Part 3: What to Expect in Therapy with a REAL Trauma Therapist
This three-part post covers why it is important to work with a real trauma therapist, what a real trauma therapist is as well as what you should look for when finding a therapist, and this week’s topic: what you can expect when in treatment with a real trauma therapist.
Not “Just Talking”
When attending therapy sessions for trauma or post traumatic stress symptoms, you should not be able to describe the sessions as “just talking.” If you attend sessions and your therapist listens to share your thoughts, experiences, etc. and offers some feedback here-and-there, that is not trauma treatment.
As mentioned in the part two post, listening to a patient share a life experience does not even cross the threshold of what is involved in understanding trauma, knowing how it impacts the individual, knowing how to effectively treat trauma, and how to problem-solve nuance aspects of the treatment process.
Your therapist should be able to describe (in detail) how treatment will take course, the goals of treatment, and what you can expect during your time in therapy. And you should be able to recognize that the therapist is following a protocol. Ask your therapist (or potential therapist) any questions about their training, background, and how they treat trauma if you are unsure what type of treatment is being offered and provided.
Participation in Structured Therapies
If you are obtaining treatment from a real trauma therapist (i.e., a clinician who has had explicit training, supervision, and clinical experience working directly, and perhaps almost exclusively, with trauma), then you can expect therapy to appear more structured. This means that you should be provided with an estimated number of sessions, that each session will have an agenda of tasks to be completed, and it is very likely that you will have homework assignments (except in the case of EMDR).
Structured therapy treatments are effective because they follow a standardized protocol that has been rigorously tested through empirical studies. This, in turn, means that the treatment has been shown to repeatedly be effective in significantly reducing or eliminating symptoms of distress.
More Specifically…Trauma-Focused Therapy Treatments
There are three evidence-based (i.e., research-based and effective) trauma-focused treatments that are the gold standard therapies for treating trauma. The therapist should be able to offer at least one, but hopefully any of the following:
Cognitive Processing Therapy (CPT)
- Cognitive Processing Therapy (CPT) is a 12-session trauma focused treatment that has been researched for over two decades and has been shown to be highly effective for treating Posttraumatic Stress Disorder (PTSD) and other related symptoms (Chard, 2005; Monson et al., 2006; Resick et al., 2002, 2008; Resick & Schnicke, 1992, 1993) in a relatively short period of time. CPT was developed in 1993 and adapted from cognitive-behavioral therapy to originally focus on the treatment of individuals who had experienced rape and or crime. CPT implements Beck’s basic cognitive techniques including cognitive restructuring to challenge maladaptive thinking, however begins first with exploring the traumatic memory to understand thoughts, beliefs, and feelings that directly resulted from the traumatic event.
Prolonged-Exposure Therapy (PE)
- Prolonged Exposure (PE) therapy is an evidence-based treatment for trauma and PTSD that consists of 12 to 16 (80-minute) therapy sessions. The treatment was originally developed for use with survivors of rape, but over two decades of research has shown PE to be highly effective in the treatment of trauma and PTSD for individuals with varying traumas. PE is endorsed by the Institute of Medicine report and SAMSHA as one of the leading treatments for trauma and PTSD, and is also one of the leading treatments recommended by the VHA-DOD Clinical Practice Guidelines. The symptom-reduction experienced over a relatively short period of time makes this an appealing treatment, as well.
Eye-Movement Desensitization Reprocessing (EMDR)
- Eye Movement Desensitization and Reprocessing (EMDR) is a unique and powerful therapy for helping people deal with stress, trauma, painful memories and places in their lives where they are stuck. EMDR specifically targets traumas that have been “locked” in the brain, but can also be used for events that are not considered trauma in the traditional sense, such as ongoing teasing while in school, chronic childhood illness, etc. After experiencing a traumatic or stressful situation, negative thoughts and beliefs about the self can dominate. Generally, these are the feelings of not being good enough, not being safe, or not being in control. These beliefs of inadequacy, helplessness, or powerless can contribute to patterns of depression and anxiety, impacting most areas of your life. Negative feelings can also become stuck leading you to experience the negative feelings in the present even though they’re connected to the past. These feelings can impact your view of current situations, which may feel “true.” Negative sensations associated with those feelings also surface and you may try to “avoid” experiencing them. Over time, these experiences can build up and lead to depression, anxiety, or PTSD.
Common “Side Effects” of Therapy That Show Treatment is Working
Possible side effects of trauma treatment may include a temporary increase in symptoms, including increased awareness of thoughts, behaviors, or recalling the traumatic memory. However, this is true of any therapy where you are finally addressing content, memories, experiences, thoughts, or emotions that have been avoided or repressed. This period is usually very brief, and for some individuals, does not occur at all. However, this is a clear way of identifying that you are finally working on and through content that needs to be addressed.
Ultimate Goal of Therapy: Reduction or Elimination of Post-traumatic Symptoms
The ultimate goal of trauma-focused therapy, and the reason why it is important to work with a real trauma therapist, is to significantly reduce or eliminate trauma response symptoms. Considering the amount of time that some individuals live with distress in their lives related to an experienced trauma (possibly years!), trauma-therapy is a relatively very short period of time to invest in feeling a whole lot better (on average about 12 sessions, or 12 weeks). When you are engaged in trauma-focused therapy treatments, you should notice that you gradually begin to feel “better” and experience less hypervigilance, less intrusive memories of the trauma, reduced irritability or anger, less avoidance, and increased positive emotions and thoughts.
Tampa Therapy: REAL Trauma Therapy That Can Help You
Unfortunately, traumatic events happen (and quite often). If you are struggling with memories, dreams or nightmares, or behavior-altering changes in your life due to trauma, Dr. Barbash is a REAL trauma psychologist who can truly help and is ready to work with you. We’ll provide a comfortable, supportive, and non-judgmental environment, along with effective treatments to help you. Contact us today to start your journey to healing.