Treating Complex Traumatic Stress Disorders (Adults)

Scientific Foundations and Therapeutic Models

Edited by Christine A. Courtois and Julian D. Ford
Foreword by Judith Lewis Herman
Afterword by Bessel A. van der Kolk

HardcoverPaperbacke-bookprint + e-book
February 5, 2009
ISBN 9781606230398
Price: $90.00 $76.50
488 Pages
Size: 6⅛" x 9¼"
September 27, 2013
ISBN 9781462513390
Price: $45.00 $38.25
488 Pages
Size: 6⅛" x 9¼"
March 1, 2011
ePub and PDF ?
Price: $45.00 $38.25
488 Pages
print + e-book
Paperback + e-Book (ePub and PDF) ?
Price: $90.00 $49.50
488 Pages
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Combining scientific and clinical perspectives, this volume brings together leading authorities on complex traumatic stress and its treatment in adults. Contributors review the research that supports the conceptualization of complex traumatic stress as distinct from PTSD. They explore the pathways by which chronic trauma can affect psychological development, attachment security, and adult relationships. Chapters describe evidence-based assessment tools and an array of treatment models for individuals, couples, families, and groups.

See also Drs. Courtois and Ford's authored book, Treatment of Complex Trauma, which presents their own therapeutic approach for adult clients in depth, and their edited volume Treating Complex Traumatic Stress Disorders in Children and Adolescents.

“A valuable addition to the libraries of both novice and experienced clinicians who treat patients with disorders as varied as reactive attachment disorder, borderline personality disorder, depression, dissociative disorders, and post-traumatic stress disorder....An unparalleled contribution to the existing literature on assessment and intervention with survivors of complex trauma. There are few existing compilations that have collected such a wide variety of treatment approaches from such prominent authors, and it is probable that this is the most comprehensive and current review to date. While multiple evidence-based treatment strategies are given attention in this book, it is detailed enough so that the reader is able to make an informed decision about whether to pursue an approach. In addition, several chapters describe essential understanding required for working with any survivor of complex trauma regardless of the particular intervention style....One of the book's highlights is its thoughtful and comprehensive summary of assessment tools for the clinician treating survivors of complex traumatic stress....Courtois and Ford have assembled an impressive volume of empirically-informed assessment and treatment approaches that 'honor and support the resilience of trauma survivors as they carry on with their lives and enrich the lives of their families and communities.'”

Trauma Psychology Newsletter (APA Division 56)

“This book is likely to appeal to clinicians who are eager to learn more about the area of complex traumatic stress and novel approaches to treating associated problems. The text is well-written and organized, making it easy to follow.”

Journal of Contemporary Psychotherapy

“Will surely become a classic textbook on complex traumatic stress. This book is appropriate for students, clinicians, and academics alike. Because the concept of complex trauma is still evolving, this text can educate and inform students in training as well as seasoned clinicians....The authors of the book are leaders in the field of trauma and they artfully illustrate the nuances of the disorder as well as subsequent treatment through rich case examples....In our current mental health climate, there exists a psychiatric debate about formally establishing Complex PTSD as a disorder. In such a climate this book documents the current knowledge and evidence supporting the disorder and will surely help to shift the paradigm of how complex trauma is understood, assessed for, and ultimately healed from.”

Clinical Social Work Journal

“Editors Courtois and Ford unite to provide a thorough, stimulating, and current text on treating a very challenging population of individuals with complex trauma....This is an important and highly relevant book, addressing a complex problem, organizing what empirical support there is for the many approaches which are currently utilized and expanded for this population. Even if you do not work with traumatized individuals, there is much to learn from this book. It can be therapeutically profitable. Well-written, it has an impressive list of contributors, and Ford has a hand in many of the chapters. This book is highly recommended and well-worth its asking price.”

Child and Family Behavior Therapy

“Presents a well-researched, comprehensive source for clinical expertise in the area of complex traumatic stress disorder—specifically PTSD.”

EABP Newsletter

“The book has a compelling philosophical unity about it - essentially humanistic, and broadly cognitive and behavioural. Among all this solid evidence-based theory and practice, I also felt uplifted by a sense of optimism....I heartily recommend this book to any psychological therapist or medical practitioner who is called upon to help those whose life experiences have resulted in intransigent mental health issues that may thus far have been diagnosed as a developmental disorder, personality disorder (particularly borderline), or post-traumatic stress disorder.”

Healthcare, Counselling, and Psychotherapy Journal

“This book is welcome as it pulls together theoretical and clinical approaches to understanding and helping people with difficulties following multiple and prolonged traumatic experiences....This book addresses important issues and was stimulating both academically and clinically....The book will be useful to most therapists, but especially those who regularly work with people whose main problems are associated with abusive or neglectful experiences in early childhood.”

Journal of Behavioural and Cognitive Psychotherapy

“A valuable addition to understanding and treating complex traumatic stress disorders, this book will enhance the knowledge and therapeutic toolbox of any practitioner working with clients who have had complex psychological traumas....I really appreciated the insights offered by the contributors and the wealth of experience and knowledge assembled by the editors.”

Addiction Today

“The first comprehensive overview on assessment and treatment of complex traumatic stress disorders. Both authors are experts in the field and have worked as clinicians with trauma survivors facing the clinical reality of complex manifestations of trauma....All the chapters are extremely well written and very informative. Each chapter makes a significant contribution to this important, fast-developing field....This important text is a clear contribution to the position that complex traumatic stress disorders can be conceptualized as a separate clinical entity....This book provides a complete overview over the current thinking regarding complex trauma disorders and should be required reading for all researchers and clinicians working with this population.”

“Courtois and Ford present an essential, comprehensive work for clinicians and researchers. Evidence-based practice recommendations for psychotherapeutic and pharmacological treatment are presented—carefully adapted for those suffering from complex traumatic stress disorders—and a range of treatment models are clearly described. Rich clinical material, and attention to management of the therapeutic alliance, therapist self-care, and other key challenges in working with these clients, make this a most useful and innovative resource.”

—Josef I. Ruzek, PhD, Director, Dissemination and Training Division, National Center for PTSD

“This is the single best source for clinical expertise in complex traumatic stress disorders. Leading clinicians and researchers share a rich array of individual, couple, family, and group therapy models that illustrate basic treatment principles and best practices. Informed by recent research, the contributors cover the developmental and neurobiological background against which to frame essential assessment and treatment issues. Chapters on such pragmatic topics as vicarious traumatization and risk management offer advice on reducing stress for therapists working with these challenging cases.”

—Frank W. Putnam, MD, Professor of Psychiatry, University of North Carolina at Chapel Hill

“Treatments based on a traditional conceptualization of PTSD are frequently insufficient to address the diverse, long-lasting, and pervasive effects of complex trauma. This book offers a comprehensive review of treatment considerations, assessment measures, best practices, and evidence-based treatment approaches specifically tailored for psychotherapy with people who have experienced prolonged abuse and neglect by caregivers. An indispensable guide for any mental health professional who works with trauma survivors.”

—Pamela C. Alexander, PhD, Senior Research Scientist, Wellesley Centers for Women

“This text is of great value in graduate social work education and training. Courtois and Ford have organized a single volume that allows students to sample the breadth of concepts and interventions offered by the complex traumatic stress conceptual lens. The research on neurobiology, human development, and attachment provides a strong foundation for the intervention chapters that follow. Students are introduced to a range of contemporary treatment strategies for individuals, rounded out by a very useful presentation of systemic approaches. This book is a terrific resource for graduate social work students that should prove useful to them long after they have completed their degrees.”

—Mark Horwitz, PhD, MSW, JD, Department of Social Work, Westfield State University

Table of Contents

Foreword, Judith L. Herman

Introduction, Christine A. Courtois and Julian D. Ford

I. Overview

1. Defining and Understanding Complex Trauma and Complex Traumatic Stress Disorders, Julian D. Ford and Christine A. Courtois

2. Neurobiological and Developmental Research: Clinical Implications, Julian D. Ford

3. Best Practices in Psychotherapy for Children and Adolescents, Julian D. Ford and Marylene Cloitre

4. Best Practices in Psychotherapy for Adults, Christine A. Courtois, Julian D. Ford, and Marylene Cloitre

5. Assessment of the Sequelae of Complex Trauma: Evidence-Based Measures, John Briere and Joseph Spinazzola

6. Assessment of Attachment and Abuse History, and Adult Attachment Style, Daniel Brown

7. Treating Dissociation, Kathy Steele and Onno van der Hart

8. Cultural Competence, Laura S. Brown

9. Therapeutic Alliance and Risk Management, Philip J. Kinsler, Christine A. Courtois, and A. Steven Frankel

10. Living and Working Self-Reflectively to Address Vicarious Trauma, Laurie Anne Pearlman and James Caringi

II. Individual Treatment Approaches and Strategies

11. Contextual Therapy, Steven N. Gold

12. Cognitive-Behavioral Therapy, Christie Jackson, Kore Nissenson, and Marylene Cloitre

13. Contextual Behavior Trauma Therapy, Victoria M. Follette, Katherine M. Iverson, and Julian D. Ford

14. Experiential and Emotion-Focused Therapy, Diana Fosha, Sandra Paivio, Kari Gleiser, and Julian D. Ford

15. Sensorimotor Psychotherapy, Janina Fisher and Pat Ogden

16. Pharmacotherapy, Lewis A. Opler, Michelle S. Grennan, and Julian D. Ford

III. Systemic Treatment Approaches and Strategies

17. Internal Family Systems Therapy, Richard C. Schwartz, Mark F. Schwartz, and Lori Galperin

18. Couple Therapy, Susan M. Johnson and Christine A. Courtois

19. Family Systems Therapy, Julian D. Ford and William Saltzman

20. Group Therapy, Julian D. Ford, Roger D. Fallot, and Maxine Harris

Conclusion: The Clinical Utility of a Complex Traumatic Stress Disorders Framework, Julian D. Ford and Christine A. Courtois

Afterword, Bessel A. van der Kolk

About the Editors

Christine A. Courtois, PhD, ABPP, a board-certified counseling psychologist, is retired from private practice in Washington, DC, and is a consultant/trainer on topics on trauma psychology and treatment. She cofounded and then served for 16 years as Clinical and Training Director of The CENTER: Posttraumatic Disorders Program, in Washington, DC. Dr. Courtois was chair of the Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults for the American Psychological Association (APA), released in 2017, and for guidelines on the treatment of complex trauma for several professional organizations. She has published a number of books (four of them coedited or coauthored with Julian Ford) and numerous book chapters and articles on trauma-related topics. Dr. Courtois is past president of APA Division 56 (Trauma Psychology) and past founding Associate Editor of the Division's journal, Psychological Trauma: Theory, Research, Practice, and Policy. She served two terms on the Board of Directors of the International Society for Traumatic Stress Studies (ISTSS). She has received the Award for Distinguished Contributions to Independent Practice from the APA, the Sarah Haley Award for Clinical Excellence from ISTSS, and, most recently, the Award for Distinguished Service and Contributions to the Profession of Psychology from the American Board of Professional Psychology.

Julian D. Ford, PhD, a clinical psychologist, is Professor of Psychiatry, Psychology, and Law at the University of Connecticut, where he is also Director of the Center for Trauma Recovery and Juvenile Justice. He has served on the Steering Committee of the National Child Traumatic Stress Network, as Associate Editor of the Journal of Trauma and Dissociation and the European Journal of Psychotraumatology, as Co-Chair of the Presidential Task Force on Child Trauma for APA Division 56, and as a board member and Vice President of ISTSS, and has published several other books on trauma-related topics. Dr. Ford developed and conducts research on the Trauma Affect Regulation: Guide for Education and Therapy (TARGET) psychosocial intervention for adolescents, adults, and families. Dr. Ford and Dr. Courtois were awarded the Print Media Award from ISSTD for this volume.


John Briere, PhD, Department of Psychiatry and Psychology and Psychological Trauma Clinic, LAC-USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, California

Daniel Brown, PhD, Department of Psychology, Harvard Medical School, Cambridge, Massachusetts

Laura S. Brown, PhD, private practice, Seattle, Washington                                                      

James Caringi, PhD, MSW, School of Social Work, University of Montana, Missoula, Montana

Marylene Cloitre, PhD, Institute for Trauma and Resilience and Department of Child and Adolescent Psychiatry, New York University, New York, New York

Christine A. Courtois, PhD, private practice, Washington, DC

Roger D. Fallot, PhD, Community Connections, Washington, DC

Janina Fisher, PhD, Trauma Center and Sensorimotor Psychotherapy Institute, Boston, Massachusetts

Victoria M. Follette, PhD, Department of Psychology, University of Nevada, Reno, Nevada

Julian Ford, PhD, Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut

Diana Fosha, PhD, AEDP Institute, New York, New York

A. Steve Frankel, PhD, JD, Department of Psychology, University of Southern California, Los Angeles, California, and Public Interest and Social Issues, Golden Gate University School of Law, San Francisco, California

Lori Galperin, LCSW, Castlewood Treatment Center, Ballwin, Missouri

Kari Gleiser, PhD, AEDP Institute, New York, New York, and private practice, Hanover, New Hampshire

Steven N. Gold, PhD, Center for Psychological Studies and Trauma Resolution Integration Program, Nova Southeastern University, Fort Lauderdale, Florida

Michelle S. Grennan, MA, Clinical Psychology Doctorate Program, Long Island University, Brooklyn, New York

Maxine Harris, PhD, Community Connections, Washington, DC

Judith Lewis Herman, MD, Department of Psychiatry, Cambridge Hospital, Harvard Medical School, Cambridge, Massachusetts

Katherine M. Iverson, PhD, National Center for Posttraumatic Stress Disorder, Women’s Health Sciences Division, Boston VA Health Care System, Boston, Massachusetts

Christie Jackson, PhD, Institute for Trauma and Resilience, New York University, New York, New York

Susan M. Johnson, EdD, Department of Psychology, University of Ottawa, and Ottawa Couple and Family Institute, Ottawa, Ontario, Canada

Philip J. Kinsler, PhD, Department of Psychiatry, Dartmouth Medical School, Hanover, New Hampshire, and private practice, Lyme, New Hampshire

Kore Nissenson, PhD, private practice, New York, New York

Pat Ogden, PhD, Sensorimotor Psychotherapy Institute, Boulder, Colorado

Lewis A. Opler, PhD, MD, Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, and Department of Psychiatry, New York University School of Medicine, New York, New York

Sandra Paivio, PhD, Department of Psychology, University of Windsor, Windsor, Ontario, Canada

Laurie Anne Pearlman, PhD, private practice, western Massachusetts

William Saltzman, PhD, UCLA Trauma Psychiatry Program, University of California, Los Angeles, California, and Department of Counseling and Psychological Services, California State University, Long Beach, California

Mark F. Schwartz, ScD, Departments of Psychiatry and Neurology, St. Louis University School of Medicine, St. Louis, Missouri, and Castlewood Treatment Center, Ballwin, Missouri

Richard C. Schwartz, PhD, Center for Self Leadership, Oak Park, Illinois

Joseph Spinazzola, PhD, Trauma Center at Justice Resource Institute, Brookline, Massachusetts

Kathy Steele, MN, CS, Metropolitan Counseling Services, Atlanta, Georgia

Onno van der Hart, PhD, Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands                                          

Bessel A. van der Kolk, MD, Trauma Center at Justice Resource Institute, Brookline, Massachusetts; Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts


Clinicians and researchers in clinical psychology, psychiatry, social work, nursing, counseling, and couple and family therapy; graduate students and residents in these fields.

Course Use

Serves as a supplemental text in graduate-level courses on trauma and PTSD.