Written by Jordan Meehan, LCSW
There are many options when it comes to finding effective trauma therapy. But what makes each option different? And what will be most effective?
Trauma is both easy and hard to define. Generally, trauma is any sort of experience that causes someone a high degree of distress. However, trauma is also relative to the person experiencing it. Therefore, not every person will react to a traumatic event the same way. As such, there are many trauma therapy techniques to address a person’s unique challenges.
What is Trauma?
What is the first thing that comes to mind when you think of the word “trauma”?
Just think.
Keep thinking.
Now, you were not given any context around which to think about the word “trauma.” However, your brain used your past experiences and knowledge to find known associations with that word. In this case, your brain recognized the word “trauma” as a familiar word. This is the way that the human brain analyzes information. The brain assesses the information to know how it needs to react and what it needs to do with the information.
The brain of a person who has lived through trauma goes through the same process. However, a brain affected by trauma doesn’t always know how to tell the difference between something harmless and the past traumatic event. As a result, a person impacted by trauma may develop a variety of mental health disorders.
While this list is nowhere near exhaustive, these are some typical sources of trauma:
- Mass and community violence events
- War
- Car accidents
- Sexual abuse/physical abuse/emotional abuse
- Childhood neglect
- Domestic violence
- Witnessing traumatic events
Effective trauma therapy is crucial to help people who have experienced trauma heal.
Reach out to schedule an appointment with a trauma-informed therapist today.
Evidence-Based Approaches to Trauma Therapy
3.6% of the US adult population experienced PTSD in the past year. 1
Post-Traumatic Stress Disorder (PTSD) is one of the more talked-about disorders that can result from trauma. However, many other common disorders can stem from trauma as well.
Some of the most common include:
- Anxiety disorders
- Depressive disorders
- Panic disorders
- Personality disorders
In many cases, the symptoms brought on by trauma are extreme versions of healthy reactions to stress. Therefore, proper diagnosis is key to getting proper treatment.
There are many psychotherapy treatments for trauma. However, only a few are backed up by extensive research and can be called “evidence-based.” While there is no single “best” trauma therapy, people may find that they respond better to one type of treatment over another. Here are the top treatments for trauma-related concerns.
1. Cognitive Behavioral Therapy (CBT)
CBT focuses on recognizing problematic thinking patterns and working to change them, which then helps change behavior patterns. This treatment requires a person to engage in weekly appointments to learn skills that can be used to manage their symptoms. Throughout the course of treatment, a person will practice skills outside of sessions. Meanwhile, the provider will make sure to address any barriers and highlight progress. Standard CBT traditionally takes 12 to 16 weeks.
2. Prolonged Exposure Therapy (PE)
This is a specific type of CBT that primarily applies behavioral therapy techniques. In PE, individuals are gradually exposed to their trauma-related memories, emotions, thoughts, and physical sensations. Since avoidance is a common symptom of trauma, PE helps people stop avoiding their trauma reminders. The types of exposures may include:
- Imaginal exposures: Recounting the details of the traumatic event.
- In vivo exposures: Repeatedly confronting trauma-related situations or people in their everyday life that they have been avoiding.
- Interoceptive exposures: Creating and then experiencing feared physical sensations that are associated with the trauma but are actually harmless.
3. Cognitive Processing Therapy (CPT)
CPT focuses on reevaluating how a person thinks following a traumatic event. This treatment targets the way people view themselves, others, and the world around them. Often, problematic or irrational thinking keeps a person “stuck” and makes recovery from trauma challenging. The CPT protocol helps a person assess their trauma and the impact it has on their thinking. A person learns skills to evaluate if their thoughts are factual, and develops more helpful ways to think about their trauma. CPT is particularly helpful for those that have a lot of shame about their traumatic event.
4. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
Designed for children and teens, TF-CBT works to improve a range of trauma-related outcomes in minors. This treatment takes anywhere from 8-25 sessions and treatment involves both the child and a caregiver or trusted adult. TF-CBT is one of the most effective trauma therapy methods available to help youth recover from Post-Traumatic Stress Disorder.2 TF-CBT addresses other trauma-related challenges like anxiety, depression, and behavior problems. Also, the caregiver or trusted adult can relieve their distress about the child’s traumatic event and learn effective parenting skills.
5. Eye Movement Desensitization and Reprocessing Therapy (EMDR)
EMDR is different than most talk therapies. It does not require a person to explain their trauma in detail. Instead, a person will do eye movements or tapping while focusing on an image related to the trauma. EMDR therapy helps a person become “unstuck” so their brain can go through its’ natural healing process. It is designed to help a person quickly resolve traumatic memories. Unlike other therapies, there is no focus on changing emotions, thoughts, or behaviors related to the trauma. Often, EMDR therapy can be completed in far fewer sessions than other talk therapies.3
6. BONUS: Medication
Medication can be used in combination with any of the methods above. Mental health professionals commonly prescribe selective serotonin reuptake inhibitors (SSRIs) for trauma-related concerns like depression and anxiety. Also, for those with panic and anxiety symptoms, benzodiazepines may be prescribed for as-needed use. However, medication only dampens the intensity of symptoms; its use alone will not allow a person to recover from their trauma.
Finding a Trauma-informed Therapist
Working with a therapist who is specifically trained or certified in one of these methods can help you resolve your trauma. At Restorative Counseling, several of our therapists are trained in a variety of trauma-focused treatments. Schedule an appointment with one of our therapists today and start your journey to healing from your trauma.
References:
1. National Institute of Mental Health
2. Trauma-Focused Cognitive Behavioral Therapy
3. EMDR International Association
Schedule an appointment with one of our trauma-informed therapists today.
Post-traumatic Stress Disorder (PTSD)
Understanding PTSD
Symptoms
Treatment & Facts
Resources
- More than 8 million Americans between the age of 18 and older have PTSD.
- 3.6% of the US Adult population experienced post-traumatic stress disorder (PTSD) in the past year.* (National Institute of Mental Health)
- 67 percent of people exposed to mass violence have been shown to develop PTSD, a higher rate than those exposed to natural disasters or other types of traumatic events.
- People who have experienced previous traumatic events run a higher risk of developing PTSD.
- PTSD can also affect children and members of the military: Watch a video about Staff Sgt. Stacy Pearsall, a combat photographer who experienced PTSD. See how she got help.
PTSD brochure.
Screen yourself or a loved one for PTSD.
PTSD Treatment Information
The main treatments for people with PTSD are specific short-term psychotherapies. These treatments are described below. Everyone is different, so a treatment that works for one person may not work for another. Some people may need to try different treatments to find what works best for their symptoms. Regardless of which option you chose, it is important to seek treatment from a mental health professional who is experienced with PTSD.
Psychotherapy
Cognitive Behavior Therapy (CBT):
CBT is a type of psychotherapy that has consistently been found to be the most effective treatment of PTSD both in the short term and the long term. CBT for PTSD is trauma-focused, meaning the trauma event(s) are the center of the treatment. It focuses on identifying, understanding, and changing thinking and behavior patterns. CBT is an active treatment involved the patient to engage in and outside of weekly appointments and learn skills to be applied to their symptoms. The skills learned during therapy sessions are practiced repeatedly and help support symptom improvement. CBT treatments traditionally occur over 12 to 16 weeks.
Main Components of CBT:
While different CBTs have different amounts of both exposure and cognitive interventions, they are the main components of the larger category of CBTs that have been repeatedly found to result in symptom reduction.
- Exposure therapy. This type of intervention helps people face and control their fears by exposing them to the trauma memory they experience in the context of a safe environment. Exposure can use mental imagery, writing, or visits to places or people that remind them of their trauma. Virtual reality (creating a virtual environment to resemble the traumatic event) can also be used to expose the person to the environment that contains the feared situation. Virtual reality, like other exposure techniques can assist in exposures for treatment for PTSD when the technology is available. Regardless of the method of exposure, a person is often gradually exposed to the trauma to help them become less sensitive over time.
- Cognitive Restructuring. This type of intervention helps people make sense of bad memories. Oftentimes people remember their trauma differently than how it happened (e.g., not remembering certain parts of the trauma, remembering it is a disjointed way). It is common for people to feel guilt of shame about aspects of their trauma that were not actually their fault. Cognitive restructuring helps people look at what happened with fact to get a realistic perspective on the trauma.
What is CBT? Listen to this podcast.
It is important for anyone with PTSD to be treated by a mental health care professional who is experienced with PTSD. Some people will need to try different treatments to find what works for their symptoms.
Description of Specific CBTs for PTSD:
- Cognitive Processing Therapy (CPT) is an adaptation of cognitive therapy that aims toward the recognition and reevaluation of trauma-related thinking. The treatment focuses on the way people view themselves, others, and the world after experiencing a traumatic event. Often times inaccurate thinking after a traumatic event “keep you stuck” and thus prevent recovery from trauma. In CPT you look at why the trauma occurred and the impact it has had on your thinking. It can be especially helpful for people who, to some extent, blame themselves for a traumatic event. CPT focuses on learning skills to evaluate whether you thoughts are supported by facts and whether there are more helpful ways to think about your trauma. There is strong research support showing the effectiveness for people recovering from many types of traumas.
- Prolonged Exposure (PE) is another form of CBT that relies more heavily on behavioral therapy techniques to help individuals gradually approach trauma related memories, situations, and emotions. PE focuses on exposures to help people with PTSD stop avoiding trauma reminders. Avoiding these reminders may help in the short term, but in the long term it prevents recovery from PTSD. PE uses imaginal exposures, which involve recounting the details of the trauma experience, as well as in vivo exposures, which involve repeatedly confronting trauma-related situations or people in their life that they have been avoiding. There is strong research support showing PEs effectiveness across a wide range of traumas.
- Stress Inoculation Training (SIT) is another type of CBT that aims to reduce anxiety by teaching coping skills to deal with stress that may accompany PTSD. SIT can be used as a standalone treatment or may be used with another types of CBTs. The main goal is to teach people to react differently to react differently to their symptoms. This is done through teaching different types of coping skills including, but is not limited to, breathing retraining, muscle relaxation, cognitive restructuring, and assertiveness skills.
Other PTSD Treatments:
There are other types of PTSD interventions that are not considered CBTs.
- Eye Movement Desensitization and Reprocessing (EMDR) is a form of psychotherapy that involves processing upsetting trauma-related memories, thoughts and feelings. EMDR asks people to pay attention to either a sound or a back-and-forth movement while thinking about the trauma memory. This treatment has been found to be effective for treating PTSD, but some research has shown that the back-and -forth movement is not the active treatment component but rather the exposure alone is.
- Present Centered Therapy (PCT) is a type of non-trauma focused treatment that centers around current issues rather than directly processing the trauma. PCT provides psychoeducation about the impact of trauma on one’s life as well as teaching problem solving strategies to deal with current life stressors.
Medications:
Medications are sometimes used as an adjunct to one of the therapies described above. One of the more common types of medications used are selective serotonin reuptake inhibitors (SSRIs). SSRIs are antidepressants, and depressed mood can be part of PTSD. Also sometimes used as a short term and adjunctive treatment are benzodiazepines. Benzodiazepines are quick-acting medications that are effective but can be habit forming.
If PTSD is a problem for you or for someone you care about, seek out a consultation with an experienced mental health professional. PTSD is a treatable condition — find out what help there might be for you or your loved one.
ADAA Resources
Meet the ADAA PTSD Special Interest Group and learn about their research and treatment work.
This page was updated June 2021
