Child Maltreatment: Creating Therapeutic Alliances with Survivors of Relational Trauma

  • Valentín Escudero
  • Myrna L. Friedlander
Part of the Focused Issues in Family Therapy book series (FIFT)


Perhaps one of the major challenges for creating a solid therapeutic relationship occurs when a child has experienced maltreatment (abuse, abandonment, or severe neglect), particularly when the maltreatment is at the hands of the child’s parents or other caregivers. In this chapter we consider the therapeutic context when there is “relational trauma,” that is, with a child whose experience of being cared for or helped has turned into maltreatment, thereby deeply affecting his/her levels of self-confidence and trust in adults. In cases like these, simply offering therapy (like any other type of help or care) can provoke the child’s fear, shame, and/or mistrust. The chapter describes specific strategies for creating a therapeutic environment of safety for the child to encourage him or her to accept the care and protective relationship of other, non-abusive adults (including foster, adoptive, or kin family). The client empowerment strategy is based on an analysis of what we call a vicious cycle of emotion management difficulties and negative identity, a common dynamic in cases of relational trauma. Key alliance-fostering interventions are described, including adapting to the client’s attachment style, avoiding an amplification of denial, and building a context of safety to facilitate emotional connection. The extended case example includes excerpts of therapy session dialogue to illustrate the primary issues for creating alliances with a young girl and her mother (both of whom were abused by the father) who were referred by child protective services and begin therapy with a highly negative attitude and strong denial of abuse.


Relational trauma Child maltreatment Denial and dissociation Resilience Family reattachment Threats to safety Emotion management difficulty Negative identity 


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Valentín Escudero
    • 1
  • Myrna L. Friedlander
    • 2
  1. 1.University of A CoruñaA CoruñaSpain
  2. 2.University at Albany/SUNYAlbanyUSA

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