Trauma Focused Therapy

Trauma is very treatable. Treatments include different types of talk therapy (aka psychotherapy) and/or medication management.

Medication management is not offered at Homecoming Wellness. If you are interested in seeing a medical provider for medication management, a list of providers can be provided. If you are currently engaged with a provider for medication management, with your consent, we will work collaboratively with them to better facilitate your healing.

Although medication management is helpful in treating trauma symptoms, psychotherapy is most supported in research. Below are 2 trauma-focused therapies heavily supported by research and offered at Homecoming Wellness:

Cognitive Processing Therapy (CPT) examines how a trauma (or traumas) have impacted your thoughts and feelings since your experienced event(s).
Prolonged Exposure (PE) is a gradual approach in understanding trauma-related memories, feelings and situations that you have been avoiding since your trauma.

Each modality requires weekly 60 to 90-minute sessions. These are structured sessions that follow a model. Each modality has homework between sessions that will help you apply what you learn in session to your everyday life. Monique will teach you specific skills to help you manage your trauma symptoms. These therapies usually last for 12+ weeks depending on your treatment goals. If you continue to have symptoms after we complete a modality, we will talk about ways to manage them moving forward.

Although there are various kinds of TFT, there is no one treatment that works for everyone. Therefore, understanding the process of trauma treatment, your readiness, and short and long terms goals you are seeking in trauma treatment will inform a recommendation by me. Ultimately, it is your decision in what trauma treatment you decided to do. Now to be clear, you will not start immediately in a specific TFT. Rather, we will work collaboratively on a good time to start. It may be necessary to build some coping strategies prior to engaging in TFT, as TFT is challenging and may create some discomfort initially. During that time you will need to be able to manage some of the strong emotions you experience since life isn’t put on hold while you work through your healing.

Cognitive Processing Therapy

Trauma impacts the way we perceive ourselves, others, and the world. When we experience trauma, our previous perceptions are shaken and you can get stuck in a belief system that may be holding you back in the life you’re wanting to live. You may find yourself doubting your safety in certain situations. Question other’s motives or your decision-making capability. Sometimes people need to have control over most, if not all, situations. Some may find they blame themselves for what happened to them or other people. People may have difficulty connecting with others despite wanting belonging. Thoughts like these can create roadblocks in doing things you used to previously enjoy, but no longer do since the trauma. Cognitive Processing Therapy addresses the roadblocks that are preventing you from living the life you want to live.

What is CPT?
Cognitive Processing Therapy (CPT) was developed in the 1980s and has been shown to be an effective treatment in reducing trauma symptoms resulting from a traumatic event, including child abuse, combat, sexual assault, natural disaster, and catastrophic events. It is an endorsed treatment by U.S. Departments of Veterans Affairs and Defense and the International Society of Traumatic Stress Studies, as a best practice for the treatment of PTSD.

CPT is a child of Cognitive Behavioral Therapy, which examines how thoughts, like those above, impact mood and behavior. It helps you identify unhelpful thoughts stemming from trauma and ways to get “unstuck.” You can then explore alternative thoughts that may be more helpful or useful and decide if the alternative thoughts make sense to adopt.

What to Expect?
During therapy, you will be given an overview of CPT. You’ll learn in-depth information about trauma, specifically, PTSD, in order to help better understand your symptoms. You may be asked to include a support person in the session so they too can learn about responses to trauma. You will be asked to briefly describe (not in detail) the trauma(s) you experienced. You will be asked to do some writing about how the trauma has impacted your negative or unhelpful thinking, and I will work with you in other possible ways to think about the trauma. You will have weekly homework assignments that will be modeled in session. CPT can also include writing details about the trauma, but is not always necessary. We will discuss what will be helpful at this juncture. Although this may sound daunting at first and provoke some intense emotions, you will be encouraged to talk about what emotions come up (i.e. guilt, shame, anger, and sadness) during your sessions. By talking about them, it can be easier to cope than storing them inside. In the second part of this treatment, we will discuss in more detail 5 areas affected by trauma: safety, trust, power and control, esteem, and intimacy.

How Long Should I Expect This to Take?
CPT is typically a 12-week protocol. Sessions are usually 55-60 minutes long. Some people report feeling improvement within the first few sessions. As you progress through the treatment, you will find CPT often has long lasting benefits, especially after completion.

Are There Any Risks in CPT?
There will be some mild to moderate discomfort when talking about trauma-related memories and/or beliefs. This discomfort is typically temporary and people indicated feeling better as they keep doing CPT. Many people described CPT the “best worst thing” they’ve been through. It’s not pleasant, yet the long-term benefits outweigh the discomfort.

Resources:
Cognitive Processing Therapy for PTSD
https://www.ptsd.va.gov/understand_tx/cognitive_processing.asp

CPT for PTSD
https://www.youtube.com/watch?v=BOZEMdwU9Ec

Mobile App: CPT Coach
https://www.ptsd.va.gov/appvid/mobile/cptcoach_app_public.asp

Prolonged Exposure Therapy

Cognitive Processing Therapy

Trauma memories, feelings, and situations can trigger a visceral response within one’s body and mind that ultimately lead to avoiding anything that reminds oneself of the trauma. Although avoidance is a coping strategy that is effective in some situations, it is ineffective in the long-term. It can prevent one from experiencing connection and enjoying life as one would like while also keep them stagnant in their fears. Prolonged Exposure Therapy directly approaches the avoidance that is getting in the way of living a fulfilling life.

What is PE?
Prolonged Exposure Therapy (PE) is a type of psychotherapy that gradually helps a person approach trauma memories, feelings related to trauma, and things/situations they have been avoiding since experiencing the traumatic event(s). It allows opportunity for one to make sense of what happened in order to decrease trauma related symptoms and regain more control over the memory itself.

What to Expect?
During therapy, you will be given an overview of PE and the past experiences that led to your current symptoms. In the first few sessions, you will learn how specific skills can help reduce the distress you feel when you experience anxiety surrounding your trauma experience. You’ll learn more about trauma, specifically PTSD, in order to help better understand your symptoms. We will explore people, places, or activities you have refrained from since the event(s).

Once we have a good understanding of what you have been avoiding since the trauma(s), we will then work through these things you’ve been avoiding by practicing in vivo exposure.

In vivos are basically setting up experiments to confront these situations that are fearful or distressing for you. You will never be asked to do something unsafe or cause more harm. With time, you will find the more you do these activities, the more comfortable you feel in doing them and will not need to avoid them anymore.

Along with in vivos, we will also address the trauma memory itself. This process is called imaginal exposure. You will be asked to speak in detail about what you recall from the traumatic event. I will guide you through this process. It is very structured and purposeful so that you are afforded an opportunity to talk about the trauma(s) and doing so can help you process emotions like fear, anger, and sadness. These sessions will be recorded so you can listen to your imaginal exposure between sessions. By confronting the details of the trauma, you will find over time you can manage the unwanted memories and emotions more effectively as they reduce in intensity and frequency.

How Long Should I Expect This to Take?
PE yields a different response for everyone. Typically, these sessions require 8-15 weekly sessions and are 1.5 hours each. Many report feeling better after a few sessions and the benefits of PE last long after the final session.

Are There Any Risks in PE?
There will be some mild to moderate discomfort when talking about trauma-related memories, feelings and/or beliefs. This discomfort is typically temporary and people indicate feeling better as they keep doing PE. It’s important to understand that someone may overhear your recording when you do your homework weekly. We will discuss how to reduce this risk in sessions before recordings begin.

Many people described PE as “the hardest thing I’ve been through” outside of their trauma itself because of that initial discomfort. However, most share that although the discomfort is intense, the long-term benefits are more rewarding.

Resources:
Prolonged Exposure for PTSD

https://www.ptsd.va.gov/understand_tx/prolonged_exposure.asp

Prolonged Exposure (PTSD)

https://www.apa.org/ptsd-guideline/treatments/prolonged-exposure

Reclaiming Your Life form a Traumatic Experience: Workbook

https://www.oxfordclinicalpsych.com/view/10.1093/med:psych/9780195308488.001.0001/med-9780195308488

Mobile App: PE Coach

https://mobile.va.gov/app/pe-coach-2

Therapy in Northern Nevada Dedicated to Treating Trauma

Trauma Focused Therapy

Cognitive Processing Therapy

Cognitive Processing Therapy

Cognitive Processing Therapy

Prolonged Exposure Therapy

Cognitive Processing Therapy

Cognitive Processing Therapy