Understanding Different Trauma Therapy Modalities: Cognitive Treatment And Recovery
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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.
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
Types of trauma and their impact
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.
PTSD and the long-term effects of trauma
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.
- Understanding the ways trauma can affect people
- Providing a safe and supportive environment for trauma survivors
- Addressing the effects of trauma on survivors’ lives
- Preventing traumatic memories from causing distress in the future
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.
A cognitive behavioral therapy treatment approach
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 as part of cognitive behavioral therapy
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.
Emerging trauma therapy modalities for PTSD treatment
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: Exploring trauma therapy modalities
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.
The effectiveness of online therapy for trauma treatment
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.
Takeaway
What is the best modality to treat trauma?
The best modality to treat trauma may often involve a combination of trauma-focused treatments such as somatic therapy, trauma-focused CBT, and cognitive behavioral therapy, which can address and process those traumatic memories or trauma-related memories, trauma symptoms, negative beliefs, and the responses of a person's nervous system. According to a clinical practice guideline, these approaches can be very effective for conditions like post-traumatic stress disorder. They may help individuals process traumatic memories while supporting the overall healing process guided by licensed mental health professionals, such as a trauma therapist.
What are the 4 R's of trauma?
The 4 R’s of trauma are important steps in a trauma-informed approach. First, we may need to realize how domestic violence or trauma affects our lives. Childhood trauma and traumatic experiences may affect an individual's mental health. Then, we recognize signs of trauma like PTSD symptoms, mood disorders, and sometimes eye movements. Next, we respond with the right care using trauma-focused treatments like talk therapy or cognitive behavioral therapy. Finally, we resist re-traumatization by ensuring mental health professionals follow a specific clinical practice guideline during a person’s healing journey.
What is the most successful trauma therapy?
Cognitive behavioral therapy may be considered one of the most successful trauma therapies, particularly when used for treating post-traumatic stress disorder and other mental health disorders. This approach may help individuals process trauma-related memories and traumatic experiences and improve emotion regulation. It may also develop coping skills to help manage distress. Other treatments and techniques, such as accelerated resolution therapy and bilateral stimulation, have also been shown to reduce a person's emotional intensity and can support healing trauma. These psychological therapies may be considered highly effective when addressing traumatic experiences and improving overall mental health conditions with the guidance and help of licensed mental health professionals.
Is EMDR or CBT better for trauma?
Cognitive behavioral therapy and using bilateral stimulation like EMDR can be considered two of the highly effective therapeutic techniques for PTSD treatment. Cognitive behavioral therapy may help build coping skills, improve emotion regulation, and address negative thinking linked to trauma-related memories. At the same time, EMDR processes trauma memory through bodily sensations and can be helpful for individuals with experienced trauma and who may struggle with traditional talk therapy. The better approach may depend on the individual’s PTSD diagnosis, the nature of their traumatic event, and guidance from licensed mental health professionals based on an available systematic review of outcomes and psychotherapy treatments.
What is the gold standard for trauma treatment?
Cognitive behavioral therapy is often considered the gold standard for PTSD treatment because of the strong evidence base and effectiveness in addressing trauma memory and responses to a traumatic event. Among various therapeutic modalities, it can help improve distress tolerance, enhance interpersonal effectiveness, and process someone's past traumatic experience. While family therapy, group therapy, and even art therapy or somatic therapy can support the healing process, cognitive behavioral therapy remains the most widely recommended.
What is the difference between RTM and EMDR therapy?
The main difference between the Reconsolidation of Traumatic Memories and Eye Movement Desensitization and Reprocessing therapy lies in how each approaches trauma memory and a traumatic event. EMDR focuses on reprocessing the individuals’ memory with the use of eye movements, while RTM diverts the emotional response to the memory of a person without reliving the trauma focus. Unlike brief eclectic psychotherapy or psychodynamic therapy, both RTM and EMDR are structured, short-term methods that do not typically use techniques like music therapy.
What are the 4 C's of trauma?
The 4 C's of trauma are calm, contain, care, and cope. They are strategies to manage the effects of an individual's traumatic event and experience. These can help individuals process a trauma memory with a clear trauma focus and can be supported by other treatments and approaches like brief eclectic psychotherapy.
- Calm: It is necessary that you also look after yourself. You should know how you feel towards yourself, others, and the people around you. Give yourself some time to relax and be calm. When you are calm, being kind to yourself and others is easy. It is nice to take a deep breath and control your emotions to promote calmness for the patient.
- Contain: You need to maintain physical and emotional safety when asking about the topic of trauma, such as a traumatic event. It is nice when you can offer choices and control. In this way, patients may feel safe and supported.
- Care: Let other people feel that you are always there for them. It is OK to remind them that their reactions to trauma memory are valid and normal. It is important as well to treat everyone fairly and with respect.
- Cope: Making ways to help people build strong relationships and create healthier ways to deal with trauma and stress. You can make a list of the things that can be helpful when handling problems and trauma. It can be talking to some friends or seeking professional help.
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