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Intro Training

The Introduction to the Treatment of Complex Trauma Parts l & ll

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Part 1

Part 1 Course Description: This is a completely newly designed course for mental health professionals who wish to develop or further enhance their knowledge and skills in working with clients who have chronic-trauma related disorders. 

The course is given in two parts, each of which consists of 6 sessions of 2 ½ hours. Part 1 is geared toward professionals with a limited background in working with those with chronic trauma. Course registrants do not need to currently be working with a client with chronic PTSD in order to take this course.

The course will focus on the etiology of chronic trauma, its clinical picture, tools of assessment, the phase oriented approach to trauma and treatment pitfalls and therapeutic alliance. The course is partly didactic, based on the assigned readings, and partly discussion of the “Case of Erica”, a teaching case which unfolds in a naturalistic progression over 4 classes.

Intended Participants: Licensed mental health professionals (psychiatrists, psychologists, clinical social workers, mental health counselors, accredited psychotherapists, etc.) who are interested in developing their skills in treating clients with chronic trauma related disorders. For Part 1 of the course, there is no need to have a client with a chronic trauma-related disorder.

Meeting Frequency: Once monthly for 6 months.  This course can also be taught as double sessions (2 sessions in one day for 3 months)

Course Format: 2.5-hour sessions of literature discussion, lecture, discussion of a “teaching case” and discussion of your cases. 

CE Credit: You may earn up to 15 continuing education credits for Part I and Part II each from CE Learning Systems, a co-sponsor of this event.

Evaluation Forms: After each session evaluation forms will be emailed to each participant who has purchased continuing education credits. At the end of the course a course evaluation will be emailed to all participants.

History: This course was originally created by the late Don Fridley, PhD, former president of the ISSTD, and former director, consultant and supervisor of the trauma and dissociative disorders services of Del Amo Hospital, in Torrence, CA.

Recommendation: We recommend that you join ISSTD. Membership in ISSTD gives you free access to every past issue of the Journal of Trauma & Dissociation and a wealth of clinical articles and discussions from past issues of The ISSTD Newsletter. 

Course objectives:
Upon completion of Part 1, students will have:

  • Explored the history of the understanding and resistance to recognizing trauma
  • Differentiated simple from complex trauma
  • Discussed and explored the etiology of complex trauma
  • Identified the clinical picture of trauma
  • Reviewed the tools to assess trauma
  • Reviewed the three phases of treatment of trauma.
  • Discussed the treatment pitfalls and therapeutic alliance (risk management)
  • Applied the theoretical knowledge of the assessment and treatment of complex trauma to a provided clinical case


Session One
Trauma and its History from simple to complex trauma

  1. Summarize the history of the understanding of trauma and the resistance to recognizing trauma in its many forms
  2. Define simple v.s. complex trauma
  3. Recognize the antecedents of trauma – from simple to complex
  4. Explore the impact of various forms of adult-onset trauma

Session Two
How childhood abuse, trauma and neglect affects development

  1. Identify the outcomes of trauma at different developmental stages during childhood
  2. Describe the symptoms in adults that indicate a further exploration for childhood trauma
  3. Discuss the impact of betrayal trauma on children

Session Three
Assessment for trauma-based disorders (PTSD and beyond)

  1. Define the DSM-V diagnosis of PTSD and the symptoms of trauma
  2. Discuss other disorders where trauma may be a major factor
  3. Review ACE studies
  4. Define “index of suspicion” and how it can be applied to clinical work, using “The Case of Erica”

Session Four
Overview of psychotherapy for complex trauma

  1. Outline phase-oriented (or sequenced) therapy
  2. Discuss the rational behind phase-oriented (or sequenced) therapy
  3. Explore the early stage of the first phase of therapy
  4. Discuss, using “The Case of Erica”, clinical interventions in the beginning stage of treatment of complex trauma

Session Five
The first phase of treatment of complex trauma

  1. Define the competencies to be achieved in the first phase of therapy
  2. Discuss the therapeutic alliance and frame in the first phase of therapy
  3. Explore the common pitfalls of early stage therapy with complex trauma
  4. Discuss, using “The Case of Erica”, clinical interventions in the phase one of treatment of complex trauma, utilizing various treatment modalities

Session Six
The second and third phases of treatment of complex trauma

  1. Discuss the second phase of treatment including, criteria for moving from the first to second phase as well as working through traumatic memory
  2. Discuss the third phase of therapy and the process of termination
  3. Explore the complex nature of the phase-oriented therapy rather than a linear progressive treatment
  4. Discuss the second and third phases of therapy, using the "Case of Erica"

Part 2

Intended Participants: Licensed mental health professionals (psychiatrists, psychologists, clinical social workers, mental health counselors, accredited psychotherapists, etc.) who are interested in developing their skills in treating clients with chronic trauma related disorders. For Part 2, the student must be treating at least one client with a chronic-trauma related disorder.

Course objectives:
Upon completion of Part 2, students will have:
  • Explored dissociation within complex trauma and its ramifications for treatment
  • Discussed various treatment modalities, such as psycho-dynamic, contextual, cognitive-behavioral, emotion focused, non-verbal therapies, etc.
  • Discussed couple and family therapy and group therapy in the treatment of complex trauma
  • Identified the factors leading to secondary post-traumatic reactions in therapist
  • Explored transference, countertransference and enactments in the therapy of clients with complex trauma disorders
  • Reviewed the role of attachment in complex trauma and it treatment
  • Applied the theoretical knowledge of the assessment and treatment of complex trauma to the students’ clinical cases
Session One
From trauma to dissociation: Betrayal and memory

  1. Define dissociation and discuss its role as a defense in overwhelming situations
  2. Define “betrayal trauma’ and discuss its role in the development of amnesia for complex trauma
  3. Apply the above theories to cases in treatment.

Session Two
Attachment styles and their implications in therapy
The therapeutic relationship

  1. Discuss the implications of trauma and abuse on adult attachment
  2. Discuss the effects of insecure attachment styles in the therapeutic relationship
  3. Explore the complications in the therapeutic relationship that are encountered when treating clients with complex trauma
  4. Apply the above to cases in treatment

Session Three
Applications of theoretical models to the treatment of complex trauma

  1. Describe various models of verbal therapy as related to the treatment of chronic trauma, including:
    1. Contextual therapy
    2. Cognitive Behavior therapy
    3. Contextual Behavior Trauma therapy
    4. Experiential and Emotion-focused therapy
  2. Discuss strengths and weaknesses of these theories
  3. Formulate eclectic models that reflect the individual therapist's working styles
  4. Apply the above to cases in treatment

Session Four
Non-verbal treatments of trauma
Modalities of treatment (individual, couple, group, family)

    1. Describe sensory-motor therapy and its utilization
    2. Explore systemic treatment approaches
    3. Discuss the healing aspects of group treatment
    4. Apply the above to cases in treatment

    Session Five
    Transference, countertransference and enactments
    The role of culture the therapy

    1. Define transference, countertransference and enactments
    2. Explore various issues in transference that are complicated by trauma
    3. Explore the use of enactments to further the therapy
    4. Apply the above to cases in treatment

    Session Six
    Secondary trauma, or how to take care of the therapist
    Wrap Up – How trauma-informed therapy makes a difference

    1. Discuss the effects of trauma therapy on the therapist
    2. Discuss ways to work through the residual effects of clients trauma in the therapist
    3. Explore how understanding underlying complex in clients advances therapy

    Continuing Education Credits

    Continuing Education Sponsor:
    CE Learning Systems is a co-sponsor of this event. To earn continuing education credits, participants must purchase credits separately. Participants will need to complete an evaluation and a post-test (online courses only). CE credits are available in the U.S. and Canada.

    ASWB - CE Learning Systems, (Provider #1020), is approved as a provider for social work continuing education by the Association of State Social Work Boards (ASWB) www.aswb.org, through the Approved Continuing Education ACE program.  ASWB Approval Period: 02/23/2013 - 02/23/2016.  Social workers should contact their regulatory board to determine course approval. Social workers participating in this course will receive continuing education clock hours.

    APA - ISSTD's Continuing Education Co-sponsor, CE Learning Systems, is approved by American Psychological Association to sponsor continuing education for psychologists. CE Learning Systems maintains responsibility for this program and its content.

    Prior to 2010 Continuing Education (CE) credits were provided by the Institute for Continuing Education.

    Course Fees
    This fee includes copyright fees and course materials. You will receive course materials when registration is complete. All fees are in U.S. Dollars. CE credits are available for purchase through our CE co-sponsor, CE Learning System, Inc. Students will receive an email directly from the CE co-sponsor with information on the cost of credits and the process to obtain them.

    Registration Requirements and Registration
    Receiving Approval to Register: ISSTD is interested in the success of this program. To ensure the highest standards in our profession, we require each potential participant to call and speak with the instructor in your area (if two instructors, speak with at least one, if registering for the online program, contact ISSTD Staff

    If your instructor agrees with your participation in this program, they will tell you to register. If you register without prior consent of an instructor, we cannot guarantee your instructors approval and your registration fee may be refunded to you, minus an administrative fee of $45 for handling of improperly submitted registration materials. Applicants must be licensed clinicians, or if you are a graduate student, a letter from your Department Chairperson giving permission for your participation in this program must be sent to your faculty person.

    Course sites which have two faculty listed will have one course co-taught by both faculty. To begin the registration process, use the information on the Faculty Page to contact the faculty member in your area for permission to register. Calendar of Programs with Instructors Contact Information


    Registration is limited to 12 persons per site and varies per hybrid/online course. Participants must be licensed professionals, and students must also receive the approval of the local faculty to attend. Clinicians in training may attend with the written recommendation of the chairperson of their training program/department. Familiarity with treating a person with a major dissociative disorder is preferred in the Advanced and Master's level courses. Progression from Intro I to Intro II, through Standard I and Standard II is highly recommended prior to attempting the upper level courses. It is recommended that participants have contextual experience of dissociative processes to be able to take in more advanced course material in a meaningful way.

    Remember, if you register without the prior approval of a faculty member, your registration may be refunded to you less a $45 administrative fee. When you click to register you are indicating that you have read the preceding paragraphs about the details of this program, and the rules surrounding the processing of registration fees.

    Members please remember to log in to receive your member discount. Contact Program Manager by email at info@isst-d.org or call 703-610-9037 if you need your username and password or any additional registration assistance.

    If you have a problem or a concern about registration, please contact the ISSTD Professional Training Administrative Director, Victor Welzant, Psy.D.

    Cancellation Policy
    If you withdraw from any course less than 15 days prior to its local starting date, there is a $45 non-refundable charge. If you are sent course materials, prior to your notification of withdrawal from the course, regardless of the date of your notice, your refund will also be less the copyright fees. Registration is limited to 12 participants per location for in person courses and varies for hybrid/online courses. Once the course starts no new students can be accepted more than one week after the course begins. The course fee is not refundable if you withdraw from the course after two weeks prior to its start, unless an acceptable replacement for your registration is found, in a timely fashion, prior to the start of the course. Refund of fees, and acceptance at that time, is the decision of the course Directors. All materials used for this course are subject to copyright laws and are not for duplication or distribution by course participants. Fees must be submitted with registration, and must be submitted in US dollars.

    Thank You
    ISSTD is thankful to the original course directors, Richard Chefetz, MD; A. Steven Frankel, PhD, JD; Donald Fridley, PhD; Elizabeth Howell, PhD; Annita Jones, PsyD; and Eli Somer, PhD as well as the many distinguished faculty members who have contributed and continue to give their energy and talents tirelessly to make this training program successful.

    © 2017 ISSTD  This course syllabus and bibliography are the copyrighted property of the International Society for the Study of Trauma and Dissociation (ISSTD).  Use of this material is prohibited without written permission from the ISSTD.



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