Grounded in 40 years of clinical practice and research, this book provides a systematic yet flexible evidence-based framework for treating adult survivors of complex trauma, particularly those exposed to chronic emotional abuse or neglect. Component-based psychotherapy (CBP) addresses four primary treatment components that can be tailored to each client's unique needs—relationship, regulation, dissociative parts, and narrative. Vivid extended case examples illustrate CBP intervention strategies and bring to life both the client's and therapist's internal experiences. The appendix features a reproducible multipage clinician self-assessment tool that can be downloaded and printed in a convenient 8½" x 11" size.
“CBP brings both wisdom and compassion to the challenge of working therapeutically when on the very edge of—and at times, thrown into—the abyss of dysregulation and dissociation that is complex trauma. The core principles and case studies reflect a deep understanding of the adult survivor’s experience as well as the importance of therapist self-awareness and self-reflection. This book's exploration of therapeutic process is a valuable counterbalance (and complement) to manualized approaches to complex trauma therapy.”
—Julian D. Ford, PhD, ABPP, Department of Psychiatry, University of Connecticut Health Center
“This excellent book is pivotal in helping therapists reach out to their traumatized clients’ profound sense of annihilation and facilitate healing from emotional abuse and neglect. The authors present a superb account of their treatment model, which masterfully integrates the key components of truly helpful psychotherapy. Reading the appealing, illuminating clinical examples is a great privilege. This volume is a 'must read' for novice and experienced therapists alike, as well as students.”
—Onno van der Hart, PhD, Department of Clinical and Health Psychology (Emeritus), Utrecht University, the Netherlands
Foreword, Bessel A. van der Kolk
Introduction, Christine A. Courtois
I. Overview and Background
1. Component-Based Psychotherapy with Adult Survivors of Emotional Abuse and Neglect, with Hilary B. Hodgdon
2. Into the Abyss: A Series of Moments in the Clinical Process for Client and Therapist
II. The Component-Based Psychotherapy Model
3. Client and Therapist Relational Patterns and Contextual Factors, with Margaret E. Blaustein
4. Across the Abyss: A Relational Approach
5. Regulation of Complex Trauma
6. Regulating on the Brink of the Abyss
7. Fragmentation of Self and Dissociative Parts
8. Working with Dissociative Parts in the Depths of the Abyss
9. Constructing a Narrative, Constructing a Self, with Jodie Wigren
10. Transcending the Abyss: Life Narrative and Identity Development
III. Component-Based Psychotherapy Model Integration: Out of the Abyss
11. Tailoring Treatment: Individualized Adaptations and Effective Pacing
12. Applications: Revisiting David and Nicole
Appendix. Component-Based Psychotherapy Clinician Self-Assessment
About the Authors:
Elizabeth K. Hopper, PhD, is a clinician, senior supervisor, and a member of the training faculty at the Trauma Center at Justice Resource Institute in Brookline, Massachusetts. She is Director of the Trauma Center's Project REACH, a national anti–human trafficking program. She has also served as Associate Director of Training at the Trauma Center. Dr. Hopper has collaborated with numerous agencies and organizations in developing trauma-informed care systems. She is coauthor of a book on yoga as a body-based intervention for trauma; has written numerous articles and chapters on complex trauma, trauma-informed care, homelessness, and human trafficking; and serves on the editorial review boards of several professional journals. She has a strong interest in integration across treatment models and in interventions that can be individually adapted.
Frances K. Grossman, PhD, ABPP, has been a senior supervisor and member of the training faculty at the Trauma Center at Justice Resource Institute in Brookline, Massachusetts, since 2001. She is Professor Emeritus in the Clinical Psychology program at Boston University, having taught there for over 30 years, and was an adjunct faculty member in the Lesley University Master's in Counseling Psychology program for a decade. Dr. Grossman has published and presented on topics including resiliency in women and men with histories of childhood sexual abuse. With a particular interest in dissociation, she teaches a Dissociation Seminar at the Trauma Center and has developed an imagery technique for engagement with dissociated parts of self. She is highly engaged in the national dialogue about implicit and explicit racism and has participated in the development of a Trauma Center working group on issues related to diversity.
Joseph Spinazzola, PhD, a clinical psychologist in private practice, was a clinician, researcher, clinical supervisor, and national trainer for the Trauma Center at Justice Resource Institute in Brookline, Massachusetts, for over 18 years, including 12 years as Executive Director. He is Adjunct Professor at Richmont Graduate University, a member of The Forensic Panel consulting practice, and Executive Director of the Dante Dieso Foundation Trust. Dr. Spinazzola founded the Complex Trauma Treatment Network of the National Child Traumatic Stress Network, coauthored the International Society for Traumatic Stress Studies’s expert guidelines for the treatment of complex posttraumatic stress disorder, served as Co-Principal Investigator of the developmental trauma disorder national field trials, and has published over 60 peer-reviewed journal articles and book chapters. He is also the lead developer of the Trauma Drama intervention for youth and young adults.
Marla Zucker, PhD, is Program Director at the Trauma Center at Justice Resource Institute (JRI) in Brookline, Massachusetts, and at the JRI's Metrowest Behavioral Health Center. She is Research Assistant Professor of Clinical Practice in the Department of Psychology at Suffolk University. At the Trauma Center, Dr. Zucker is on the training faculty and works clinically with traumatized children, adolescents, and adults. She has published and presented widely in the areas of trauma and trauma treatment and developmental learning and attention disorders. A clinical psychologist, she is also a certified sport psychologist and has a private practice in sport and performance psychology in Boston.