Treating Complex Trauma In Adolescents (Parts 1 And 2)
Treating Complex Trauma inAdolescents (Parts 1 and 2)John Briere, Ph.D.USC Adolescent Trauma Training CenterNational Child Traumatic Stress NetworkDepartments of Psychiatry and Psychology, Keck School of MedicineUniversity of Southern Californiaattc.usc.edu
Trauma exposure:“Simple” versus “Complex” OnsetRelationalityFrequency and durationNumber of different trauma typesRevictimizationSymptom interaction: Child x adult
Complex posttraumatic outcomes Anxiety, depression, angerPosttraumatic stressAffect dysregulationNegative relational and self schemaAvoidance responses– Dissociation– Tension reduction behaviors Self-injurious behavior, sex, bulimia, aggression, suicidality– Substance abuse– Suicidality
Integrative Treatment of ComplexTrauma for Adolescents (ITCT-A) Manual at attc.usc.edu Assessment-based: The ATF-A Focus beyond posttraumatic stress– Relational, affect dysregulation, problematic avoidance Centrality of the therapeutic relationshipSafety within therapy and n therapist behaviorsAdvocacy and system intervention
Applying ITCT-A treatment components Relationship Building and Support– Attachment, acceptance, compassion Acute safety issues– Environmental, self-endangering, survival behaviors Interventions: Place to stay, suicidality, safer-sex, substance abuse,prostitution, gangs, child protection Psychoeducation––––Trauma prevalence, perpetrator dynamicsCultural mythsNormalization of traumatization, effectsResources
Applying ITCT-A treatment components Distress reduction and affect regulation training– Relaxation, breath training, visualization– Emotion identification and discrimination– Mindfulness Meta-cognitive awareness: Just Thoughts, Not Facts Urge/emotion surfing Trigger Identification and Intervention– The “Trigger Grid”– Identify triggers and triggered states– Learn coping strategies (self-talk, including meta-cognitivestatements, problem-solving)– Additions and revisions over time
Applying ITCT-A treatment components Titrated exposure–––––Multiple sources versus systematizedResistance/avoidance as self-titrationPermission to control exposure processThe therapeutic windowIntensity control Relational processing as exposure therapy––––Exposure to archaic relational schemaActivation of abuse/neglect-era emotionsDisparity between memory and treatment ��
Applying ITCT-A treatment components Family/caretaker interventions––––Caretaker education groupsParenting groupsFamily therapyBrief caretaker individual or couple’s therapy,if indicated
Pre-Post Data for ITCT (A and C)Average of 40% improvement across symptomsNo control groupN 151
ITCT-A referencesBriere, J., & Lanktree, C.B. (2014). Treating substance use issues intraumatized adolescents and young adults: Key principles and components. LosAngeles, CA: USC Adolescent Trauma Training Center (available at attc.usc.edu)Briere, J., & Lanktree, C.B. (2013). Integrative treatment of complextrauma for adolescents (ITCT-A): A guide for the treatment of multiplytraumatized youth, 2nd edition. Los Angeles, CA: USC Adolescent TraumaTreatment Training Center (available at attc.usc.edu)Lanktree, C.B., Briere, J., Godbout, N., Hodges, M., Chen, K., Trimm, L.,Adams, B., Maida, C.A., & Freed, W. (2012). Treating multi-traumatized, sociallymarginalized children: Results of a naturalistic treatment outcome study. Journalof Aggression, Maltreatment & Trauma, 21, 813–828.Lanktree, C.B., & Briere, J. (2013). Integrative Treatment of ComplexTrauma (ITCT) for children and adolescents. In J.D. Ford and C.A. Courtois,Treating complex traumatic stress disorders with children and adolescents: Anevidence-based guide (pp. 143-161). NY: Guilford.
Treating Complex Trauma in Adolescents (Parts 1 and 2) John Briere, Ph.D. USC Adolescent Trauma Training Center National Child Traumatic Stress Network Departments of Psychiatry and Psychology, Keck School of Medicine . Trauma exposure: “Simple”versus .
What is Complex Trauma? A Resource Guide for Youth The National Child Traumatic Stress Network www.NCTSN.org 6 Part II. How Complex Trauma Can Impact Me Complex Trauma can affect people in lots of different ways. Children and adolescents with Complex Trauma often have negative thoughts, emotions, or beliefs about themselves or the world. They
Behind the Term: Trauma Prepared in 2016 by Development Services Group, Inc., under contract no. HHSS 2832 0120 0037i/HHSS 2834 2002T, ref. no. 283– 12–3702. 1 Behind the Term: Trauma Related terms: complex trauma, historical trauma, human-caused trauma, naturally caused trauma, trauma,
categories of trauma as a framework for trauma assessment. “Little t” trauma “Big T” trauma Complex trauma “Little t” Trauma “Little t” trauma involves events that we encounter day to day that can make life difficult but are not out of the ord
The assessed content included prima - ry survey, secondary survey, airway and ventilation, circulation, shock, thoracic trauma, head/spinal trauma, abdomen/pelvis trauma, musculoskeletal trauma, paediatric trauma, geriatric trauma, obstetric trauma, trans - fer of care, and other course specific inclusions.
LEVEL I PEDIATRIC TRAUMA CENTER The Level I Regional Pediatric Trauma and Burn Center at Children’s Hospital Colorado is a large, multi-disciplinary program. We provide timely, comprehensive, cost- . Trauma/Burn Medical Director Trauma/Burn Program Manager Trauma Coordinators Trauma Registrars Staff Assi
complex trauma. What do you mean by complex trauma? Dr. Daniel Brown: Well, what evolved in the field was a distinction between simple versus complex trauma or what’s now called type I vs. type II trauma. Type I or simple trauma is usually circumscribed as one act producing conditions like post-traumatic stress disorder, anx-
Historical trauma - Cumulative emotional and psychological wounding from massive group trauma across generations, including lifespan Historical trauma response (HTR) is a constellation of features in reaction to massive group trauma, includes . historical unresolved grief (similar to Child of Survivors Complex re: Jewish Holocaust survivors and
AAT Advanced Diploma in Accounting Synoptic Assessment – SAMS – Assessment book 2 Notes for students and training providers This is a sample assessment and mark scheme which is reflective of the question types, depth of content coverage, the level of demand, duration and mark allocation of tasks that will be in the live assessment It is not designed to be used on its own to determine .
