Treating Traumatic Stress in Children and Adolescents, First Edition

Margaret E. Blaustein, PhD, is a practicing clinical psychologist whose career has focused on the understanding and treatment of complex childhood trauma and its sequelae. With an emphasis on the importance of understanding the child-, family-, and provider-in-context, her study has focused on identification and translation of key principles of intervention across treatment settings, building from the foundational theories of childhood development, attachment, and traumatic stress. With Kristine Kinniburgh, Dr. Blaustein is codeveloper of the Attachment, Self-Regulation, and Competency treatment framework. She has provided extensive training and consultation to providers and consumers within the United States, Canada, and Europe. She is currently the Director of Training and Education at The Trauma Center at Justice Resource Institute in Brookline, Massachusetts, and is actively involved in local, regional, and national collaborative groups dedicated to the empathic, respectful, and effective provision of services to this population. Kristine M. Kinniburgh, LICSW, is the former Director of Child and Adolescent Services at The Trauma Center at Justice Resource Institute in Brookline, Massachusetts. She is currently a practicing clinical social worker and organizational consultant, working with agencies to integrate trauma-informed and trauma-specific practices into all facets of service delivery. Over the past 15 years Ms. Kinniburgh has dedicated her practice to work with children and families affected by trauma in a range of settings including outpatient clinics, schools, residential programs and hospitals. Her clinical experience, broad in scope, inspired her to explore and subsequently identify core components of trauma-informed intervention that can be implemented in the array of treatment settings serving this population. Ms. Kinniburgh is the originator and codeveloper of the Attachment, Self-Regulation, and Competency treatment framework and is currently training and consulting on this framework with agencies across the United States and abroad.

Introduction

I. Overview

1. The Developmental Impact of Trauma

2. Child Development, the Human Danger Response, and Adaptation: A Three-Part Model for Understanding Child Behaviors

3. The Attachment, Self-Regulation, and Competency Treatment Framework

II. Attachment

4. Caregiver Management of Affect

5. Attunement

6. Consistent Caregiver Response

7. Building Routines and Rituals

Beyond Attachment: The Role of the Caregiving System in Building and Supporting Regulation and Competency

III. Self-Regulation

8. Affect Identification

9. Modulation

10. Affect Expression

IV. Competency

11. Strengthening Executive Functions

12. Self-Development and Identity

V. Integration

13. Trauma Experience Integration

A Postscript

Appendix A. Provider Materials

Appendix B. Caregiver Educational Materials and Worksheets

Appendix C. Group Activities

Appendix D. Youth Educational Handouts and Worksheets

Appendix E. Milieu-Systems Materials

Additional Resources