Trauma-Focused Therapy

Trauma-Focused Therapy is a type of Cognitive-Behavioral Therapy that deals with traumatic events. There are two main techniques used in this type of therapy and both are scientifically proven to be effective for clients who have PTSD, Complex PTSD or who have been exposed to some kind of trauma. These approaches are also helpful for treating depression, sleep problems, anxiety, shame, and fear that often accompany these conditions.

The Trauma-Focused Therapy approaches described here are the Prolonged Exposure (PE) approach and the Cognitive Processing (CPT) approach.

 The Prolonged Exposure (PE) approach focuses on reducing the intense negative emotions that are caused by memories or being reminded of the trauma. The main negative emotions that go with remembering the traumatic event are fear and shame. The idea is that facing up to the memory in a safe environment, in a planned way, eventually wears down the negative emotions connected to the memory so that remembering or being reminded of it is not so upsetting. When the memory or reminders are not as upsetting, the client will not have to avoid them and can experience a more normal life. 

Prolonged Exposure (PE) involves:

1. Breathing retraining in which the client learns calming breathing when memories are upsetting while doing therapy.
2.  Imaginal re-experiencing where the client repeatedly tells their story about what happened in the first person including what they thought and felt during the trauma. The objective is for the client to relive the traumatic experience in a safe place, over and over again until the memory is no longer upsetting. Over time, the negative emotions connected to the traumatic event tends to lessen and fade. It is often helpful for the client to make a tape of the reliving of the memory and listen to it between sessions. The client will also identify situations that remind them of the traumatic experience. Their therapist will encourage facing up to these situations during therapy session until the connection between the traumatic event and negative memories are lessened.

Prolonged Exposure (PE) can seem very scary at first. Clients often want to avoid remembering or being reminded of their trauma because it is so upsetting. So deciding to remember or be reminded of it on purpose will be hard at first. But it is worth the effort because, over time, it works.

The Cognitive Processing Therapy (CPT) approach focuses primarily on unrealistic and unhelpful thoughts a client might have about the trauma they experienced. These thoughts can cause memories or reminders of the trauma to be very upsetting because they cause can intense negative feelings such as fear or shame. With Cognitive Processing (CPT) the objective is to identify and change the thoughts in a planned way. When the client thinks in a more realistic and helpful way, remembering or being reminded of the traumatic event is not as upsetting and the client can return to a normal life.  

Generally, the Cognitive Processing Therapy (CPT) approach follows the below-described steps:

1. The client is educated in the connection between thoughts, feelings and behavior. The client learns how often a memory of a reminder of a traumatic event can lead to unrealistic or unhelpful thoughts that cause negative feelings and leads to behavior that is unhelpful.
2. The client writes an impact statement about the traumatic event that includes their thoughts and feelings. With coaching by their therapist, the client analyzes their impact statement analyzes it identify their unrealistic or unhelpful thoughts. These unrealistic or unhelpful thoughts are called “stuck points.”
3. The client then comes up with more realistic and helpful thoughts to replace their “stuck points.” In between sessions the client analyzes situations using the thought-feeling-behavior connection learned in therapy and practices using the new thoughts instead.

Cognitive Processing Therapy (CPT) can seem hard to do at first. Most often people have a feeling without realizing that there is a thought behind it. Learning to stop and identify the thought and substitute a more helpful thought takes a lot of effort. But it is a technique that, if practiced, works overtime.

The decision to use the Prolonged Exposure (PE) approach or the Cognitive Process Therapy (CPT) approach is one you and your therapist will decide. While both approaches have been scientifically proven to be effective, your decision should be based on which approach is the best fit for you and what is worked out with your therapist. Sometimes the therapy can be a combination of aspects of Prolonged Exposure (PE) (remembering on purpose) and Cognitive Processing Therapy (CPT) (identifying and changing unhelpful thoughts.

Oftentimes, Trauma-focused Therapy can show results in just a few months. Sometimes a full course of therapy isn’t needed. However, at other times, especially for more severe or long-lasting traumas, or where there is a past history of trauma, therapy results can take longer.

The thing to remember is that Trauma-Focused Therapy does work. What is required to make it work is a motivated client actively seeking change in between therapy sessions. Practicing facing up to your fears, and substituting new, more helpful thoughts for the old, negative ones also helps it work. Yes, it’s hard work, but your therapist at Phoenix Counseling and Trauma Treatment Center is there to help you succeed. Click here to contact us today to lessen the impact trauma has had on your life.