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Now in a fully updated second edition, this book presents theory, research, and practice guidelines for short-term, evidence-based individual treatment for adults experiencing the effects of complex relational trauma.
This fully updated second edition presents theory, research, and practice guidelines for short term, evidence based individual treatment for adults experiencing the effects of complex relational trauma.
Disrupted narrative and emotional processes are common effects of complex trauma, and emotion focused therapy for trauma (EFTT) is well suited to address these difficulties. Clients with complex trauma often suffer long term challenges after repeated exposure to violence and betrayals of trust, typically by attachment figures in the form of child abuse and neglect. The authors bring more than 25 years of research and clinical expertise to this evidence-based treatment model, which enables therapists to skillfully navigate the unique challenges facing these clients.
Chapters present practical aspects of EFTT alongside supporting research, allowing clinicians from different theoretical perspectives to either apply the complete package, or integrate aspects of the model into their current practice. This comprehensive and essential resource is fully updated with current developments in research, clinical practice, and training.
Sandra C. Paivio, PhD, CPsych, maintains a private practice in Toronto, Canada, provides individual psychotherapy and clinical training at the York University Psychology Clinic, and is professor emeritus in the Psychology Department at the University of Windsor. She is one of the developers of emotion-focused therapy, particularly applied to complex trauma (EFTT), has conducted clinical trials evaluating the efficacy and processes of change in EFTT, and is author of numerous publications on trauma and psychotherapy. Dr. Paivio received a Lifetime Achievement Award from the Trauma Section of the Canadian Psychological Association (2 4) for her contributions to research and training in treatment for complex trauma.
Antonio Pascual-Leone, PhD, CPsych, is a professor in psychology at the University of Windsor, Canada, where he is director of the Emotion Change Lab, and is honorary professor of psychiatry at the University of Lausanne, Switzerland. He has published seminal contributions to theory and research of emotion-focused therapy and is regarded as a world expert in emotional processing. He coauthored the first edition of this book with Sandra Paivio and is writing a trans-theoretical book on changing emotion. His work is recognized by career awards from international societies as well as distinguished publication awards. He runs a private practice seeing individuals and couples.
Acknowledgments
Introduction to Emotion-Focused Therapy for Trauma: Development, Defining Features, Strengths, and Contributions
I. Theory
Chapter . Trauma and its Effects
Definition of Trauma
Types of Traumatic Events
Prevalence and Risk Factors
Effects of Trauma
Implications for Treatment
Chapter 2. The EFTT Treatment Model
Theoretical Foundations
Distinguishing Features of EFTT
Distinctions Between EFTT and the General Model of Emotion-Focused Therapy
The Treatment Model
Chapter 3. Working with Emotion
Review of Emotion Theory Underlying EFTT
Change Processes: Emotional Processing in EFTT
Model of Change and Phases Of EFTT
II. Practice
Early Phase of Therapy
Chapter 4. Cultivating the Alliance
Intervention Principles for Developing a Productive Alliance
Goals of Alliance Formation in Phase Of EFTT
Conducting the First Three Sessions
Alliance Difficulties
Chapter 5. Promoting Experiencing
Features of Experiencing
EFTT Compared With Other Perspectives on Experiencing
Experiencing Compared to Other Constructs
Measurement of Experiencing
Research on Experiencing in Therapy
The Process of Deepening Experiencing Step by Step
Guidelines for Structured Focusing Procedure
Difficulties With Experiencing
Chapter . The Imaginal Confrontation Procedure
Imaginal Confrontation of Perpetrators
Intervention Principles
The Process of Engagement in IC
Steps in the IC Procedure and Corresponding Therapist Operations
Relationship Development in the Initial IC
Evocative Exploration as an Alternative to IC
Client Difficulties With the Initial IC
Middle Phase of Therapy
Chapter 7. Memory Work in EFTT
Theory
Different Approaches to Memory Work
Goals and Processes of Memory Work In EFTT
Practice Guidelines for EFTT Memory Work
Memory Work When Memories Are Shallow
Memories Are Warded Off
Memories of Self as Defective or Damaged
Summary, Considerations, and Cautions
Chapter 8. Reducing Fear, Anxiety, and Avoidance of Internal Experience
Perspectives on Fear, Anxiety, and Avoidance: EFTT Compared With Other Approaches
Process Diagnosis: Distinguishing Different Types of Fear and Anxiety
Change Processes and Goals
Interventions for Managing Anxiety and Fear
Helping Clients Allow Primary Emotional Experience
Chapter 9. Transforming Guilt, Shame, and Self-Blame
Perspectives on Guilt and Shame: EFTT Compared With Other Approaches
Process Diagnosis: Distinguishing Different Types of Shame Experience
Change Processes and Goals
Intervention Principles Relevant to Shame
Interventions for Reducing Secondary Shame
Intervention for Primary Adaptive Shame About Violating Personal Standards
Intervention for Transforming Primary Maladaptive Shame
Compassionate Self-Soothing
Difficulties When Working With Fear and Shame
Late Phase of Therapy
Chapter . Resolution of Interpersonal Trauma Through Adaptive Anger
Review of Theory and Research on the Resolution of Interpersonal Trauma
Anger and Trauma Across Theoretical Perspectives
Process Diagnosis: Distinguishing Different Types of Anger
Intervention Principles
Interventions for Changing Maladaptive Anger
Intervention for Promoting Primary Adaptive Anger
Chapter . Resolution of Interpersonal Trauma Through Sadness and Grief
Traumatic Grief Across Theoretical Perspectives
Process Diagnosis: Distinguishing Different Types of Sadness
Change Processes and Goals
Intervention Principles for Promoting Adaptive Sadness
Interventions for Promoting Sadness and Grieving Losses
Intervention for Other Types of Sadness
Chapter 2. Termination
Completion and Consolidation of Changes
Awareness and Acceptance of Limited Change
Sharing Mutual Feedback
Difficulties With Resolution
Difficulties With Therapy Termination
Bridge to The Future
Afterword
Appendix A: Short Form of the Client Experiencing Scale
Appendix B: Short Form of the Working Alliance Inventory
Appendix C: The Degree of Resolution Scale (Short Form)
Appendix D: Yoga Therapy as a Complement to EFTT: Integrating Body-Based Interventions
References
Index
About the Authors
This book is a breath of fresh air. It calls it like it is. The differential treatment model of what treatment for what disorder has had its day. The authors amp rsquo proposed process-based approach to treatment moves us forward to a promising new transdiagnostic, transtheoretical approach focused on evidence-based processes of change that fit the needs of a given client. This is the future. A must-read, wonderful contribution. - Leslie Greenberg, PhD, Distinguished Research Professor Emeritus of Psychology, York University, York, Ontario, Canada, and author of Patterns of Change and Changing Emotion With Emotion Sandra C. Paivio and Antonio Pascual-Leone have written an accessible and invaluable second edition of their integrative treatment model, emotion-focused therapy for complex trauma (EFTT). This innovative model is especially important as an evidence-based treatment of complex trauma of relatively short duration and with clearly delineated strategies and markers. Moreover, it has a flexibility of application and can be adapted for use with other treatment models depending on the needs of the client. - Christine A. Courtois, PhD, ABPP, Licensed Psychologist and Consultant/Trainer, Trauma Psychology and Trauma Treatment; coauthor of Treating Complex Trauma: A Sequenced, Relationship-Based Approach and coeditor of Treating Complex Traumatic Stress Disorders in Adults The second edition of this classic text on emotion-focused therapy and trauma offers a fresh, coherent, and comprehensive perspective on the richness of emotional processes involved in the healing of wounds from adverse events. Many sufferers who need healing can be helped by the caring, compassionate, validating, but also well-informed and well-researched approach described in this incredibly clear and practitioner-friendly book. Well done and thank you to the authors for this pivotal contribution! - Ladislav Timulak, PhD, Professor in Counselling Psychology, School of Psychology, Trinity College Dublin, Dublin, Ireland
This fully updated second edition presents theory, research, and practice guidelines for short term, evidence based individual treatment for adults experiencing the effects of complex relational trauma. Disrupted narrative and emotional processes are common effects of complex trauma, and emotion focused therapy for trauma (EFTT) is well suited to address these difficulties. Clients with complex trauma often suffer long term challenges after repeated exposure to violence and betrayals of trust, typically by attachment figures in the form of child abuse and neglect. The authors bring more than 25 years of research and clinical expertise to this evidence-based treatment model, which enables therapists to skillfully navigate the unique challenges facing these clients. Chapters present practical aspects of EFTT alongside supporting research, allowing clinicians from different theoretical perspectives to either apply the complete package, or integrate aspects of the model into their current practice. This comprehensive and essential resource is fully updated with current developments in research, clinical practice, and training.