The impact of early trauma on response to psychotherapy

The primary thesis of this paper is that most patients who have experienced sexual abuse or early loss of a parent are optimally treated with psychotherapy as a core component of their treatment, though pharmacotherapy is often also required. We briefly review the prevalence and clinical sequelae of early sexual abuse and parental loss. Then, we present an overview of a biopsychosocial model that can inform and guide clinical practice and serve as a heuristic framework for clinical research. We review the extant outcome studies with a focus on controlled clinical trials. We conclude with some practical clinical suggestions based on our experiences with treatment that combines psychotherapy and pharmacotherapy for patients who have suffered from complex clinical syndromes secondary to abuse and parental loss during critical developmental periods of their lives. (C) 2005 Association for Research in Nervous and Mental Disease. Published by Elsevier B.V. All rights reserved.