Trauma Therapy Methods: Explore Your Options

Trauma usually involves a stressor, often called a traumatic event, that causes a person severe distress. A wide variety of events can lead to trauma. For example, natural disasters, car crashes, violence, abuse, war, homelessness, bullying, and chronic illness can all be traumatic experiences. 

Acute trauma generally refers to the trauma-related symptoms a person experiences during and for a short time after a traumatic event. Chronic trauma typically refers to symptoms that last for weeks, months, or even years after the trauma took place. Complex trauma can describe the ongoing experience of traumatic events for an extended time or repeated traumatic events over time, as in cases of abuse.

All types of trauma can impact a person's mental health, potentially leading to mental health concerns like acute stress disorder (ASD), post-traumatic stress disorder (PTSD), panic attacks, or the resurfacing of traumatic memories. Trauma treatment often involves trauma therapy, sometimes alongside prescription medications. In trauma-focused therapy, people usually focus specifically on how their past trauma affects their lives now and work to reduce symptoms stemming from trauma. 

Trauma-informed therapy

Trauma-informed therapy can serve as an umbrella term describing any type of therapeutic approach that takes into consideration the profound impact of trauma on a person's mental health. Instead of simply trying to treat symptoms of trauma, trauma-informed therapy usually addresses how trauma has impacted a person's life. All of the other types of therapy listed in this article can be, and often are, conducted through a trauma-informed lens.

Cognitive behavioral therapy (CBT)

Randomized, controlled research studies have found that cognitive behavioral therapy (CBT) can treat PTSD, as well as reduce symptoms of anxiety and depression after trauma, in children, adolescents, and adults. 

In CBT sessions, people typically identify negative beliefs they hold about themselves and others, and then work to change any inaccurate beliefs. A person undergoing CBT for trauma may also explore and process emotions like self-blame, distrust of others, an exaggerated sense of danger, or a sense of inadequacy. They may identify negative coping strategies they've used to manage their trauma symptoms thus far, and then work to change those behaviors and engage in healthier coping strategies instead.

Cognitive processing therapy (CPT)

Studies show that cognitive processing therapy (CPT) can successfully treat PTSD. CPT is often specifically used to treat PTSD in people who have experienced trauma involving physical or sexual violence. 

CPT is generally based on the idea that, after trauma, a person often develops distorted beliefs as they try to make sense of what happened. For example, they may analyze their behavior related to the trauma and blame themselves for being assaulted, when, in reality, they did not cause another person to commit assault. CPT can help a person work through these distorted beliefs and replace them with more accurate beliefs that can help them release negative feelings surrounding the trauma.

Exposure therapy and prolonged exposure therapy

In exposure therapy, a person may gradually receive more exposure to the situations they fear or avoid due to anxiety, despite those situations being safe. Through repeated exposure, the anxiety experienced in response to trauma-related stimuli tends to decrease. Initially, exposures may happen through imagining, writing about, or talking about a feared place, situation, thought, or feeling while in the safe space of a therapy session. 

Prolonged exposure therapy is a type of exposure therapy that was created specifically to treat people with PTSD. In prolonged exposure therapy, a person may repeatedly revisit traumatic memories, and then process the experience through discussions with their therapist. This approach usually allows a person to reprocess their emotions surrounding trauma, and it is primarily based on the theory that people do not emotionally process traumatic events while they are happening. 

In time, a person undergoing exposure therapy may begin gradually facing situations or places they avoid due to trauma by intentionally placing themselves in them in real life. This approach can help people reduce the anxiety they experience while out in the world and reduce the limitations they’ve put on their lives due to trauma.

Eye movement desensitization and reprocessing (EMDR) therapy

Eye movement desensitization and reprocessing (EMDR) is a unique therapy in which a person may think about traumatic memories as a therapist guides them through specific patterns of side-to-side eye movements. The purpose of EMDR is typically to help people identify and adopt more positive outlooks on their past trauma. 

EMDR normally treats PTSD through eight phases:

• Phase 1: The clinician takes a person's history.
• Phase 2: The clinician explains how EMDR works and prepares the client for the therapy.
• Phase 3: Together, the clinician and client assess the memory on which they are about to focus.
• Phases 4 to 7: The clinician and client work together to reprocess the memory so that it no longer causes as much distress. This usually involves making eye movements, identifying more positive thoughts about the traumatic events, and scanning the body for physical responses to the traumatic memory.
• Phase 8: The clinician and client evaluate the results of the treatment.

Some people prefer EMDR because it doesn't necessarily require them to talk or think about their thoughts and emotions surrounding trauma at length like some other therapies do. Instead, EMDR normally focuses on changing the body's reaction to specific memories and the way those memories are stored in the brain. By the end of EMDR therapy, traumatic memories should seem less vivid, and they should not be distressing to recall.

Internal family systems (IFS) therapy

Internal family systems (IFS) is another type of therapy that can reduce PTSD symptoms. IFS generally operates on the assumption that a person's self is made up of multiple parts. Some of these parts are considered "vulnerable" parts, and they may hold painful, traumatic memories. Others are "protective" parts, and they likely developed habits and ways of being that helped a person cope with or distract themselves from trauma at the time, but they may not be helpful in their current life.

In IFS, the mature, adult form of a person's self may try to act mindfully and with compassion as it "talks" with these vulnerable and protective parts. Developing this self-compassion may be particularly helpful for people who experienced trauma as children. When children experience trauma, they often develop self-blame, and self-compassion can change that line of thinking and replace it with something that is kinder and more accepting. 

Remote therapy for trauma

Whether a person has PTSD or not, they may want to try therapy as a way of reprocessing traumatic memories and working through thoughts and emotions related to past trauma. Remote therapy could be an even more attractive option, since it typically allows a person to do the work of trauma reprocessing from the safety and comfort of home or another preferred location. BetterHelp is an online remote therapy platform that can pair you with a mental health professional who is equipped to help you.

A scoping review of 38 research studies found that remotely delivered trauma therapy may treat trauma as well as in-person therapy while reducing stigma, reducing costs, and increasing access. However, the study authors caution that more research may be needed to explore potential risks, as well as other details related to remote therapy for trauma. The studies that were reviewed looked at a variety of types of therapy given to veterans and military members, including prolonged exposure therapy, cognitive processing therapy, and cognitive behavioral therapy. While CBT appeared to return mixed results, all other forms of therapy reviewed were given a high rating for their ability to treat trauma.