How to use this manual

The authors have designed this manual to be utilized in many settings and modalities, by therapists from various disciplines, and at any frequency of session scheduling to facilitate use by the broadest range of therapists and clients. Research on implementation suggests that evidence-based interventions need to be adapted to the particular needs of a clinical population and setting to be maximally effective. Clinicians may share the impact that a part of a session has had on them or otherwise disclose their experience in the here and now. In the face of troubled emotions and the impulse to avoid, clients may employ “strategies of disconnection,” which may involve withdrawal, anger, or displays of emotional dysregulation. This treatment focuses on emotions and experiences that are by definition difficult for clients to tolerate, and clinicians may also have strong reactions to this process.