Trauma is really common, with more than 70% of individuals experiencing a traumatic event at some point in their lives. People who have experienced are more likely to seek mental health care than those who have not.
For consumers, it is essential to be educated in what trauma therapy is, and what treatments are effective in order to make informed choices about one’s mental health care.
For providers, it is important to be aware that most clients that seek therapy will have experienced trauma at some point in their lives. In order to provide ethical care, clinicians need to be well-trained and knowledgeable about trauma based therapy and trauma-focused therapy.
This post will clarify what trauma therapy is, what someone can expect from trauma therapy, who trauma therapy is for, how trauma therapy can help and how to find trauma therapy that’s right for them.
What is trauma focused therapy?
Trauma focused therapy is psychotherapy or counseling that aims to address and ameliorate the psychological after-effects of a traumatic event. A traumatic event is defined as exposure to death, threatened death, actual or threatened serious injury or actual or threatened sexual violence.
Traumas can be experienced in any one of four ways:
Directly experiencing the event,
Witnessing the traumatic event in person,
Learning that a traumatic event occurred to close friend or family member (violent/accidental),
Experiencing first-hand repeated or extreme exposure to aversive details of trauma (not via media, unless work-related).
Examples of traumatic events can include:
Childhood sexual abuse and physical abuse
Rape or sexual assault
Physical assault
Intimate partner violence
Combat
Serious motor vehicle accident
Natural disasters
Terrorism/shootings
Witnessing serious injury or death
Learning about death of someone close
Exposure to death
Immediately after traumas, most people experience some posttraumatic distress. While many people naturally recover and distress dissipates over time, others experience a “stalling out” of recovery and many continue to struggle with trauma-related symptoms for months, years or decades, especially if left untreated.
The nature of someone’s trauma-related difficulties can vary widely. Therefore, the best way to determine the most appropriate course of trauma therapy is to consult with a mental health professional, particularly one with expertise in trauma.
Because the impact of trauma is heterogeneous, therapies to address trauma symptoms can also greatly differ, depending on the specific nature of a client’s symptoms, difficulties and treatment goals.
For example if someone’s post-trauma difficulties are mostly interpersonal, they would benefit from trauma therapy that addresses relational challenges and improves interpersonal skills.
If someone’s post-trauma difficulties are more consistent with Posttraumatic Stress Disorder (PTSD), then they would most benefit from a gold-standard, evidence-based PTSD treatment like Cognitive Processing Therapy (CPT), Prolonged Exposure Therapy (PE) or Eye Movement Desensitization and Reprocessing (EMDR).
What is trauma based therapy
Types of trauma based therapy
There are many different types of trauma focused therapies. It is important to note that some trauma therapies have extensive research showing that they are effective for a majority of individuals with trauma-related symptoms, while other trauma based therapy options lack sound empirical support.
For prospective clients and clinicians alike, it is useful to know which treatments are backed by science and which are not in order to have realistic expectations of what to expect from trauma therapy.
For clients who meet criteria for Posttraumatic Stress Disorder (PTSD), including Complex-PTSD, there are several short-term effective treatments that can lead to full remission of symptoms. PTSD is characterized by:
Recurrent re-experiencing of the trauma(s) during daytime or at night, in the form of nightmares.
Avoiding thinking or feeling about the trauma(s) and any reminders of the trauma(s).
Changes in thinking and changes in mood, including significant trauma-related blame and changes in thinking about safety, trust, power/control, esteem and intimacy.
Changes in physiological arousal and reactivity, such as exaggerated startle reaction, being super-alert and on-guard, hypervigilance, and trouble with concentration and sleep.
These symptoms must be present for at least one month following the trauma(s), they must lead to significant impairment and/or distress and they cannot be accounted for by another mental or physical illness.
The most effective treatments for PTSD have over two decades of research showing that they lead to clinically significant improvements that are long-lasting.
All of these treatments are specific subtypes of Cognitive Behavioral Therapies (CBT) that address avoidance and problematic beliefs that form after trauma(s), as both of these factors maintain PTSD.
Cognitive Processing Therapy (CPT)
CPT is a short-term trauma-focused PTSD treatment that helps clients address problematic and painful thoughts that often follow trauma.
These thoughts often center around the meaning that one makes about why the trauma happened (“it was my fault,” “it could have been prevented”) and the impact of the trauma on how someone thinks about themselves (e.g., “I am broken”), others (“no one can be trusted”) and the world (“nowhere is safe”).
CPT helps decrease avoidance, facilitates processing natural emotions and helps clients develop skills for making sense of the traumatic events and their impact in more balanced ways.
Prolonged Exposure Therapy (PE)
PE is a short-term trauma-focused PTSD treatment that teaches clients how to gradually approach trauma memories and people, places and activities (that are objectively safe) that have been avoided since the trauma(s), in a safe and supportive manner.
Confronting these challenges leads to a decrease in PTSD symptoms and to a greater sense of self-confidence.
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR helps clients process distressing memories, feelings and thoughts about trauma(s) they have experienced while focusing on an external stimuli that moves back and forth (e.g., lights, sounds, tapping). Although EMDR has been shown to be effective for PTSD, there is disagreement about exactly how it works.
If someone is struggling with trauma-related symptoms, but they do not suffer from PTSD, there are a number of other treatments that may be a great fit, including Dialectical Behavior Therapy (DBT), Seeking Safety, Skills Training in Affective and Interpersonal Relations (STAIR), Acceptance and Commitment Therapy (ACT) or general Cognitive Behavioral Therapy (CBT) skills.
Who trauma focused therapy is for
Trauma therapy is for anyone who is looking for relief from symptoms that began or got worse after the experience of a traumatic event.
Trauma focused therapy is especially beneficial for those who suffer from PTSD. Trauma therapy can help with any of the following kinds of difficulties.
What is Trauma Therapy? Everything you Need to Know
Written By Stephanie Sacks
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