Treating Trauma in Adolescents: Development, Attachment, and the Therapeutic Relationship

This book presents an innovative and empathic approach to working with traumatised teens. It offers strategies for getting through to high-risk adolescents and for building a strong attachment relationship that can help get development back on track. Martha B. Straus draws on extensive clinical experience as well as cutting-edge research on attachment, developmental trauma, and interpersonal neurobiology. Vivid case material shows how to engage challenging or reluctant clients, implement interventions that foster self-regulation and an integrated sense of identity, and tap into both the teen's and the therapist's moment-to-moment emotional experience. Essential topics include ways to involve parents and other caregivers in treatment.

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Table of Contents

I. Theory

1. Attachment Theory in Development and Clinical Practice with Adolescents
2. The Legacy of Developmental Trauma in Adolescence
3. Interpersonal Neurobiology and Co-Regulation of Affect

II. Developmental–Relational Therapy

4. Developmental–Relational Therapy with Traumatized Teens
5. Attachment Styles: Transference and Countertransference Revisited
6. Getting Hooked and Unhooked

III. Interventions

7. Increasing Connection with Preoccupied and Dismissive Adolescents
8. Treating Dissociative Adolescents: Alternative Strategies for Healing Disorganized/Fearful Attachment
9. Including Parents and Families in Treatment
10. The Corrective Relational Ending

"Straus provides a comprehensive description of her psychotherapy model for adolescents, as well as a glimpse of the creative therapist who developed it. She thoroughly presents the core principles of her approach, which rests soundly on theory and research. The many case presentations attest to the importance of developing, maintaining, and continuously repairing connections with adolescents in order to help them resolve attachment trauma and develop an integrated self. This book will find a place in the frequently-referred-to section of the bookcases of both beginning and experienced therapists who have the privilege of entering the lives of these isolated young people."
- Daniel Hughes, PhD, private practice, Annville, Pennsylvania

"This beautifully crafted book weaves together attachment theory, neurobiology, and adolescent development with the author's years of masterful practice as an individual and family therapist. The case descriptions of traumatized, hard-to-reach teens draw the curtain back on how to use language and the therapeutic relationship to connect and heal when there has been abuse, loss, and rupture. Straus combines the language of a gifted storyteller with the erudition of a scholar. A beginning therapist will find comfort and inspiration in Straus's generous sharing of her own work, and the most seasoned therapist will feel enlivened and enriched as well."
- Anne K. Fishel, PhD, Director, Family and Couples Therapy Program, Massachusetts General Hospital; Department of Psychiatry, Harvard Medical School

"Straus gives us the rare treat of inviting us into her therapy room to be witness to the authentic, reciprocal, intimate relationships with her teen clients that are the fabric of healing in her relational model of treatment. This book brings the attachment literature to life in a new way and helps therapists understand their own relational strengths and weaknesses. Case examples of teens with varying attachment styles show how building a therapeutic relationship, over time, can integrate the self and overcome the disruptions caused by early trauma. I found the cases moving, the theoretical analysis enlightening, and the modeling of a warm, honest, related, and constantly struggling therapeutic stance a beautiful example to emulate. "This beautifully crafted book weaves together attachment theory, neurobiology, and adolescent development with the author's years of masterful practice as an individual and family therapist. The case descriptions of traumatized, hard-to-reach teens are page-turners, and draw the curtain back on how to use language and the therapeutic relationship to connect and heal when there has been abuse, loss, and rupture. Straus combines the language of a gifted storyteller with the erudition of a scholar. A beginning therapist will find comfort and inspiration in Straus's generous sharing of her own work, and the most seasoned therapist will feel enlivened and enriched as well."--Anne K. Fishel, PhD, Director, Family and Couples Therapy Program, Massachusetts General Hospital; Department of Psychiatry, Harvard Medical School""
- Joyanna Silberg, PhD, Senior Child Trauma Consultant, Sheppard Pratt Health System; President, Leadership Council on Child Abuse and Interpersonal Violence

"Rarely in our field does one find a voice so research-anchored, clinically precise, and utterly human at the same time. Straus demonstrates how to consistently 'show up'--to maintain a therapeutic connection when struggling with real kids, real therapy, and real trauma. The accessibility of her teaching is remarkable, making the book relevant to both trainees and deeply experienced clinicians. In a therapeutic landscape divided between protocol-driven and vague eclectic approaches, this book 'holds the center, ' where most therapists and adolescents fitfully live with each other. Straus's approach can restore health to kids frozen by life events, in ways that will open the hearts of therapists as well."
- Ron Taffel, PhD, Chair, and Founding Director of Family and Couples Treatment Services, Institute for Contemporary Psychotherapy, New York City