge.com/Wounded-Angels-Inspiration-from-Children-in-Crisis-Second-Edition/Kagan/p/book/9781138291294
Kagan, R. (2004). Rebuilding Attachments with Traumatized Children; Healing from Losses, Violence, Abuse and Neglect. New York, NY: Routledge Press: https://www.routledge.com/Rebuilding-Attachments-with-Traumatized-Children-Healing-from-Losses-Violence/Kagan/p/book/9781138169661
Thank you for visiting the RLH webiste. For more information on Real Life Heroes® and other training programs on traumatic stress, please contact Richard Kagan Ph.D. Training Programs on Traumatic Stress at richardkagan7@gmail.com