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Beyond PTSD

Helping and Healing Teens Exposed to Trauma

Edited by Ruth Gerson, M.D., and Patrick Heppell, Psy.D.
Foreword by Bruce D. Perry, M.D., Ph.D.

  • ISBN 978-1-61537-110-5
  • Item #37110

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Impulsivity, poor judgment, moodiness, risky behavior. You don't understand. I don't care. Whatever, bro. Engaging and working with teenagers is tough. Typically, we attribute this to the storms of adolescence. But what if some of the particularly problematic behaviors we see in teens – self-destructive behaviors, academic issues, substance abuse, reluctance to engage in therapy or treatment – point to unspoken trauma?

Teens nationwide struggle with traumatic stress related to poverty, abuse, neglect, bullying, traumatic loss, and interpersonal or community violence. But youth are also generally reluctant to disclose or discuss experiences of traumatic stress, and adults working with these youth may not immediately perceive the connection between prior trauma and the teen's current risky or concerning behavior. Beyond PTSD: Helping and Healing Teens Exposed to Trauma helps adults recognize and understand traumatized youth, and provides concrete strategies for talking to and engaging the teen, overcoming resistance, and finding the most appropriate evidence-based treatment approach for them.

Nearly twenty contributors pull from their extensive and varied experience working in schools and hospitals to child welfare programs, juvenile justice facilities, pediatric offices, and with families to provide concrete tips to manage the challenges and opportunities of working with trauma-exposed adolescents. Chapters present trauma-informed approaches to youth with aggression, suicide and self-injury, psychosis, and school refusal; youth with physical or developmental disabilities or medical comorbidities, those in juvenile justice or child welfare; teen parents; and LGBTQ youth, among others.

Throughout the text, tables compare different types of trauma therapies and provide information about how treatments might be adapted to fit a specific teen or setting. Readers will also find real life case vignettes and concrete, specific clinical pearls—even examples of language to use—to demonstrate how to work effectively with difficult-to-engage teens with complex symptoms and behaviors.

Written to be practical and accessible for clinicians, social workers, pediatricians, school counselors, and even parents, with the information, context, and strategies they need to help the teen in front of them.


  • Contributors
  • Foreword
  • Chapter 1. Teens and Traumatic Stress: A Toxic Combination
  • Chapter 2. Recognition and Treatment
  • Part 1: Working With Symptoms of Traumatic Stress
  • Chapter 3. Aggression
  • Chapter 4. Suicide and Self-Injury
  • Chapter 5. Risky Behavior and Substance Use
  • Chapter 6. School Refusal and Other Behavioral and Academic Problems at School
  • Chapter 7. Trauma and Psychosis
  • Chapter 8. Implications of Trauma For Sexual and Reproductive Health in Adolescence
  • Chapter 9. Trauma and Teens With Developmental and Physical Disabilities
  • Part 2: Working With Systems and Traumatic Stress
  • Chapter 10. Acute Psychiatric Services
  • Chapter 11. School Systems and Trauma
  • Chapter 12. Child Welfare and Juvenile Justice
  • Chapter 13. Medical Providers
  • Chapter 14. Families and Caregivers Caring for Teens Exposed to Traumatic Stress
  • Chapter 15. Advocacy and Systems Change: Making Services Work for Youth Exposed to Trauma and Their Families
  • Index


    Komal Bhasin
    Jennifer Cabrera, M.D.
    Gabrielle Carson, Ph.D.
    Sin Chu, M.D.
    Sophie de Figueiredo, Psy.D.
    Ruth Gerson, M.D.
    Fadi Haddad, M.D.
    Schuyler W. Henderson, M.D., M.P.H.
    Patrick Heppell, Psy.D.
    Aron Janssen, M.D.
    Jessica Linick, Ph.D.
    Rachel Mandel, M.D.
    Bruce D. Perry, M.D., Ph.D.
    Blake Phillips, M.D.
    Moises Rodriguez, Ph.D.
    Karen C. Rogers, Ph.D.
    Jeanette M. Scheid, M.D., Ph.D.
    J. Rebecca Weis, M.D.
    Jeremy A. Wernick, L.M.S.W.
    Alexis K. Yetwin, Ph.D.

About the Authors

Ruth Gerson, M.D., is Assistant Professor in the Department of Child and Adolescent Psychiatry and Associate Director of Child and Adolescent Telepsychiatry at NYU School of Medicine; and Director of the Children's Comprehensive Psychiatric Emergency Program at Bellevue Hospital in New York, New York.

Patrick Heppell, Psy.D., is Clinical Assistant Professor in the Department of Child and Adolescent Psychiatry at NYU School of Medicine in New York, New York.

This book can help mental health clinicians, pediatricians, educators, and parents to understand adolescent trauma. Realistic case examples illustrate the wide diversity of problems that traumatized teens may develop, and the value of evidence-based trauma-focused therapy, family support, and trauma-informed systems in helping traumatized teens to recover and regain a healthy developmental trajectory.—Judith A. Cohen, M.D., Professor of Psychiatry, Drexel University College of Medicine, Allegheny Health Network

Beyond PTSD: Helping and Healing Teens Exposed to Trauma speaks plainly to the issues of understanding trauma and how to treat it while demonstrating a deep sophisticated understanding of the subject. Therapists, social workers, parents, treatment foster parents, and other clinical and professional staff who work with children and teens will find this book informative and practical. Beyond PTSD offers professionals and parents a clear pathway to helping teens embrace both a sense of accountability for their trauma-influenced behavior and responsibility for making the appropriate choices to change that behavior. This book makes it clear that trauma-influenced behavior provides us insight into the impact that trauma has had on a person's decision making. It does not provide us with a definition of that person's character.—William C. Bell, Ph.D., President and CEO, Casey Family Programs

Rich in case examples, steeped in experience, informed by research, and graced with insight, Beyond PTSD goes blessedly beyond the behavioral and symptom-control approaches that characterize far too much of clinical practice in our time. Rather than asking, How do we change what you do, it inquires, What happened to you and how did that affect you? A valuable contribution to the literature on teenage suffering and healing, this book helps fill a gaping need in professional education and practice.—Gabor Mate, M.D., Author, In The Realm of Hungry Ghosts: Close Encounters With Addiction

This is a first-class compilation of accessible, compassionate and expert guidance on understanding and supporting traumatized young people and their families. Beyond PTSD provides a superb foundational understanding of the impact of trauma on adolescent development, detailed chapters addressing common specific challenging behaviors in traumatized youth and explicit strategies for the systems and settings these youth occupy to better help them. The rolling case-based approach in each chapter skillfully lays out the practical approaches to helping these young people overcome their challenges, making this work useful to a broad range of stakeholders, including clinicians, educational, child welfare and juvenile justice workers and families.—Jennifer F. Havens, M.D., Professor and Vice Chair, Department of Child and Adolescent Psychiatry, NYU Langone Medical Center

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