Treating Trauma: Relationship-Based Psychotherapy with Children, Adolescents, and Young Adults

Clinicians working with traumatized youth face many challenges in supporting growth and development while addressing the many negative consequences of abuse and neglect. When working with youth in foster care, additional obstacles must be overcome: changing placements, overwhelmed substitute caregivers, caseworker turnover, complication with birth siblings and family, and communication difficulties with and within the child welfare system. Treating Trauma: Relationship-Based Psychotherapy with Children, Adolescents, and Young Adults presents a theoretically based and empirically supported framework for work with traumatized children, youth, and young adults who have spent time in foster care. It offers vivid examples of cases from the work of clinicians of A Home Within, a national non-profit focused on meeting the emotional needs of current and former foster youth. These nine case studies illustrate the vital role that relationships play in helping overcome the trauma of chronic, unexpected, and unexplained losses. They describe the work with clients, the collateral work, and also the therapists’ personal experiences of treating this vulnerable population. This work also explores the impact of secondary trauma on those working in an around the foster care system and addresses ways that therapists and others vulnerable to vicarious trauma can protect themselves, as well as their clients. In particular, three chapters examine the power of peer consultation in sustaining therapeutic work with vulnerable and traumatized populations. Methods of integrating evidence-based approaches into treatment of youth with multiple mental health problems and unavailable parents are discussed and explored. Essential elements of effective mental health interventions with traumatized foster youth are presented and illustrated.

Table of Contents:
Acknowledgments Introduction: The Need for a Relationships Framework in Effective Trauma Treatment for Children and Youth PART 1: Holding the Hope: Establishing Relationship with Multiply Traumatized, Psychiatrically Complex Patients CHAPTER 1: Molly CHAPTER 2: Juan CHAPTER 3: Lilly CHAPTER 4: Joining a Consultation Group PART 2: The Heart and Soul of Psychotherapy: Unique Challenges in Treatment of Foster Youth CHAPTER 5: Lucy CHAPTER 6: Michael CHAPTER 7: Isaiah CHAPTER 8: An Experience in a Long-Term Consultation Group PART 3: Shared Memories: The Nature and Impact of Long-Term Trauma Treatment CHAPTER 9: Clemee CHAPTER 10: Zina CHAPTER 11: Ben CHAPTER 12: How Consultation Groups Change Therapy (and Therapists) CHAPTER 13: Conclusion: Eight Elements of Relationship-Based Therapy Index About the Contributors

About the Author :
Toni V. Heineman, DMH, is executive director and founder of A Home Within. Dr. Heineman is a clinical psychologist who has been in private practice treating children, adults, and families in the San Francisco Bay Area for over thirty years. June M. Clausen is chair and professor of psychology at the University of San Francisco. Dr. Clausen directs the Foster Care Research Group, and maintains a clinical practice in San Jose, California. Saralyn C. Ruff oversees the Fostering Relationships Program of A Home Within, dedicated to improving mental health services for foster youth. Dr. Ruff also teaches in the psychology department at the University of San Francisco and is a practicing clinician in San Francisco, California.

Review :
A Home Within is an organization in San Francisco that provides open-ended, relationship-based therapy for children and youth in foster care; their motto is, 'One child. One therapist. For as long as it takes.' The model has now spread to 24 states. In this book, Heineman, executive director and founder of A Home Within, presents the rationale for the relationship-based approach. Therapists using the approach offer nine chapter-length case studies, plus three chapters on long-term consultation groups that support clinicians. A concluding chapter outlines elements of relationship-based therapy. This book is a must read for all professionals, legislators, and policy makers working to improve outcomes for children and youth in foster care. It makes the compelling case for the importance of relational based therapy in creating permanence for foster children in a system that, while well-meaning, continues through its fragmentation, diminished resources, mandates, and bureaucratic structures to engage in a parallel process that can further traumatize youth. Promising evidence-based practices should heed the call this book so eloquently makes for the model of A Home Within. This book represents an invaluable contribution to the field and to those of us working clinically in the context of the welfare system from a psychodynamic perspective. Through beautifully written narratives and rigorous theoretical integration, this volume challenges the reader to become aware of the need for an extensive reconsideration of the way in which we formulate and intervene clinically with traumatized children and youth. The authors accomplish this task by using the lens of the child’s perspective and placing the clinical experience in the context of the multiple systems supporting the child in a manner that only thoughtful and experienced clinicians can. This book will be of value not only to both experienced and beginning clinicians interested in working with this population but also to all other professionals in allied fields who seek to give a voice to the experience of these young people. Treating Trauma: Relationship-Based Psychotherapy with Children, Adolescents, and Young Adults is a compelling collection of therapists’ perspectives on how engaged therapeutic relationships can serve as a bridge to self-understanding, trust of others, and healthier lifelong relationships for children, adolescents and young adults who have experienced the trauma of child abuse, neglect and foster care. This collection deepens our understanding of the impact of trauma on personality development. This book also informs mental health and child welfare practitioners who encourage and facilitate positive life transitions from foster care.