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Principles of Trauma Therapy
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Principles of Trauma Therapy
A Guide to Symptoms, Evaluation, and Treatment

Third Edition
  • John N. Briere - University of Southern California, USA
  • Catherine Scott - University of Southern California, Keck School of Medicine, Los Angeles
Courses:
Trauma
March 2025 | SAGE Publications, Inc
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John Briere and Catherine Scott's Principles of Trauma Therapy, Third Edition is both comprehensive in scope and highly practical in application. This best selling text provides a creative synthesis of cognitive-behavioral, relational, affect regulation, mindfulness, and psychopharmacologic approaches to the "real world" treatment of acute and chronic posttraumatic states. Grounded in empirically-supported trauma treatment techniques and adapted to the complexities of actual clinical practice, this book is a hands-on resource for front-line clinicians, those in private practice, and graduate students of public mental health.
 
Acknowledgments
 
Introduction to the Third Edition
 
Part I: Trauma, Effects, and Assessment
 
1. What Is Trauma?
Single Versus Multiple Traumatic Events In DSM-5

 
Major Types of Trauma

 
 
2. 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 Response

 
Trauma- and Stressor-related Disorders

 
Disorders and Symptoms Typically Related to Trauma Exposure

 
Generic Symptoms Sometimes Associated with Trauma Exposure

 
Trauma Syndromes in Non-Western Cultures

 
Complex Posttraumatic Presentations

 
 
3. Assessing Trauma and Posttraumatic Outcomes (John Briere, Erin Eadie, & Catherine Scott)
Assessment In The Clinical Interview

 
Assessing the Sociocultural Environment

 
Assessing Current and Past Exposure to Discrimination and Maltreatment (SDM)

 
Evaluating the Effects of Trauma

 
Structured Interviews

 
Psychological Tests

 
Trauma-Specific Tests

 
Recommendations for Assessment through Telehealth Platforms

 
 
Part II: Clinical Interventions
 
4. Central Issues in Trauma Treatment
A Basic Philosophy of Trauma, Recovery, and Growth

 
Central Treatment Principles

 
 
5. Psychoeducation
Handouts

 
Books

 
Verbal Information During Therapy

 
General Focus

 
Constraints

 
 
6. Distress Reduction and Emotional Regulation Training
Dealing with Acute Intrusion

 
Intervening in Chronic Emotional Dysregulation

 
Meditation and Yoga

 
 
7. Cognitive Interventions
Cognitive processing

 
Developing a Coherent Narrative

 
Cognitive Changes Arising from Non-overwhelming Emotional Activation

 
Cognitive Interventions and Insight

 
Addressing the Cognitive Impacts of Social Maltreatment

 
 
8. Trigger Management
Steps of Trigger Management

 
Intervening in Triggers and Triggered States

 
Intervening in DRBs

 
 
9. Emotional Processing
Reexperiencing as Trauma Processing

 
The Components of Trauma Processing

 
Written Homework

 
Written Exposure Therapy (WET)

 
Eye Movement Desensitization and Reprocessing (EMDR; Shapiro, 2018)

 
The Therapeutic Window

 
Emotional Processing and Substance Use

 
Sequence and Session-Level Structure of Memory Processing

 
 
10. Increasing Identity and Relational Functioning
Identity Problems

 
Relational Disturbance

 
 
11. Mindfulness in Trauma Treatment
What Is Mindfulness?

 
Research

 
The Mindful Therapist

 
 
12. Treating the Effects of Acute Trauma (Sarah Stoycos, Heidi Ardern, John Briere, & Catherine Scott)
Research on Acute Traumatic Stress

 
Intervening in Acute Posttraumatic Stress: An Overview

 
Central Components of Treatment for Acute Trauma

 
Special Issue: Trauma Work in Acute Medical Contexts

 
 
13. Remote Treatment of Trauma: Teletherapy Principles
Acceptable Teletherapy Platforms

 
Teletherapy Guidance for Major Professional Groups

 
Articles and Guides on Teletherapy Practice

 
Teletherapy Principles

 
 
Part III: Psychobiology and Psychopharmacology of Trauma
 
14. Psychobiology of Posttraumatic Stress (Catherine Scott, John Briere, & Janelle Jones)
The Hypothalamic-Pituitary-Adrenal (HPA) Axis and the Adrenergic System

 
The Endocannabinoid (eCB) System

 
Other Biological Correlates of PTSD

 
Findings From Neuroimaging Studies

 
Integrating Biological Models with Psychological Trauma Theory

 
 
15. Psychopharmacology of Trauma (Catherine Scott, Janelle Jones, & John Briere)
Psychotherapy and Psychopharmacology

 
Medications for PTSD

 
Special Topic: Repurposed Drugs and Drug-assisted Psychotherapy

 
 
16. Conclusions
 
Appendix 1: Trauma Exposure Review (TER)
 
Appendix 2: Social Discrimination and Maltreatment Scale, Short Form (SDMS-SF)
 
Appendix 3: Mindfulness-based Breath Training (MBBT) Handout
 
Appendix 4: A Brief Urge/Emotion Surfing Exercise
 
Appendix 5: ReGAIN handout
 
References
 
Index
 
About the Authors

Supplements

Instructor Resource Site
edge.sagepub.com/briere3e

Online resources included with this text

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Key features
NEW TO THIS EDITION:
  • information on additional adversities (for example, COVID-19, pregnancy loss, moral injury, extended homelessness, and incarceration)
  • an expanded review of complex and cumulative trauma, including discussion and analysis of borderline personality disorder as it relates to early trauma and disattunement
  • analyses of the strengths and weaknesses of current DSM-5 trauma-relevant diagnoses, including a new section on DSM-5’s recategorized adjustment disorder
  • additional coverage of social maltreatment and its effects on marginalized groups, including the short form of the Social Discrimination and Maltreatment Scale presented in the Appendix section
  • expanded information on acute trauma interventions
  • a new chapter on trigger management, summarizing research on activated emotional states and subsequent distress-reduction behaviors, with implications for the treatment of self-injury, compulsive sexual behavior, binge-purge eating, and reactive suicidality
  • further adjustments to exposure-based treatment -- including the concept of interspersal -- that support its use with even highly traumatized clients, while taking into account emotional regulation capacity issues and trauma load
  • discussion of memory reconsolidation as it relates both to psychological and pharmacological treatment,
  • the new mindfulness based ReGAIN procedure for deescalating activated states
  • expanded information and advice on working in emergency rooms and burn centers 
  • a new chapter on the neurobiology of posttraumatic stress
  • an updated chapter on trauma psychopharmacology and coverage of the new hybrid approach, drug-assisted psychotherapy, including potential applications of ketamine, psilocybin, the cannabinoids, and MDMA
  • a new chapter on teletherapy adaptations to trauma therapy
  • over 200 new references to scientific research and clinical practice

 

KEY FEATURES:
  • Written by experts in the fields of trauma therapy, psychopharmacology and psychobiology.
  • Integrated Approach to trauma treatment for a comprehensive, multi-modal approach to simple and complex trauma presentations.
  • Provides directly applicable, empirically-informed information on how to apply different treatment techniques and modalities to address a variety of issues and symptom clusters found in trauma survivors.
  • Presents a clinician-friendly review of treatment literature with specific, practical information on trauma effects and trauma treatment, calling on the most current information available in the trauma literature and applying new DSM-5 diagnostic formulations.
  • Addresses innovative and cutting-edge topics, including social and gender discrimination, microaggressions, trauma psychopharmacology, trigger management, teletherapy, indications and limitations of psychoactive medication in the treatment of trauma survivors, assessment and diagnostic strategies, and contemporary research and discussions on current and emerging types of trauma, disorders, and behaviors.
 

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