Integrative Treatment of Complex Trauma (ITCT)

Domain VI · Brief, integrative, trauma, hypnosis & coaching · John Briere, Cheryl Lanktree

What it is

ITCT-A has no fixed phases. Components are chosen and sequenced from repeated ratings of the client's problems. The stage labels below are an organising frame; the rules inside each stage are from the guide.

Format

• Format and dose
• Individual therapy: one 50–60 min session a week as standard; a minority need more than one a week.

Who practises it, and how they are trained or regulated

• Goals: psychoeducation, distress reduction and affect regulation (grounding, relaxation, breath training, visualisation, emotion identification), optional mindfulness, and trigger identification (Trigger Grid).
• Move to processing when: the client can regulate enough not to be overwhelmed. Clients with weak affect regulation should not approach especially upsetting memories until regulation improves; if overshooting is frequent, spend several sessions on affect regulation and cognitive work before resuming.
• Version followed: ITCT-A (Integrative Treatment of Complex Trauma for Adolescents), Treatment Guide 2nd edition (Briere & Lanktree, 2013), as published free online by the USC Adolescent Trauma Training Center (ATTC, Keck School of Medicine, NCTSN site; PDF revision dated 2015-09-01 and the web chapters). The child version, ITCT-C (Lanktree & Briere; book Treating Complex Trauma in Children and Their Families, 2017),…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• keep sessions problem-solving rather than complaint-focused.
• basic needs often must be met before psychological work moves.
• working when the youth names feelings earlier and more precisely, before acting.
• handouts given without discussion do little; some books trigger youth who are not ready.
• do not demand abstinence before trust exists; escalating self-injury requires the safety steps in 4.6.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.