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A Review of: “Courtois, C. A., & Ford, Julian D. (Eds.). (2009). Treating Complex Traumatic Stress Disorders: An Evidence-Based Guide.”

Editors Courtois and Ford unite to provide a thorough, stimulating, and current text on treating a very challenging population of individuals with complex trauma. Courtois founded the Posttraumatic Disorders Program at the Psychiatric Institute of Washington (DC) and Co-Directed the Maryland Psychological Association’s Post Doctoral Institute on Psychological Trauma. She is joined by Ford, Associate Professor of Psychiatry at the University of Connecticut School of Medicine and Director of the University of Connecticut’s Health Center Child Trauma Clinic and Center for Trauma Response Recovery and Preparedness. Both have written extensively on this issue and, in this book, reached out to experts in this field to provide a variety of evidence-based approaches to conceptualize, assess, and manage—both pharmacologically and psychotherapeutically—Complex PTSD. Herman, who writes the Foreword, initially proposed the notion of Complex Posttraumatic Stress Disorder (Complex PTSD) in 1992. Complex PTSD emerges when trauma is extreme, prolonged, repeated, involving direct harm, neglect and=or abandonment, occurring during critical developmental stages such that there is a marked probability of compromising development of psychological integrity. The concept was promulgated to unify and make sense of the ‘‘bewildering array’’ of clinical presentations presented by survivors of such abuse, revolving around core areas of somatization, dissociation, and affect dysregulation. Herman couches the development of Complex PTSD as occurring within ‘‘a deranged social ecology’’ where the strong can do as they please, caretakers are blind to abuse (or themselves afraid to respond), and the targets and victims of abuse and neglect have no one to turn to for safety and protection. With this background, Herman believes that a therapeutic relationship based on trust and collaboration, rather than an authoritarian structure becomes most important, noting that current treatment approaches mostly rest upon a three level model of recovery. First, safety must be established, second the ‘‘story’’ of trauma must be faced and, finally, repair and establishment of positive social relationships must be developed. Complex PTSD is difficult to categorize as it combines elements of Anxiety Disorder, Dissociative Disorder, and Borderline=attachment-based Disorders. Interestingly, Child & Family Behavior Therapy, 32:70–81, 2010 Copyright # Taylor & Francis Group, LLC ISSN: 0731-7107 print=1545-228X online DOI: 10.1080/07317100903539980