Understanding Evidence-Based Trauma Therapy For Adults

Attempting to heal from traumatic events while navigating the responsibilities and challenges of adult life isn’t always easy. Research suggests that psychotherapy techniques developed for conditions like post-traumatic stress disorder (PTSD) can help. These methods typically promote healthy processing of traumatic memories, along with adjusting harmful habits of thought, emotion, and behavior. We’ll review what you need to know to find success in trauma therapy as an adult. 

Many effective trauma therapy techniques focus on learning to recognize and modify dysfunctional thoughts, beliefs, and expectations resulting from traumatic stress. Others involve exposure therapy, which usually requires revisiting recollections of trauma under controlled conditions. Confronting the memories and aftermath of a traumatic event can be painful, but support from loved ones and a strong working relationship with your therapist can help you stick with treatment and move forward.

Trauma-focused therapy can help you heal

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General vs. trauma-focused therapies

The effects of trauma on mental health can be far-reaching and unpredictable. While many people are aware that severely stressful and frightening events can lead to post-traumatic stress disorder, undergoing trauma (especially as a child) can also increase the risk of conditions like the following:

• Depression
• Anxiety
• Schizophrenia and other psychotic disorders
• Personality disorders

Some people with these conditions may be effectively treated using therapies that don’t have a specific focus on trauma. For example, manualized cognitive behavioral therapy (CBT) and psychodynamic therapy (PDT) can both lead to significant reductions in depressive symptoms. Schizophrenia, meanwhile, may respond best to a combination of antipsychotic medications, psychosocial support interventions, and talk therapy. 

Types of trauma therapy for adults

The following trauma-focused therapies have been found effective in repeated clinical trials and meta-analyses. They’re frequently recommended in clinical practice guidelines for PTSD by organized bodies of mental health professionals, such as the American Psychological Association (APA).

Cognitive therapy for PTSD (CT-PTSD)

CT-PTSD is primarily based on the concept that an overly negative understanding of traumatic events and their aftermath can lead survivors to sense they are constantly threatened and endangered. The therapist can facilitate healthier attitudes by questioning the client about their mental and behavioral processes and helping them identify distortions in their thinking. CT-PTSD is strongly recommended by the American Psychological Association as a treatment for trauma symptoms.

Trauma-focused cognitive behavioral therapy (TF-CBT)

Like CT-PTSD, this method is largely rooted in the basic principles of cognitive behavioral therapy. In addition to exploring creative, constructive ways of processing traumatic memories, the client may learn relaxation techniques and other evidence-based coping skills to help them regulate their emotions. Although it was first developed for use with children and adolescents, there’s evidence that TF-CBT can also effectively reduce symptoms in adult patients. 

Cognitive processing therapy (CPT)

This form of psychotherapy can assist participants in re-examining negative beliefs about themselves and the world that they’ve developed in an attempt to make sense of their traumatic experiences. By helping them let go of unhealthy self-blame, expectations of danger and disaster, and a sense of hopelessness, CPT may be able to relieve many other symptoms of trauma. CPT is recommended as highly effective for PTSD by organizations like the APA and the Department of Veterans Affairs.

Eye movement desensitization and reprocessing therapy (EMDR)

EMDR usually involves calling to mind a specific traumatic memory while paying attention to some type of rhythmic stimulation alternating between different sides of the body — often back-and-forth eye movements, though repetitive taps or sounds may also be used. Between recollections, the patient talks through the resulting thoughts and emotions with the therapist. This process is generally intended to alter the habitual bodily and mental response to distressing memories, and the available evidence suggests it can be strongly effective in treating PTSD.

Prolonged exposure therapy 

Avoidance — habitual and exaggerated efforts to avoid recalling traumatic memories — may play an important role in developing PTSD symptoms by increasing a survivor’s sense of anxiety and expectations of danger. 

Prolonged exposure generally focuses on addressing avoidance by helping the client gradually become more comfortable confronting reminders of their trauma, both in and out of the therapy setting. This technique has repeatedly been identified as one of the most effective forms of trauma treatment for adults.

Challenges of trauma therapy

While undergoing trauma-focused psychotherapy may be an effective way to relieve distressing mental health symptoms, it’s not always easy or pleasant. Adults who have undergone this type of treatment often report that confronting memories of trauma can be painful, sometimes more so than they expected. 

Many also find that the effects of working through their traumatic recollections aren’t limited to their time in the therapist’s office. They may experience distressing thoughts and emotions intruding into their everyday lives, which can sometimes have negative impacts on their work, social lives, and other meaningful activities. 

However, most participants also discover that these difficulties lessen over time as they grow to be better able to manage their responses to discussing and remembering trauma. Clients often come to view the challenging aspects of therapy as a necessary, cathartic aspect of the healing process. A 2017 study of veterans who engaged in CPT and prolonged exposure reported that most believed the experience was worth the difficulty in the long run due to the symptom relief they attained. 

What can help you complete trauma therapy successfully?

Dropout — patients choosing not to continue the treatment process — tends to be a frequent obstacle to recovery in trauma-focused therapies. 

One factor that may help a great deal is social support. Encouragement and understanding from family and friends are often cited as the primary reasons why adult patients complete therapy for trauma symptoms.

If you’re preparing to engage in trauma-focused mental health treatment, you may benefit from talking with loved ones ahead of time and letting them know that you could use their support as you go through this challenging process. This could mean listening to you when you need to talk, being patient when you experience difficult emotional reactions, or providing practical assistance to help you manage your day-to-day responsibilities.

A strong relationship with your therapist can also be a helpful factor. The connection between the client and the treatment provider, commonly known as the therapeutic alliance, has been identified in many studies as a significant predictor of positive outcomes in adult therapy for trauma. 

This suggests that choosing the right trauma therapist could be crucial to setting yourself up for success. When evaluating possible treatment providers, you might want to look for online ratings and reviews to see what their past clients have said. 

Setting up a consultation before committing to therapy may also be helpful, allowing you to ask questions about the therapist’s treatment approach and philosophy. If you are respected, comfortable, and secure while talking with them, it could be a sign that they’re someone with whom you’d work well in therapy.

Finding trauma therapy as an adult

The most common way to start looking for psychotherapy is typically by talking with your primary care doctor. They may be able to refer you to a trauma-informed therapist who’s worked successfully with past patients. Looking for therapists who are trained in specific trauma-focused therapy modalities, such as CPT, EMDR, or prolonged exposure therapy, can help you ensure your provider is qualified.

Another option may be to search through your insurance company, which can help you find treatment providers who are covered by your insurance policy. Former service members with PTSD may also be able to seek assistance through the Veterans Administration.

Some professional associations and educational institutions can also help adults locate mental health providers. In addition to general databases of psychotherapists, such as the APA’s Psychologist Locator, you can search trauma-specific resources like those listed below: 

• Emory University’s Nationwide Directory of Prolonged Exposure Providers
• The Cognitive Processing Therapy Provider Roster
• The International Society for Traumatic Stress Studies (ISTSS) Clinician Directory
• The EMDR Therapist Directory from the EMDR International Association (EMDRIA)

Trauma-focused therapy can help you heal

Match with a qualified therapist online

Online therapy platforms can offer another helpful option. These services can typically pair you with a qualified therapist based on your preferences and desired expertise, making it simpler to find a provider with whom you’ll have a strong connection. As noted above, forging a healthy therapeutic bond can improve your odds of positive treatment outcomes.

As online therapy becomes increasingly common, a growing number of studies suggest that it can be convenient and effective. A 2015 clinical trial directly comparing online and in-person cognitive processing therapy found no difference in the quality of results. If you’re comfortable receiving trauma therapy over the internet, there’s a good chance you’ll find it helpful.