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:
Counselling Psychology | Trauma | Working with Trauma

December 2024 | 400 pages | SAGE Publications, Inc

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.

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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

The online resources for your text are available via the password-protected Instructor Resource Site, which offers access to all text-specific resources, including a test bank and editable, chapter-specific PowerPoint® slides.

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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!

Lisa Najavits, PhD

Director, Treatment Innovations and Adjunct Professor, University of Massachusetts Medical School

Essential reading for clinicians assessing and treating traumatic stress. These master clinicians have made the complexity of traumatic stress accessible, and their approach is applicable to treating diverse clients. Their revised edition includes important and extensive updates, such as guidance for navigating clients’ experiences of social injustice within the context of relational treatment, a new chapter on the neurobiology of posttraumatic stress, and an introduction to the new mindfulness based ReGAIN procedure for deescalating activated states.

S. Megan Berthold, PhD, LCSW

Professor, University of Connecticut School of Social Work

This book, Principles of Trauma Therapy: A Guide to Symptoms, Evaluation, and Treatment, has been a mainstay in clinical and more generic training courses in traumatic stress studies since its original publication. This third edition continues this tradition. It contains a great deal of clinical wisdom based both on the latest empirical findings as well as clinical experience and consensus. It recognizes expanded types of trauma and the complexity of consequences and incorporates the latest information on new areas of emphasis, including diversity and other contextual issues. The heart of the book, a detailed outline and description of the average treatment trajectory, is especially useful. An essential guide for all who work with the traumatized. Bravo to the authors!

Christine A. Courtois, PhD, ABPP

Delaware Licensed Psychologist, Board Certified Counseling Psychologist

If I were to advise the young scholar on a source for the development of a foundation of knowledge in trauma therapy, I could ask them to read a list of 50+ worthy candidate tomes, each containing a piece of the puzzle, or, alternatively, I could point them to this one text. The astounding breadth, complexity, and practicality of this work, combined with the compassion and openness of its authors, radiates from every page. This book should be in the library of every trauma expert.

Constance Dalenberg, Ph.D.

Distinguished Professor, Alliant International University

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.

Sample Materials & Chapters

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A Guide to Symptoms, Evaluation, and Treatment

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