Treatment of Complex Trauma

Christine A. Courtois, PhD, ABPP, a board-certified counseling psychologist, is retired from private practice in Washington, DC, and is a consultant/trainer on topics on trauma psychology and treatment. She cofounded and then served for 16 years as Clinical and Training Director of The CENTER: Posttraumatic Disorders Program, in Washington, DC. Dr. Courtois was chair of the Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults for the American Psychological Association (APA), released in 2017, and for guidelines on the treatment of complex trauma for several professional organizations. She has published a number of books (four of them coedited or coauthored with Julian Ford) and numerous book chapters and articles on trauma-related topics. Dr. Courtois is past president of APA Division 56 (Trauma Psychology) and past founding Associate Editor of the Division's journal, Psychological Trauma: Theory, Research, Practice, and Policy. She served two terms on the Board of Directors of the International Society for Traumatic Stress Studies (ISTSS). She has received the Award for Distinguished Contributions to Independent Practice from the APA, the Sarah Haley Award for Clinical Excellence from ISTSS, and, most recently, the Award for Distinguished Service and Contributions to the Profession of Psychology from the American Board of Professional Psychology.Julian D. Ford, PhD, ABPP, a clinical psychologist, is Professor of Psychiatry at the University of Connecticut School of Medicine, where he is Director of the Center for Trauma Recovery and Juvenile Justice and the Center for the Treatment of Developmental Trauma Disorders. He has served as President of the International Society for Traumatic Stress Studies, is a Fellow of the American Psychological Association, and is Associate Editor of the Journal of Trauma and Dissociation and European Journal of Psychotraumatology. Dr. Ford has published more than 250 articles and book chapters. He is coeditor of Treating Complex Traumatic Stress Disorders in Adults, Second Edition, and Treating Complex Traumatic Stress Disorders in Children and Adolescents, and coauthor of Treatment of Complex Trauma: A Sequenced, Relationship-Based Approach. His research focuses on developmental trauma disorder and the Trauma Affect Regulation: Guide for Education and Therapy (TARGET) therapeutic intervention.

"The state of the art of treating complex trauma, both the basics and the nuances, as summarized by two wise and sophisticated experts."--Judith Lewis Herman, MD, Department of Psychiatry, Harvard Medical School"Both authors have worked extensively with survivors of complex trauma, and share their wisdom and experience in this book. At a time when this clinical population is becoming more visible to clinicians, this thoughtful, extensively documented work is a real treasure. The emphasis on therapist self-care and the ways in which the authors underscore the central importance of therapist self-awareness and self-regulation are particularly valuable. This book will be required reading for all of my interns."--Laura S. Brown, PhD, ABPP, past president, Division of Trauma Psychology, American Psychological Association; private practice, Seattle, Washington"Courtois and Ford, two internationally acknowledged experts, have written a magnificent book on the nature and phase-oriented treatment of complex trauma. Destined to become an instant classic, the book is illustrated throughout with instructive case material. It is at once an excellent guide for the uninitiated and an outstanding resource for experienced clinicians in the field. As most forms of complex trauma occur in interpersonal relationships, the book's emphasis on the therapeutic relationship as the vehicle for healing contributes to its importance."--Onno van der Hart, PhD, Department of Clinical and Health Psychology (Emeritus), Utrecht University, The Netherlands"Finally! We have long needed a clinical guidebook that takes treatment providers through the process of therapy for complex posttraumatic stress syndromes, which are among the greatest challenges that professionals encounter. Courtois and Ford's broad and deep clinical experience shines through in their discussion of assessment, engagement, and treatment--as do their optimism, passion, and hope."--Sandra L. Bloom, MD, founder, The Sanctuary Model"Courtois and Ford provide detailed guidelines for conducting their sequenced treatment approach, from preparation, assessment, and planning, to each of the phases of therapy. The book covers the 'meat and potatoes' of trauma therapy: ensuring client safety, cultivating the therapeutic relationship, and processing trauma memories. It includes strategies from different theoretical approaches and treatment modalities and addresses more complex processes, such as psychic emptiness and dissociation. Written with exceptional clarity, compassion, and respect, and richly illustrated with clinical material, this is an invaluable resource for clinicians."--Sandra C. Paivio, PhD, CPsych, Department of Psychology, University of Windsor, Ontario, Canada-This is a must-have for any clinician working with patients with trauma on a daily basis and for those therapists who do not necessarily have a specialization in trauma, but would like to get more knowledgeable about complex trauma. It should also be a required textbook for graduate students, especially doctoral level students interested in working in and/or researching PTSD situations.--Doody's Review Service, 8/23/2013ƒƒ“Courtois and Ford have demonstrated that they are masters of their subject and are masterful in communicating about the treatment of a very difficult patient population and have contributed a masterpiece in their book….This book is not only essential reading for therapists who want to take on the challenge of treating patients with complex trauma but also an excellent source for any professional who engages in psychotherapy. The reader comes away with not only important tools in establishing a meaningful relationship with patients but also a sense of the gratification that results from treating patients and being a partner in their growth and development.”--Journal of Nervous and Mental Disease, 3/1/2014

• Foreword, John BriereI. Overview of Complex Traumatic Stressors and Sequelae1. Complex Trauma and Traumatic Stress Reactions2. Complex Traumatic Stress Reactions and DisordersII. Treatment of Complex Traumatic Stress Reactions and Disorders3. Preparing for Treatment of Complex Trauma4. Treatment Goals and Assessment5. Phase 1: Safety, Stabilization, and Engagement--Measured in Skills, Not Time6. Phases 2 and 3: Trauma Memory, Emotion Processing, and Application to the Present and Future7. Systemic Therapy across Phases: Group, Couple, and Family ModalitiesIII. Advanced Treatment Considerations and Relational Issues8. Into the Breach: Voids, Absences, and the Posttraumatic/Dissociative Relational Field9. Walking the Walk: The Therapeutic Relationship10. Transference and Countertransference in Complex Trauma TreatmentPostscript