Frank Vega, LMFT - Hogg Foundation for Mental Health

Frank Vega, LMFT 

Frank Vega is a licensed marriage and family therapist who has 

worked in the behavioral health field for 23 years. Currently he is 

director of the E-Merge/Integrated Behavioral Health Program for 

Austin Travis County Integral Care. During his tenure with the 

Department of State Health Services, he was appointed by the 

governor as the children’s mental health expert for Texas and led 

the state in its redesign of children’s mental health services 

delivered by community mental health centers. Understanding 

the impact that trauma plays in the lives of children, adolescents 

and adults has been an area of interest for Vega. As clinical 

director for a child-placing agency in Texas, he led the effort to 

bring trauma-informed care to the agency by training CPA staff, 

foster families, agency staff and other professionals on 

incorporating trauma-informed care in their work.

Children affected by trauma: 

What works – and what doesn’t 

Tools for working with children and 

adolescents with traumatic histories

Trauma’s Impacts 

• Attachment 

• Lack of trusting, protective relationships 

• Boundary Issues 

• Social Isolation 

• Biology 

• Neurological Impact 

• Hypersensitivity 

• Somatic Complaints 

• Behavioral 

• Impulse Control 

• Sleep Disturbances 

• Self Destructive Behaviors

Trauma’s Impacts 

• Cognitive Abilities 

• Learning Related Issues 

• Inability of Focus 

• Language Development 

• Detachment 

• Mood 

• Emotional Dysregulation 

• Depressed 

• Sense of Self 

• Low Self-Esteem 

• Shame 

• Guilt

Adverse Childhood Experiences (ACE) Study 

•Division of Adult and Community Health, National Center for Chronic Disease Prevention and 

Health Promotion 

www.acestudy.org

Assessment of Need 

• Family Assessment 

• Safety Assessment 

• Assess all areas impacted 

• Psychological/Behavioral 

• Development 

• Identification of treatment needs 

• Don’t start until the child is ready

Assessments 

• Adolescent Clinical Sexual Behavior 

Inventory-Parent Report 


Inventory-Self Report 

• Attachment Questionnaire for 

Children 

• Beck Anxiety Inventory 

• Beck Depression Inventory-Second 

Edition 

• Child PTSD Symptom Scale 

• Child Report of Post-traumatic 

Symptoms 

• Child Sexual Behavior Inventory 

• Child's Reaction to Traumatic 

Events Scale-Revised 

• Children's PTSD Inventory 

• Clinician-Administered PTSD Scale 

for Children and Adolescents for the 

DSM-IV 

• Post Traumatic Symptom Inventory 

for Children 

• Posttraumatic Stress Disorder 

Semi-Structured Interview and 

Observational Record 

• PTSD in Preschool Aged Children 

• Response to Childhood Incest 

Questionnaire 

• Trauma and Attachment Belief 

Scale 

• Trauma Symptom Checklist for 

Children 


Young Children 

• Trauma Symptom Inventory 

• Violence Exposure Scale for 

Children-Revised

Purpose of Trauma Assessments 

• Development of Treatment Plan 

• Assessment of trauma’s impact 

• Re-evaluation of treatment 

• What worked 

• What didn’t 

• Have symptoms decreased/increased 

• Child’s sense of safety 

• How often to re-evaluate 

• Outcomes

Assessment of Need 


Inventory-Parent Report 


Inventory-Self Report 

• Attachment Questionnaire for 

Children 

• Beck Anxiety Inventory 

• Beck Depression Inventory-Second 

Edition 

• Child PTSD Symptom Scale 

• Child Report of Post-traumatic 

Symptoms 

• Child Sexual Behavior Inventory 

• Child's Reaction to Traumatic 

Events Scale-Revised 

• Children's PTSD Inventory 

• Clinician-Administered PTSD Scale 

for Children and Adolescents for the 

DSM-IV 

• Post Traumatic Symptom Inventory 

for Children 

• Posttraumatic Stress Disorder 

Semi-Structured Interview and 

Observational Record 

• PTSD in Preschool Aged Children 

• Response to Childhood Incest 

Questionnaire 

• Trauma and Attachment Belief 

Scale 


Children 


Young Children 

• Trauma Symptom Inventory 

• Violence Exposure Scale for 

Children-Revised

What works with Traumatized kids? 

• Alternatives for Families-A Cognitive 

Behavioral Therapy (AF-CBT) 

• Adapted Dialectical Behavior Therapy 

for Special Populations (DBT-SP) 

• Assessment-Based Treatment for 

Traumatized Children: Trauma 

Assessment Pathway (TAP) 

• Attachment, Self-Regulation, ad 

Competence (ARC): A Comprehensive 

Framework for Intervention with 

Complexly Traumatized Youth 

• Child Adult Relationship Enhancement 

(CARE) 

• Child-Parent Psychotherapy (CPP) 

• Cognitive Behavioral Intervention for 

Trauma in Schools (CBITS) 

• Combined Parent Child Cognitive- 

Behavioral Approach for Children ad 

Families At-Risk for Child Physical 

Abuse 

• Culturally Modified Trauma-Focused 

Treatment (CM-TFT) 

• International Family Adult and Child 

Enhancement Services (IFACES) 

• Integrative Treatment of Complex 

Trauma (ITCT) 

• Multimodality Trauma Treatment – 

Trauma-focused Coping (MMTT) 

• Parent-Child Interaction Therapy 

(PCIT) 

• Real Life Heroes (RLH) 

• Sanctuary Model 

• Structured Psychotherapy for 

Adolescents Responding to Chronic 

Stress (SPARCS) 

• Trauma Grief Component Therapy for 

Adolescents TGCT-A 

• Trauma Affect Regulation: Guidelines 

for Education ad Therapy for 

Adolescents And Pre-Adolescents 

(TARGET-A) 

• Trauma-Focused Cognitive Behavioral 

Therapy (TF-CBT) 

• Trauma-Focused Cognitive Behavioral 

Therapy for Childhood Traumatic Grief 

(TFCBT-CTG) 

• Trauma Systems Therapy (TST)

Alternatives for Families-A Cognitive 

Behavioral Therapy (AF-CBT) 

• Physically abused children and offending 

caregivers 

• Phase 1: Psychoeducation and Engagement 

• Phase 2: Individual and Family Skills Training 

• Phase 3: Family Applications 

• Key Components 

• Working with the Child 

• Working with the Caregiver 

• Family Systems

Trauma-Focused Cognitive Behavioral Therapy 

(TF-CBT) 

• PRACTICE 

• Psycho-education 

• Relaxation skills 

• Affective modulation 

• Cognitive coping 

• Trauma narrative 

• Conjoint parent-child sessions 

• Enhancing future personal safety

Attachment, Self-Regulation, and 

Competency (ARC) 

• ARC is a guideline not a manualized 

intervention 

• Attachments 

• Strengthening Self Regulation 

• Developing Competencies within the child 

http://www.traumacenter.org/

10 building blocks of ARC 

• Attachment 

• Caregiver 

Affect 

Management 

• Attunement 

• Consistent 

Response 

• Routines and 

Rituals 

• Self-Regulation 

• Affect 

Identification 

• Affect 

Modulation 

• Affect 

Expression 

• Competency 

• Developmental 

Tasks 

• Executive 

Functions 

• Self 

Development 

http://www.traumacenter.org/

References and Resources 

• National Child Traumatic Stress Network 

• www.nctsn.org 

• www.learn.nctsn.org 

• www.nctsnet.org/products/child-welfare-trauma-training-toolkit-2008 

• Division of Adult and Community Health, National Center for Chronic Disease 

Prevention and Health Promotion 

• http://www.cdc.gov/ace/index.htm 

• ACE Study 

• www.acestudy.org 

• Trauma Systems Therapy 

• http://traumasystemstherapy.wordpress.com/ 

• US Department of Veteran’s Affairs National Center for PTSD 

• www.ptsd.va.gov/index.asp 

• National Child Traumatic Stress Network Empirically Supported Treatments and 

Promising Practices: 

• www.nctsnet.org/nccts/nav.do?pid=ctr_top_trmnt_prom 

• The Chadwick Center 

• http://www.chadwickcenter.org/

• California Evidence-Based Clearinghouse for Child Welfare 

• www.cachildwelfareclearinghouse.org 

• Attachment, Self-Regulation and Competency (ARC) 

• http://www.traumacenter.org/ 

• Treating Traumatic Stress in Children and Adolescents: How to Foster 

Resilience through Attachment, Self-Regulation, and Competency 

Margaret E. Blaustein PhD, Kristine M. Kinniburgh LICSW

CEU Statement 

Copyright 2005 

Medical University of South Carolina 

All Rights Reserved

Frank Vega, LMFT - Hogg Foundation for Mental Health

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