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Treating Complex Trauma in Children and Their Families
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Treating Complex Trauma in Children and Their Families
An Integrative Approach



January 2016 | 296 pages | SAGE Publications, Inc
“This is a must-read for clinicians who help traumatized children and their families. Lanktree and Briere have developed and tested an accessible, integrated, assessment-driven model that recognizes the ample impact of trauma on young children in different social contexts. A valuable alternative to rigidly manualized treatments, this book relies on clinical judgment and customized planning.”

Eliana Gil
Gil Institute for Trauma Recovery and Education


One of the few books on the treatment of psychological trauma in children that provides specific, in-depth individual, group, and family therapy interventions for complex psychological trauma, this practical book focuses on the treatment of 6-12 year-old children and their family members. The authors employ an evidence-based, yet flexible and individualized treatment model, Integrative Treatment of Complex Trauma for Children (ITCT-C), as they address the use of play therapy and other expressive approaches, attachment processing, multi-target titrated exposure, mindfulness techniques, psychoeducation, and affect regulation skill development, as well as interventions with family/caretaker and community systems. The authors emphasize a culturally sensitive and empowering perspective, one that addresses the effects of social marginalization and supports not only recovery, but also posttraumatic growth. Clinical examples and specific tools, such as the Assessment Treatment Flowchart (ATF-C), illustrate how assessment can be used to guide individualized and developmentally-appropriate interventions.
 
Acknowledgments
 
About the Authors
 
Chapter 1: Introduction
Empirical Support for ITCT

 
Structure of This Book

 
 
Chapter 2: Effects of Complex Trauma in Children
Complex Posttraumatic Events

 
Effects of Complex Trauma

 
Phenomena That May Intensify, Compound, or Complicate Trauma Effects

 
 
Chapter 3: Central Aspects of ITCT-C
Assessment-Driven Treatment

 
Attention to Complex Trauma Issues

 
Early Focus on Immediate Issues

 
Focus on a Positive Working Relationship With the Therapist

 
Customization

 
Attention to Attachment Difficulties

 
Skills Development

 
Titrated Therapeutic Exposure and Exploration of Trauma Memories

 
A Flexible Time Frame

 
Advocacy and Interventions at the System Level

 
Positive Professional Collaborations and Therapist Self-Care

 
 
Chapter 4: Assessment of Complex Trauma
Background and Current Assessment Information

 
Assessment of Trauma Exposure

 
Evaluation of Trauma-Relevant Symptoms

 
Assessment Measures That Can Be Used in ITCT-C

 
 
Chapter 5: The Assessment-Treatment Flowchart for Children (ATF-C) and the Problems-to-Components Grid for Children (PCG-C)
The Assessment-Treatment Flowchart for Children

 
The Problems-to-Components Grid for Children (PCG-C)

 
 
Chapter 6: Characteristics and Tools of the Therapy Environment
The Therapy Office/Agency Environment

 
Session Consistency and Safety

 
Play Therapy Materials and Resources

 
 
Chapter 7: Relationship Building and Support
Expanding the Child’s Sense of Identity

 
Therapist Behaviors That Contribute to a Positive Therapeutic Relationship

 
Use of Play and Humor

 
The Role of Attachment History for the Therapist and the Client

 
Family Therapy, Group Therapy, and Advocacy to Enhance the Therapeutic Relationship

 
Advocacy and Case Management

 
Dealing With Difficult Client-Therapist Relationship Challenges

 
A Special Topic: Pet-Assisted Therapy or Sessions Involving Pets

 
 
Chapter 8: Safety Interventions
Impediments to Therapy

 
Reporting Suspected Child Abuse and Neglect

 
Ongoing Monitoring of Safety Issues and Interventions

 
Suicidality and Harmful Behavior Toward Others: Assessment and Interventions

 
Possible Safety Issues During Monitored Visits

 
Safety Within the Therapy Sessions

 
 
Chapter 9: Psychoeducation
General Focus of Psychoeducation

 
Books and Other Materials Used in ITCT-C

 
Other Approaches to Psychoeducation With Children

 
Psychoeducation With Caretakers

 
 
Chapter 10: Advocacy and Systems Interventions
Culture-Specific Advocacy

 
Advocacy for Economically Disadvantaged Clients

 
Advocacy as Therapy

 
Mental Health Advocacy and Support for Caretakers

 
Advocacy With Child Protection and Foster Care Systems

 
Court/Legal Systems Advocacy

 
School Collaborations and Advocacy

 
 
Chapter 11: Distress Reduction and Affect Regulation Training
Acute Distress Reduction

 
Emotional Regulation Capacity

 
 
Chapter 12: Facilitating Positive Identity
Resilience and Its Relationship to Self-Esteem

 
Specific Interventions to Enhance Positive Identity Development, Self-Efficacy, and Assertiveness

 
 
Chapter 13: Cognitive and Emotional Processing
Preconditions for Emotional Processing When Addressing Complex Trauma

 
Cognitive Processing

 
Emotional Processing

 
 
Chapter 14: Relational/Attachment Processing
Specific Client Attachment Styles

 
Avoidant Attachment

 
Resistant/Preoccupied/Ambivalent Attachment

 
Disorganized Attachment

 
Assessment of Attachment Disturbance

 
Relational Processing of Complex Trauma Effects

 
Conclusions

 
 
Chapter 15: Interventions With Caretakers
ITCT-C Caretaker Interventions: Multiple Modalities

 
Individual Psychotherapy With Caretakers

 
Couple’s Sessions

 
Conjoint/Dyadic Caretaker-Child Interventions

 
Support, Education, and Parenting Skills

 
The Caretaker Support Group Module

 
Follow-Up Group

 
 
Chapter 16: Family Therapy
Who to Include in Family Therapy Sessions?

 
Cultural Factors to Consider

 
When Should Family Therapy Be Considered?

 
What Improves the Likelihood of Effective Family Therapy?

 
Impacts of Systems Issues on Families

 
Family Therapy Interventions

 
ITCT-C Family Therapy Module for Sessions

 
 
Chapter 17: School-Based Adaptation of ITCT-C
School-Based ITCT-C Interventions

 
The ITCT-C School-Based Group Model

 
 
Chapter 18: Supervision and Therapist Self-Care
Common Reactions and Feelings in Therapists Working in the Trauma Field

 
Supervision and Consultation

 
Team-Building and Support

 
Further Training and Professional Development

 
Personal Therapy

 
Developing a Mindful Perspective

 
Self-Care

 
 
Appendix
 
References
 
Index

“This is a must-read for clinicians who help traumatized children and their families. Lanktree and Briere have developed and tested an accessible, integrated, assessment-driven model that recognizes the significant impact of trauma on young children in different social contexts. A valuable alternative to rigidly manualized treatments, this book relies on clinical judgment and customized planning.”  

Eliana Gil
Gil Institute for Trauma Recovery and Education

“Once again, the brilliance of the Lanktree and Briere team has been demonstrated.  The comprehensive nature and depth of this challenging topic is thoughtfully and creatively illustrated.  The cultural/marginalization perspective is unparalleled within the topic of complex trauma. This text is a must read for both my undergraduate and graduate trauma-focused courses.”

Russell T. Jones
Virginia Tech University

“An indispensable, practical guide for every therapist working with children and families who have been exposed to complex trauma. The treatment model is truly integrative in incorporating the authors’ extensive experience, sophisticated clinical sensitivity, and broad knowledge of the evidence-informed approaches to psychotherapy, and their deep understanding of the challenges facing children and families who are recovering from complex trauma.”

Julian Ford
University of Connecticut Health Center

“Relevant, timely, and essential for all disciplines working to effectively and affectively help children.  This book provides the theory underlining how to begin the healing process with children while demonstrating sensitivity and clarity as one proceeds with specific steps towards that healing.”

Naomi Lynch White
The University of Akron

“A wonderful integrative approach for students to learn how to work with both child who have experience trauma as well as families.”

Becky L. Thomas
The University of Akron

Sample Materials & Chapters

Chapter 1

Chapter 13


Cheryl B. Lanktree

Cheryl B. Lanktree, Ph.D. is Project Director of the USC Adolescent Trauma Training Center, National Child Traumatic Stress Network, a Research Assistant Professor of Psychiatry at the University of Southern California, and a licensed clinical psychologist in private practice. The developer of Integrative Treatment of Complex Trauma (ITCT), she has published various articles, chapters, treatment manuals, and books on treating complex trauma in children and adolescents. Her website is cblanktree.com. More About Author

John Neale Briere

John N. Briere, PhD, is Associate Professor of Psychiatry and Psychology at the Keck School of Medicine, University of Southern California, where he consults and teaches in the ER, burn unit, and inpatient psychiatry, and Center Director of the USC Adolescent Trauma Training Center’s National Child Traumatic Stress Network. A past president of the International Society for Traumatic Stress Studies, he is recipient of the Robert S. Laufer Memorial Award for Scientific Achievement from ISTSS, and the Award for Outstanding Contributions to the Science of Trauma Psychology from the American Psychological Association’s Division 56, and has been... More About Author

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ISBN: 9781452282640
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