Applying TF-CBT for complex trauma: Phase-based treatmentSeveral authors recommend that youth with complex trauma respond best to phase-based treatment with an initial stabilization phase to provide coping skills, a trauma processing phase to understand personal trauma experiences, and a final integration phase to consolidate and generalize safety and trust (e.g., Ford et al., 2005; Ford & Cloitre, 2009). TF-CBT consists of several progressive components summarized by the acronym PRACTICE. As Figure 1 illustrates, these components are divided into three distinct phases that parallel the recommended phases for youth with complex trauma: an initial copingskills-building phase (stabilization phase); a second trauma narrative and processing phase (trauma processing phase) and a final treatment consolidation and closure phase (integration phase) (Murray, Cohen, Ellis, & Mannarino, 2008).Proportion and balance are important concepts in providing TF-CBT. Typically therapists dedicate approximately the same number of treatment sessions to each of the 3 TF-CBT treatment phases (i.e., 1/3 of sessions for coping skills; 1/3 for trauma narrative and processing; 1/3 for treatment consolidation and closure). However, youth with complex trauma have significant regulation problems in multiple domains and these are frequently compounded by challenges in establishing a consistent, trusting therapeutic relationship. Therefore the proportionality of treatment is modified to dedicate about half of the total TF- CBT treatment sessions to the coping skill building phase. The duration of TF-CBT treatment also often needs to be extended, from the typical 8-16 sessions to 25 sessions and occasionally up to 28-30 sessions assuming sessions of 50 minute duration.