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Book Review: Trauma systems therapy for children and teens

In this follow-up and revision of Collaborative Treatment of Traumatized Children and Teens: The Trauma Systems Therapy Approach (Saxe, Ellis, & Kaplow, 2007), Saxe, Ellis, and Brown deliver a comprehensive book on trauma systems therapy (TST) and guide readers through how to apply and integrate this approach when working with children, teens, and families impacted by trauma. Children and teens are part of the current society that seems to deal with trauma at every turn. Counselors, social workers, psychologists, and psychiatrists are on the front lines with teachers and medical providers when it comes to addressing the systemic and multifaceted issues of trauma in a child and teen’s world. This text connects the various entities that come into contact with a child or teen that has experienced suffering. Specifically, this text details TST for working with and supporting children, teens, and families coping with dynamic challenges rooted in traumatic stress. Saxe, Ellis, and Brown provide an intervention model in TST that addresses the needs of children in a practical and comprehensive, yet focused and intensive way. The authors make sure to account for the realities of being a provider working in trauma care. Specifically, TST is designed to be adapted to various organizations or providers using the approach with the goal of providing care to children with trauma histories and traumatic lives. According to the authors, TST is both a model for treatment and a model for organizations implementing TST. There is no one-size-fits-all approach to trauma and thus, TST involves many interventions from emotional regulation, skill building advocacy, and even psychopharmacology. TST is a focused, effective, and dynamic approach. The text is organized and practical, using four case studies throughout to illustrate many of the principles of TST. In using these case studies, the authors share the aspects of TST that assist in regulating emotions. Also, with case study examples, the authors elaborate on how TST addresses the social environment and services that are not helping the traumatized child. The book is divided into four parts: foundations (Chapters 2–5), getting started (Chapters 6–8), doing trauma systems therapy (Chapters 9–15), and improving trauma systems therapy (Chapters 16–18). In Part 1, foundations, the basics of trauma and the systems linked to trauma are detailed. In these foundation chapters, the reader is educated on brain processes and traumatic stress, survival and the regulation of survival as it relates to traumatic stress, the social environment and services systems that respond to trauma, and finally, the importance of a safe and caring relationship for children whom have experienced or are experiencing trauma. Part 2 of the text is the reader’s opportunity to get started on the guiding principles of TST. The chapters in part to educate readers on treatment principles, building a multidisciplinary treatment team, and how to organize a TST program. Part 3 of the text explains in great detail how to do TST. Specifically, in this part of the book, readers are instructed on assessment, treatment planning, engagement, safety focus, regulation-focused treatment, future planning, and integrating psychopharmacology into TST. Finally, in Part 4, authors Saxe, Ellis, and Brown include several chapters on how to improve TST. New to this edition, Section 4 provides information on the wide appeal of TST and extends the possible use of TST to nontrauma-related issues. In addition, the appendices include 100 pages of practical, reproducible, and downloadable forms, guides, and exercises for service providers to use. The strength of this text is that it is clinician friendly. Information on assessment and treatment using TST is rich and practical. Clinicians who work with survivors of trauma will experience validation when reading this text, knowing that the authors get what it means to work with traumatized children. Another strength of this particular edition is the chapter on organizational planning. Providing comprehensive integrated care and navigating the many obstacles of trauma treatment can be daunting, but this text provides a practical road map for organizations and service providers to follow. The positive tenant of “doing whatever it takes to leave a better system” is felt throughout the text. Insofar as the authors propose the possibility of using TST in nontrauma-related issues. The hallmark of this text is that TST is an outstanding approach and usable therapy for trauma in children and adolescents. The hope and possibility are that more clinicians will take a systemic perspective when addressing problems, we all might face be it trauma or otherwise.