Ten Foundations for Safe Trauma Therapy

These Ten Foundations for Safe Trauma defined by Babette Rothschild are principles that are pinned to the side of my desk and at the front of my work folder.

1. First and foremost: Establish reliable safety and stabilization for the client within and outside the therapy (i.e.,

   in the client’s daily life).

2. Develop good contact between therapist and client as a prerequisite to applying any techniques — even if that

   takes months or years.

3. Client and therapist must be confident in applying the "brake" before they use the "accelerator." That means the

   client must be in control of symptoms, including dissociation.

4. Identify and build on the client's internal and external resources.

5. Regard defenses as resources. Never "get rid of" coping strategies/defenses; instead, strengthen and create more

   choices.

6. View the trauma system as a "pressure cooker." Always work to reduce — never to increase — the pressure.

7. Adapt the therapy to the client, rather than expecting the client to adapt to the therapy. This requires that the

   therapist be familiar with several theory and treatment models.

8. Have a broad knowledge of theory — both psychology and physiology of trauma and PTSD. This reduces

   errors and allows the therapist to create techniques tailored to a particular client's needs.

9. Regard the client with his/her individual differences, and do not judge her for non-compliance or failure of an

   intervention. Never expect one intervention to have the same result with two clients.

10. The therapist must be prepared, at times — or even for a whole course of therapy —, to lay aside any and all

    techniques and just talk with the client.

Source: Rothschild, B. (2000). The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment. New York: W.W. Norton.