Trauma
Evidence-Based Treatments for Trauma
About
Traumas can look different for different people…
Trauma could include childhood emotional, physical, sexual abuse, childhood emotional or physical neglect, adulthood sexual assault, combat trauma, or violence experienced because of your identity (i.e., your race, gender, sexual orientation, etc.). However, the impact of trauma can look very similar. A traumatic experience can affect the way you think about yourself, the world, and/or other people:
“I am worthless, unlovable, to blame…”
“Other people can’t be trusted”
“The world is dangerous/scary”
Despite our best efforts to avoid being reminded of the trauma, trauma can pop up when we don’t want it to and cause us incredible distress, guilt, or shame. Whether the trauma occurred once, multiple times, in childhood and/or in adulthood and beyond, traumatic experiences and Posttraumatic Stress Disorder (PTSD) can have lasting unwanted impacts on your relationships, your self-esteem, and your ability to feel safe and to successfully navigate the world.
Fortunately, effective evidence-based treatments exist that can help you reclaim your life and decrease your trauma symptoms. And the good news is that these treatments don’t take years to complete!
Genesee Valley Psychology (GVP) offers gold-standard, scientifically-studied trauma-focused treatments, including Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), Trauma Focused Cognitive Behavioral Therapy (TF-CBT), and Written Exposure Therapy (WET). These therapies typically range from 5-16 sessions. Trauma treatment at GVP can be longer based on a collaborative discussion between clinician and client.
Interested to know which treatment may be right for you? Here are text and video breakdowns of each treatment (CPT, PE, TF-CBT, WET):
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Cognitive Processing Therapy (CPT) is a 12 session, 50-minute, weekly manualized trauma treatment.
In CPT, the focus is on understanding what we tell ourselves about the causes and consequences of the trauma(s) and to address how these beliefs following the trauma(s) impact our sense of safety, trust, power/control, self-esteem, and intimacy.
In CPT, you and your therapist will collaboratively work to understand, examine, and work through these trauma-related beliefs if they are making it hard for you to cope following the trauma. CPT can be completed with or without a trauma account (an in-depth narrative of the trauma).
The ultimate goals of CPT are to (1) reduce avoidance of trauma-related thoughts and emotions, (2) decrease your trauma symptoms, and (3) to help you become your own cognitive therapist even after treatment ends.
To begin CPT a single trauma is selected. The skills learned in CPT typically transfer to processing other traumatic experiences.
You are an active participant in CPT. CPT involves completing weekly worksheets and assignments. These assignments are invaluable for developing skills to process the trauma and to change the way the trauma impacts you in the here-and-now. As a part of CPT, you will also complete weekly symptom assessments to measure changes in your trauma symptoms over the course of treatment.
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Prolonged Exposure (PE) is a 12-16 session, 50-minute, weekly manualized trauma treatment.
In PE, the focus is on reducing trauma-related avoidance behaviors that make it hard for us to function following a traumatic experience. Avoidance is a natural response following a traumatic event and is our body’s way of keeping us safe from further harm. Unfortunately, sometimes we also begin to avoid people, places, and situations that were not necessarily a part of the traumatic experience but that serve as powerful trauma reminders. Although it may seem helpful in the short-term, avoidance also confirms negative beliefs we may have about our sense of safety and ability to cope with trauma reminders, resulting in a vicious cycle of avoidance of trauma reminders, increased trauma symptoms, and low mood.
In PE, you and your therapist will explore what you have been avoiding since the trauma, talk about the trauma, and then collaboratively create a list of previously avoided situations that you can begin to approach in an intentional and masterful way.
To reduce harmful avoidance and promote recovery from trauma symptoms, PE involves encouraging you beyond your comfort zone, but not your safety zone.
The goals of PE are to 1) help you learn that approaching rather than avoiding is the key to reducing trauma symptoms and distress, 2) to help you discriminate between the trauma that happened in the past and the here-and-now, and 3) to show you that you can effectively manage trauma triggers when they do come up, without them overwhelming you. By taking these steps you will likely be able to expand your life and do the things that matter to you, once again.
You are an active participant in PE. PE involves completing weekly assignments. These assignments involve intentionally approaching objectively safe trauma reminders (i.e., sitting in your car if your trauma was a car accident) and are designed to decrease emotional distress and avoidance, as well as to improve your sense of mastery, competency, and safety. As a part of PE, you will also complete weekly symptom assessments to measure changes in your trauma symptoms over the course of treatment.
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Trauma-Focused Cognitive Behavioral Therapy (TFCBT) is a 12-16 session, 50-minute, weekly manualized trauma treatment for children, adolescents and young adults ages 3 to 21.
TFCBT is adaptable and flexible with a focus on the family system. In TFCBT, you and your therapist will work together to develop coping strategies and to understand, examine, and process the traumatic experience(s). Through writing a trauma narrative, the focus will be on cognitive processing and understanding and challenging trauma-related beliefs that are making it difficult to cope with the trauma.
The PRACTICE acronym reflects the core elements of TFCBT:
Psychoeducation and Parenting Skills
Relaxation
Affective Modulation
Cognitive Processing
Trauma Narrative
In vivo Desensitization
Conjoint parent-child sessions
Enhancing safety and social skills
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Written Exposure Therapy (WET) is a brief (5-session, 50-minute weekly) manualized trauma treatment.
Like PE, WET is an exposure-based treatment, meaning it involves repeatedly approaching a traumatic memory. In WET, this is done by writing about the traumatic event. WET focuses on processing your experiences (thoughts and feelings) as you remember them during and immediately after the trauma and then processing how the trauma event has changed your life.
As a part of WET, you will complete weekly symptom assessments to measure changes in your trauma symptoms over the course of treatment.
A brief video describing CPT
A brief video describing PE
A brief video describing TF-CBT
A brief, helpful video explaining WET
It can be challenging to determine which trauma treatment is right for you. This is not a decision you have to make alone. Our trauma-trained and trauma-informed clinicians can help you determine the most appropriate therapy based on your needs and how your trauma symptoms are impacting you.
Meet the trauma Team at GVP
What can I expect if I begin trauma-focused treatment?
Pre-treatment phase
Trauma assessment: You and your trauma therapist will begin with a basic assessment of your trauma history, determine the trauma symptoms that are present for you and determine the impact the symptoms are currently having on your functioning. For instance, are you finding it difficult to make or keep friends because you find it hard to trust others? Are you avoiding going to places or being in situations that remind you of the traumatic event? Given the immense emotional pain that revisiting the trauma memories can cause, the trauma assessment process does not require that you give a full detailed account about your traumatic experiences. In fact, your therapist will support you in giving just enough initial detail for them to understand what happened. The trauma assessment session will also consider the ways in which your identities (e.g., age, race, gender) interact with your symptoms (if at all). The assessment is designed to be a first experience to approach these memories in a safe, supportive, and structured therapeutic space. After clarifying the trauma and trauma symptoms present, you and your provider will discuss the different treatment options available and decide which treatment is right for you.
Treatment phase
Once you and your therapist have agreed on a treatment, you can immediately begin trauma-treatment.
Post-treatment phase
After completing trauma treatment, some clients prefer to continue working with their therapist on additional areas of concern while other clients are ready to end treatment. Clients are encouraged to discuss their preferences and the post-treatment options available with their therapist.
What if I decide that trauma-focused treatment isn’t a good fit for me?
We fully believe that people can recover from traumatic experiences and are committed to providing quality care that supports this journey. However, we recognize that a number of factors can make it difficult to engage in or complete this journey. We also acknowledge that trauma treatments are not one-size-fits-all and some clients may benefit from other trauma-focused approaches, such as Eye Movement Desensitization and Reprocessing (EMDR) or relationally-oriented trauma therapy.
Clients are encouraged to discuss their concerns about ending trauma treatment with their therapist and are free to end treatment at any time. We are also happy to provide referrals for additional services, such as Dialectical Behavior Therapy (DBT) or long-term supportive therapy services, if more appropriate for your needs.
OCD & Trauma/PTSD
At GVP we specialize in OCD and Trauma, as well as the overlap of OCD/Trauma. With collaborators at McLean Hospital/Harvard Medical School, we developed the OCD Trauma Timeline Interview (OTTI) to help clinicians and clients understand the ways that OCD and trauma symptoms are presenting, and potentially overlapping.