Clients shared what helped them change and we have incorporated their ideas into the Collaborative Change Model (CCM). Best practices in trauma-informed care have also infl uenced the model. A comprehensive review of the literature coupled with decades of clinical practice have shown us there are certain consistent structures and functions present when therapy is successful. So while the fi ve essential ingredients spring specifi cally from the clients’ reporting of their experiences, the foundational elements of effective treatment permeate the observation and study of effective trauma treatment models. In fact, clients have reported to us what makes therapy work for them, and we have observed this in action by attending to the vast array of theoretical models. Together this is an affi rmation of good treatment. There are fi ve foundational treatment elements that organize guidelines for good care and these elements parallel the fi ve essential ingredients reported by clients and are similar to what Linehan (1993) has described. We have found the following fi ve foundational elements. The fi rst element is to augment and amplify the client’s natural capacity and capabilities, expanding their repertoire of thought and action. The second is to provide inspiration, motivation, and incentive to work away from survival mindstates toward engaged mindstates. The third is to provide predictability, order, and structure for treatment and for the treatment team. The fourth element is ensuring generalizability of learning outside the therapy encounter, and the fi fth and fi nal is to enhance therapeutic confi dence and competence.