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Professionals in the child trauma field, eager to bring best practices to children and their families who have suffered from traumatic life events, have developed a number of evidence-based treatments (EBTs) and promising practices available for adoption and implementation into community practice. Clinicians and researchers alike have raised questions about “if, when, and how” these EBTs can be applied to some of the more complex trauma presentations seen in real world practice. The authors take an evidence-based practice approach, including critical appraisal of clients' unique needs and preferences, utilizing applicable trauma treatment core components and current EBTs, and emphasizing monitoring strategies of client progress, particularly when needing to adapt EBTs for select clients. [ABSTRACT FROM AUTHOR]

This paper describes a pilot study of a 1-year multi-modal treatment for incest survivors, incorporating individual psychotherapy, group psychotherapy, and pharmacotherapy. The treatment was designed to provide a therapeutic context in which the affective intensity and meaning originally attached to the traumatic experience could be tolerated, and in which a thoughtful, reflective construction of the impact of the trauma could be developed. PTSD symptoms decreased in all participants, with all but one no longer meeting the diagnosis at post-treatment and follow-up. Using a narrative methodology, maladaptive schemas and overwhelming affects, 'trauma themes', were also assessed to understand the survivors' views about themselves, others and the world around them. Participants demonstrated a steady pattern of improvement in the resolution of trauma themes. A discussion of the complex posttraumatic response to incest is included, as is a brief description of the treatment. [ABSTRACT FROM AUTHOR]