Although there is increasing literature on secondary traumatic stress, little is known about the therapist's perspective and experience in working with traumatized children. This qualitative study utilized an interpretivist paradigm to understand therapists' experiences in working with such children. Interviews suggest that therapists perceive common issues related to treatment, impact of the therapeutic work, and the importance of making personal meaning of their work. Most importantly, becoming a trauma specialist is a developmental process requiring careful examination, willingness to be changed, and a program of self-care, as therapists work to help children who have been witness to and often victims of horrors many find unspeakable. Implications for training, supervision, community support, and self-care are discussed. [Brief Treatment and Crisis Intervention 4:353-366 (2004)] KEY WORD: trauma therapist development.

This case describes a family’s struggle with a child’s traumatic brain injury (TBI). The family had difficulty discussing how the injury had changed their lives. Emotions were often expressed as explosive outbursts. Initially, the father refused to participate in counseling.Various treatments were tried, but family therapy was needed. Because of the father’s resistance, family sessions initially involved only the siblings. Aspects of filial play therapy were also introduced. Specifically, the parents viewed portions of their children’s sessions from behind a one-way mirror. While behind the mirror, the parents consulted with another therapist about what was going on, how they could generalize treatment, and how TBIs affect children’s social/ emotional functioning. The effects of TBIs on families were also discussed, and the parents’ began to openly discuss their concerns. Eventually, family therapy included everyone. Throughout treatment, it was clear that important changes had occurred on both sides of the mirror.

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