Complex trauma therapy in the treatment of psychosis: toward an integrative approach

An increasing number of studies have demonstrated that there is a high incidence of childhood trauma and posttraumatic stress disorder (PTSD) in individuals with schizophrenia, yet established treatments for psychosis do not address trauma. Recently, there has been an increasing emphasis on incorporating trauma treatment into care for schizophrenia. Despite heightened awareness of the need, there is little information available detailing an effective treatment strategy specifically tailored to this population. To address this need, a phase-oriented individual psychotherapy model is proposed that integrates Courtois and Ford’s (2013) relationship based model, widely recognized as the gold-standard treatment for the treatment of complex trauma, with interpersonal psychodynamic treatment for schizophrenia. The theoretical rationale for the choice of models and their integration are provided along with the historical development leading to the creation of each model. The proposed integrated model is designed for an outpatient population of individuals with psychosis and complex PTSD and is broken down into three general phases. Broadly, Phase I addresses safety, stabilization, and engagement, Phase II focuses on psychosis specific and trauma specific processing, and Phase III involves the consolidation of treatment gains and preparation for treatment termination. Following the outline of the model, a theoretical study is proposed to evaluate the effectiveness of this model in a population of individuals with first episode psychosis and complex PTSD, as compared to two control groups.Psy.D.Includes bibliographical reference