Principles of Trauma Therapy

John N. Briere, PhD is Professor Emeritus of Psychiatry and the Behavioral Sciences at the Keck School of Medicine, University of Southern California, and is past director of the Psychological Trauma Program at Los Angeles County + USC Medical Center. A past president of the International Society for Traumatic Stress Studies (ISTSS), he is recipient of the Award for Outstanding Contributions to the Science of Trauma Psychology from the American Psychological Association, the Robert S. Laufer Memorial Award for Scientific Achievement from ISTSS, the Presidential Award for Contribution to Methods from the Association for Scientific Advancement in Psychological Injury and Law, and the William N. Friedrich Lecturer: Outstanding Contribution to the Field of Child Psychology from the Mayo Clinic. A long-term student of Buddhist psychology, he has been Remote Faculty at the Institute for Meditation and Psychotherapy since 2013.Catherine Scott, MD, is Assistant Clinical Professor of Psychiatry and the Behavioral Sciences at the Keck School of Medicine of the University of Southern California. Her academic background includes Harvard College, Columbia University College of Physicians and Surgeons, and psychiatric residency training at both Cornell and USC. Previously, Dr. Scott served as Medical Director of the Psychological Trauma Program at Los Angeles County + USC Medical Center, and the Associate Medical Director of the Psychiatric Emergency Service at Los Angeles County + USC Medical Center. In that capacity she taught and supervised resident physicians and medical students in the assessment and treatment of trauma-related disorders arising from sexual and physical violence, torture, child abuse, and other forms of interpersonal violence. She continues to practice as well as teach residents at USC, and serves as an expert witness in the areas of trauma and posttraumatic stress. Her clinical and research interests include women’s issues, treatment of adult survivors of child abuse, human rights, and the remediation of sexual violence and its effects.

An eloquent, inspiring and classic text—now updated. Principles of Trauma Therapy is that rare book that has changed the field, helping bring trauma awareness into the mainstream and educating a generation of trauma therapists, researchers, and policy makers. It is eminently practical, with realistic guidance for day-to-day clinical work while embracing a wide range of theoretical orientations. Kudos to Briere and Scott for this gem of a book to help trauma survivors!

• AcknowledgmentsIntroduction to the Third EditionPart I: Trauma, Effects, and Assessment1. What Is Trauma?Single Versus Multiple Traumatic Events In DSM-5Major Types of Trauma2. The Psychological Effects of Trauma (John Briere, Catherine Scott, & Janelle Jones)What Makes Trauma Responses More Likely, More Intense, or More Complicated?Types Of Posttraumatic ResponseTrauma- and Stressor-related DisordersDisorders and Symptoms Typically Related to Trauma ExposureGeneric Symptoms Sometimes Associated with Trauma ExposureTrauma Syndromes in Non-Western CulturesComplex Posttraumatic Presentations3. Assessing Trauma and Posttraumatic Outcomes (John Briere, Erin Eadie, & Catherine Scott)Assessment In The Clinical InterviewAssessing the Sociocultural EnvironmentAssessing Current and Past Exposure to Discrimination and Maltreatment (SDM)Evaluating the Effects of TraumaStructured InterviewsPsychological TestsTrauma-Specific TestsRecommendations for Assessment through Telehealth PlatformsPart II: Clinical Interventions4. Central Issues in Trauma TreatmentA Basic Philosophy of Trauma, Recovery, and GrowthCentral Treatment Principles5. PsychoeducationHandoutsBooksVerbal Information During TherapyGeneral FocusConstraints6. Distress Reduction and Emotional Regulation TrainingDealing with Acute IntrusionIntervening in Chronic Emotional DysregulationMeditation and Yoga7. Cognitive InterventionsCognitive processingDeveloping a Coherent NarrativeCognitive Changes Arising from Non-overwhelming Emotional ActivationCognitive Interventions and InsightAddressing the Cognitive Impacts of Social Maltreatment8. Trigger ManagementSteps of Trigger ManagementIntervening in Triggers and Triggered StatesIntervening in DRBs9. Emotional ProcessingReexperiencing as Trauma ProcessingThe Components of Trauma ProcessingWritten HomeworkWritten Exposure Therapy (WET)Eye Movement Desensitization and Reprocessing (EMDR; Shapiro, 2018)The Therapeutic WindowEmotional Processing and Substance UseSequence and Session-Level Structure of Memory Processing10. Increasing Identity and Relational FunctioningIdentity ProblemsRelational Disturbance11. Mindfulness in Trauma TreatmentWhat Is Mindfulness?ResearchThe Mindful Therapist12. Treating the Effects of Acute Trauma (Sarah Stoycos, Heidi Ardern, John Briere, & Catherine Scott)Research on Acute Traumatic StressIntervening in Acute Posttraumatic Stress: An OverviewCentral Components of Treatment for Acute TraumaSpecial Issue: Trauma Work in Acute Medical Contexts13. Remote Treatment of Trauma: Teletherapy PrinciplesAcceptable Teletherapy PlatformsTeletherapy Guidance for Major Professional GroupsArticles and Guides on Teletherapy PracticeTeletherapy PrinciplesPart III: Psychobiology and Psychopharmacology of Trauma14. Psychobiology of Posttraumatic Stress (Catherine Scott, John Briere, & Janelle Jones)The Hypothalamic-Pituitary-Adrenal (HPA) Axis and the Adrenergic SystemThe Endocannabinoid (eCB) SystemOther Biological Correlates of PTSDFindings From Neuroimaging StudiesIntegrating Biological Models with Psychological Trauma Theory15. Psychopharmacology of Trauma (Catherine Scott, Janelle Jones, & John Briere)Psychotherapy and PsychopharmacologyMedications for PTSDSpecial Topic: Repurposed Drugs and Drug-assisted Psychotherapy16. ConclusionsAppendix 1: Trauma Exposure Review (TER)Appendix 2: Social Discrimination and Maltreatment Scale, Short Form (SDMS-SF)Appendix 3: Mindfulness-based Breath Training (MBBT) HandoutAppendix 4: A Brief Urge/Emotion Surfing ExerciseAppendix 5: ReGAIN handoutReferencesIndexAbout the Authors