First-line picks and clinical guidance for the presentations under this topic.
Post-Traumatic Stress Disorder
Re-experiencing, avoidance, negative cognition/mood, and hyperarousal following a traumatic event.
Trauma-focused psychotherapies outperform medication for PTSD. Three first-line options have comparable efficacy; choice often depends on client preference and avoidance level. Stabilization and resourcing precede reprocessing in complex trauma.
First-line:PE · CPT · EMDR
Complex Trauma / C-PTSD
Prolonged, repeated interpersonal trauma with disturbances in self-organization, affect, and relationships.
Complex trauma requires phase-based treatment: safety/stabilization → processing → integration/reconnection (Herman). Single-shot trauma protocols often destabilize without preparation. Parts-based and somatic approaches are well-suited.
First-line:IFS · SE
Dissociative Disorders
Disruptions in identity, memory, consciousness, or perception — usually trauma-rooted.
Phase-based treatment (ISSTD guidelines): safety/stabilization → trauma processing → integration. Standard trauma protocols without preparation typically destabilize dissociative clients. Specialist supervision is essential.
First-line:IFS · SE