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Child Maltreatment: Creating Therapeutic Alliances with Survivors of Relational Trauma

  • Valentín Escudero
  • Myrna L. Friedlander
Chapter
Part of the Focused Issues in Family Therapy book series (FIFT)

Abstract

Perhaps one of the major challenges for creating a solid therapeutic relationship occurs when a child has experienced maltreatment (abuse, abandonment, or severe neglect), particularly when the maltreatment is at the hands of the child’s parents or other caregivers. In this chapter we consider the therapeutic context when there is “relational trauma,” that is, with a child whose experience of being cared for or helped has turned into maltreatment, thereby deeply affecting his/her levels of self-confidence and trust in adults. In cases like these, simply offering therapy (like any other type of help or care) can provoke the child’s fear, shame, and/or mistrust. The chapter describes specific strategies for creating a therapeutic environment of safety for the child to encourage him or her to accept the care and protective relationship of other, non-abusive adults (including foster, adoptive, or kin family). The client empowerment strategy is based on an analysis of what we call a vicious cycle of emotion management difficulties and negative identity, a common dynamic in cases of relational trauma. Key alliance-fostering interventions are described, including adapting to the client’s attachment style, avoiding an amplification of denial, and building a context of safety to facilitate emotional connection. The extended case example includes excerpts of therapy session dialogue to illustrate the primary issues for creating alliances with a young girl and her mother (both of whom were abused by the father) who were referred by child protective services and begin therapy with a highly negative attitude and strong denial of abuse.

Keywords

Relational trauma Child maltreatment Denial and dissociation Resilience Family reattachment Threats to safety Emotion management difficulty Negative identity 

References

  1. Castonguay, L., & Hill, C. E. (Eds.). (2011). Transformation in psychotherapy: Corrective experiences across cognitive behavioral, humanistic, and psychodynamic approaches. Washington, DC: American Psychological Association.Google Scholar
  2. Diamond, G. S., Diamond, G. M., & Levy, S. A. (2014). Attachment Based Family Therapy for depressed adolescents. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  3. Escudero, V. (2013). Guía Práctica de la Intervención Familiar II. Intervención en contextos cronificados o de especial dificultad. Junta de Castilla y León.Google Scholar
  4. Flaskerud, J. H. (1990). Matching client and therapist ethnicity, language and gender: A review of research. Issues in Mental Health Nursing, 11, 321–336.CrossRefPubMedGoogle Scholar
  5. Friedlander, M. L., Escudero, V., & Heatherington, L. (2006). Therapeutic alliances with couples and families: An empirically-informed guide to practice. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  6. Johnston, J. R. (1990). Role diffusion and role reversal: Structural variation in divorced families and children’s functioning. Family Relations, 39, 405–413.CrossRefGoogle Scholar
  7. Miller, A. (1981). The drama of the gifted child. New York: Basic Books.Google Scholar
  8. Rivett, M., & Street, E. (2009). Family therapy: 100 key techniques. London: Routledge.Google Scholar
  9. Sheinberg, M. (1992). Navigating treatment impasses at the disclosure of incest: Combining ideas from feminism and social constructionism. Family Process, 31, 201–216.CrossRefPubMedGoogle Scholar
  10. Sheinberg, M., True, F., & Fraenkel, P. (1994). Treating the sexually abused child: A recursive, multimodal program. Family Process, 33, 263–276.CrossRefPubMedGoogle Scholar
  11. Sheinberg, M., & Fraenkel, P. (2001). The relational trauma of incest: A family-based approach to treatment. New York: Guilford Press.Google Scholar
  12. Sheinberg, M., & True, F. (2008). Treating family relational trauma: A recursive process using a decision dialogue. Family Process, 47, 173–195.CrossRefPubMedGoogle Scholar
  13. Van der Kolk, B. A. (2005). Developmental trauma disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35, 401–408.CrossRefGoogle Scholar
  14. Van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. New York: Viking.Google Scholar
  15. Walsh, F. (2017). Strengthening family resilience (3rd ed.). New York: Guilford Press.Google Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Valentín Escudero
    • 1
  • Myrna L. Friedlander
    • 2
  1. 1.University of A CoruñaA CoruñaSpain
  2. 2.University at Albany/SUNYAlbanyUSA

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