TRAUMA THERAPY MODALITIES
Being updated
Therapy Approaches For Trauma
There is no such thing as a certified complex trauma therapist.
There are continuing education training in treating complex trauma and dissociation, available from the ISSTD, ISTSS, etc.
For PTSD, you can be certified in the various modalities like CPT, PE, EMDR, etc.
List of evidence based therapies can be found here.
You can find more modalities here.
Cognitive Processing Therapy (CPT)
Cognitive processing therapy (CPT) is a specific type of cognitive behavioral therapy that has been effective in reducing symptoms of PTSD that have developed after experiencing a variety of traumatic events including child abuse, combat, rape and natural disasters.
CPT is generally delivered over 12 sessions and helps patients learn how to challenge and modify unhelpful beliefs related to the trauma.
In doing so, the patient creates a new understanding and conceptualization of the traumatic event so that it reduces its ongoing negative effects on current life.
Listen to a CPT session on NPR (Ten Sessions) here.
Exposure is an intervention strategy commonly used in cognitive behavioral therapy to help individuals confront fears. Prolonged exposure is a specific type of cognitive behavioral therapy that teaches individuals to gradually approach trauma-related memories, feelings and situations
Most people want to avoid anything that reminds them of the trauma they experienced, but doing so reinforces their fear. By facing what has been avoided, a person can decrease symptoms of PTSD by actively learning that the trauma-related memories and cues are not dangerous and do not need to be avoided.
Watch a PE introductory video here.
Eye Movement Desensitization and Reprocessing (EMDR) Therapy
A structured therapy that encourages the patient to briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation (typically eye movements), which is associated with a reduction in the vividness and emotion associated with the trauma memories.
Narrative exposure therapy is a treatment for trauma disorders, particularly in individuals suffering from complex and multiple trauma.
It has been most frequently used in community settings and with individuals who experienced trauma as result of political, cultural or social forces (such as refugees).
Often, small groups of people receive four to 10 sessions of NET together, although it can be provided individually as well.
It is understood that the story a person tells himself or herself about their life influences how the person perceives their experiences and wellbeing. Framing one’s life story solely around the traumatic experiences leads to a feeling of persistent trauma and distress.
The Internal Family Systems Model is an integrative approach to individual psychotherapy developed by Richard C. Schwartz in the 1980s.
It combines systems thinking with the view that the mind is made up of relatively discrete subpersonalities, each with its own unique viewpoint and qualities.
Listen to an informal IFS session here.
Somatic experiencing is a form of alternative therapy aimed at treating trauma and stressor-related disorders like PTSD.
The primary goal of SE is to modify the trauma-related stress response through bottom-up processing.
Sensorimotor psychotherapy is body-based talk therapy, integrating current findings from neuroscience to transform traumatic memories into strengths and resources for the client.
It works with developmental trauma, such as maternal lack of attunement, as well as acute or gross trauma like sexual abuse, violence, or verbal abuse.
Sensorimotor therapists work on mindfulness and collaboration with the client, repeatedly asking permission to do each experiment or process along the way.
The NeuroAffective Relational Model(NARM) is an advanced clinical training for mental health professionals who work with complex trauma.
NARM is a cutting-edge model for addressing attachment, relational and developmental trauma, by working with the attachment patterns that cause life-long psychobiological symptoms and interpersonal difficulties.
These early, unconscious patterns of disconnection deeply affect our identity, emotions, physiology, behavior and relationships. Learning how to work simultaneously with these diverse elements is a radical shift that has profound clinical implications for healing complex trauma. As such, NARM is positioned to become an invaluable treatment option for the Trauma-Informed Care movement as we gain greater understanding of the nature of adverse childhood experience (ACEs).
Accelerated Experiential Dynamic Psychotherapy (AEDP)
Accelerated experiential dynamic psychotherapy (AEDP) is a form of talk therapy that aims to help people overcome trauma, loss, or other serious emotional challenges.
Drawing on attachment theory, body-focused approaches, and other related disciplines, AEDP posits that humans are wired for resilience and have an inborn ability to cope with emotional pain; however, many people who have undergone trauma are unable to access the skills that would allow them to navigate these emotional challenges.
AEDP aims to help clients uncover and draw on these innate coping mechanisms to manage their trauma and move toward flourishing.
Accelerated Resolution Therapy (ART)
Accelerated Resolution Therapy (ART) is a unique approach to psychotherapy. ART is unique because the ART Therapist guides the client to replace the negative images in the mind that cause the symptoms of Post-Traumatic Stress with positive images of the client’s choosing. And this is done quickly, most often within one session! Once the negative images have been replaced by positive ones, the triggers will be gone. Nightmares and repeated intrusive thoughts will stop.
Comprehensive Resource Model (CRM)
The Comprehensive Resource Model™ (CRM) is a neuro-biologically based, affect-focused trauma treatment model which facilitates targeting of traumatic experiences by bridging the most primitive aspects of the person and their brain (midbrain/brainstem), to their purest, healthiest parts of the self. This bridge catalyzes the mind and body to access all forms of emotional trauma and stress by utilizing layers of internal resources such as attachment neurobiology, beneficial affiliation neurochemistry, breathwork skills, brain neuroplasticity, our deep connection to the natural world for survival, toning and sacred geometry, and one’s relationship with self, our intuition, and higher consciousness.
The sequencing and combination of these resources, and the eye positions that anchor them, provide the opportunity for unbearable emotions and pain to be stepped into and felt fully while the client is fully present and aware moment to moment which changes how the memories affect the person.
Brainspotting locates points in the client’s visual field that help to access unprocessed trauma in the subcortical brain.
Brainspotting (BSP) was discovered in 2003 by David Grand, Ph.D. Over 13,000 therapists have been trained in BSP (52 internationally), in the United States, South America, Europe, the Middle East, Asia, Australia and Africa. Dr. Grand discovered that "Where you look affects how you feel." It is the brain activity, especially in the subcortical brain that organizes itself around that eye position.
MDMA, the psychoactive drug sometimes known as ecstasy, is poised to become a powerful tool in the treatment of PTSD.
In 2017, the U.S. Food and Drug Administration (FDA) designated MDMA-assisted psychotherapy as a breakthrough therapy. Although MDMA itself is not officially legal or approved for clinical use, phase III trials are underway, and expanded access status was granted in 2020 in the United States and Israel.
The results of preliminary clinical studies are extremely promising, and the FDA could approve MDMA-assisted psychotherapy for PTSD as early as 2024 or 2025.
Written Exposure Therapy is a manualized exposure-based psychotherapy for PTSD. A growing number of studies indicate that WET is effective for PTSD, even among patients with complicated presentations and other comorbid disorders (3-5).
In addition, compared with other trauma-focused treatments, a low number of those who receive WET drop out of treatments (e.g., less than 10%; 1).
The WET treatment protocol was developed through a series of systematic studies. Based upon a fear extinction/emotional processing treatment model, these studies examined the extent to which trauma survivors with PTSD symptoms experienced symptomatic relief from writing about their experiences. The amount of writing necessary to bring about clinically significant symptom change was also evaluated.
This work indicated that 5, 30-minute writing sessions in which patients are directed to write about a traumatic experience in detail, paying particular attention to their thoughts and emotions that occurred at the time of the event, resulted in reduction of pathological fear and subsequent significant PTSD symptom reduction. Using an empirically derived set of instructions for repeatedly writing about their traumatic experience, the patient learns that:
The trauma memory is not dangerous and can be experienced without significant distress.
Distress associated with remembering the trauma is transient.
Emotional distress gradually reduces with time, even without doing anything.
Physiological responses, such as rapid heart rate and sweating, are not dangerous.
High negative affect can be tolerated.
It is possible to develop new ways of thinking about the trauma event and its meaning.
Dialectical Behavior Therapy (DBT)
Dialectical Behavioral Therapy (DBT) is a multicomponent psychosocial intervention based on a model which views dysfunctional behavior as either a consequence of dysregulated emotions or a maladaptive approach to emotion regulation.
DBT groups a collection of skills translated from behavioral research and other evidence-based treatments into four modules: mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance.
Mindfulness skills emphasize observing, describing, and participating in the present moment efficiently and without judgment.
Interpersonal effectiveness skills range from acting assertively to maintaining self-respect.
Emotion regulation skills include strategies for changing emotions and the tendency to respond with appropriate emotions.
Distress tolerance skills are strategies to control impulsive actions and to radically accept difficult life events.
Psychodynamic therapy focuses on unconscious processes as they are manifested in the client's present behavior.
The goals of psychodynamic therapy are client self-awareness and understanding of the influence of the past on present behavior. In its brief form, a psychodynamic approach enables the client to examine unresolved conflicts and symptoms that arise from past dysfunctional relationships and manifest themselves in the need and desire to abuse substances.
Several different approaches to brief psychodynamic psychotherapy have evolved from psychoanalytic theory and have been clinically applied to a wide range of psychological disorders. A growing body of research supports the efficacy of these approaches.