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Principles of Trauma Therapy


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Table of Contents

INTRODUCTION PART I: TRAUMA, EFFECTS, AND ASSESSMENT Ch 1. What is Trauma: Major Types of Trauma The Problem of Combined and Cumulative Traumas Ch 2. The Effects of Trauma What Makes Trauma Responses More Likely, More Intense, or More Complicated Types of Posttraumatic Responses Ch 3. Assessing Trauma and Posttraumatic Outcomes Assessment in the Clinical Interview Psychological Tests PART II: CLINICAL INTERVENTIONS Ch 4: Central Issues in Trauma Treatment A Basic Philosophy of Trauma, Recovery, and Growth Central Treatment Principles Gender Issues Cultural Issues Therapist Countertransference Ch 5: Psychoeducation Handouts and Other Media General Focus Constraints Ch 6: Distress Reduction and Affect Regulation Training Dealing With Acute Intrusion - Grounding Intervening in Chronic Affect Dysregulation Ch 7: Cognitive Interventions Cognitive Reconsiderations Cognitive Processing Developing a Coherent Narrative Cognitive Changes Arising From Non-Overwhelming Emotional Activation During Treatment Insight Ch 8: Emotional Processing Reexperiencing as Trauma Processing The Therapeutic Window Constraints on Trauma Processing The Components of Trauma Processing Processing "Hot Spots" Emotional Processing and Substance Abuse: Suggested modifications Emotional Processing From Another Perspective: A Note on EMDR Sequence and Session-Level Structure Ch 9: Increasing Relational Functioning and Other Self-Capacities Relational Disturbance Identity Problems Ch 10: Treating the Effects of Acute Trauma Acute Traumatic Stress Brief Review of the Acute Trauma Intervention Literature Intervention Strategies Ch 11: Biology and Psychopharmacology of Trauma The Psychobiology of Trauma Principles of Trauma Psychopharmacology Medications for PTSD Antipsychotics for Trauma-Related Psychosis Sleep Medications Medication, Pregnancy, and Lactation Ch 12: Conclusions References Appendix I: The Brief Interview for Posttraumatic Stress Disorders (BIPD) Appendix 2: The Initial Trauma Review (ITR) Appendix 3: Breath Training Protocol

About the Author

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 designated Highly Cited Researcher (Behavioral Sciences) by the Institute for Scientific Information. He is author of a number of books, articles, and psychological tests in the areas of trauma and interpersonal violence, and has a long-standing interest in the clinical applications of meditation, mindfulness, and compassion. His website is Catherine Scott, MD, is Assistant Clinical Professor of Psychiatry and the Behavioral Sciences at the University of Southern California Keck School of Medicine. Her educational background includes Harvard College, Columbia University College of Physicians and Surgeons, and psychiatric residency training at Cornell and USC. She was formerly 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, where 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. Although continuing to teach, Dr. Scott stepped down from administrative duties in order to pursue writing and research projects. Her clinical and research interests include human rights, women's issues, and the remediation of sexual violence and its effects.


"This groundbreaking book takes trauma therapy to a new stage of development, brilliantly integrating the diverse findings of cognitive behaviorists, relational and attachment theorists, and neurobiologists. The authors understand that therapy is an intimate relationship between two people -- the (often distrusting and fearful) patient who wishes relief from pain and the (often frustrated but empathic) therapist who would like to provide that relief. The authors generate in the reader a respect for the biological underpinnings of trauma and the power of early attachment dynamics, showing us how to accept these realities while building the structures that will help the patient achieve symptom relief. The clarity of the text, particularly given the complexity of the material, combines with the wisdom and warmth of the authors to produce a "must read" for any therapist working with trauma patients." -- Constance Dalenberg, Ph.D.,
"The authors have provided a definitive resource on the treatment of all types of trauma, especially important as society faces more and more traumatic events. This book admirably meets its goal as a hands-on, practical guide for clinicians working with adult and older adolescent trauma survivors. The material is cutting edge, encompassing a wide range of interventions, including a very comprehensive chapter on psychopharmacology. It includes discussion of techniques and principles for which an evidence base has developed, as well as other techniques developed from clinical experience. This book will serve as an essential reference for all clinicians treating the traumatized, as well as a textbook for courses on the treatment of trauma." -- Christine A. Courtois, PhD
"This is a phenomenal compilation of clinical, biological, neuropsychiatric, and psychotherapeutic information on the subject of trauma. The authors move from the very basic subject of "what trauma is" to the most complicated subjects of etiology and intervention. The usefulness of the book is greatly enhanced by the many case examples. This is a major contribution, both for those who treat and for theoreticians.... a must for every clinician!" -- Marcia Goin, MD, PhD

"This book bridges the divide between CBT oriented, evidence based practitioners and those who endorse a more relationship based approach to chronic traumas. The authors offer a components based model for the delivery of trauma therapy that clearly illustrates how these two approaches can be compatible. As Briere and Scott demonstrate, the science and the art of therapy are both honored when there is systematic application of treatment components in the context of specific client needs. This book is just what is needed to advance our field."

-- Lucy Berliner, MSW
"The chapter on psychopharmacology stands out in two ways. First, the integrative discussion of the psychology and biology of post-trauma outcome provides essential understanding for all who work with survivors, regardless of discipline. Second, the clarity and scope of this work provides both an accessible primer for practitioners new to trauma and a comprehensive pharmacology update for more experienced clinicians." -- James High, MD
"This book is an excellent teaching tool -almost what one would expect from a course with details printed in different fonts and useful checklists for clinical work. I appreciate the choice of either reading individual chapters one at a time, each one with recommended reading sections at the end, or the benefits of reading the book as a whole...Of special value in this book is the chapter dedicated to the psychopharmacology of trauma, as special attention is given to the most up-to-date research in the field of psychobiology" -CONTEMPORARY PSYCHOLOGY -- Nicole Ruysschaert * CONTEMPORARY PSYCHOLOGY *

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