Authors: ETM History

My name is Jesse Collins. Nancy Carson is my wife. We began developing ETM in 1979. We are the authors of all ETM materials copyrighted from 1981 - 2005. I began translating ETM to this (Internet) information system in 1994.


For health reasons (described in an addendum found at the end of this page), Nancy and I are retired from basic ETM clinical and management dissemination activities. I do, however, provide system administration for the Web based technical elements of the  Online Etiotropic Trauma Management – Trauma Resolution Therapy Training – Certification Program. It is different from this tutorial in that the tutorial is available for free study and reference, and the online program attaches a fee for a full and structured professional facilitated curriculum. It provides database storage and processing of the student’s (professional therapist – counselor – other manager) course conferencing discussions, forum, study, testing functions and other indicators of progression.

Chemical Dependency Family Counseling, Vietnam Combat, and Cost Accounting

As described later, Nancy and I developed ETM and TRT while participating in the chemical dependency profession as counselors, and consultants to and administrators of inpatient and outpatient settings. We were fortunate to train at institutions internationally recognized for their excellences and extraordinary advances in treatment of and social response to virtually all addiction permutations. The advances were particularly noted to include a primary focus on the family. That focus would result in the initiation of both ETM and TRT. In depth descriptions of those initiations and follow throughs are provided in the Professional / Academic / Development sections.

There were two more pre development factors. Both pertained to earlier skills and experiences taken from employments unrelated to counseling. In the first, I served a 4 year contract as an enlisted man with the United States Marine Corps. As a PFC, I worked in a combat role in Vietnam between 1965 and 1966. In one  assignment, I was part of the first installation of Combined Action Programs. I, with two teams comprised of 4 men each, lived in villages and worked in conjunction with limited (2 man teams) South Vietnamese militia to defend villagers against communist assault, and to support corpsmen as they provided healthcare to those villagers. In a second duty, I participated in many of the jobs attending helicopter operations. Upon returning home, I served the last two years (1967 and 1968) at Camp Pendleton, CA. As pertaining to that job’s influences on ETM, I worked as an anti guerrilla warfare training NCO for the 5th Marine Division.

In hindsight, Those experiences gave me an affinity for, or capacity to assist, people affected by severe trauma. In addition, the experiences would also later in ETM's system application provide insight into the needs of organizations influenced by battle trauma. My ebook Guerrilla Warfare's Pathogenesis and Cure and attending crisis management programs were a direct consequence of my combat experiences. Where they relate to a counselor’s training or patient’s assistance, I’ll make them available in limited translation.

In the second employment, I worked in the investment banking field. I received academic credentials, a BBA in Accounting and Management, from the University of Texas at Austin. I also earned a Registered Representative (of the NYSE and other financial institutions) license required in stockbroker and corporate finance activities. Like the combat, the accounting had a significant influence on TRT's development. Extinction of identity, which is ETM TRT theory of psychological trauma etiology, is a host of traumatic event caused and apparently scrambled contradictions to values, beliefs, images, and other realities. Myriad losses attend the contradictions, making the whole matter seem indecipherable. Scrignar (1987) stated that this damage was so overwhelming that it overloaded the psychodynamic helping model, making it impossible for clinician and patient to address the destruction. But were it not for the tools available to me and used in corporate finance to address complex cost accounting problems, there would have been no evaluative model from which to identify and clarify the consequences of traumatic events. When that identification – clarification was provided through the accounting framework, the solution to Scrignar’s ‘overload’ followed. It dissipated immediately. In listening to hundreds of battering descriptions by spouses of chemically dependent persons and people with other kinds of trauma, the developing trauma consequences accounting model provided a view that facilitated the incremental codification of the etiology and its symptoms. That solution became the basis of resolution in Trauma 'Resolution' Therapy.

I attribute ETM’s and TRT’s developments primarily to the confluences of chemical dependency family clinical work, accounting business and Vietnam combat histories.

From Alcoholism Counseling to Psychological Trauma Professional Leadership

Because alcoholism counselors are usually not looked to for clinical, professional, or academic leadership in the field of psychological trauma, 3 questions pertaining to our background - credentials, and thus ETM's TRT’s credibility, merit answers.

How and why did such people, alcoholism and drug abuse counselors:

  1. become involved in the psychological trauma field?
  2. produce a clinical/prevention management model different from that which dominates the psychological trauma discipline?
  3. create an academic curriculum and certification program for the transfer of the ability and authority to use the models by professionals of all disciplines?

Detailed answers may be found at Professional / Academic / Development. The rest of this 'Authors: ETM History' overview summarizes them.

Development Environment - Responsibilities

Beginning in the late 1970's we started (in Texas), with consultation from the Johnson Institute of Minnesota, a family intervention chemical dependency and violence prevention program. It quickly became a clinical treatment process for spouses / family members of alcoholics, alcoholics and other drug addicted people, and eventually anyone afflicted by chemical dependency induced traumatic life experiences.

Having considerable success with these efforts, we opened and managed an additional 5 facilities. Importantly, all were government licensed (the first in the state) or JCAH accredited, which authorities mandated annual detailed audits. They required extensive explanation, definition and rigorous defense by us of theory and methodology as they pertained to client progress. All phases of care, to include entry, treatment planning, acute and continuing care (the latter lasting no less than 2 years) were monitored for progress by the auditing process. Making compliance considerably more complex than other (competing individually - intrapsychically focused) approaches, patient families participated and were charted fully over the entire 2 year period, with each member (to 5 - 7 years of age) having his or her own peer group, individual counseling and interactive family group therapy (3 to 4 families per group).

Other factors influenced our efforts. All facilities were multi- disciplined. Subsequently, they were staffed with Social workers, Alcoholism and Drug Abuse Counselors, Psychologists, Psychiatrists and other mental health workers, all licensed in their respective professions. Moreover, these people routinely interacted through our facilities in intervention, treatment and case management circumstances with the courts, probation departments, children protective services, police (including domestic violence units), family service centers, correction, and parole administration elements of our communities.

As CEO, clinical directors, primary owners of the facilities and authors of ETM, Nancy and I had several responsibilities that in meeting, strengthened ETM's early development. First, we were required to understand fully the various doctrines (theories and methodologies) accompanying the staff's many training backgrounds. Second, those understandings had to be interpretated so that the otherwise often competing modalities became integratable with our developing ETM approach (next paragraph) into a homogeneous clinical model. Third, we ensured that it complied with the stringent facility licensing auditing processes, formalizing it into facility clinical and management protocols. Unlike circumstances where other academically credentialled professionals, for example, an MD Psychiatrist, might be in charge of a facility or individual case management, by virtue of the licensing - compliance processes, the formalized protocols, and the knowledge of our own model, we bore and met those duties and all attending final responsible parties.

Producing a Different Clinical Psychological
Trauma Theory and Methodology

The referenced 'developing model' (preceding paragraph) originated from use of the Johnson intervention approach (Johnson, 1980 Select 'References' #127). For the purpose of getting the drug dependent person into a treatment environment, the model required a focus by family members upon the chemically dependent person's drug use behaviors. Because they were very often traumatic, the model elicited considerable pain from family members as the events were recalled.

Making a major change (1979 - 1981) from the Johnson approach, we concluded that the first priority, as opposed to that of getting the chemically dependent person into treatment, should be upon the family members' pain, facilitating them to identify, understand and reconcile its intrapsychic, interactional and systemic origins. They were always the trauma-induced erosions to family member identity (values, beliefs, self - family images, and other realities) that were caused by the chemically dependent person's drug - using behaviors. We referred to this destruction as the trauma's etiology.

Having listened to many hundreds of these identification and reconciliation efforts, we found repeating presenting patterns in the process. Codifying them, we invented a series of written and patient - therapist interactive procedures that when utilized by the therapist and family members, strengthened their capacities to negotiate the patterns more effectively and efficiently, culminating in the straightforward address, and thus eventually what came to be our model's definition, of trauma etiology's 'reversal', or 'resolution.'

The procedures comprise ETM's referenced structured approach. It was and is named Trauma Resolution Therapy (TRT). ETM derives its base name, 'Etiotropic,' from that structure's focus upon, and resolution / reversal of, trauma etiology.

At the time (1979 - 1985), virtually everyone else (clinically speaking) used a symptom - behavioral (nosotropic) approach. It identified untoward family member behaviors and attempted to correct, change, control them, defining their etiologies, in some nosotropic ideological variations, as neurosis stemming from childhood developmental issues. Spouses of chemically dependent (and violent) people were seen through the prism of the nosotropic model as attracting to the trauma. Other ideas interpreted aberrant systemic activity as dysfunctional, ascribing its etiology to unlearned communications skills. The learning failures had been passed down intergenerationally. Subsequently, the nosotropic approach provided no definition of and treatment response to the etiology resulting from the drug use behavior caused trauma.

Eventually, TRT was found to provide the same treatment benefits to all trauma victims. Along with this application, it became our responsibility to define, convey and otherwise dispense ETM and TRT clinical theories and methodologies to interested professionals. Increasingly more often than not, those professionals did not practice, or interpret themselves as practicing, in the chemical dependency intervention - treatment environments.

System Management and Violence Prevention

From an organizational management perspective, ETM was first developed to implement TRT in treatment facility settings. Secondly, ETM provided a management theory and methodology for consultations to the referenced community social management resources. Thirdly, and most importantly, our work with treatment of trauma victims, intervention on perpetrators, and done in conjunction with referenced community social, educational, and legal service resources, produced our ETM theory and plans for preventing violence within our culture.

Transition: Focus on Education

During a very difficult financial time for all of Texas, the mid 1980's, we ended our direct service activities and created the academic and certification programs that now convey the skills and the authority required to administer the models to the public. The programs, which include the ETM Professional Training School and this ETM Tutorial, are a synthesized compendium of the body of actual and academic work produced over the past 26 years (now updated at year 2004).

In 1986 we were asked by the University of Houston’s chemical dependency counselor’s course to provide an advanced curriculum based on the ETM TRT model. We did and it was taught until 1990 when at that time we were contacted by other academic systems to teach our school through them. We did. ETM TRT got additional history of teaching around the state of Texas, and next door in Louisiana. We built several curriculums. One taught clinical applications of ETM TRT to treatment programs, including private practices. Another had a background in combat and was designed for the military. A third emphasized crisis management in Schools, to include a focus on near term trauma addressed by ETM TRT. And a fourth demonstrated ETM TRT application on the EAP industry model. All models were taught through such academic and other programs like the University of Texas El Paso, Permian, School of Public Health University of Houston, clinical hospitals, Austin Independent, Fort Worth, Dallas and 150 plus other districts in Texas. The work with combat chaplains for the US Army produced the ebook today called Guerrilla Warfare’s Pathogenesis and Cure by me. Their needs and the system work done in schools, police departments, EAPs, children protective services, and etc. contributed to the development of the Strategic Application of ETM theory and implementation. That model was studied by one of our school districts (client) who before hand studied competing models. After applying ours through to September, 1994, the program’s leadership was invited by the management of the Texas Education Agency to present its findings to the Annual Symposium of Principals, Superintendents and Counselors. The 6000 participants heard that ETM TRT was the best of the programs studied and the recommendation that every principal and counselor in Texas should be ETM TRT trained and certified.

As you can see under the Health Addendum below the next heading, we were unable to follow through with statewide delivery for health reasons. In fact, excepting the work of trainers and certified clinicians, ETM TRT has been withdrawn from our contributions since that time in 1995, when the health problems began to intrude on academic activities, and until now, when some improvements in my treatments are allowing limited return to the ETM TRT training certification work in late 2004 and early 2005.

Deserving of its own emphasis, the academic effort included (by itself) a 2 year investigation of, and engendering of a theory for, psychological trauma etiology's substrate. I did this because no one else (all focusing on the nosotropic substrate) had, and our clinical approach defined etiology as no one else had either (at the time; 1991 - 1994). It was the first dissertation on the subject. Ten  years later, it is still the primary consideration of the neurobiology of psychological trauma etiology and its reversal with ETM.

For you to appropriately use ETM and TRT, you will eventually have to evaluate for yourself whether or not this author's academic study and research supports their (ETM TRT) theories and methods. You may find that investigative and in some instances intended scholarly activity with all pertinent references and considerations in the Academic section. Also speaking for my wife, we wish you good luck and hope that all of the sections and the online ETM TRT Training Certification School are valuable to your pursuit  of trauma’s understanding and resolution for your patients, clients and associates..


Jesse Collins

Addendum regarding health influence on ETM TRT’s dissemination: Top

In 1995 and 1996, at the height of our installation of trauma crisis management systems for school districts (161) in Texas (see the paragraphs above),  Nancy and I each sustained major depreciations in health. They not only stopped the ETM work with schools, but have gone on to affect this life’s work, apparently, we are told, forever. For Nancy, she was found to have and treated for breast cancer. Compounding the difficulties of her situation, within the year a truck lost control on the other side of the highway and came into our lane, hitting us head-on. Nancy sustained brain injury, a malady that still adversely affects her. At the beginning of 1996, I was in a bizarre oral surgery accident where a suction apparatus was used and intended to retrieve a lost tooth root tip. The device when applied within the walls of the maxillary sinus became entangled in the major Trigeminal facial and cranial nerves, causing me irreparable damage, manifested by chronic pain – now atypical Trigeminal Neuralgia. I’m told that this is a lifetime condition, as is Nancy’s brain injury. The Trigeminal Neuralgia has neurological ramifications that retard my professional and social skills dramatically, enough to have placed our trauma management activities on hold for about a decade to this time, 2005. I’m formerly disabled by the injury 100%. We have an experimental brain surgery planned for this year should treatment providers agree.

The work I do with ETM TRT is now done within the context and limitations of the condition. I have limited speaking capacities, reducing my communications on the phone and bringing an end altogether to educational presentations. While new medicines are allowing me to reconnect to the work process through writing, I still rely on ETM TRT Trainers to maintain most contact with clients. I’m grateful to them for their steadfast efforts when filling in for me.

I am grateful most of all that my wife’s cancer condition has been in remission now for 9 years following the surgeries and radiation treatments.