Children who have suffered physical or sexual abuse are as vulnerable as adult trauma victims to experience `secondary trauma', in which the reactions of the family or broader system exacerbate the child's difficulties. Three clinical cases are presented that suggest that this secondary trauma can be made worse by either excessive or insufficient provision of individual child psychotherapy, and the way the system interprets and reacts to these clinical decisions. Types of secondary trauma and their interactions with clinical decisions are discussed. Ways of framing clinical decisions to minimize the potential secondary trauma are presented.
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