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Trauma-Focused Therapy

Kristin Hall, FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 2/24/2022

Trauma is more than just a difficult, unpleasant experience.

Trauma is ruptured relationships, depression, anxiety and confusion. It’s a tearing apart of one’s life and identity.

But with such profound pain and confusion comes an even more profound choice: do you sit still and allow trauma to overtake and rule your life, or do you do something about it?

There are many evidence-based treatments and mental health resources available to help folks overcome their respective trauma, as well as many trauma-focused treatments.

One mental health solution to overcoming trauma is talk therapy — specifically a kind of therapy called trauma-focused therapy. 

But what is trauma-focused therapy? How is it used, and how might it be useful on your path to recovery

What Is Trauma-Focused Therapy?

Trauma-focused therapy focuses on the impact a traumatic episode (or episodes) has on one’s psychological, behavioral and physical well-being. It can address anything from the less severe traumatic experiences to things like posttraumatic stress disorder (PTSD).

Trauma-focused therapy emphasizes a recognition of the traumatic event and the person’s understanding of the event, as well as the various responses the patient has to the trauma and its coinciding triggers

Trauma-focused therapy is also, to a degree, a form of behavioral therapy, because it takes a holistic approach to addressing one’s traumatic experiences.

Therapists have developed and continue to employ trauma-focused treatment in order to help those suffering with trauma gain an understanding of the trauma itself, as well as provide them with coping tactics and mechanisms to help them lead full, healthy lives.

How Do You Structure Trauma-Focused Therapy?

Through rigorous effort and research, therapists have developed a structure by which they administer trauma-focused therapy.

Here’s a basic rundown for how the practice works.

Maybe it’s for you, maybe it isn’t — what’s important is that you feel comfortable with this approach if you’re someone who believes trauma-focused treatment can assist you in overcoming serious mental health care challenges.

Realize

Before trauma-focused therapy can be of any use to you, you first have to realize you’re suffering from trauma. 

The trauma itself can be rooted in an event or even a string of events — your experience and pain are wholly yours. 

What matters is your respect for what has happened in the past and how it impacts you in the present, regardless of whether you have posttraumatic stress disorder, traumatic memories, or other forms of psychological trauma.

Once you realize what the trauma specifically means to you, you can — with a mental health professional’s help — then take a critical next step: charting a course forward.

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Recognize

Remember that old saying?

The first step to solving a problem is admitting it’s there in the first place.

Well, realizing the existence of trauma is a critical first step in taking control of the trauma and, consequently, your life.

But what follows that critical first step of realization? Recognizing the signs of trauma. 

How it manifests in your behavior — physical, spoken and unspoken — as well as how trauma affects those around you, is a critical next step in employing trauma-focused therapy.

Respond

So you’re doing the critical grunt work with your therapy practitioner. You’ve realized you’ve had a traumatic past or have experienced traumatic life events, an assortment of behaviors in reaction to the trauma incurred and you see how the trauma affects your life’s entire ecosystem.

Fantastically done.

The next step?

Responding with procedures and practices designed to assist all your behavioral and mental health challenges.

In short, you employ a concrete strategy designed to get you back on your feet, moving towards not just a brighter today — but towards living a brighter now.

Before moving forward with an action plan to assist you in confronting and controlling your trauma, there’s one final, critical element to trauma-focused based therapy.

Avoid Retraumatization

It seems self-evident, but no one wants therapy to worsen their mental health.

No one wants to do the hard work of being vulnerable in front of another person and articulate, in intimate detail, their mental health challenges, only to find their depression, anxiety or traumatic triggers have worsened.

Retraumatization is a broad, all-encompassing term. It incorporates the emotional and behavioral reactions one has to being exposed to a traumatic event or episode. 

When one is retraumatized, they’re slung back into the painful event (or events) that laid the groundwork for the trauma itself.

So, it’s critical to avoid retraumatization in the process of trauma-focused therapy.

Part of avoiding retraumatization is finding a therapist who is competent in strategically planning a course of action for bettering yourself amid the challenges of confronting and overcoming trauma.

While that sounds self-evident, finding a competent therapist isn’t as common as you’d hope or expect.

Now, you may ask yourself: what is retraumatization?

What Is Trauma?

Now that we’ve given you a solid outline regarding what trauma-focused therapy is, as well as how it would address trauma experience if you were to give it a shot, it’s important to give you a holistic understanding of what trauma is in the first place.

Trauma, according to the American Psychological Association, is, “an emotional response to a terrible event such as an accident, rape or natural disaster.”

When one incurs trauma, it can manifest in several forms. 

First, in the immediate aftermath of a traumatic event — whether it’s a natural disaster, sexual abuse or another awful traumatic memory — one’s reactions can be shock or denial. What that means is, it would look almost like the person who’s just been traumatized is perfectly fine.

Beneath the surface, however, their brain is processing something far more profound — and the person’s reaction to that processing, to that profound event, can rear its head in a number of ways.

The longer-term implications of trauma can show itself in multiple ways. Symptoms of trauma can show in flashbacks, angry outbursts, depression and strained relationships. Worse yet, the symptoms can show themselves physically, manifesting in things like nausea or headaches.

What If Trauma-Focused Therapy Isn’t for Me?

Then it’s not for you — and that’s okay!

Fortunately, there are many other therapeutic alternatives out there for you, should you simply choose a different therapeutic route to confronting your trauma and its underlying symptoms.

In fact, there are two popular, prominent forms of therapy — aside from trauma-focused therapy — that come highly recommended to help a patient in dealing with their trauma: prolonged exposure therapy and cognitive processing therapy.

Prolonged Exposure Therapy (PET)

Prolonged Exposure Therapy, based on emotional processing theory, theorizes that trauma isn’t processed emotionally the moment in which the trauma is incurred.

Emotional processing theory hypothesizes that trauma and its underlying fear builds a structure of sorts in the mind, and that part of understanding trauma is that that ‘fear structure’ has a number of stimuli.

Everyone has fear structures, regardless of whether or not they’ve experienced a traumatic event.

The difference with trauma, however, is that there are fear structures specifically associated with the trauma itself.

As a result, prolonged exposure therapy deconstructs that fear structure by exposing the patient to what can trigger a fearful, traumatic response.

The response might manifest in an angry outburst, depression, anxiety, cruelty, screaming or becoming withdrawn.

Once those stimuli are recognized, prolonged exposure therapy seeks to deaden the severity of those traumatic stimuli. In turn, the prolonged exposure resets the patient’s fear to the stimuli so that they don’t have such profound, emotional responses to them.

Cognitive Processing Therapy (CPT)

Cognitive processing therapy is a trauma-focused therapy. 

The basic thrust behind CPT is the theory that survivors of trauma, in attempting to make sense of the trauma inflicted on them, attempt to make sense of the trauma itself. 

Where things get interesting is that CPT believes that the trauma survivor distorts their trauma. They create a trauma narrative that does more harm than good.

The reason people do it is in order to assimilate, accommodate or over-accommodate themselves to their present surroundings. 

In short, this cognitive distortion is a survival mechanism of sorts. However, in attempting to survive by distorting their past experiences, survivors can end up inflicting serious harm upon themselves.

What CPT tries to do is reel back peoples’ understanding of their trauma, bringing it into a fresh, believable, realistic perspective — and then tackling the event and its after-effects for what they truly are.

By shrinking the proverbial gremlin down to its actual shape and size, those who practice CPT believe it enables the patient to be in the best possible position to fight and eventually take control over their trauma. 

Alternatives

For some, one-on-one, individual sessions of talk therapy aren't necessarily the way to go.

The good news is there are limitless options when it comes to addressing your mental health.

For example, group therapy can be a powerful healing tool when it comes to addressing your trauma.

By sitting down with a group of people, even if — and sometimes especially if — they’re strangers, all of whom share a similar source of pain and are enduring the same battle as you, it can be a serious tool when it comes to improving your mental health.

Another alternative to addressing your trauma can be psychiatry.

When you work with a psychiatrist, you’re working with a trained medical professional who’s been through medical school.

A psychiatrist can perform talk therapy with you, but what makes a psychiatrist unique and different from a psychologist, however, is that they can prescribe medications.

Antidepressants can be a powerful tool in helping you overcome anxiety, depression, sleep problems or other mental health challenges you may have.

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Trauma Doesn’t Have to Control Your Life 

Trauma is nothing to be sneezed at. It’s a dynamic experience that can control and even destroy lives if one isn’t careful in getting a handle on the trauma itself.

The good news is that there are plenty of avenues when it comes to taking control of your mental health. The first step is, of course, to recognize that the trauma itself exists, and to then seek out a mental health professional in understanding your trauma, and then concocting a concrete plan to strengthen your mental health.

Although the journey sounds difficult — daunting, even — that doesn’t mean it’s impossible. The step-by-step process of making sense of the trauma you’ve endured, and then doing something about it — that’s pretty damn brave, if you ask us.

Not just that — it’s a sign that you’re already turning the corner.

11 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.