Structure of the Fellowship Program:

The Fellowship is a program run by Dr. Kathleen Bush, Dr. Robert Lusk, and licensed clinical supervisors, with the support of the Attachment and Trauma Fellowship Advisory Council.

Eligibility:

• Applicants must be employed or accepted for employment as a Therapist in The Baby Fold’s ASAP program. They must be graduates of a CACREP accredited Master’s program, or have completed the educational and clinical internship requirements established by State of Illinois for professional licensure (LCPC, LCSW, LMFT), or doctoral graduates of a program that meets criteria for State of Illinois professional licensure at the doctoral level.
• Individual staff progress within the fellowship program will be assessed and the supervisory staff will support the therapist’s path towards completion using an established rubric.
• The process of application to the Fellowship program can occur simultaneously with an application for employment, but acceptance to the program can only occur following an offer of employment from The Baby Fold as an ASAP Therapist.

Training:

The Attachment and Trauma Fellowship Program is a three-year intensive training program that results in a Certification in Attachment and Trauma Therapy. The following are required elements of the program:

1. Fellows are expected to fully participate in the training activities of the program, complete each training opportunity provided, and demonstrate understanding and competency as determined by their supervisor before moving to the next training opportunity in the sequence. It is estimated to take three full calendar years to complete the Fellowship and receive Certification. The official Training Checklist for the ASAP training describes the entire training. Here are highlights from the checklist which are pertinent to the certification:
   1. Year 1: This part of the program supports new therapists in helping families in addressing Stage I of Trauma Recovery (as originally defined by Judith Herman). Stage I entails establishing safety and restoring the system of care for the family and client. Herman (2002) stated that recovery can only occur in relation to others, within a healthy attachment system. Year 1 elements include training in the following:
      1. START 24/7 (Start early, Trauma-Informed, Attachment-focused, Resiliency-building, Therapeutic services) Model developed by Dr. Rob Lusk and Dr. Kathleen Bush in conjunction with Illinois DCFS under the Quality Improvement Center for Adoption and Subsidized Guardianship. The widely accepted three-stage model of trauma therapy is thoroughly incorporated into this model as well as additional training information provided within this three-year fellowship.
      2. Training and competency in reflective practices. Reflective practice is both an evidence based intervention for working with children and families within in-home programs, as well as a critical style of supervision for attachment focused therapy. Reflective supervision trains the therapist in self-reflection and develops a safe alliance with the supervisor critical for the therapist to work through emotional responses to sessions with clients and learn coping skills and reflective practices that can help prevent vicarious trauma and compassion fatigue (Herman, 2002).
      3. National Training Initiative for Adoption and Guardianship Competency (NTI). This free online 26-hour web-based training was developed by CASE and sponsored by a grant from The Children’s Bureau. The Baby Fold had input on the development and pilot testing of this training. The training was developed to ensure therapist and caseworker competency in attachment and trauma related service provision to families formed through foster care, adoption, and guardianship.
      4. Trust Based Relational Intervention (TBRI) Caregiver Training: This training with demonstration of competency of using the TBRI in-home therapy manuals and materials is expected within the first year.
      5. Child and Adolescent Wellbeing Scale (CAWS): This clinical tool, developed by the Karen Purvis Institute for Child Development with the support of The Baby Fold, is used to assess attachment and emotional felt-safety.
      6. Dyadic Developmental Psychotherapy PACE Training (Playfulness, Acceptance, Curiosity, and Empathy): This therapeutic intervention developed by Dan Hughes is used for enhancing attachment between children with trauma and their caregivers.
      7. Successfully build a full case load of 10 families. This level of service provision must be established prior to advancing to the next training in the program and maintained for progression to the following stages of training.
      8. Level 1 Theraplay training with the Theraplay Institute, with demonstration of competency in using the Marschak Interaction Method assessment tool and Theraplay interventions with families.
   2. Year 2: This part of the program addresses skills necessary for Stages II and III of Herman’s model of trauma processing. This entails remembrance and mourning, as grief and loss is associated with trauma and adoption. Therapists focus on assisting the children and families in attaining the coping and communication skills for attending to grief, loss, and engagement in trauma processing. Therapists learn how to adjust the speed of therapy to ensure the pace is appropriate for the child and family to maintain felt-safety within the home.
      1. Phase I and II of Eye Movement Desensitization and Reprocessing (EMDR) with 10 hours of consultation. Therapists must demonstrate they understand and can use this intervention, as well as understand how to adjust the speed of the intervention to the needs of individual clients.
      2. Integrative EMDR: Therapists learn to combine the elements of other therapies, specifically Theraplay, to enhance attachment and build skills in preparation for trauma processing.
      3. Begin Phase 1 Training in Neurosequential Model of Therapeutics (NMT).
      4. Complete supervision hours towards licensure in field of practice (LCSW, LMFT, LCPC, PhD- Clinical Psychology). Upon receipt of licensure, fellows will receive a $1,000 salary increase (in addition to any other annual salary increases).
   3. Year 3: This part of the training assists new therapists in the integration of various therapeutic interventions and skills to individualize treatment specific to the needs of each client.
      1. EMDR Integrative Team Treatment for Attachment Trauma in Children Protocol training and certification with the Nebraska Trauma Institute and EMDRIA.
         1. Monthly supervision with the Nebraska Trauma Institute consultant.
         2. Support towards achieving eligibility for EMDR Certification.
         3. Fellows will be provided the supervision, consultation, and training towards Certification in EMDR.
         4. Fellows will be provided with potential clients to work towards the minimum requirements of the Certification in EMDR
         5. Fellows will be expected to pay for their own EMDR Certification as Certification requires membership with EMDRIA and completion of the requirements set by that organization. Some Fellows may not achieve the EMDRIA required 25 clients by three-year mark, but they will have their supervision and training towards Certification for when they are ready to request that from EMDRIA.
      2. Completion of Phase 1 training and Certification in NMT.
      3. Based upon the availability of training dollars, Fellows who have committed to staying at The Baby Fold following their completion of their Fellowship and Certification can submit an application to attend a Trust Based Relational Intervention Practitioner training.
2. Fellows are expected to participate in weekly 90-minute supervision using reflective practices. Success in use of reflective practices in the field, as assessed by the direct supervisor, will be an expected competency for completion of the program.
3. Fellows are provided a quarterly review of their progress with their supervisors, Dr. Rob Lusk and Dr. Kathleen Bush.
4. Fellows are expected to attend their scheduled consultation sessions.
5. Fellows are expected to maintain productivity and a caseload that meets the contractual requirements of the Adoption Support and Preservation program.
6. Request for Certification is submitted by the supervisor with evidence of the completion of the above tasks and verified by the Advisory Council.

Reference
Herman, J. L. (2002, January 4).  Recovery from psychological trauma.  Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1046/j.1440-1819.1998.0520s5S145.x