What is trauma-focused therapy, and how it works?

Trauma knows no boundaries; no one is exempt from its potent imprint. We are all familiar with the phrase “scarred for life.” However, many fail to cognize the vast spectrum of trauma – causes to consequences. Traumatic experiences leave a deep etching, a mark on the mind and body. The impact can be of disastrous proportions, crystalizing years after the triggering experience. While a person may appear to be functional on the surface and their behavior within the social norms, trauma frequently operates stealthily, eating the psyche outwards, very much like a parasite. It affects all aspects of one’s life; our emotional apparatus, professional life, interpersonal relationships, and most importantly – our sense of self. Most individuals will experience at least one traumatic event during their lifetime; many will experience multiple. There are several trauma therapy techniques available. Today we’re discussing trauma-focused therapy and how it all works.

Defining trauma

There are two sides to a definition of trauma. Generally speaking, trauma can be identified as any sort of experience that causes a high degree of distress in an individual. It is a lasting emotional response resulting from experiencing a distressing event, further endangering one’s sense of self, sense of safety, as well as one’s ability to regulate responses and emotions. Around 70% of the U.S. adult population is thought to have experienced at least one traumatic event; however, not every individual will face lasting consequences. 6% of the 70% (1 in 11) will develop PTSD (post-traumatic stress disorder) during their lifetime. Trauma is known to cause brain and nervous system aberrations, further leading to potential dysregulation and symptoms such as anxiety and depression. There is no universal cure for trauma, nor are there “best solutions.” No two cases are alike.

At our Texas behavioral health center, the highly trained personnel focuses on tailored treatment plans, taking every aspect and piece of information about the individual’s needs and history into consideration. This is especially important while you undergo medically assisted detox in Texas. No detail is too small. We’re here to soothe, encourage and support mind, body, and soul healing. Walking the healing path alone is not how we do it.

All about trauma-focused therapy

Psychologically speaking, trauma is considered one of the most significant experiences in one’s life. Passage of time doesn’t necessarily alter the subjective perspective on the event; it doesn’t have the control or the capacity to change the fact that something inconceivably distressful happened. These events often create permanent changes in one’s existential outlook (for example, being more vigilant, safety-focused, acute distrust, etc.). Trauma-focused therapy (also known as trauma-informed therapy) is, in modern language, an umbrella term, meaning it represents a group of co-existing therapeutic modalities that are specifically designed to address the causes and effects of trauma; post-traumatic stress disorder included (PTSD). The goal of this particular type of treatment is to decrease acute distress, put the traumatic event into a constructive perspective and help patients become fully functional once again.

Who is it for?

Initially designed for children and adolescents, trauma therapy is deeply rooted in understanding the connection between the negative experience and the child’s or teenager’s behavioral and emotional responses. However, its healing qualities have been successfully extended to serve adults diagnosed with PTSD.

• children
• adolescents
• families
• veterans (we offer treatment programs for veterans struggling with addiction)

TF-CBT, or trauma-focused cognitive behavioral therapy, is designed to address the mental and emotional needs of children, adolescents, and families suffering from the detrimental effects of early trauma. The treatment is specifically sensitive to mood disorders and post-traumatic stress resulting from violence, physical and sexual abuse, or grief. If a child is a client, TF-CBT usually brings caregivers (the non-offending parent) into treatment and implements family therapy principles. The sole purpose of trauma-focused therapy is to provide strategies and skills for coping with and processing painful memories and emotions tied to traumatic events. The goal is to enable the patient to adopt healthy coping mechanisms by creating a more adaptive meaning and narrative of the negative experience.

How It Works

Early trauma often leads to an individual developing (and accumulating) feelings of powerlessness, anger, guilt, and shame. Depression, anxiety, and substance or alcohol abuse are more than common in trauma survivors. Post-traumatic stress disorder (affecting both children and adults) can be manifested in various ways (again, depending on the individual and their defense mechanisms), such as:

• insomnia
• irritability, anger, aggressive outbursts
• emotional numbness
• poor concentration
• being easily frightened or startled
• self-destructive behavior: drinking, drug consumption
• extreme emotional and physical responses to trauma memory triggers

TF-CBT is considered the number one therapy for treating post-traumatic stress in adolescents (techniques of different therapeutic interventions are incorporated). Key features of TF-CBT treatment often include:

1. Psychoeducation
2. Coping skills
3. Gradual exposure
4. Cognitive processing
5. Caregiver involvement

Psychoeducation

Psychoeducation focuses on diminishing the feelings of the survivor’s culpability or guilt. “I caused it. It’s my fault”. The goal is to help individuals better understand their condition, as well as teach them about normal or expected reactions to traumatic events.

Coping skills

The goal of implementing coping skills is to include relaxation exercises such as mindfulness, deep breathing, acceptance, identifying negative thought patterns, and redirecting – or transforming them. Coping skills are an integral part of any therapy form, as their purpose is to soothe the nervous system and regulate feelings of acute distress and discomfort.

Gradual exposure

Exposure is the standard treatment for trauma; gradual exposure usually involves creating a safe environment in which the patient is gradually exposed (or introduced) to their traumatic experience. The goal is to reprogram the response to trauma triggers as well as decrease emotional distress. Our PTSD treatment for veterans Texas is proud to have enabled patients to face their fears with the help of a certified professional.

Cognitive processing

Another important aspect of trauma-focused therapy is cognitive processing; it is best described as a series of cognitive operations carried out in the formation and manipulation of mental presentations of information. In other words, it includes developing essential skills for recontextualizing negative thoughts and feelings tied to a traumatic experience. It also helps regulate the negative emotional curve.

Caregiver involvement

Caregiver involvement focuses on rebuilding adult relationships and renewing trust. The caregiver goes through training so as to learn and adopt various techniques for becoming a better support system for the child in question. The goal is to develop effective parenting skills and rebuild the caregiver’s confidence in helping the child in a constructive and caring manner.

Benefits of trauma-focused therapy

By engaging in trauma treatment, patients can learn more about the intricate layers of the traumatic event, how to address the symptoms, as well to develop healthier coping mechanisms. Our behavioral health center in San Antonio offers patients the following benefits of trauma-focused therapy:

• learning about the impacts of trauma
• identifying triggers
• restoring a sense of safety: physical, psychological, emotional, and relational
• decreasing trauma symptoms
• trauma processing
• developing healthy coping skills

Techniques used in trauma therapy

There are various psychotherapy treatments for trauma. However, only a handful can be called “evidence-based” and are backed up by extensive research. As previously mentioned, one-size-fits-all is not how therapy works. Each individual is different; the way trauma impacted their emotional and mental well-being, the way the negative experience was stored, how it was (and if it was) processed, etc. Every trauma-based experience is different, so to answer the question “What do you consider the best therapy for trauma?”; there is no single “best” solution, but there are options. Do they work equally well? Again, yes and no. At our Texas behavioral health center, patients find certain types of treatment more effective and more suited to their needs than other tried methods. Different approaches, one goal: getting better.

CBT (Cognitive-Behavioral Therapy)

Cognitive-Behavioral Therapy primarily focuses on negative thinking patterns and working on restructuring them, further leading to substantial behavior pattern changes. Usually, this type of treatment requires the patient to engage in weekly appointments so as to learn and adopt skills for symptom relief purposes. Standard CBT usually takes 12 to 16 weeks. However, a traumatic experience in adults can often lead to other mental health problems, such as alcohol and substance addiction.

Our inpatient dual diagnosis treatment center in Texas focuses on treating co-existing conditions equally and with utmost dedication.

PE (Prolonged Exposure Therapy)

Prolonged Exposure therapy is an evidence-based psychotherapy for post-traumatic stress disorder. It is a specific type of CBT that was designed to teach trauma-stricken individuals to approach trauma-tied memories, emotions, thoughts, physical sensations, and situations. With avoidance being one of the most common symptoms of trauma, PE gradually works on facing and addressing the root cause. Avoiding triggers can only amplify fear around the traumatic event. The goal is to stop avoiding trauma triggers altogether. Therapy exposure involves:

• In vivo exposure: the patient is encouraged to engage with people or objects that are associated with trigger symptoms. This type of exposure teaches the individual to face the fear situation, activity, object, or subject in real life.
• Imaginal exposure: the patient will be asked to recount and explore the depths of their traumatic memory; in detail. The goal is to face the fear without physical exposure. Patients will often address the event in the present tense.
• Interoceptive exposure: artificially creating feared physical sensations tied to trauma. This type of exposure strategically induces somatic symptoms associated with a threat. It encourages patients to maintain full contact with the negative sensation.
• Virtual reality exposure: This technique is used when in vivo exposure is not possible (or practical). Virtual technology is used instead to recreate the traumatic event.

EMDR (Eye Movement Desensitization and Reprocessing Therapy)

Unlike most trauma therapies (with a primary focus on thought patterns), EMDR works directly with the patient’s memory. A trained therapist will have the individual focus on the traumatic event while they are being subjected to alternating taps and soft or gentle tones. EMDR helps patients access trauma memories in a specific way; the memories help them reprocess their recollection of the negative experience. Unlike other techniques, EMDR  does not focus on “reprogramming” thoughts, emotions, and behavior patterns. The reprocessing helps rehabilitate the psychological injury deriving from the very memory of the detrimental event. This technique is used at Alamo Behavioral Health, the residential treatment center Texas residents highly recommend.

CPT (Cognitive Processing Therapy)

CPT is another specific type of Cognitive Behavioral Therapy used for treating PTSD. It narrows its focus on changing the thought wiring. The treatment targets an individual’s irrational or negative thinking pattern that keeps them “stuck” and unable to recover from trauma fully. The goal of this type of therapy is to help the patient assess their trauma, as well as the overall impact it has on their perception and thinking. With the help of a certified therapist, they will learn to develop new skills that help determine whether their thoughts are indeed fact-based and find new, constructive ways to process the negative experience. CPT is considered to be exceptionally helpful for the ones who struggle with feelings of shame.

Trauma-focused therapy and medication

Our mental health experts often prescribe SSRIs for trauma-related issues, such as anxiety and depression (chronic fear, guilt, shame, and anger). Medication-assisted therapy (especially in the case of comorbidity and the need for dual diagnosis treatment) can be used with any of the previously mentioned methods. Additionally, benzodiazepines are frequently prescribed to those with anxiety symptoms and panic disorders. Nevertheless, medication only serves as a symptom reliever; without proper psychotherapy treatment, trauma survivors will not be able to recover from traumatic experiences.

Finding the right therapist

Is there a difference? Absolutely. Unlike a “regular” therapist, a trauma-informed therapist is specifically trained to help trauma survivors. Their approach differs from standard therapy, as it integrates deep awareness of the complexity of trauma, as well as the individual’s suffering. Working with a certified therapist protects patients from potential re-traumatization. Trauma therapist will use their skills and knowledge to help survivors overcome the effects of the negative experience. Our experts at Alamo Behavioral Health are trained in a variety of trauma-focused therapy treatments. Schedule an appointment today, and we’ll be more than happy to walk the road to healing with you.

References:

• https://cctasi.northwestern.edu/
• https://www.traumainformedcare.chcs.org/what-is-trauma/
• https://mantracare.org/therapy/therapy-types/trauma-focused-therapy/