Trauma and the Family

An analysis of family support or lack of family support as key protective and risk factors is reviewed. Specific aspects of family support is defined and research on how it impacts trauma as both a preventative measure and a central component of the healing process is provided. Research regarding lack of family support and the consequences to the trauma survivor is offered. A description of numerous types of family interactional patterns and they interfere with family support is outlined. Cross-cultural issues related to trauma and trauma treatment are addressed.

Overview of Integrative Family and Systems Treatment (I-FAST)

This chapter outlines integrative family and systems treatment (I-FAST). Theoretical and philosophical perspectives in which I-FAST is organized around are described. Treatment steps are outlined. Family assessment and goal setting procedures are described. How these procedures are used for in-session and between-session tasks, framing and reframing, and the use of questions as intervention procedures within I-FAST are described. The chapter also discusses how to integrate intervention procedures from any evidence-based trauma treatment into I-FAST and how I-FAST is culturally competent and consistent with trauma-informed care is discussed. Finally, a detailed case example showing the application of I-FAST is offered.

Intergenerational Trauma

Intergenerational trauma and subsequent impairment of trauma survivors parenting of their children is explored. How to engage these parents in integrative family and systems treatment (I-FAST) and how to simultaneously help with their parenting impairments and their trauma symptoms is described. Four cases are examined in detail, covering four types of treatment situations. In Cases 1 and 2, helping a trauma survivor parent when they are requesting help for their problem teenagers, but not for their trauma-related difficulties is described. In Case 3, helping a trauma survivor mother focus directly on resolving her trauma symptoms as a method for helping her seriously impaired daughter is described. In Case 4, focusing on serious dissociative symptoms of a mother, which only developed after the successful resolution of her son’s difficulties is described.

I-FAST Trauma and Frames

Cultural, family, and professional frames and narratives are identified and discussed as they pertain to trauma. How all of these types of frames and narratives can reinforce and exacerbate trauma symptoms is explored. How integrative family and systems treatment (I-FAST) utilizes strengths-based frames in working with trauma survivors and their families is described. Several case examples are outlined with family frames tracked and frames offered to set the stage for treatment.

Deciding Whom to Include in Treatment

This chapter explores the decision of who to include in treatment. In integrative family and systems treatment (I-FAST), this is a case-by-case decision that in and of itself is considered an intervention. Guidelines for making this decision are offered. Two special situations are examined in detail: whole-family interviews as they relate to trauma and family interviews that include both survivor and perpetrator in cases of intrafamilial sexual abuse. Criteria for when and when not to conduct these interviews, along with detailed steps are outlined. Several case examples are offered covering a wide range of issues related to who to include in treatment are given.

Trauma and Children

Trauma and children placed in foster care is examined. Statistics related to foster care placement, duration of stay, and number of disrupted placements are offered. How these factors exacerbate the problems of trauma survivors in the child welfare system is explored. A family to family approach is described. Several case examples are offered covering numerous treatment issues including how to stabilize at-risk foster placements, how to recruit and include biological family of children placed in foster care, and how to enlist therapeutic help from biological family members when their child is placed in foster care.

Overview of Trauma

An overview of issues related to trauma is offered. Freud’s influence, definitions of trauma and complex trauma, epidemiology, adverse childhood experience studies, neurobiological aspects of trauma, characteristics of trauma clients, trauma-informed care and its implications for treatment are all outlined and reviewed.

Trauma and Substance Abuse

Substance abuse and trauma are the topics of this chapter. The relationship between substance abuse and trauma histories, particularly intrafamilial sexual abuse, is examined. The application of integrative family and systems treatment (I-FAST) with two cases is described in detail. Both cases are examples of adult women who suffered serious intrafamilial sexual abuse, were not supported by their mothers, and subsequently developed serious substance abuse problems. In both cases, their mothers were included in the treatment. Support from their mothers regarding the sexual abuse was finally obtained. In both cases, repairing the mother–daughter relationship resulted in total amelioration of both trauma and substance abuse problems.

I-FAST Intervention for Trauma

Integrative family and systems treatment (I-FAST) family intervention procedures are described in this chapter. How to integrate intervention procedures from any trauma-related treatment approach into I-FAST is shown. How to organize a family treatment approach when trauma symptoms are the direct focus of treatment is described. When survivors and or families request help on problems other than trauma, how to indirectly address trauma symptoms on a family treatment level is outlined. Several case examples showing how to focus on trauma both directly and indirectly are offered.

Trauma and Interactional Patterns

Family interactional patterns that interfere with the resolution of trauma symptoms are identified in detail. Two types of patterns are described: how family are habitually responding to trauma symptoms and how the family was structured before traumatic events occurred and their respective impact on trauma. Several case examples are offered with one or both types of patterns identified in each case.