Clients with complex trauma usually lose oversight of their lives and this leads to a knock-on accumulation of problems. The loss of control over their current life situation in and of itself can be a trigger for trauma-associated reactions and may cause clients to feel despondent and hopeless. When therapy begins, it is important to help clients gain control over their life situation so that daily stressors reduce rather than increase. Depression usually accompanies long-term trauma symptoms. It is a consequence of avoiding the triggers that evoke trauma reactions. Rational rehabilitation uses techniques from behavioural therapy, counterconditioning, and cue-conditioning. It focuses not so much on counteracting symptoms as on improving their management. People with complex trauma have many problems with reexperiences, nightmares, and constant vigilance, so it is only natural for them to look for ways to alleviate these troubles. The prevalence of a double diagnosis of post-traumatic stress disorder (PTSD) with some type of substance abuse is very high.