Our Chair, child psychologist Maria Callias, explains how our trauma recovery programme TRT works

Q: What is TRT?

A: Teaching Recovery Techniques, or TRT, is a well-structured programme that enables responsible adults to provide sound practical psychological help to the many children affected by dreadful experiences of wars and disasters. It is a fairly short five-session course for use with groups of children as early as possible. It was developed by psychologists to enable trained adults to reach high numbers of children in groups.

Q: Who can be helped by TRT?

A: TRT can help children, aged 8 years and over, to learn ways of coping with their psychological trauma, reducing their distress and enabling them to manage better in their daily lives. The problems they face include intrusive thoughts and feelings that can be triggered by particular ordinary sights or sounds, nightmares, being anxious and vigilant all the time even though they are now in a safer place, and avoiding doing ordinary activities because of fearfulness or of being reminded of bad experiences.

Q: How does TRT help them?

A: TRT helps children to understand that their reactions are common in children (and adults) who have been through such awful experiences, and that there are ways of reducing their distress and strange reactions. The children learn specific psychological ‘tools’ to help them calm down, reduce the intrusive images and nightmares and face distressing situations that they are avoiding.

Q: What effect does this have?

A: First of all, the child learns to understand that their distress and reactions do not mean that they are ‘going mad’ but that their reactions are understandable in the context of what they have experienced. Secondly and most importantly, the child learns a wide range of psychological skills or ‘tools’ that they can use to reduce these reactions, and also ways of reducing their avoidance by trying tools to help them overcome the anxiety that stops them doing things – often things they would like to do if only they could get over their distress.

Q: How long does it take?

A: That is a difficult question to answer. Practice is important and is given as the homework after each session to focus on specific skills. Usually, the children report some success as soon as they begin to practice the tools. Over a few weeks, they begin to gain some control over many of their adverse feelings and reactions and report less distress.

Q: Why do you think it works?

A: It works because the specific skills that the children are taught are well proven to reduce post traumatic stress reactions in research and clinical settings. The children are supported to try these out in a supportive group setting, where they are encouraged to ‘have a go’ and where they see that other children are also in the same boat as them and trying too. The emphasis in the programme is on coping with the distress in a safe place, but without necessarily sharing the distress.

Q: Are there other treatments like this?

A: The specific techniques are well researched and widely used in clinical practice, usually in one-to-one sessions. The special value of TRT is that many of these specific techniques are brought together in a carefully structured programme that can be used more widely in other community settings, such as schools, and does not rely only on highly specialist mental health staff. The group setting allows far more children to benefit than is possible otherwise and more adults to understand their needs and how to support them.

Q: Where has TRT been used?

A: Over the years, TRT has been used in many parts of the world, starting with former Yugoslavia, where it was pioneered after the wars of the 1990s. In the past, it has been used in war-torn countries in the middle East, after earthquakes in Greece and Turkey and fires in Australia and the UK.  Currently it is being used to help children affected by conflicts in Ukraine and Gaza.

Q: Who would find TRT useful in the UK?

A: Those supporting children affected by traumatising events across a community or school (such as mass shootings or tragic accidents) would be able to offer this specific programme for psychological trauma, as part of their overall support to children. Also services supporting children displaced from their countries of origin and because of wars as is happening with Ukrainian children.

A: What’s the best way for someone to start using TRT?

Q: They should ideally apply for our training in how to use the TRT manual. The manual is available for free download from our website, but our training provides a systematic introduction to issues such as how to set up the children’s groups, the reasons for techniques, the way TRT should be integrated into other support and the importance of the parent group component of TRT. After training they are welcome to cascade their knowledge to colleagues. At least two people in any organisation should be trained. In addition, they should ensure that providing TRT to children in their setting is feasible.

Q: What is your own experience of teaching or using TRT?

A: My experience of teaching TRT has been very positive, enjoyable and heartening. Feedback from participants has been very positive and it has been a privilege to meet the trainees. We have trained participants from widely different backgrounds both in person and via Zoom. They have been eager to learn, raised important issues for discussion and clarification, and have had the opportunity of practicing the exercises that they will go on to teach children.

Q: What is your role at CAW UK?

A: I am the Chair of the Board of Trustees of CAW UK. We are a relatively new charity but I have been involved in this work for many years. Our aims are to work with organisations and individuals to ensure that children who need this support in the UK and worldwide have access to well-founded ways of reducing their distress, so that they can rebuild their lives. Our ultimate goal is to give the children a brighter future.