By: Joan M. Cook. Vanessa Simiola, Elana Newman, and Richard Thompson
Psychological trauma and its consequences have been recognized by multiple agencies as a significant concern requiring specialized training for mental health professionals working with survivors (Institute of Medicine, 2014; Substance Abuse and Mental Health Services Administration, 2014). However, despite recent advances and the broad scope of knowledge about traumatic stress, most psychologists appear to have only a cursory understanding of this area (Cook, Dinnen, Rehman, Bufka & Courtois, 2011; DePrince, & Newman, 2011). This is not surprising because trauma is not typically covered in the standard curricula in graduate level education in psychology (Champion, Shipman, Bonner, Hensley, & Howe, 2003; Courtois & Gold, 2009).
In order to identify minimal expectations for training a trauma-informed mental health workforce, 60 experts participated in a national consensus conference delineating broad competencies in the areas of trauma-focused and trauma-informed knowledge, skills, and attitudes (Cook, Newman, & the New Haven Trauma Competency Group, 2014). The resulting comprehensive descriptive model of empirically-informed trauma competencies, dubbed the New Haven Competencies, have been approved by the American Psychological Association (APA) as part of their official policy as guidelines for education and training for practice in the United States (APA, 2015). Although it would be helpful for educators to develop training curricula based on the consensus competencies, it is first important to determine agreed upon sources of information for this endeavor. Previous examinations of authors and specific articles and books that influence the fields of psychology and psychotherapy have been conducted (e.g., Cook, Biyanova, & Coyne, 2009; Heesacker, Heppner, & Rogers, 1982; Heyduk & Fenigstein, 1984; Smith, 1982; Wehmeyer, & Wehmeyer, 1999). However to date, none of these investigations were specific to prominent resources in the traumatic stress field.
Recent assessment of information regarding one type of traumatic experience, child maltreatment, in abnormal psychology and introductory psychology textbooks found that most had inaccuracies, inconsistencies and/or overemphasized sensational and controversial topics (Kissee, Isaacson, & Miller-Perrin, 2014; Wilgus, Packer, Lile-King, Miller-Perrin, & Brand, 2016). It is unclear if this is the case for other forms of traumatic exposure or in books for graduate level or continuing education. Carello and Butler (2014) argued the need for trauma-informed practices in the education of trauma across higher education in both clinical and non-clinical courses. Indeed, when exploring ways in which trauma material was presented within various curricula, Carello and Butler (2014) uncovered how non-trauma informed books might result in both retraumatization and secondary traumatization of students. Previous survey research indicates that practicing psychotherapists are influenced by books considerably more so than peer-reviewed empirical research articles (Beutler, Williams & Wakefield, 1993; Cook, Schnurr, Biyanova, & Coyne, 2009); thus, it seems important to understand how books influence training and education practice as they are the cornerstones to teaching.
This study had two specific aims. The first was to survey published traumatic stress experts to ascertain their top recommended books and resources across five mental health competency domains (i.e. scientific knowledge about trauma; psychological trauma-focused assessment; trauma-focused psychological interventions; trauma-informed professionalism; trauma-informed relational and systems). The second was to ascertain if there were sociodemographic and practice setting differences in endorsement of top books. Information gathered in this study can be used to assist mental health professionals and trainees expand their knowledge of trauma mental health issues through shared knowledge of experts in the field.
Participants and Procedure
Published traumatic stress experts were invited to participate in a survey to help inform the development of trauma competencies in five domains: scientific knowledge, psychosocial assessment, psychosocial intervention, professionalism, and relational and systems (Cook et al., 2014). At the end of the survey, participants were specifically asked to answer a set of questions giving their top three recommendations of reading material within each domain. These results regarding top book and resource suggestions are presented here.
Membership lists of the International Society for Traumatic Stress Studies (ISTSS) and APA’s Division (56) of Trauma Psychology were obtained. Bibliographic literature searches were conducted on each member using PsychInfo and PubMed. Publication of at least five peer-reviewed publications was used as a proxy for expertise in traumatic stress. Up to three email requests were sent to 376 members of ISTSS and/or Division 56. In addition, all 60 conference participants were sent multiple requests to participate.
In total, 217 experts responded to the survey. Of these, 162 people completed the entire survey and 58 completed a portion of the survey. Only 106 (48.8%) provided any responses to the question on recommended books or resources. These 106 are the focus of this brief report.
One purpose of the survey was to generate a list of recommended readings and other resources for practitioners who were interested in building or augmenting competencies in trauma mental health. Specifically, the survey item read, “Please list the most important book or resource for each of the following competencies: Scientific knowledge about trauma, psychological trauma-focused assessment, trauma-focused psychological intervention, trauma informed professionalism, and trauma-informed relational and systems.”
There were no significant differences between those who provided recommendations and those who did not based on demographic or professional variables, with one exception. Those who provided recommendations were significantly younger than those who did not, t(213) = 2.37, p = .02. The sociodemographic information on the sample is provided in Table 1. As can be seen, the sample was predominantly female, psychologists, and had academic doctoral degrees. More than half of the sample currently worked in academic settings.
In total, 696 books or resources were recommended by the participants. The mean number of endorsements per title was 2.1 and the median and mode were 1. However, only seven different books and one website was recommended by at least ten percent of the sample. The domains where resources were most often recommended were scientific knowledge and psychosocial intervention (n = 202, each). As can be seen in Table 2, two books were recommended by more than a 30% of the recommending sample: Friedman, Keane, and Resick’s (2007) Handbook of PTSD: Science and Practice and Foa, Keane, Friedman, and Cohen’s (2009) Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies. These were predominantly in the domains of scientific knowledge and psychosocial intervention, respectively. Only one website was widely recommended in the domains of scientific knowledge and psychosocial assessment, the Department of Veterans Affairs’ National Center for PTSD. With the exception of the books listed in Table 2, there was limited overlap in recommendations.
The relationships between professional characteristics and recommendations are presented in Table 3. Time since degree awarded was inversely related to the likelihood of recommending Handbook of PTSD, Effective Treatments for PTSD, and Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences-Therapist Guide. There was no relationship between highest professional degree and recommendations. No professional characteristics were related to recommendations of Herman’s (1997) Trauma and Recovery or the National Center for PTSD website.
The goal of this paper was to report on the top trauma mental health books and resources based on the recommendation of experts in traumatic stress. Three recommendations were made within the domains of scientific knowledge and psychosocial intervention and two for psychosocial assessment. Given the available research supporting the influence of books on psychotherapists’ knowledge (Beutler et al., 1993; Cook et al., 2009), this list may be used to help professionals increase their training in trauma psychology. Indeed, in a sample of over 2,400 North American psychotherapists, books were one of the most influential factors on one’s current practice (Cook et al., 2009). Thus, one way to increase availability of trauma training is to create and disseminate information about evidence-informed trauma mental health books.
A few investigations have examined the content of available trauma resources used for training and education of trauma psychology. For example, Wilgus and colleagues (2016) reviewed ten undergraduate abnormal psychology textbooks to determine the coverage of child maltreatment and found that the majority lacked key information on child maltreatment, overly focused on controversies and did not present information consistent with available research findings. In another review of introductory psychology textbooks, Letourneau and Lewis (2009) found similar results in that most textbooks reviewed made unsupported claims or overgeneralizations when discussing memory issues related to childhood sexual assault, and less than half covered prevalence rates and psychological consequences to childhood sexual assault. Finally, a third study examined undergraduate and graduate level coursework in trauma and concluded that students are being misinformed regarding many important issues in psychology (Gleaves, 2007). Namely, much of the undergraduate coursework on childhood sexual abuse focuses on false memories, rather than the lifetime effects of abuse, such that graduate students have become trained to respond first with disbelief towards clients.
One way to rectify the potential misinformation about trauma available in undergraduate and graduate coursework such as these is to use evidence-informed knowledge when teaching about trauma. While there was great diversity in many of the recommendations made by participants in the current study, there was also consensus by over ten percent of the sample regarding a handful of books and resources.
The number of citations a resource receives is widely accepted as an objective measure of the impact and potential quality of the material (Garfield, 1972). Although the list of resources compiled in this study were not determined based on the number of citations in published works, the same principles were applied. Participants in this study were identified through their affiliation with one of two professional trauma organizations, suggesting expertise or interest in traumatic stress studies. Out of the 696 recommended resources only those that were endorsed by at least ten percent of the sample were retained and presented here.
In a discussion of her development of a specialized graduate course in trauma, Newman (2011) noted that she uses three primary texts: Trauma and Recovery (Herman, 1992); Handbook of PTSD: Science and Practice (Friedman et al., 2007); and Principles of Trauma Therapy (Briere & Scott, 2006). Two of these were also identified by the trauma experts in this sample.
Two of the recommended readings concerned EBPs for PTSD: PE and CPT. Most mental health providers (such as psychologists, psychiatrists, and social workers) do not have formal training in, and do not utilize, evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD) regularly, if at all (e.g., Gray, Elhai, & Schmidt, 2007; Sprang et al., 2008). Encouraging the review of these books may help providers recognize the importance of these EBPs.
Given that training in trauma at the graduate level is inconsistent, disseminating resources such as this list of top resources identified by traumatic stress experts, can help improve standardization of training materials. Educators and clinicians can use information presented here to increase trauma-informed practices in both classroom and clinical settings.
American Psychological Association. (2015). Guidelines on Trauma Competencies for
Education and Training. Retrieved from: http://www.apa.org/ed/resources/trauma-competencies-training.pdf
Beutler, L. E., Williams, R. E., & Wakefield, P. J. (1993). Obstacles to disseminating applied psychological science. Journal of Applied and Preventive Psychology, 2, 53-58.
Carello, J., & Butler, L. D. (2014). Potentially perilous pedagogies: Teaching trauma is not the
same as trauma-informed teaching. Journal of Trauma & Dissociation, 15, 153-168.
Champion, K. M., Shipman, K., Bonner, B. L., Hensley, L., & Howe, A. C. (2003). Child
maltreatment training in doctoral programs in clinical, counseling and school psychology: Where do we go from here? Child Maltreatment, 8, 211-217.
Cook, J. M., Biyanova, T., & Coyne, J. C. (2009). Influential psychotherapy figures, authors and
books: An internet survey of over 2,000 practitioners. Psychotherapy: Theory, Research, Practice, and Training, 46, 42-51.
Cook, J. M., Dinnen, S., Rehman, O., Bufka, L., & Courtois, C. (2011). Responses of a sample
of practicing psychologists to questions about clinical work with trauma and interest in specialized training. Psychological Trauma: Theory, Research, Practice, and Policy, 3, 253-257.
Cook, J. M., Newman, E., & the New Haven Trauma Competency Group. (2014). A
consensus statement on trauma mental health: The New Haven Competency Conference process and major findings. Psychological Trauma: Theory, Research, Practice and Policy, 6, 300-307.
Cook, J. M., Schnurr, P., Biyanova, T., & Coyne, J. C. (2009). Apples don’t fall far from the
trees: An internet survey of influences on psychotherapists’ adoption and sustained use of new therapies. Psychiatric Services, 60, 671-676.
Courtois, C. A., & Gold, S. N. (2009). The need for inclusion of psychological trauma in the
professional curriculum: A call to action. Psychological Trauma: Theory, Research, Practice, and Policy, 1, 3-23.
DePrince, A., & Newman, E. (2011). Special issue editorial: The art and science of trauma-focused training and education. Psychological Trauma: Theory, Research, Practice, and Policy, 3, 213-214.
Garfield, E. (1972). Citation analysis as a tool in journal evaluation. Science, 178, 471–479.
Gleaves, D. H. (2007). What are students learning about trauma, memory, and dissociation?
Journal of Trauma & Dissociation, 8, 1–5. doi: 10.1300/J229v08n04_01
Gray, M. J., Elhai, J. D., & Schmidt, L. O. (2007). Trauma professionals’ attitudes toward
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Heyduk, R. G., & Fenigstein, A. (1984). Influential works and authors in psychology: A survey
of eminent psychologists. American Psychologist, 39, 556-559.
Heesacker, M., Heppner, P., & Rogers, M. (1982). Classics and emerging classics in counseling
psychology. Journal of Counseling Psychology, 29, 400-405.
Institute of Medicine. (2014). Treatment for posttraumatic stress disorder in military and veteran
populations: Final assessment. Washington, DC: The National Academies Press.
Kissee, J. L., Isaacson, L. J., & Miller-Perrin, C. (2014). An analysis of child maltreatment
content in introductory psychology textbooks. Journal of Aggression, Maltreatment & Trauma, 23, 215-228. doi: 10.1080/10926771.2014.878891
Letourneau, E. J., & Lewis, T. C. (1999). The portrayal of child sexual assault in introductory
psychology textbooks. Teaching of Psychology, 26, 253–258. doi: 10.1207/S15328023TOP260402
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the behavioral health of the nation 2015-2018. Rockville, MD: Author.
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Table 1. Demographics of Traumatic Stress Experts Surveyed
(N = 217)
|Outpatient psychiatric/Mental health care||27||12.5|
|Years in clinical practice||20.20||11.62|
a Participants were able to provide more than one response.
Table 2. Top Resources
| Friedman, M. J., Keane, T. M., & Resick, P. (Eds.). (2007). Handbook of PTSD:
Science and practice. Guilford Press.
National Center for PTSD [www.ptsd.va.gov] including PILOTS database
Herman, J. L. (1997). Trauma and recovery: The aftermath of violence-from domestic
abuse to political terror. New York: Basic Books.
Wilson, J. J. P., & Keane, T. M. (2004). Assessing psychological trauma and PTSD.
New York: The Guilford Press.
National Center for PTSD [www.ptsd.va.gov]
Foa, Keane, Friedman, & Cohen. (2009). Effective treatments for PTSD: Practice
guidelines from the International Society for Traumatic Stress Studies. New York,
NY: Guilford Publication.
Foa, E., Hembree, E., & Rothbaum, B. O. (2007). Prolonged exposure therapy for
PTSD: Emotional processing of traumatic experiences therapist guide. New York,
NY: Oxford University Press.
Resick, P. A., & Schnicke, M. (1993). Cognitive processing therapy for rape victims: A
treatment manual (Vol. 4). Thousand Oaks, CA: SAGE Publications, Incorporated.
Table 3 Differences between Experts’ Recommendations Based on Sociodemographic Characteristics
Time Since Degree
Highest Degree Ph.D.
|Friedman, M. J., Keane, T. M., & Resick, P. (Eds.). (2007).
Handbook of PTSD: Science and practice. Guilford Press.
|17.79 (10.12)||23.90 (12.77)||2.42*||87.9% (29)||84.9% (62)||0.16|
|National Center for PTSD [www.ptsd.va.gov] including
|19.64 (10.35)||22.34 (12.57)||0.76||85.7% (12)||85.9% (79)||0.00|
|Herman, J. L. (1997). Trauma and recovery: The aftermath of
violence-from domestic abuse to political terror. New York:
|25.85 (9.96)||21.43 (12.53)||1.21||84.6% (11)||86.0% (80)||0.02|
|Wilson, J. J. P., & Keane, T. M. (2004). Assessing
psychological trauma and PTSD. New York: The Guilford
|21.95 (10.93)||21.99 (12.65)||0.01||90.0% (18)||84.9% (73)||0.35|
|National Center for PTSD [www.ncpstd.org]||20.00 (11.07)||22.34 (12.52)||0.70||93.8% (15)||84.4% (76)||0.97|
|Foa, Keane, Friedman, & Cohen. (2009). Effective treatments
for PTSD: Practice guidelines from the International Society
for Traumatic Stress Studies. New York, NY: Guilford
|18.27 (9.61)||23.68 (13.05)||2.13*||87.9% (29)||84.9% (62)||0.16|
|Foa, E., Hembree, E., & Rothbaum, B. O. (2007). Prolonged
exposure therapy for PTSD: Emotional processing of
traumatic experiences therapist guide. New York, NY:
Oxford University Press.
|15.43 (10.40)||23.82 (12.21)||3.00*||87.0% (20)||85.5% (71)||0.03|
|Resick, P. A., & Schnicke, M. (1993). Cognitive
processing therapy for rape victims: A treatment
manual (Vol. 4). Thousand Oaks, CA: SAGE
|17.00 (10.63)||23.01 (12.41)||1.91||88.9% (16)||85.2% (75)||0.17|
Joan Cook, PhD is an Associate Professor in the Yale School of Medicine, was a member of the American Psychological Association (APA) Guideline Development Panel for PTSD and was the 2016 President of APA’s Division of Trauma Psychology.
Vanessa Simiola, PsyD, is currently completing her post-doctoral residency at VA Pacific Islands Healthcare System and the National Center for PTSD. She is affiliated with Yale University and her interests are evidence based care for posttraumatic stress disorder (PTSD) and dissemination and implementation research. In addition, Vanessa has committed to advancing the practice of trauma psychology by investing in trauma-specific training and competencies through her involvement in the development of the New Haven Trauma Competencies as well as two national studies of trauma training at the doctoral and internship level. She served as the Hospitality Suite Chair for Division 56 in 2016 and is Co-Chairing the Division 56 Task Force on Developing Web-Based Trauma Psychology Resources. Vanessa has also been an active member of the International Society for Traumatic Stress Studies and served on the Membership Committee for two years.
Elana Newman, PhD, is the McFarlin Professor of Psychology at the University of Tulsa and has conducted research on a variety of topics regarding the psychological and physical response to traumatic life events, assessment of PTSD in children and adults, journalism and trauma, and understanding the impact of participating in trauma-related research from the trauma survivor’s perspective.
Richard Thompson, PhD is an Assistant Professor of Pediatrics at the Texas Children’s Hospital, in the Public Health Pediatrics section. He has published more than 100 articles on trauma outcomes and correlates in vulnerable populations, as well as on access to mental health services.