Guidelines for Treatment of Complex Trauma

In 2012, The Last Frontier: Practice Guidelines for Treatment of Complex Trauma and Trauma-Informed Care and Service Delivery were released by the Sydney-based organisation ‘Blue Knot Foundation’ (formerly Adults Surviving Child Abuse; ASCA). Prior to their release, guidelines for trauma related to ‘single-incident’ trauma (i.e. post-traumatic stress disorder; PTSD) rather than to cumulative, underlying and interpersonally generated trauma which is actually more common. The ASCA Practice Guidelines for Treatment of Complex Trauma… have received wide national and international endorsement from experts in the complex trauma field.

As co-author of these Guidelines, I had the privilege of presenting them by invitation at the 29th Annual Conference of the International Society for the Study of Trauma and Dissociation (ISSTD) in Long Beach, California. A week later, on October 29 2012, they were launched in the Australian Federal Parliament by Federal Minister for Mental Health Mark Butler. Subsequent state launches of the ASCA Practice Guidelines followed in 2013.

The Blue Knot Practice Guidelines for Treatment of Complex Trauma… comprise two sets of guidelines. The first is clinical (i.e. for one-to-one therapy/treatment of complex trauma) and the second set of guidelines is organisational (i.e. non-clinical, for services which are accessed by people with unresolved, and often unrecognised, trauma histories). While designed in the first instance for the sector of mental health, the organisational guidelines can be adapted and tailored to the full range of diverse service-settings (e.g. employment agencies and legal services) society-wide.

Federal launch of The Last Frontier: Practice Guidelines for Treatment
of Complex Trauma and Trauma Informed Care and Service Delivery

Adults Surviving Child Abuse (ASCA) 29 October 2012

Implementation of both sets of guidelines would have major implications not only for clinical treatment but for the way in which all human service-delivery is provided. Here it is important to note that the second set of (‘organisational’) guidelines do not address the clinical treatment of trauma, and do not presume any specialist knowledge of trauma. Rather, they are designed to assist organisations to avoid the compounding of prior trauma in their clients by becoming ‘trauma-informed’.

Major principles of trauma-informed practice are attentiveness to the way in which service is delivered (i.e. not just what the service is) and to the question of what has happened to a person, rather than what is ‘wrong’ with a person (Jennings, 2004; Fallot & Harris, 2009). This means attentiveness to all protocols, procedures and interactions with respect to the possibility of unresolved trauma in the lives of clients. ‘Trauma-informed’ service-delivery is ‘win-win’. This is because it not only minimises the potential for stress which can be destabilising for clients, but also assists staff well-being.

In my current role at Blue Knot, I am directly involved in research and program development of exciting workshops and trainings in trauma-informed practice.

  • Contact Blue Knot for information about trauma-informed trainings tailored to your organisation’s needs (how to implement trauma-informed principles at various levels within respective service settings)  (02) 8920 3611
    Blue Knot also offers free short-term professional counselling telephone support (1300 657 380) for adults who experience the effects of childhood (complex) trauma
  • In my private capacity I am available for counselling and consultation  with respect to complex trauma and the principles of trauma-informed practice

Queensland Launch of the ASCA Practice Guidelines

Queensland launch of the ASCA Practice Guidelines by Health Minister Lawrence Springborg 29 May 2013

The Last Frontier

Download free of charge at

‘It’s a brilliant document and a wonderful summation of the important insights that have emerged from neuro-science and psychotherapy…it’s hard to fault the text’

Jan Resnick    Senior Psychotherapist, WA

‘It is with great pleasure that I endorse your guidelines. What an achievement – congratulations!’

Christine A. Courtois, PhD, ABPP Washington, DC