Supervising Trauma Treatment: The Contextual Trauma Treatment Model Applied to Supervision

The recent publication of the American Psychological Association’s “Clinical Practice Guideline for the Treatment of PTSD in Adults” resulted in debates concerning multiple issues, among them, an overreliance on randomized controlled trials (RCT) to the exclusion of other research methods, the application of the guideline recommendations to clinical practice, generalizability, and whether cognitive-behavioral approaches are superior to other modalities for the treatment of posttraumatic stress disorder (PTSD) symptoms. The guideline not only has far-reaching implications for practice and research, but for training and education as well. Training is often quite limited regarding when and how to apply trauma-responsive intervention, whether evidence-based or evidence-informed, particularly when the presenting problems are more complex than are typically addressed by an RCT design. The Trauma Resolution and Integration Program, a training program specifically for the treatment of trauma based on the contextual trauma therapy (CTT) model, was developed at a university-based training clinic staffed entirely by doctoral psychology students. Central to this treatment approach is the observation that clients with PTSD and those with complex trauma histories suffer not only from trauma symptoms, but also from gaps and warps in their personal development that interfere with their ability to function effectively. We begin by delineating the principles undergirding the CTT model and their application to supervision. We also discuss how foundational training in trauma psychology and treatment modalities for PTSD, along with supervision, are essential, but often unavailable, components of the implementation of evidence-based and evidence-informed recommendations made in the available PTSD treatment guidelines