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Reply to "PRACTICE STANDARDS FOR TRAUMA WORK"

yes, and no. People familiar with the "ICCE" - International Center for Clinical Excellence -- will know it is but one example of how important the therapeutic relationship, over and above ANY particular treatment model; and past research has shown that behavioral / CBT practitioners (what is "the" CBT approach, since there are many forms of CBT) are as empathic, if not more empathic and supportive as treatment providers from any other approach. So,  I  would have to disagree with Bessel's broad-brush condemnation of any approach. If therapists do not tune into how their clients are going they can certainly re-traumatise certain, but not all,  people. A similar argument could be made concerning the use of Mindfulness -- either it's extremely risky (if you don't know your patient's vulnerabilities) or it's the bees-knees. So, hasten slowly, REALLY get to know your patients, and have  a solid relationship in place, before you doing anything else.

People who have been following the treatment literature -- from Cloitre's article in American J of Psychiatry onwards, including the consensus statement (again, the details are obtainable from my website -- search "consensus") -- will know there's to and from arguments concerning the proposal that treatment needs to be phase-based, with clients "needing" to be trained in emotion regulation skills before addressing the fear-focused exposure phase, with some of the best, "single-phase" treatment coming from Europe (unfortunately the most recent articles are in Dutch! but the authors are very generous in supplying the background articles in English). Similar caveats could be raised concerning the "poor response" to treatment of patients with "Personality Disorder" -- many of those with CPTSD - with the Dutch research showing they cause no problems in treatment and respond at least as well.

But, following your line, if people like more cookbook-style approaches, there's Ogden's recent excellent book on sensorimotor psychotherapy for trauma.

On the other hand (and I'll be ending this soon), one "body" therapy for trauma, and everything else, is Primal Therapy --- one of my current clients -- desperate to understand his issues has practically memorized two of Janov's books -- and I was never into it so it's especially challenging.

Again, and I didn't mean for this to be a lecture, I think if client and therapist can establish a good relationship, respect those fundamentals raised by Bennett, and find a language by which they can establish a shared language in which to share their understanding of the client's wishes, reformulate stored constructions, and take steps to help the client build a life consistent with the client's values, I think that goes a substantial way towards helping the client to a better life -- and no one particular model will be THE way to that end, certainly not for us all. Just my 2c worth :-D

 

 

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