Building Confidence in Treating Trauma

About half the population will experience at least one traumatic event in their lifetime. [1] Yet clinicians often take a “too-careful approach” to treating it, according to research published in the European Journal of Psychotraumatology. [2] One major reason is a fear of causing additional harm to their patient.

“Therapists are often seeing these patients for other conditions, such as depression or an eating disorder, and they may fear a patient may be too fragile to discuss past trauma and its effects,” says Kim Anderson, PhD, CEDS (she/her/hers), East Executive Director at ERC Pathlight. “The therapist’s instinct is to want to stabilize the patient first. As a result, trauma treatment is sometimes delayed and delayed, and, ultimately, in some cases, it may never be addressed.”

Specialized Trauma Training

In addition, a therapist may avoid treating trauma symptoms because they lack training in this area. “However, once a clinician is trained in empirically supported treatments, with good supervision, they will find treating trauma no more overwhelming than any other disorder they’re working with,” says Dr. Anderson. “At ERC Pathlight, we use cognitive processing therapy, known as CPT, and also trauma-focused cognitive behavioral therapy, or TF-CBT. Both are first-line, evidence-based treatment modalities that work well in conjunction with other treatment approaches we’re using for depression or general anxiety.”

“Trauma can often be a tricky diagnosis,” notes Kelly Souza, PsyD, CEDS (she/her/hers), Clinical Lead at ERC Pathlight. “Many of its symptoms—such as rage, substance abuse, being withdrawn—overlap with depression, anxiety, bipolar disorder and other mental health diagnoses.”

Spotting the Symptoms

Trauma-related symptoms tend to fall into four clusters, says Dr. Souza:

• Avoidance: steering clear of memories, people and locations related to the trauma
• Hyperarousal: physiological reactions, such as concentration or sleep problems or being easily startled
• Intrusive Symptoms: nightmares, flashbacks
• Negative Moods: self-blame, extreme fear, guilt, anxiety

“Because these symptoms are seen in a number of conditions, it’s important that intake assessments include screening for trauma, whether for outpatient therapy or a higher level of care,” Dr. Souza says.

ERC Pathlight provides free assessments by master’s-level clinicians and trauma-informed care for patients at all levels, including inpatient, residential, partial hospitalization and intensive outpatient care (on-site and virtual). “We then partner with outpatient providers on their essential role on the treatment team throughout the admissions process, treatment and discharge,” Dr. Souza says. “This collaboration throughout the patient’s journey ensures the continuity of care they need.”

Treating Trauma: Evidence-Based and Effective

The treatment modalities ERC Pathlight uses to treat trauma are forms of cognitive behavioral therapy:

Cognitive Processing Therapy (CPT)

More than 23 controlled trials have demonstrated that CPT is effective in decreasing trauma-related symptoms. “With CPT, the patient doesn’t have to relive and focus on the details of the traumatic event,” says Dr. Anderson. “Instead, we ask them to describe their thoughts or beliefs about the experience. Then we identify what we call ‘stuck points’ that contribute to the perpetuation of trauma reactions.”

To “interrupt” negative thoughts, the therapist will ask a series of Socratic questions. “You’re checking the facts, questioning the evidence, helping the patient look at the experience in different ways so they can find a different meaning in it,” Dr. Anderson says.

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

“This approach is more appropriate for younger patients and, unlike CPT, includes family members,” explains Dr. Souza. “Similar to CPT, we’ll examine what the patient is telling themselves about the trauma and decide whether those things are true or not, at an age-appropriate level.” In the course of treatment, the child learns coping skills for stress-related emotions and behaviors, and family members develop skills to support the child.

The long-lasting effects of trauma are hard to overstate. However, our experience has shown that, with a trauma-informed approach and the right treatment, patients can learn the skills and tools they need to recover.

Find Trauma Treatment with the Experts

Pathlight Mood & Anxiety Center offers expert trauma treatment in our residential and partial hospitalization programs. Our trauma-informed care approach can help patients understand the impacts of trauma, address trauma-related beliefs and rebuild their lives.

Benefits to our trauma approach include:

• Cognitive processing therapy (CPT) is a foundational, first-line, evidence-based psychotherapy to treat the symptoms of PTSD in addition to trauma-focused cognitive behavioral therapy (TF-CBT)
• Collaborative treatment planning with the patient and caregivers
• A multidisciplinary team with strong collaboration between psychiatric and psychotherapy approaches

Learn more about Eating Recovery At Home and Pathlight At Home, our virtual intensive outpatient programs for eating disorders and mood and anxiety disorders. Available and accessible across the nation, these programs are covered in-network by most commercial insurance plans.
 

Related Reading:

• Evidence-Based Trauma Treatment: What is Cognitive Processing Therapy?
• Healing Childhood Sexual Trauma
• Helping Someone Find Trauma Treatment

Citations:

1. National Center for Posttraumatic Stress Disorder. (2022). How common is PTSD in adults? U.S. Department of Veterans Affairs
2. Gielen, N., Krumeich, A., Havermans, R.C., Smeets, F., & Jansen, A. (2014). Why clinicians do not implement integrated treatment for comorbid substance use disorder and posttraumatic stress disorder: A qualitative study. European Journal of Psychotraumatology, 5, 10.3402/ejpt.v5.22821