Cover Page......Page 2
Title Page......Page 5
Copyright......Page 6
Dedication......Page 8
Contents......Page 9
Contributors......Page 21
Foreword Robbie Dunton......Page 24
Preface......Page 29
Acknowledgments......Page 33
Chapter 1. EMDR Therapy, the Adaptive Information Processing Model, and Complex Trauma......Page 36
Childhood Complex Trauma and the Adaptive Information Processing Model......Page 38
Affective Neuroscience, AIP, and EMDR Therapy......Page 43
Polyvagal Theory, AIP, and EMDR Therapy......Page 46
The Windows of Tolerance and the Arousal Zones......Page 51
IPNB, AIP, and EMDR Therapy......Page 52
Attachment Theory, AIP, and EMDR Therapy......Page 53
Dissociation......Page 56
Liotti’s Etiological Model of Dissociation—Multiplicity of Ego States......Page 60
The Structural Dissociation Theory, EMDR Therapy, and AIP Model......Page 63
EMDR Therapy and the Neurosequential Model of Therapeutics......Page 67
A Typology for EMDR Therapy: Case Conceptualization......Page 68
Type 1 Cases......Page 69
Type 2 Cases......Page 70
Type 3 Cases......Page 71
Summary and Conclusions......Page 73
Chapter 2. Phase One: Client History and Treatment Planning......Page 75
Who Is Appropriate for EMDR Therapy?......Page 76
Level of Expertise of the Clinician......Page 77
Conducting the Intake Interview With the Caregiver......Page 78
The Use of the AAI in EMDR Therapy With Children and Their Parents......Page 88
Assessing the Strengths and Resources......Page 94
Targeting Sequence Treatment Plan Form......Page 95
Conducting the Intake Interview With the Child......Page 96
Creating the Complete Clinical Landscape......Page 99
Appendix: Parent’s Rating Scale......Page 102
Chapter 3. Phase Two: Preparation......Page 108
The Preparation Phase of EMDR Therapy and the Polyvagal Theory......Page 110
Accessing and Stimulating Different Systems During the Preparation Phase......Page 112
Talking to Children About Trauma......Page 115
Talking to Children About EMDR Therapy......Page 119
Explaining the Different Forms of Bilateral Stimulation......Page 120
Emphasizing Present Awareness......Page 121
Creating a Safe Place......Page 123
Calm–Safe–Happy Place Protocol......Page 125
When the Safe Place Does Not Exist......Page 128
Calm–Safe–Happy Activity......Page 129
Creating Containment......Page 133
The Cushion House......Page 134
The Helpers......Page 135
Imaginary Containers......Page 136
Developing Boundaries......Page 137
The Importance of Touch......Page 139
The Helping Luggage and the Trip Analogy......Page 140
The Harvest Analogy and Peritraumatic Resources......Page 142
The Survival Kit and the New Helping Kit......Page 145
Relational Resources......Page 146
Mastery Experiences and Acts of Triumph: Medals, Diplomas, and Trophies......Page 148
Using Nature as a Resource......Page 149
Animal-Assisted Therapy......Page 151
Preparing for the Potential Aftermath of EMDR Therapy Sessions......Page 152
Summary and Conclusions......Page 153
Chapter 4. The Skill-Building Phase and EMDR Games......Page 155
The Importance of Play......Page 156
Developing Cognitive Literacy......Page 160
Negative Cognitions–Positive Cognitions......Page 162
Using Positive Cognition Cubes......Page 164
Using Positive Cognition Cards......Page 165
Using Positive Cognition Balls and Bowling Pins......Page 166
Using Negative Cognition Cubes......Page 167
Using Negative Cognition Balls and Bowling Pins......Page 168
The Feeling Finder......Page 169
Using Feeling Cubes......Page 170
Developing Sensory Literacy......Page 172
Developing the Targeting Sequence With Children......Page 173
Using the Float Back and the Affect Scan With Children......Page 176
Using Drawings to Assist Children in Creating the Targeting Sequence......Page 177
The Memory Wand......Page 182
The “Bag of Mixed-Up Stuff”......Page 184
Time Lines......Page 186
Memory Detectors: Exploring Preverbal Memories......Page 188
The Story of a Hero: Once Upon a Time . . .......Page 190
Medals, Trophies, and Diplomas......Page 191
Things That Make Me Have Mixed-Up Thoughts and Feelings......Page 192
My Buttons......Page 193
Identifying Disturbing Events and Resources While Assessing Readiness for Trauma Processing......Page 194
Exploring Targets Associated With Parent–Child Interactions......Page 195
The “Heart Jar”......Page 198
Summary and Conclusions......Page 201
Chapter 5. Working With Parents and the Family System: The AIP Model and Attachment Theory......Page 202
The Mirror Analogy: Understanding Basic Principles of Attachment Theory and AIP......Page 213
The Thermostat Analogy: Understanding Regulation Theory Principles......Page 215
Teaching Parents How to Parent From the AIP and Attachment Perspective......Page 218
Level II—Self-Regulation......Page 219
Assisting Parents in Developing Attunement......Page 220
Developing Boundaries......Page 224
Boundary Exercises for Parents......Page 225
Developing Resources......Page 228
Level III—Memory Reprocessing and Integration......Page 231
Participation of Caregivers During the Child’s Sessions......Page 239
Summary and Conclusions......Page 242
Chapter 6. Assessing and Diagnosing Dissociation in Children: Beginning the Recovery......Page 244
Theoretical Developments and Conceptualization of Dissociation......Page 246
Assessment Process for Child and Adolescent Dissociation......Page 250
Core Dissociative Indicators and Case Description......Page 251
Amnesia......Page 254
Trance Behavior and Trance States or Self-States......Page 255
Extreme Mood and Behavior Switches......Page 257
Auditory and Visual Hallucinations......Page 258
Depersonalization and Derealization......Page 259
Assessment Tools......Page 260
Differential Diagnoses and Comorbidity......Page 262
Attention Deficit Hyperactive Disorder......Page 263
Bipolar Disorder......Page 264
Hallucinations, Psychosis, or Schizophrenia......Page 265
Components in the Interviewing Process......Page 267
Assessing the Family Environment......Page 268
History Gathering From the Parent Regarding Their Child......Page 269
List of Questions to Ask Parents......Page 270
Interviewing the Child......Page 271
Some Suggestive Questions to Ask the Youth......Page 274
Other Collateral Interviews and Collateral Reports......Page 276
Clinical Summary and Conclusions......Page 278
Chapter 7. Advanced Preparation Strategies for Dissociative Children......Page 280
Talking to Children About Dissociation......Page 281
The Rainbow Analogy......Page 283
The Dissociation Kit for Kids......Page 285
Tools to Explain, Maintain, and Restore Dual Awareness......Page 286
Tools to Assist Children in Exploring and Assessing Present Awareness......Page 287
Enhancing the Brain–Body Connection: Sensory-Focused EMDR Strategies......Page 293
Enhancing the Child’s Present Interoceptive Awareness......Page 294
Enhancing Kinesthetic Awareness: Muscle Talk......Page 296
Breathing and Grounding Exercises for Children......Page 297
Helping Children Reclaim Their Bodies......Page 298
Strategies With Young Children......Page 299
Strategies for School-Age Children......Page 300
When the Body Is Nonexistent......Page 303
Meeting the Body for the First Time......Page 304
Games to Develop and Stimulate Affect Regulation......Page 308
The “Memory-Visiting Muscle”......Page 309
Installation of Present Resolution (IPR)......Page 311
State-Change Installation......Page 314
State-Change Installation With Caregiver......Page 317
Constant Installation of Present Orientation and Safety......Page 318
Using the Dissociation Kit for Kids With the CIPOS Protocol......Page 319
Summary and Conclusions......Page 320
Chapter 8. Phase Three: Assessment......Page 322
Working With Children With Sensitized Sympathetic Systems......Page 325
Working With Children With Sensitized Parasympathetic Dorsal Vagal Systems......Page 326
Target Selection......Page 327
Accessing Preverbal Memories Through Current Triggers Using Time Lines, Memory Detectors, Life Stories, Internal Satellites, and Antennas......Page 329
Targeting Attachment Behaviors......Page 332
Working With Children With Avoidant Strategies......Page 333
Working With Children With Ambivalent Strategies......Page 335
Children With Disorganized Strategies......Page 337
Targeting Developmental Stages......Page 338
Diagramming and Outlining the Memory: Finding the Lost Treasure......Page 340
Layering the Memory......Page 342
The EMDR Kit for Kids......Page 343
The EMDR Team......Page 345
Using EMDR Therapy and Sandtray Therapy......Page 347
Assessment Phase Script......Page 352
Summary and Conclusions......Page 355
Chapter 9. Phase Four: Desensitization......Page 357
The Interweave......Page 359
Promoting Horizontal Integration: When We Can See the Parts and the Whole......Page 361
Promoting Vertical Integration......Page 364
Responsibility......Page 367
Safety......Page 370
Control/Power......Page 371
Child-Friendly Interweaves......Page 372
The Throw-Up Interweave......Page 373
The EMDR Advisors......Page 374
Using Illustrations......Page 376
Stimulating Mindfulness During Reprocessing......Page 379
Using Images and Stories Inspired From Nature: Animal and Plant Totems......Page 381
Putting It All Together: Creating the Child’s “Tools and Advisors”......Page 388
Inner-Self Helpers......Page 391
Using Objects and Devices to Promote Playfulness and Containment......Page 392
The Shy Blanket and the Invisible Hats......Page 393
Interweaves Using Storytelling......Page 396
Stimulating the Use of Nonverbal Communication Through the Use of Interweaves......Page 397
Using Drawings and Art......Page 398
Working With the Attachment System: Reparative Interweaves......Page 400
Reparative Interweaves With the Younger Self......Page 405
Cultural Issues......Page 409
Using Sandtray Therapy Strategies......Page 412
Standard Procedural Steps for the Desensitization Phase With Children......Page 414
Summary and Conclusions......Page 416
Chapter 10. Installation, Body Scan, Closure, Reevaluation, and the Future Template......Page 417
Phase Five: Installation......Page 418
Phase Seven: Closure......Page 422
Phase Eight: Reevaluation......Page 426
Resuming Reprocessing of an Unfinished Target......Page 430
Future Template......Page 431
Summary and Conclusions......Page 434
Chapter 11. EMDR Therapy and Sensorimotor Psychotherapy With Children......Page 435
Dysregulated Arousal, Animal Defenses, and the Brain......Page 437
Brief Introduction to Sensorimotor Psychotherapy......Page 442
The Adaptive Information Processing Model and Sensorimotor Psychotherapy......Page 443
Phase One: Client History and Treatment Planning......Page 447
Psychoeducation: The Triune Brain and the Alarm System......Page 449
Safe Place......Page 454
Developing Sensorimotor Awareness and Literacy......Page 456
Tracking......Page 457
Contact Statements......Page 459
Translating the Language of the Body......Page 460
Oscillation Techniques......Page 462
Boundaries......Page 463
Using Music......Page 466
Desensitization Phase......Page 468
Using Touch......Page 469
Creating Experiments......Page 471
Sensorimotor Sequencing......Page 473
Installation Phase......Page 474
Summary and Conclusions......Page 475
Chapter 12. Using EMDR Therapy and Theraplay......Page 477
What Is Theraplay?......Page 479
Theraplay Theory and Basic Principles......Page 480
Structure......Page 481
Engagement......Page 482
Nurture......Page 484
Challenge......Page 485
Core Concepts: Theraplay in Action......Page 486
Adaptations to Complex Trauma......Page 489
The AIP Model and Theraplay Principles......Page 491
EMDR Therapy and Theraplay: When and How......Page 494
Phase One: Client History and Treatment Planning......Page 495
Phase Two: Preparation......Page 497
EMDR Preparation Phase: Theraplay Sessions......Page 498
EMDR Preparation Phase: Theraplay Strategies With Parents......Page 499
Using Theraplay Activities as State Change Strategies......Page 503
Using Theraplay Activities as Interweaves to Heal the Attachment System......Page 504
Phase Five: Installation......Page 507
Phase Six: Body Scan......Page 508
Phase Seven: Closure......Page 509
Phase One: Client History and Treatment Planning......Page 510
Phase Two: Preparation......Page 512
Phases Three, Four, Five, and Six: Assessment, Desensitization, Installation, and Body Scan......Page 516
Summary and Conclusions......Page 517
Chapter 13. EMDR Therapy and the Use of Internal Family Systems Strategies With Children......Page 519
Overview of IFS: Basic Principles......Page 520
Second Assumption......Page 521
Third Assumption......Page 522
Step One: Create a Trusting Relationship Between the Client’s Self and Part......Page 525
Step Three: Retrieval......Page 528
Step Five: Invitation......Page 529
Step Six: Integration......Page 530
Incorporating Parents or Caregivers Into the Therapy......Page 531
The Adaptive Information Processing (AIP) Model and IFS Principles......Page 532
EMDR Therapy and IFS Psychotherapy With Children: Why, When, and How......Page 535
Accessing the Family System: Creative Strategies With Children......Page 537
Phase Three: Assessment......Page 541
Phase Four: Desensitization......Page 544
Phase Five: Installation......Page 547
Phase Six: Body Scan......Page 548
Phase Eight: Reevaluation......Page 549
Summary and Conclusions......Page 551
References......Page 553
Index......Page 576