Enhancing Engagement and Treatment Efficacy in Youth and Families with Persistent Trauma Exposure.

Emerging research highlights important distinctions in symptomatology between Posttraumatic Stress Disorder (PTSD) resulting from a single, discrete event, complex interpersonal traumas in the past, and the pervasive effects of chronic, ongoing complex trauma. Despite these well-documented differences, much of the existing practice and professional guidelines for PTSD-focused interventions apply a uniform framework across the distinct clinical presentations resulting from different types and timing of trauma exposure. This gap carries significant clinical consequences, as individuals may be treated for PTSD and comorbid diagnoses or behavioral difficulties without recognition of the impact of persistent ongoing exposure to trauma. The present article is a clinical applications paper that directly builds upon a prior published theoretical and empirical literature review study that introduces the construct of persistent trauma. The objectives are to (1) examine the effects of persistent trauma; (2) explore four types of persistent trauma exposure differentiated by the predictability and preventability of past and current trauma; and (3) offer intervention strategies tailored to each type of persistent trauma. Using a composite case study methodology, we present intervention strategies to inform treatment for children and families who continue to experience each form of persistent trauma.