Overview

The research base on complex psychological trauma has grown significantly in recent years. Yet even with the development of more effective techniques for treating complex trauma survivors, therapists often struggle to build strong relationships with these severely distressed clients. In this guide, the authors present an approach for helping adult clients move through the three phases of posttraumatic recovery -- and for managing the inevitable roadblocks and relationship issues that occur. The introductory chapters explore how complex trauma emerges from chronic victimization and the disruption of attachment bonds in childhood or adulthood and review diagnostic considerations. Two extended case examples highlight clinical issues that arise with this population and, running throughout the chapters, show how to use a secure therapeutic alliance as a foundation for utilizing evidence-based treatment strategies. The authors demonstrate ways to weave together elements of cognitive-behavioral, psychodynamic, relational, and systemic therapies, along with other proven approaches, in the service of working toward clearly defined therapeutic goals. In Phase 1, the emphasis is basic safety and personal stabilization. Phases 2 and 3 address trauma processing and the challenges of creating a new, more satisfying life. Strategies for tailoring interventions to each individual's needs and strengths, aided by ongoing assessment, are detailed. Applications in group, couple, and family therapy are also discussed.