Social workers should contact their regulatory board to determine course approval.
The field of trauma psychology grows daily, and new information may emerge that supersedes these course materials.
For some clients, these boundary conditions are more or less in place when they enter therapy; this is most likely true for individuals with single-episode adult-onset traumas who have good social supports, or children whose single-episode trauma occurred outside of the family system.
For other clients, safety and stability are dimensions on which they have always experienced deficit, and a large component of the treatment may consist of ensuring that these elements are in place before proceeding to more directly address the specific material of the trauma.
This “ecological model of trauma treatment” (Harvey, 1996) used by Herman, Harvey, and their colleagues at the Cambridge Victims of Violence Program reflected much earlier recommendations made by Janet regarding working with complex trauma, and Kardiner and Spiegel’s descriptions of effective treatment of soldiers with combat-related PTSD, as well as more recent work by colleagues such as Putnam.
There are other aspects of this phase of treatment that are foundational and must be established with every client in order for trauma treatment to proceed.The individual with a positive developmental experience and solid attachment who suffers an adult-onset trauma may need to spend little to no time in the stabilization and safety phase of treatment, while the person with a complex developmental trauma history may spend almost the entire course of therapy there.Clients go in and out of these stages; they often enter treatment with florid intrusive or dissociative symptoms, which call for the therapist to utilize interventions that directly target those distressing experiences.Once the clinician has determined that trauma constitutes an important aspect of what is troubling a client, there are a number of considerations to take into account when moving forward with treatment.Clinicians working with trauma survivors should become familiar with the overarching paradigm for trauma treatment, which serves as the foundation and framework for the application of specific interventions.