From leading authority John Briere, this book provides a comprehensive treatment approach for survivors of childhood trauma who numb or avoid emotional distress by engaging in substance abuse, risky sexual activities, self-injury, suicidality, bingeing and purging, or other self-harming behaviors. Briere shows how to help clients identify and manage the triggers of these "distress-reducing behaviors," learn to regulate intrusive emotional states, and safely process trauma- and attachment-related memories. Emphasizing the therapeutic relationship, Briere's approach draws on elements of psychodynamic, interpersonal, and cognitive-behavioral therapy; mindfulness training; and dialectical behavior therapy. The book combines cutting-edge clinical and experimental research with clearly described interventions, case examples, and reproducible handouts and forms. Purchasers get access to a Web page where they can download and print the reproducible materials in a convenient 8 1/2" x 11" size.

John Briere, PhD, is Professor of Psychiatry and Behavioral Sciences at the Keck School of Medicine, University of Southern California (USC); Director of the USC Adolescent Trauma Training Center of the National Child Traumatic Stress Network; and Remote Program Faculty at the Institute for Meditation and Psychotherapy. Past president of the International Society for Traumatic Stress Studies (ISTSS), Dr. Briere is a recipient of the Award for Outstanding Contributions to the Science of Trauma Psychology from Division 56 of the American Psychological Association and the Robert S. Laufer Memorial Award for Scientific Achievement from ISTSS, among other honors. At USC, he teaches and consults in the burn center, inpatient psychiatry, and emergency services. He lectures internationally on trauma, therapy, and mindfulness.

Introduction
1. Reactive Avoidance and Risky Behavior
2. An Overview of Specific Distress Reduction Behaviors
3. Key Treatment Recommendations
4. Assessing Distress Reduction Behaviors in Context
5. Safety, Stabilization, and Harm Reduction
6. Acceptance and Mindfulness
7. Trigger Management
8. Processing Trauma- and Attachment-Related Memories
9. Treatment Planning and Implementation: Bringing It All Together
10. Special Considerations for Certain Distress Reduction Behaviors and Patterns
Conclusion
Appendix 1. Breathing Exercises
Appendix 2. Review of Distress Reduction Behaviors (Rev-DRB)
Appendix 3. Trigger Review (TR)
Appendix 4. Functions of Distress Reduction Behaviors (F-DRB)
Appendix 5. Triggers-to-Memories Worksheet (TMW)
Appendix 6. In-Session Emotional Regulation and Activation Scale (ERAS)
Appendix 7. ReGAIN for Triggered States
References
Index