This text is designed to demystify the complex challenges that clinicians face when working with vulnerable young people who have faced significant interpersonal, prolonged or repetitive trauma; as well as the impact on their development. The text goes beyond specific trauma models, providing a unifying conceptualization of complex traumatic stress disorders, their development and presenting features, before directing the reader to specific clinical recommendations.

Over recent years significant advances have been made in our understanding of the impact of complex trauma on brain development and the associated disruptions to typical social, cognitive, affective and self-regulation. There is an advancing evidence base for a range of therapeutic models that target these mechanisms; however, the field has often remained disparate, with unique terminology used to describe common concepts. Clinicians face a challenge in identifying at which point and using which mode to intervene. Furthermore, the question of how one engages a young person whose relationships with others have been fraught with betrayal, neglect, inconsistencies and epistemic mistrust, whose emotions are dysregulated and whose underlying concept of self has been shattered is complex.

As the chapters unfold, the reader is led through a developmental, biological and social construction of complex trauma. The core disruptions to attachment and cognitive, biological, social and emotional regulation are described, with a clear focus on the latest empirical evidence base.

The text is comprised of three parts. Part 1 presents the developmental and clinical picture of complex trauma. The first three chapters focus on developing a narrative around the links between relational trauma, development and the brain. Chapters 3 and 4 describe the clinical complexity relating to working with young people whose interpersonal relationships have involved betrayal and cumulative trauma. Chapters 5 and 6 complete the picture describing the translational evidence base and focus the reader on an integrative model of assessment and diagnosis. Chapter 7 provides an integrative approach to assessment and diagnosis that supports the identification of key mechanisms and idiosyncratic formulation.

Part II, Chapters 8–12 describe five individual psychotherapeutic models of treatment. Cognitive behavioural approaches such as Dialectical Behaviour Therapy and Trauma Focused-Cognitive Behavioural Therapy sit comfortably alongside neuro-sequential models. In the final part, chapters 13–18 consider systemic approaches to treatment including both family and care systems models and a consideration of organizational culture. An overview of the components of each treatment model is given, and techniques are demonstrated through case examples, and therapeutic transcripts. The concluding chapter delivers an excellent summary and re-asserts the important message that early and repetitive trauma fundamentally alters biological functioning that is essential to typical development, emotional and social regulation, and an integrated sense of self.

The reader is offered an evidence-based conceptualization, directed to specific areas of clinical focus (e.g. betrayal) and introduced to a range of options for therapeutic delivery. The goal is to assist the clinician to overcome the therapeutic challenges involved in engaging children that can be otherwise unreachable. What this text offers is a both a framework, and hope.

One omission from this text is the consideration of the impact of unusual experiences, such as voices, paranoid thoughts that often feature in those with complex trauma. There is little consideration of the process of disclosure, the trauma of the justice process and the impact on an individual's sense of self and therapeutic roles during this time.

The text is written for clinicians, researchers and training health professionals. The summaries are accessible and complex and the text may be of interest to those new to the field, as well as providing an update suggesting new techniques to the experienced clinician. I would thoroughly recommend this book.