Systemic and family therapy with socially disadvantaged children and young people with complex trauma

Young people who have experienced complex trauma are often under-reached by statutory therapeutic provisions. Systemic therapy has potential for these clients as many of their difficulties are systemic in nature but adaptations to practice can be beneficial in order to support engagement and enhance positive outcomes. I describe an approach based on several years of practice experience which includes using expressive and physical activities, attending to issues of power and difference, using non-clinical settings, providing long term attachment-informed therapy, combining family with individual work and adopting an integrative practice that combines systemic and other approaches. The paper illustrates this approach with reference to theoretical explanations, practice experience and case material. Practitioner points Systemic and family therapy with adaptations can be an effective intervention for socially disadvantaged young people with histories of complex trauma and their families Because of the complexity of both need and symptomology it may be helpful to synthesise elements of evidence-based practices (EBPs) which target particular symptomologies and also to use strategies that address the engagement difficulties often encountered with EBPs. Particular strategies that can aid engagement and therapeutic process include making available the option of non-verbal activities, providing therapy in school and at home, attending to attachment needs (including availability of long-term work and individual sessions for young people) and tailoring therapy to suit the particular needs of male, minority ethnic and working-class clients.