Trauma-Focused Presence

The purpose of this article is to capture and illuminate a trauma-focused presence in psychotherapy treatment. The goal is to highlight an integrative approach that centers on the trauma survivor’s battle with freedom and limitation. Both the expansive and the constrictive tendencies of many traumatized clients are exemplified, focusing on the dichotomous or polarized positions that clients present. Key factors of evidence-based therapeutic relationships that can guide therapist stances and engagement efforts are explored. This approach moves away from an overemphasis on and strict adherence to the medical model framework and toward a contextual standard grounded in a humanistic blanket and characterized by a person-centered and relationally driven therapeutic approach. The trauma therapist chiefly fosters engagement and makes space or pathways for an assortment of therapeutic interventions that are congruent with the client’s theory of change and take shape organically. Developing intrapersonal and interpersonal presence are primary focal points that correlate with the importance of personal and interactive processes in successful psychotherapy outcome research. Meaning making is at the core of a trauma-focused presence and takes place through client and therapist dialogue.

Goals and psychotherapy research

This chapter, ‘Goals and psychotherapy research’, examines goals in psychotherapy as they relate to clinical outcomes by surveying the extant research. Following a brief discussion of the importance of goals for personal development, the chapter focuses on research concerning the collaborative relationship between client and psychotherapist in goal-setting and effecting psychotherapy tasks to meet therapy goals, with particular emphasis on the client-therapist collaborative-outcome relationship. Next, the chapter reviews goal-psychotherapy outcome research for both adult and child/adolescent clients. The research presented is interpreted using clinical examples. The chapter closes with conclusions gleaned from the research reviewed followed by suggestions for practitioners.