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Integrative Treatment of Complex Trauma for Children (ITCT-C)


Delivery Approach:
  • Individual
  • Group
  • Individual & Group
  • Dyadic
Delivery Format:
  • In-Person
  • Virtual
  • Hybrid
Provider Requirements:
  • Licensed/Certified Professional Led
Type of Experience Addressed:
  • Domestic Violence
  • Child Abuse 
  • Sexual Abuse
  • Community Violence
  • Neglect 
  • Family Separation
  • Substance Abusing Caregiver 
  • Natural Disasters 
  • Grief/Bereavement 
  • Refugee/Immigration
  • Reunification
  • Medical Trauma
  • Homelessness
  • Verbal/Emotional abuse
  • Mental Health Issues/Concerns
  • Historical trauma
  • Homophobia/Transphobia
  • Trafficking
Engagement Methods:
  • Talk-based
  • Arts-Based
  • Experiential
  • Play-based
Level of Intervention:
  • Tertiary Prevention
  • Intervention
  • Greater than 12 weeks
  • School
  • Home 
  • Hospital-based
  • Residential 
  • Correctional
  • Homeless Shelter
  • Family service agencies
  • Health Services 
  • Foster Care 
  • Mental Health Setting
Program Details:
Type of services provided:

Integrative Treatment of Complex Trauma for Children (ITCT-C) is an assessment-driven, multimodal treatment for children from diverse backgrounds experiencing complex trauma. ITCT-C was specifically developed to be responsive and sensitive to cultural differences and the effects of poverty and social marginalization. Assessment occurs at 2-3-month intervals to identify symptoms and issues requiring focused clinical attention. ITCT-C uses multiple treatment modalities including:

  • Relational/attachment-oriented
  • Cognitive therapy
  • Exposure therapy
  • Play therapy
  • Mindfulness skills development
  • Affect regulation training
  • Trigger management
  • Psychoeducation in individual and group therapy

Collateral and family therapy approaches are integrated into treatment as needed. ITCT-C is relationally-based and incorporates specific approaches for complex trauma including elements of the Self Trauma model, attachment theory, cognitive behavioral approaches, and family systems theory. Current trauma-related concerns such as safety, anxiety, depression and post-traumatic stress are addressed as early in treatment as possible to increase the client’s capacity to explore more chronic and complex trauma issues. Complex trauma concerns, including attachment problems, chronic negative relational scheme, behavioral and affect dysregulation, interpersonal difficulties and identity-related challenges are addressed as they arise. The impact of insecure caregiver-child attachment relationships relative to magnifying the effects of traumatic experiences is integral to ITCT-C clinical formulations and interventions. Disparities and inequities associated with poverty and cultural/racial injustices are also considered potential sources of trauma for the child and family, and addressed through advocacy and collaboration with community agencies.

Program setting:

Outpatient clinic, school, hospital, inpatient and forensic; appropriate for children in the foster care system, the juvenile justice system and residential treatment; involves collaboration with multiple community agencies.

Length of program/number of sessions:

16-36 sessions; the length of ITCT-C can be longer or shorter depending on the needs of the individual and family as determined by periodic assessment.

Type(s) of trauma/concerns addressed:

Complex trauma, intimate partner violence, physical abuse, sexual abuse, emotional abuse and neglect, medical trauma, traumatic loss, parental substance abuse.

Education level of providers:

Mental health clinician

Unique/Innovative Characteristics:
  • ITCT-C is designed to meet the complex and individualized needs of traumatized children and their families. ITCT has also been adapted and expanded for adolescents and is profiled on the website: for the University of Southern California Adolescent Training Center). Many treatment guides, assessment and intervention tools, and other resources can be downloaded free-of-charge.
  • Culturally inclusive, client-oriented intervention that is specifically adapted for children who are economically disadvantaged and socially marginalized
  • Designated as a trauma-informed, culturally competent intervention by the National Child Traumatic Stress Network (NCTSN) in 2017.
  • ITCT-C and ITCT-A (adolescent version) are supported by empirical evidence published in 2016.

Date Added/Updated:


Population Served

  • 6-12 (Childhood)
  • 13-17 (Adolescent)
  • 18-25 (Young Adult)
  • 25 and Up (Adult)
Population Language:
  • English
  • Spanish
Ethnic Racial Group:
  • Asian
  • Black or African American
  • Hispanic or Latino
  • Indigenous People – American Indian/Native American, Alaskan Native
  • Native Hawaiian or other Pacific Islander
  • White
  • Child and Non-abusive Parent/Caregiver
  • Child
  • Family
  • Grandparents
  • Survivor parent
  • Foster/Adoptive Parents
Population Adaptations:
Age range of children served:

5 to 12 years of age; ITCT-C has been implemented in outpatient clinics,residential and hospital settins, and school settings with elementary and middle school students

Are parent/adult caregiver(s) included in intervention?

Yes; parenting groups are offered in two phases during the intervention. The first phase helps parents understand the effects of trauma on their children, trauma-informed parenting practices and dealing with other co-occurring issues such as intimate partner violence and community violence. The second phase delves more deeply into personal issues and parents understanding their own history of trauma. Caregivers attend regular collateral sessions to support their child’s treatment and frequently, also attend family therapy sessions.

Ethnic/racial and other groups served:

Hispanic-Americans, African-Americans, Caucasian Americans, Asian-Americans, unaccompanied minors from Central America and Mexico throughout the U.S.; ITCT-C has also been implemented in Australia, Canada, Scotland, and Sweden.

Specific cultural adaptations:

Adapted for Spanish-speakers; particularly adapted for economically disadvantaged and culturally diverse clients in inner city environments; ITCT-C has been adapted for children and families in rural settings.

Languages that service/resource is available:

English, Spanish


Goals of the program/services: 

Not Specified

Evaluation Studies:
Has there been any evaluation?


Key evaluation results:

A pilot study was conducted with 151 ethnically diverse (25% Hispanic; 14% Black or African American, 13% Asian or other, 14% non-Hispanic White) children living in an economically deprived inner-city environment. Records were reviewed for 151 consecutive clients at a specialized child trauma center. There was no comparison group. The mean age of children in the study was 11.43 years old. Child had been referred to the treatment center by parents, clinics, other agencies, schools and service providers. Trauma symptoms were measured with the Trauma Symptom Checklist for Children (TSCC).

The change in pre-post scores on the TSCC demonstrated significant reductions in children’s anxiety, depression and posttraumatic stress. There were also reductions, of a lesser magnitude, in children’s anger, dissociation and sexual issues. The decreases in children’s symptoms was dose-dependent; the longer a child received the intervention, the greater the reduction in symptoms.

Lanktree C.B., Briere J., Godbout N., Hodges M., Chen K., Trimm L., Adams B., Maida C.A. & Freed W. (2012). Treating multi-traumatized, socially marginalized children: results of a naturalistic treatment outcome study. Journal of Aggression, Maltreatment & Trauma, 21, 813-828.

Other Publications:

Lanktree C.B. & Briere J.N. (2016). Treating complex trauma in children and their families: An integrative approach. Thousand Oaks, CA: Sage.

Lanktree C.B. & Briere J.N. (2013). Integrative treatment of complex trauma (ITCT) for children and adolescents. In J.D. Ford and C.A. Courtois, Treating complex traumatic stress disorders with children and adolescents: An evidence-based guide (pp.143-161). NY; Guilford.

Training & Resources

Training Language
  • English
Training Available:
  • Yes
Training Details:
Training manuals/protocols:


Training Costs:

$3000 for one-day training (plus travel expenses or technological support as needed); $6000 for two-day training (plus travel or technological support); virtual follow-up consultations are available at $325 per hour.

Training Contact:

Cheryl Lanktree, Ph.D.

Program Contact

Cheryl Lanktree
(213) 701-1149