Understanding Different Trauma Therapy Modalities

Trauma can have a range of negative effects on mental health. These effects, from post-traumatic stress disorder (PTSD) to substance use disorders, can be distressing and add challenges to your life. A range of therapies may help survivors heal, including cognitive processing therapy, prolonged exposure, eye movement desensitization and reprocessing, and more. 

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Understanding trauma

Trauma can be thought of as a reaction to events that are scary, disturbing, or life-threatening. The exact causes of trauma can vary, but some common examples include the following:

• Witnessing or experiencing violence
• Having a life-threatening illness or injury
• Experiencing domestic abuse
• Experiencing sexual assault
• Surviving a natural disaster, terrorist attack, or other near-death experience

Events like these can affect your emotional and mental well-being. When these effects last a long time and cause challenges in your daily life, you may be living with trauma.

In general, there are three broad types of trauma:

• Acute trauma: Acute trauma can be seen as trauma from a one-time event, like a car crash or a natural disaster. 
• Chronic trauma: Chronic trauma can be defined as repeated trauma that continues over time, such as domestic abuse. 
• Complex trauma: Like chronic trauma, complex trauma also tends to be repetitive or ongoing. However, complex trauma usually happens during childhood and often involves a caregiver. 

Post-traumatic stress disorder, or PTSD, may be one of the most well-known effects of trauma. PTSD can involve symptoms like nightmares, disturbing flashbacks, and ongoing feelings of fear. People with PTSD may go out of their way to avoid reminders of their trauma and may withdraw from their relationships and responsibilities.

Beyond PTSD, the long-term effects of trauma may also include substance use disorders, depression, panic disorder, and other mental health challenges. 

What is trauma therapy?

Living with trauma can be challenging, especially if you’re experiencing lasting side effects like PTSD. However, treating trauma is often possible with professional support. This is where trauma therapy can be beneficial. 

Trauma-informed therapy may help survivors improve their well-being and move forward from their experiences.

An overview of trauma therapy modalities

As useful as trauma therapy can be, it may not look the same for everyone. There are several therapeutic techniques a therapist might use to help someone with trauma. These techniques are sometimes called “modalities.” Let’s take a look at a few examples.

Cognitive processing therapy: Cognitive behavioral therapy, or CBT, generally focuses on helping individuals change unhelpful thoughts that may be contributing to their difficult feelings and behaviors. Cognitive processing therapy, or CPT, is a type of CBT. As part of the CPT process, patients may be asked to write statements about their trauma, read them aloud, and reflect on them with a therapist. 

Cognitive therapy: Like CPT, cognitive therapy (CT) originates from cognitive-behavioral therapy. The idea behind CT is generally to help trauma survivors reframe the ways they think about and cope with their experiences by changing unhelpful beliefs. 

Prolonged exposure: Also known as PE, prolonged exposure therapy usually aims to help trauma survivors overcome feelings of stress or fear related to their experiences. PE typically involves gradually exposing patients to reminders of their trauma over several therapy sessions. 

Eye movement desensitization and reprocessing: Also known as EMDR, this form of trauma treatment normally focuses on helping survivors process their traumatic memories. During EMDR, clients may move their eyes in specific patterns while thinking about a traumatic memory, which may change the way the memory is stored in the brain. 

Narrative exposure therapy: The goal of narrative exposure therapy, or NET, is primarily to help survivors put traumatic events in context by writing their life stories. Narrative exposure therapy may be helpful for survivors of complex trauma.  

Though less common, other types of therapy that aren’t specific to trauma may also be used to treat trauma survivors. Some examples include those listed below:

Internal family systems therapy: Internal family systems (IFS) therapy is generally based on the idea that a person’s mind can take on different “sub-personalities” that may affect their behavior. IFS therapy usually focuses on finding balance in this “internal system.” Research has shown that IFS therapy may benefit survivors of childhood trauma. 

Dialectical behavior therapy: Dialectical behavior therapy, or DBT, usually aims to help people who experience intense emotions learn to manage them more effectively. DBT is most often used to help people with borderline personality disorder. However, recent research has found that certain types of DBT may also be helpful for people with PTSD. 

Mindfulness-based cognitive therapy: Mindfulness-based cognitive therapy, or MBCT, often combines techniques from cognitive therapy with mindfulness practices. These practices may involve being present in the moment, focusing on physical sensations, and observing thoughts and feelings. 

Early studies have found that mindfulness-based treatments may reduce trauma symptoms. 

Several new and emerging forms of therapy are also being explored as possible PTSD treatments. Psychedelic-assisted therapy and therapy using wearable technology are two examples. However, these treatments are still being studied. We will likely need more research to know whether they are effective. 

Starting your trauma therapy journey

If you’re living with the effects of trauma, working with a trauma-informed therapist may help you find a path forward. That said, talking about traumatic experiences can be deeply personal. Finding a therapist with whom you are comfortable can sometimes take a few tries, which is why online therapy may be helpful. Platforms like BetterHelp match you with a licensed therapist and let you change therapists at any time. This flexibility may make it easier to find the right therapist for you.

Research shows that online therapy can effectively treat several mental illnesses that may develop in response to trauma. In a 2017 analysis, researchers reviewed data from 373 studies of online therapy. They found that online therapy could be an effective treatment for substance use disorders, PTSD, panic disorders, and depression.