Trauma Focused Therapy
Trauma focused therapy aims to help individuals who have experienced traumatic events, in childhood in particular. It’s usually intended for children and adolescents, and sometimes their families as well. A trauma focused approach to mental health care embraces an understanding of the emotional, neurological, psychological, social, and biological effects of trauma. Trauma-informed therapists help promote healing by providing mental health services and treatment tailored to each individual's trauma history.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines trauma as “exposure to actual or threatened events involving death, serious injury, or sexual violation in one (or more) of the following ways:
- Directly experiencing the events;
- Witnessing the events in person as they occur to others; or
- Experiencing repeated or extreme exposure to adverse details of the events."
Trauma can come about after someone experiences physical, emotional, or psychological danger or harm. Even being close to or witnessing these sorts of experiences can lead to the development of trauma and related mental health responses.
- Childhood neglect
- Sudden separation from a loved one
- Natural disasters
- Accidents
- Assault
- Poverty and food insecurity
- Violence in one's community
- Living with someone who experiences unmanaged substance use and/or mental health disorders
- Experiences of sexual, emotional, or physical abuse. *
Regardless of the type or cause, trauma can be a pervasive problem that can have both short- and long-term effects on a person’s functioning and/or emotional, physical, or social well-being. Trauma focused care focuses on addressing these potential effects of a past traumatic event, which may include but are not limited to:
- Shock and denial
- Unpredictable emotions
- Flashbacks and nightmares
- An inability to feel comfortable
- Physical symptoms like stomach aches and headaches
- Confusion
- Exhaustion and fatigue
- Anxiety
- Difficulty concentrating
- Risky behavior, such as substance misuse
The toll that trauma takes on an individual’s well-being can be significant. However, people who have had traumatic experiences can also be highly resilient and may develop a sense of perseverance and strength in the face of challenges with the right support. Healing from trauma and living a fulfilling life can be possible with the help of a trauma focused therapy. See below for distinctions between the effects an individual may experience during childhood and adulthood after experiencing trauma at a young age.
Research also suggests that the more a child is exposed to stress and trauma, the greater their risk of experiencing trauma-based chronic health conditions and risky behaviors later in life. Childhood PTSD (childhood post-traumatic stress disorder) is an example of a diagnosable mental health condition and stress disorder that could occur in some children who have had an ACE. There are various types of therapy that may be used to help a child recover from trauma depending on the type of experience, from Trauma focused therapy to reunification therapy.
Trauma focused therapy techniques
Trauma focused therapy is typically conducted by trauma-informed therapists who understand the effects of trauma and utilize therapeutic tools to address thoughts, behaviors, and feelings that may occur as a result of it. These therapists usually undergo specialized training and follow certain evidence-based practices to ensure that they provide effective post-traumatic support for their clients.
Trauma focused therapy takes into account the potential effects of a past trauma(s) when administering therapeutic treatment to a child or adolescent. It was originally designed to help those who had experienced sexual abuse, but it has since been expanded to support children and teens who have experienced any number of traumatic situations. It’s a shorter-term type of therapy and is usually done with a parent or caregiver present. There are typically three phases of trauma focused therapy.
The first part of trauma therapy is usually helping the child and their parent(s) understand what normal reactions to trauma can look like, which may help increase understanding in the parents and reduce feelings of guilt in the child. Next, the therapist may help the child learn to get comfortable identifying and expressing their emotions. Then, they can teach them relaxation techniques for calming symptoms of trauma that may arise. After that, the cognitive behavioral therapy portion usually begins, which aims to help adolescents in particular learn to identify and shift distorted thoughts about the experience of trauma or about themselves.
Trauma focused therapy
"Is therapy right for me if I’ve experienced trauma?" The way people choose to move through the trauma they’ve experienced is individual and up to them. However, many people find engaging in some form of trauma focused therapy to be beneficial.
Although trauma focused therapy in particular is often discussed in reference to children, there are various forms that are geared toward adults as well, from dialectical behavior therapy (DBT) to eye movement desensitization and reprocessing (EMDR) therapy. A therapist who is trained in these types of modalities can generally offer a nonjudgmental, welcoming space where the individual can freely express and process their emotions and learn techniques for managing distress and moving forward toward healing.
Those who prefer to meet with a therapist to address trauma face to face can contact their insurance company for a list of in-network providers or ask their primary care doctor for a referral. Those who would prefer to meet with someone from the comfort of their own home might consider online therapy. With a platform like BetterHelp, you can get matched with a licensed therapist who you can meet with via phone, video call, and/or in-app messaging. If your child aged 13–19 has experienced trauma, TeenCounseling can offer the same services with parental consent. Research suggests that online therapy can be as effective as in-person sessions for addressing post-traumatic stress disorder and similar conditions in many cases, so it may be worth exploring if you prefer this format.
Experiencing or witnessing trauma during childhood can cause a number of short- and long-term effects. If your child has been through a traumatic experience, trauma focused therapy could help them on the path to healing. If you’ve experienced trauma in the past, some form of trauma focused therapy could also be helpful for you. There are both in-person and online options and resources available for this type of care.
Trauma Focused Therapy
A trauma-informed approach to the therapy process refers to a practice used to avoid retraumatization of an individual who has experienced a traumatic event. It can be used with all patients, regardless of their age or history. Trauma focused therapy is an evidence based child health care approach as well.
This approach may also be integrated with a variety of treatment modalities and can be used to treat various types of mental health conditions and challenges, including those unrelated to the trauma itself. A trauma-informed approach may even be helpful when addressing complex conditions like personality disorders and dissociative disorders.
As a clinical practice guideline, trauma-informed therapists are encouraged to keep in mind the five principles of trauma-focused treatment:
- Safety
- Trustworthiness
- Choice
- Collaboration
- Empowerment
According to the National Institutes of Health, the three core elements of trauma-informed practice include:
- Realizing the prevalence of trauma
- Recognizing its impact
- Responding to trauma
- What is an example of trauma-informed practice in mental health?
One example of trauma-informed practice is asking someone what happened to them rather than what’s wrong with them. This practice assumes that everyone has endured at least one trauma in their lives.
What are the 4 R's of trauma?
According to the Substance Abuse and Mental Health Services Administration, the four Rs of trauma include:
- Realize that nearly everyone has traumatic memories
- Recognize the impact of trauma
- Respond to trauma with trauma-focused treatments
- Resist trauma triggers and retraumatization
The 3 Rs of treating trauma are:
- Regulate emotions
- Relate to the person
- Reason with the person
There are various ways to treat trauma related disorders such as posttraumatic stress disorder, and experts may disagree about the best approach. Moreover, each individual may respond differently to trauma treatment. Here are some popular therapeutic modalities for treating PTSD symptoms:
- Cognitive behavioral therapy
- Cognitive processing therapy
- Internal family systems therapy
- Eye movement desensitization and reprocessing
- Prolonged exposure therapy
- Accelerated resolution therapy
- Trauma-focused CBT
- Trauma-focused psychodynamic therapy (talk therapy)
- Family therapy
What techniques are used in trauma therapy?
There are many techniques a trauma-focused therapist might employ alongside various trauma therapies.These can help clients regulate emotions and process traumatic memories. Some examples include:
- Accelerated experiential dynamic psychotherapy
- Narrative processing
- Grounding
- Mindfulness meditation
- Somatic experiencing
- Psychedelics for complex trauma or severe trauma
How do you explain trauma focused therapy?
Trauma-informed therapy strives to provide effective mental health care through psychological therapies in a safe and supportive environment without causing the individual any additional emotional or psychological harm.
The four Cs of trauma-informed care include:
- Calm: Pay attention to feelings related to the client’s trauma memory. Calm yourself using your own coping strategies.
- Contain: Contain the risk of retraumatization by keeping discussions of the trauma suffered to a minimum and removing any trauma reminders.
- Care: Provide encouragement if and when the client shares trauma memories or trauma related symptoms like trauma stress and anxiety, for example. Avoid shaming the client for any unhelpful beliefs or coping methods such as substance abuse.
- Cope: Provide healthy coping skills for trauma symptoms that the client can use throughout the healing process as intense emotions and negative beliefs resurface. Make note of any successful trauma-focused interventions.
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