Evidence-based treatments (EBT) for traumatized children have been increasingly used for children with complicated clinical presentations. Many of these children have experienced early, severe, and multiple interpersonal traumas, have lived in serial foster placement or residential treatment facilities, and/or have many psychiatric comorbidities. This CCB addresses the clinical management of children with complicated trauma presentations, integrating the current empirical evidence with the presenters’ clinical experience in providing direct services or consultation to direct service providers. There is a particular focus on the value of evidence-based psychotherapeutic interventions. As a starting point for attendees to discuss there own challenging cases, three cases involving children with complicated clinical presentation across the developmental spectrum are presented: a preschool child in foster care; a school-aged child recently discharged from an inpatient program; and a teen who was living in residential treatment. In each discussion, treatment management, including whether or not to use or discontinue medication, is addressed.