Vliegen, Nicole; Midgley, Nick; Tang, Eileen; Luyten, Patrick; Fonagy, Peter; (2025) A three-track, psychodynamic treatment approach for children who have experienced complex trauma. Journal of Child Psychotherapy 10.1080/0075417x.2025.2482646. (In press).

Text Fonagy_Draft Complex Trauma 11 2024 Resubm nm.pdf Access restricted to UCL open access staff until 14 April 2026. Download (867kB)

Abstract

Complex trauma involves severe and pervasive events such as abuse or profound neglect, in which there is usually a lack of a ‘safe haven’ for the young child, as their caregivers may be unavailable and/or a source of threat and danger. The impact of complex traumatic experiences on the child’s social, emotional and behavioural development is complex and pervasive, and burdens the mentalizing capacities of parents and other caregivers. In this paper, we propose a three-track approach to treat these children and their environment, in which direct psychotherapeutic work with the child goes hand in hand with a mentalization-based parent and network approach. In describing the case of Michael and his foster parents, we hope to show how complex trauma impacts the child’s development as well as the parents’ and network’s mentalizing capabilities, and illustrate what the three-track model can look like. We hope that our treatment guide can be of interest to child psychotherapists as well as to other mental health professionals, given the challenges of working with this group of children. In this regard, we have attempted to explain and frame relevant psychoanalytic concepts in concise and accessible language.

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