Treating Complex Traumatic Stress Disorders in Adults

Second Edition
Scientific Foundations and Therapeutic Models

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

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ISBN 9781462542178
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646 Pages
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646 Pages
Size: 6⅛" x 9¼"
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Price: $45.00 $33.75
646 Pages
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646 Pages
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This authoritative reference on complex traumatic stress disorders (CTSDs) and their assessment and treatment has now been significantly revised with more than 75% new material reflecting a decade of advances in the field. Leading experts delve into ways to understand, engage, assess, and treat adults with complex trauma histories, whose symptoms often include but may go well beyond those of posttraumatic stress disorder. The volume presents cutting-edge theory and research on CTSDs, considers diagnostic controversies, and identifies core elements of effective, culturally responsive treatment. Established and emerging therapies specifically tailored to this population are described and illustrated with vivid case examples. Other highlights are chapters on transtheoretical treatment, the crucial role of professionalism and training, and recognizing and managing vicarious traumatization.

New to This Edition See also Drs. Ford and Courtois'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.

“An unparalleled contribution to the existing literature on assessment and intervention with survivors of complex trauma....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 (on the first edition)

“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 (on the first edition)

“Will surely become a classic textbook on complex traumatic stress. This book is appropriate for students, clinicians, and academics alike....The editors and contributors 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.”

Clinical Social Work Journal (on the first edition)

“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.”

Behavioural and Cognitive Psychotherapy (on the first edition)

“Editors Courtois and Ford unite to provide a thorough, stimulating, and current work on treating a very challenging population....This is an important and highly relevant book.”

Child and Family Behavior Therapy (on the first edition)

“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 posttraumatic stress disorder.”

Healthcare Counselling and Psychotherapy Journal (on the first edition)

“A valuable addition….This book will enhance the knowledge and therapeutic toolbox of any practitioner working with clients who have had complex psychological traumas.”

Addiction Today (on the first edition)

“Bringing together the voices of numerous leaders in the field, this work has become a classic text on CTSDs and should be considered an essential guide for students. Beginning with foundations such as developmental neurobiology and therapeutic best practices, the volume reviews a range of treatments—from cognitive and exposure-based therapies to body-based therapies—developed or adapted for complex trauma. The second edition significantly expands the number of approaches discussed and includes important issues such as treatment of co-occurring substance use disorders. It deftly integrates scientific perspectives with clinical experience and wisdom, including sound evidence-based practice recommendations that cut across treatment models. Well written and packed with information.”

—Elizabeth K. Hopper, PhD, Program Director, The Trauma Center at Justice Resource Institute, Brookline, Massachusetts

“Essential reading for practitioners in all disciplines who work with trauma-affected populations. Edited and written by international leaders in the area, the volume provides deep insight into the nature and phenomenology of CTSDs and details an array of expert approaches to intervention. This work—combining the current best science and practice—is an outstanding reference for any clinician working to improve the lives of those experiencing CTSDs.”

—David Forbes, PhD, Department of Psychiatry, University of Melbourne; Director, Phoenix Australia Centre for Posttraumatic Mental Health

“This comprehensive work delves into the assessment and treatment of the wide symptom array associated with developmental trauma. The book provides incredible depth, breadth, and cutting-edge research on CTSDs. This fully revised second edition will be the leading text for years to come. A 'must read' for all clinicians, trainees, and researchers working in the area of complex traumatic stress.”

—Ruth A. Lanius, MD, PhD, Professor and Harris–Woodman Chair in Mind–Body Medicine, Department of Psychiatry, Western University, Canada

“Ford and Courtois are among the most knowledgeable authorities in the complex trauma field today. This volume provides a thorough update on the clinical and scientific controversies surrounding CTSDs in adults, as well as the rapidly expanding evidence base. Exciting theoretical and research developments on the neurobiology of the survival brain, complex PTSD, self-regulation, developmental trauma, vicarious trauma, and posttraumatic resilience are highlighted and translated into practical guidelines for culturally responsive clinical practice. I highly recommend this second edition as a valuable resource, both for students learning about complex trauma for the first time and for practitioners who wish to stay up to date on knowledge and treatment approaches.”

—David L. Corwin, MD, Professor and Director of Forensic Services, Department of Pediatrics, University of Utah School of Medicine

“The definitive international handbook on CTSDs. This superb book yields wonderful insights into the therapeutic treatment of an important but difficult-to-treat group of patients. Every reader from a health care profession can learn something from it. Experts who have been working in the field of complex trauma for decades are complemented by highly respected scholars on classic PTSD. The case studies and therapy dialogues in the various treatment chapters are highly practical.”

—Andreas Maercker, PhD, MD, Department of Psychology, University of Zurich, Switzerland; Chair, ICD-11 working group on trauma-associated disorders

Table of Contents

Foreword, Judith Lewis Herman

I. Overview

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

2. Developmental Neurobiology, Julian D. Ford

3. Best Practices in Psychotherapy for Adults, Christine A. Courtois, Julian D. Ford, Marylene Cloitre, & Ulrich Schnyder

4. Therapeutic Alliance and Risk Management, Christine A. Courtois

5. Evidence-Based Psychological Assessment of the Sequelae of Complex Trauma, Joseph Spinazzola & John Briere

6. Assessing and Treating Complex Dissociative Disorders, Kathy Steele & Onno van der Hart

7. Cultural Humility and Spiritual Awareness, Laura S. Brown

8. New Perspectives on Vicarious Traumatization and Complex Trauma, Laurie Anne Pearlman, James Caringi, & Ashley R. Trautman

II. Evidence-Supported Individual Treatment Modalities and Models

9. Prolonged Exposure Therapy, Elizabeth Hembree & Edna B. Foa

10. Cognitive Therapy, Anke Ehlers & Hannah Murray

11. Cognitive Processing Therapy, Kathleen M. Chard, Ellen T. Healy, & Colleen E. Martin

12. Brief Eclectic Psychotherapy, Berthold Gersons, Mirjam J. Nijdam, Geert E. Smid, & Ulrich Schnyder

13. Eye Movement Desensitization and Reprocessing Therapy, Deborah L. Korn & Francine Shapiro

14. Narrative Exposure Therapy, Maggie Schauer, Katy Robjant, Thomas Elbert, & Frank Neuner

15. Emotion-Focused Therapy, Sandra C. Paivio & Lynne E. Angus

16. Interpersonal Psychotherapy, Ari Lowell, Andrea Lopez-Yianilos, & John C. Markowitz

17. Cognitive-Behavioral Therapy, Christie Jackson, Kore Nissenson, & Marylene Cloitre

18. Trauma Affect Regulation: Guide for Education and Therapy, Julian D. Ford

III. Group/Conjoint Therapy Models

19. Group Therapy, Julian D. Ford

20. Dual-Trauma Attachment-Based Couple Therapy, Pamela C. Alexander

21. Family Systems Therapy, Julian D. Ford

22. Complex Trauma and Addiction Treatment, Denise Hien, Lisa Caren Litt, Teresa López-Castro, & Lesia M. Ruglass

IV. Emerging Psychotherapy Models

23. Sensorimotor Psychotherapy, Pat Ogden

24. Experiential Approaches, Janina Fisher

25. Mindfulness Approaches, Barbara L. Niles, Sarah Krill Williston, & DeAnna L. Mori

26. Complementary Healing Therapies, Stefanie F. Smith & Julian D. Ford

Epilogue: Overview and Future Directions in Treatment for Complex Traumatic Stress Disorders, Julian D. Ford & Christine A. Courtois

Afterword, Bessel A. van der Kolk

Author Index

Subject Index

About the Editors

Julian D. Ford, PhD, ABPP, a clinical psychologist, is Professor of Psychiatry at the University of Connecticut School of Medicine, where he is Director of the Center for Trauma Recovery and Juvenile Justice and the Center for the Treatment of Developmental Trauma Disorders. He has served as President of the International Society for Traumatic Stress Studies, is a Fellow of the American Psychological Association, and is Associate Editor of the Journal of Trauma and Dissociation and European Journal of Psychotraumatology. Dr. Ford has published more than 250 articles and book chapters. He is coeditor of Treating Complex Traumatic Stress Disorders in Adults, Second Edition, and Treating Complex Traumatic Stress Disorders in Children and Adolescents, and coauthor of Treatment of Complex Trauma: A Sequenced, Relationship-Based Approach. His research focuses on developmental trauma disorder and the Trauma Affect Regulation: Guide for Education and Therapy (TARGET) therapeutic intervention.

Christine A. Courtois, PhD, ABPP, a counseling psychologist, is retired from clinical practice and now serves as a consultant/trainer on trauma psychology and treatment. She is a Fellow of the American Psychological Association (APA) and the International Society for the Study of Trauma and Dissociation. Dr. Courtois is a past president of APA Division 56 (Trauma Psychology) and served as Chair of the APA’s Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults. She has received the Award for Distinguished Contributions to Independent Practice from the APA, the Sarah Haley Award for Clinical Excellence from the International Society for Traumatic Stress Studies, the Award for Distinguished Service and Contributions to the Profession of Psychology from the American Board of Professional Psychology, and the APA Division 56 Lifetime Achievement Award. She is coeditor of Treating Complex Traumatic Stress Disorders in Adults, Second Edition, and Treating Complex Traumatic Stress Disorders in Children and Adolescents, and coauthor of Treatment of Complex Trauma: A Sequenced, Relationship-Based Approach.


Clinicians and researchers in clinical psychology, psychiatry, social work, nursing, and counseling, and couple and family therapy.

Course Use

Serves as a supplemental text in graduate-level courses.

Special package offer: Drs. Courtois and Ford's edited volumes, Treating Complex Traumatic Stress Disorders in Adults, Second Edition, and Treating Complex Traumatic Stress Disorders in Children and Adolescents, review research on the nature of complex trauma and showcase evidence-based treatment models. Their authored book, Treatment of Complex Trauma, presents their own therapeutic approach for adult clients.

Order all 3 items — a $110.00 value for $79.95!

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Previous editions published by Guilford:

First Edition, © 2009
ISBN: 9781462513390
New to this edition: