This article reviews the existing literature on the potential advantages and drawbacks of therapy that is conducted when the clinician and client are not sitting in the same room. Specifically, forms of psychotherapy that are conducted via the telephone, e-mail, and video chat are addressed. As different researchers have reported contradictory findings on this topic, and the laws and policies that govern these types of therapy interactions are still being developed, it is suggested that clinicians use extra caution when providing treatment through these media.

Public Significance StatementUnfortunately, most mental health providers receive little systematic training in assessing and treating trauma-related difficulties as part of their routine training, despite the extensive need for it. This article provides guidance on the development, implementation, and evaluation of graduate trauma courses and professional certification programs that could be created to systematically train clinicians in treating trauma.

There is a shortage of clinicians who have been trained in treating traumatized clients, despite the high prevalence of trauma exposure and its frequent link with psychopathology. To address this need, professional guidelines and resources have been developed, including a core set of trauma competencies that professionals must develop to provide trauma-informed services to clients and several treatment guidelines. We discuss The New Haven Competencies for Trauma Training and Practice, then review recently developed clinical and professional practice guidelines, with an emphasis on the American Psychological Association (APA)'s Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD; "APA PTSD Guideline"). The APA PTSD Guideline was developed to guide clinicians in treatment planning for traumatized clients. However, numerous concerns about the Guideline and its limitations have been raised, and we present those that are relevant to training students and professionals about treating traumatized clients. We consider whether the APA Guideline is consistent with current trauma training needs, models, initiatives, and resources. We conclude that students and professionals who apply the treatments identified by the APA PTSD Guideline as "strongly supported" by empirical evidence may inadvertently overwhelm some clients with complex trauma presentations, which could result in poor outcomes or even harm. Furthermore, the Guideline does not adequately address aspects of treatment that are crucial to training about trauma, such as considering the client's cultural and individual needs and clinician self-care. We suggest training methods that take into consideration the limitations of the APA PTSD Guideline. Clinical Impact StatementQuestion: What is the applied clinical practice question this article is hoping to address? There is a shortage of clinicians with appropriate training to treat traumatized clients. One potential resource for trauma training is the Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (APA, 2017). However, concerns have been raised about its limitations and applicability. Findings: How would clinicians meaningfully use the primary findings of this article in their applied practice? Concerns have been raised about the Guideline's conclusions and implications for trauma education and training for mental health practitioners. Clinicians can use this article's description of these concerns to determine whether the Guideline provides appropriate guidance for their own clinical work with trauma-exposed individuals. Meaning: What are the key conclusions and implications for future clinical practice and research? The Guideline does not adequately address necessary considerations for safe and effective treatment of trauma clients with complex presentations and fails to address crucial issues such as the importance of attending to the therapeutic relationship, stabilization of clients, and self-care for clinicians who are treating traumatized clients. ...

In response to Wickramasekera II's description of his empathic involvement theory of hypnosis in "Mysteries of hypnosis and the self are revealed by the psychology and neuroscience of empathy" (Wickramasekera II, 2015), Henning offers further reflections on what empathy might be and what it allows therapists to do, particularly in conditions of hypnotic trance. She defines her intersubjective view of hypnotic trance as an experience in which client and therapist mutually engage in a shared state of consciousness, and a mutual bidirectional or multidirectional exchange of verbal and nonverbal, as well as conscious and unconscious, material occurs, and which may include shared taking on of roles and expectations in each party, as suggested by the other, particularly when both client and therapist are highly hypnotizable. Research on the concept of "mutual hypnosis," or co-trance, is reviewed, and barriers to scholarly discussions about intersubjectivity in therapy relationships are described. Concepts from other disciplines and traditions, including quantum physics, transpersonal psychology, contemplative Christianity, and shamanistic practices and trance in other cultures are then offered to clarify the processes of intersubjectivity, and perspectives about empathy and hypnotic co-trance are offered from the context of the author's own clinical work as a trauma therapist. Finally, suggestions are provided for future research approaches and methods to further explore and understand these phenomena.