In this episode of the JCP Podcast, host Dr. Ben Everett speaks with Dr. Steven Berkowitz, Professor of Psychiatry at the University of Colorado School of Medicine and Director of the Stress, Trauma, and Adversity Research and Treatment (START) Center at CU Anschutz. Drawing on a career spanning the Yale Child Study Center, Penn, and CU, Dr. Berkowitz discusses how childhood trauma shapes psychiatric illness across the lifespan and what that means for early intervention, assessment, and treatment.

The conversation covers the neurobiology of early maltreatment, the development and outcomes of the CFTSI early intervention model, the debate over developmental trauma disorder and complex PTSD, and how trauma presents differently in autistic youth. Dr. Berkowitz also addresses treatment sequencing for comorbid substance use and ADHD, the central role of sleep in trauma care, sensory processing deficits in children in the child welfare system, and the scientific and ethical questions that would need to be answered before psychedelic research could be extended to children and adolescents with PTSD.

🎯 KEY EPISODE HIGHLIGHTS:

🌱 WE CAN'T TREAT OUR WAY OUT OF THIS CRISIS [07:00]

“I really believe in prevention, and I think unfortunately, given our current set of circumstances, we're never gonna treat our way out of what is a mental health crisis in this country.”

Dr. Berkowitz frames pediatric trauma work as prevention, noting that most adults in outpatient psychiatric care carry a history of childhood trauma.

😴 TRAUMA PSYCHIATRY IS SLEEP PSYCHIATRY [25:42]

“Trauma psychiatry in many ways is about sleep psychiatry. The goal is to get people sleeping.”

Targeting nightmares and nighttime intrusive symptoms first may make it possible for patients to engage meaningfully in trauma therapy.

🧠 PSYCHOTHERAPY IS ESSENTIAL IN YOUTH PSYCHEDELIC RESEARCH [35:32]

“With kids, feeling is it's not even a question. We should absolutely be doing psychotherapy in these sessions as well as before and after.”

Any future psychedelic trials in children and adolescents will require extensive family preparation and integrated psychotherapy, raising design questions the field has yet to answer.

CHAPTERS:

00:00 – Introducing Dr. Steven Berkowitz

01:30 – Forensic Expert Work and Delayed-Onset PTSD

05:00 – Prevention and the Neurobiology of Childhood Trauma

11:00 – Developing the CFTSI Early Intervention Model

16:00 – Developmental Trauma, Complex PTSD, and the Limits of the DSM

19:30 – How Trauma Presents in Autistic Youth

23:30 – Sequencing Treatment for Substance Use, Comorbidities, and Sleep

26:30 – The START Center, Sensory Processing, and the “Trauma-Informed” Debate

32:00 – PTSD Pharmacotherapy and Psychedelic Research in Youth

LINKS:

Full transcript and show notes:

https://www.psychiatrist.com/jcp/ep24-trauma-expert-view-psychedelic-medicine-steven-berkowitz/

Journal of Clinical Psychiatry

https://www.psychiatrist.com/jcp/

Publisher of peer-reviewed research discussed in this episode.

Dr. Steven Berkowitz – LinkedIn https://www.linkedin.com/in/stevenberkowitz/

CU Anschutz START Center https://www.cuanschutz.edu/home Dr. Berkowitz's family-centered, lifespan trauma research and treatment center.

Child and Family Traumatic Stress Intervention (CFTSI) https://www.nctsn.org/interventions/child-and-family-traumatic-stress-intervention

Brief early intervention model for children and caregivers discussed in this episode.

#ChildTrauma #PTSD #CFTSI #TraumaPsychiatry #PsychedelicResearch