There is a shift in evidence-based practice toward an understanding of the treatment elements that characterize empirically-supported interventions in general and the core components of specific approaches in particular. The evidence-base for Behavioral Parent Training (BPT), the standard of care for early-onset disruptive behavior disorders (Oppositional Defiant Disorder and Conduct Disorder), which frequently co-occur with Attention Deficit Hyperactivity Disorder, is well-established; yet, an ahistorical, program-specific lens tells little regarding how leaders, including Constance Hanf at the University of Oregon, shaped the common practice elements of contemporary evidence-based BPT. Accordingly, this review summarizes the formative work of Hanf, as well as the core elements, evolution, and extensions of her work, represented in Community Parent Education (COPE; Cunningham, Bremner, & Boyle, 1995; Cunningham, Bremner, Secord, & Harrison, 2009), Defiant Children (DC; Barkley 1987; Barkley, 2013), Helping the Noncompliant Child (HNC; Forehand & McMahon, 1981; McMahon & Forehand, 2003), Parent-Child Interaction Therapy (PCIT; Eyberg, & Robinson, 1982; Eyberg, 1988; Eyberg & Funderburk, 2011), and the Incredible Years (IY; Webster-Stratton, 1981; 1982; 2008). Our goal is not to provide an exhaustive review of the evidence-base for the Hanf-Model programs; rather, our intention is to provide a template of sorts from which agencies and clinicians can make informed choices about how and why they are using one program versus another, as well as how to make inform flexible use one program or combination of practice elements across programs, to best meet the needs of child clients and their families. Clinical implications and directions for future work are discussed.

Borderline Personality Disorder (BPD) has been associated with both trauma and insecure attachment styles. Betrayal Trauma Theory proposes survivors of interpersonal trauma may remain unaware of betrayal in order to maintain a necessary attachment. This preliminary study reports on the relations between self-reports of betrayal trauma experiences and borderline personality characteristics in a college sample. Using multiple regression, betrayal was significantly associated with BPD characteristics. High-betrayal trauma was the largest contributor to borderline traits and medium-betrayal trauma was also a significant predictor. However, traumas of low betrayal were not associated with BPD features. These results stand even after controlling for gender. These findings suggest betrayal may be a key, and yet heretofore unaddressed, feature of borderline personality disorder.

A frequently studied hypothesized cause of borderline personality disorder (BPD) is experiencing interpersonal trauma. A recent study by L. A. Kaehler and J. J. Freyd (2009 ) found a connection between betrayal trauma and BPD characteristics, with higher betrayal traumas associated with greater BPD characteristics. The present study seeks to expand upon that study by investigating relational health as a potential mediator for the association between betrayal trauma and BPD. A sample of 165 college students completed measures of betrayal trauma life events, relational health, and BPD traits. Mediation analyses showed significant partial mediation for total relational health (bootstrap coefficient = .0168) and its community subscale (bootstrap coefficient = .0204); however, significant mediating effects for the mentor and friend subscales were not found. Given the significant finding for only the community subscale, which may be driving the total relational health effect seen, the results suggest that connection with a valued community may be an important protective factor for BPD after one experiences betrayal trauma.

Betrayal trauma theory proposes that one response to betrayal may be to keep knowledge of the trauma out of conscious awareness. Although this betrayal blindness may be beneficial for survival while the abuse is ongoing because it helps maintain crucial relationships, this distortion of reality can lead to subsequent psychological and behavioral problems. The current article presents three exploratory studies that examine the associations among exposure to betrayal trauma, dissociation, and hallucinations. The first study (N 397) examined the associations between exposure to medium and high betrayal trauma and dissociation. The second study (N 199) examined the associations between exposure to low, medium, and high betrayal trauma and hallucinations. The third study (N 566) examined the associations between medium and high betrayal child and adolescent/adult sexual abuse and hallucinations. Our results suggest that exposure to betrayal trauma increases the likelihood of both dissociation and hallucinations. These findings provide further evidence that the toxic nature of betrayal in traumas has lasting effects on both cognitive and perceptual processes-dissociation and hallucinations-having implications for therapeutic treatment for individuals who have experienced betrayal traumas and related outcomes.