This article delineates the key role that empathy in the context of relationalbased healing plays in enabling severely abused/traumatized children to break their silence to talk about horrific experiences that had rendered them voiceless. A case example involving an adolescent boy who had been severely traumatized is provided.

This article expands an earlier model of the tasks of grieving (1990, [1995], [2001]) by building on science based findings derived from research in attachment theory, neuroscience, interpersonal neurobiology, and childhood traumatic grief (CTG). The proposed treatment model is a prescriptive approach that spells out specific tasks to be undertaken by children suffering traumatic grief under the direction of a therapist who is trained in trauma-informed therapy approaches and draws heavily on the empirically derived childhood traumatic grief treatment model developed by Cohen and Mannarino (2004; Cohen, Mannarino, & Deblinger, 2006). This model expands on their work by proposing specific tasks that are informed by attachment theory research and the interpersonal neurobiological research (Schore, 2003a, 2003b; Siegel, 1999). Particular emphasis is placed on developing a coherent and meaningful narrative since this has been found as a crucial factor in recovery from trauma in attachment research (Siegel, 1999; Siegel & Hartzell, 2003).

Cohen and Mannarino (2004) define childhood traumatic grief (CTG) as "a condition in which trauma symptoms impinge on children's ability to negotiate the normal grieving process" (p. 819). Brown and Goodman (2005) add further clarification, "According to our current understanding of CTG and normal grief, thoughts and images of a traumatic nature are so terrifying, horrific, and anxiety provoking that they cause the child to avoid and shut out these thoughts and images that would be comforting reminders of the person who died. In contrast, a child who does not have intrusive reminders, or who did not experience the death as traumatic, is able to access the person in memory in a manner that is positive and beneficial to integrating the death in his or her total life experience" (pp. 255, 257). The distressing and intrusive images, reminders, and thoughts of the traumatic circumstances of the death, along with the physiological hyperarousal associated with such re-experiencing, prevent the child from proceeding in a healthy way with the grieving process. In addition, while such children are ordinarily excluded from studies of empirically validated treatment studies because of severity and co-morbidity of their conditions, clinicians often see youngsters where traumatic death has been superimposed on a history of multiple losses and in some cases socio-cultural trauma and/or major psychiatric disorders in the child or family. The projective drawing and storytelling strategies and the evocative technique described in this article are intended to offer clinicians additional tools to deal with such seriously impacted youth so that the trauma work can be approached in the relative safety of symbolism and metaphor prior to directly confronting the trauma events.The grief of children and adolescents can be facilitated when the clinician structures the therapeutic context to enable them to express the varied, intense, and often confusing emotions of grief. A significant portion of young children will find 239 Ó 2005, Baywood Publishing Co., Inc.

Therapeutic presence occupies a prominent place in the study of depth psychotherapy with adults but has received minimal attention in play therapy. The exceptions are the humanistic psychologists Virginia Axline, Clark Moustakas, and Garry Landreth, all of whom were influenced by the person-centered theory of Carl Rogers. In his writings, Rogers not only emphasized the importance of the therapeutic relationship but also did groundbreaking research that made the therapist's warmth, empathy, and genuineness cornerstones of the therapeutic relationship. In an interview later in his career, Rogers suggested that therapeutic presence may capture all three of these essential components of the therapeutic relationship. In this article, the concept of therapeutic presence is reviewed along with case studies illustrating its importance.

Courtrooms in the United States whether family court or criminal court fall far short of being either developmentally or trauma sensitive. While there is growing recognition that vulnerable child witnesses are at risk of retraumatization by court procedures and some judges have used their discretionary powers to render courtrooms less toxic to children, the system was designed by adults for adults, and certainly not for children. The court process especially in criminal trials does not typically take into account the developmental constraints of children nor do they fully understand trauma in children and the risks to testifying child witnesses. Humanistic psychology has long stood for social justice and compassion toward our most vulnerable humans, especially children, but the long and slow-to-change traditions of the court system in the United States creates an environment that is inhospitable to children and even older victims as illustrated by the low rate of prosecutions in rape cases. This article outlines the distressing conditions that await child victims/witnesses in this country in comparison with other developed countries and an innovative, out-of-the box solution that does not interfere with the rights of the accused.