Innovations in Treating Complex Traumatic Stress Disorders: The PRISM Principles and Their Application

Cost: CSCSW Members and USC Alumni: $159 for | Nonmembers: $259 | Student: $40 (Recording will be available for Member's Only)

CEUs: 6 CEU’s 

Presenter: Christine A. Courtois, PhD, ABPP | Delaware Licensed Psychologist, Trainer/Consultant/Author, Trauma Psychology and Treatment, Bethany Beach, DE, Private Practice, Washington, DC (retired)

Confused over the difference between complex and other types of trauma, or how to treat PTSD or CPTSD? Confused by the different methods being advertised as the one way to treat trauma? Concerned you didn’t receive training about working with traumatized clients.  Confused about when and how to address a history of trauma and fearful of intensifying your client’s suffering or making your client worse? Not sure you want to work with these issues? This workshop is designed to provide information on these issues and to offer detailed guidance for the treatment of this patient population.

Over the past decade, understanding of what constitutes complex trauma and what differentiates it from more time-limited impersonal forms of trauma has grown significantly. Complex trauma is now recognized as the most common type of lifespan trauma with a wide range of developmental and posttraumatic consequences. A history of complex trauma is prevalent in many clients who seek mental health treatment, making it important for clinicians to be able to recognize symptoms and to offer relevant evidence-based and supported treatment and medication, if indicated.

The primary focus of the workshop is the treatment of CPTSD, with an emphasis on recent treatment guidance and innovations. We start by covering the recommendations of the major treatment guidelines (both clinical practice and professional practice) for PTSD as they apply to CPTSD. The presenter (with co-author Dr. Julian Ford) has recently developed a meta-model of CPTSD treatment entitled PRISM referring to trauma-informed and responsive treatment that is Personalized, Relational, Integrative, Sequenced/Strategic, and Multi-Modal/Multi-Dimensional as an update and supplement to the now classic Sequenced Relationship-Based Model outlined in their previous books. The PRISM meta-model will be presented in detail as it is intended to guide the clinician in the treatment of a diversity of clients each of whom have unique histories, contexts, and presentations to address. It will be integrated with and applied within the phases of the sequenced model. Current best practices in the treatment of complex traumatic stress disorders will be presented.

This workshop will further address common process issues, transition points, and crises that arise in the treatment of this population. Although no one-size-fits-all protocol is adequate to address the complexity of each such point in treatment, the reenactment of developmental trauma experiences and the emergence of a dissociative fragmentation of consciousness are two prominent dynamics. Two filmed psychotherapy session excerpts developed and archived on the Center for the Treatment of Developmental Trauma Disorders Identifying Critical Moments in Healing Complex Trauma webinar series (available at no cost on learn.nctsn.org) will be shown to demonstrate different approaches taken when clients experience developmental trauma reenactments and dissociation. The sessions were filmed as learning tools with real therapists and actors portraying the clients. They illustrate different paths that therapists can take in guiding clients through critical moments and crises in the treatment. These films provide the opportunity to reflect on elements of the PRISM model that are evident. They also serve as catalysts for discussion for reactions and emotions elicited in the viewer. The workshop will end with discussion of some of the challenges and satisfactions/posttraumatic growth for the therapist that are inherent in work with this population. 

Learning Objectives

At the completion of this workshop, attendees will be able to:

1. Describe differences between complex and other types of traumatic stressors.
2. Identify common developmental and posttraumatic consequences of complex trauma.
3. Describe the criteria for Complex PTSD in the ICD-11. 
4. Describe the primary elements of the PRISM acronym and the phases of the sequenced treatment model for CT.
5. Describe both countertransference and secondary traumatic stress reactions that psychotherapists often experience with complex trauma clients.

Reference Citations

• Cloitre, M. K., Courtois, C. A., Charuvastra, A., Carapezza, R., Stolbach, B. C., et al., … (2011). Treatment of complex PTSD: Results of the ISTSS expert clinician survey on best practices. Journal of Traumatic Stress, 24(6): 615-627.
• Courtois, C. A., & Ford, J. D. (2013). Treatment of complex trauma: A sequenced, relationship-based approach. Guilford.
• Ford, J. D. (2021). Crises in the psychotherapy session: Transforming critical moments into turning points. American Psychological Association.
• Ford, J. D., & Courtois, C. A. (Eds.). (2020). Treatment of complex traumatic stress disorders in adults (2nd Edition). Guilford.
• Ford, J. D., & Courtois, C. A. (2021). Complex PTSD and borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 8(1), 16. https://doi.org/10.1186/s40479-021-00155-9
• Zucchetto, J., Jacobs, S. & L. Vick Johnson. (2020). Understanding the paradox of surviving childhood trauma: Techniques for working with suicidality and dissociation. Routledge, Taylor & Francis Group.

About the Presenter: 

Christine A. Courtois, PhD, ABPP

My career has been devoted to the clinical care of adult survivors of childhood abuse and of other types of trauma and has closely followed the trajectory of the contemporary development of the field of traumatic stress studies. It began in 1971, when I co-founded and directed a campus rape crisis center at the University of Maryland in College Park (the first of its type in the country) and conducted original research on the aftermath of incestuous abuse for my dissertation in 1979. In 1988, I published my first book based on that research entitled, Healing the Incest Wound: Adult Survivors in Therapy, the first of a dozen clinical books I have authored or edited since then. Although not a permanent faculty member (I have had a number of adjunct appointments, up to the present), my work is academically and theoretically-based and is highly integrative of research findings to clinical applications. The primary focus of my work has been on complex forms of childhood developmental trauma, its consequences--across the lifespan but particularly in adults--and its treatment in settings such as a specialized in-patient and day hospital program, in my private practice, and as a consultant to addiction, rape crisis, and grief programs. I retired from my practice in Washington, DC after 35 years and am now semi-retired. I continue to remain professionally active however, pursuing many interests related to traumatic stress studies, including the provision of clinical consultation, forensic assessments and expert witness services, efforts to develop clinical and professional practice guidelines for trauma treatment, the development of a meta-model of treatment for complex trauma and its consequences, the inclusion of topics related to trauma into general education and professional and post-doctoral training curricula, and the development of a sub-specialty of trauma psychology through the American Psychological Association and the American Board of Professional Psychology. I also continue to develop and teach workshops on a wide variety of topics related to trauma and its treatment, including the challenges and rewards of this area of emphasis for the clinician and the maintenance of self-care and emotional health.