For many, the field of mental health counseling comes across as a “touchy-feely” arena akin to sitting around a coffee table and talking about feelings with a friend. While understanding and exploring our emotions is certainly an important element for mental and emotional wellness, clients are often surprised to learn that counseling is a science-based profession. This is particularly true when it comes to considering the types of trauma therapy available.
In fact, skilled clinicians rely on what we call “evidence-based treatments.” These are treatment protocols that have gone through the same sort of rigorous testing you would expect in any other avenue of the medical profession, and are validated by consistent, demonstrable results.
In other words, this is far more than just coffee with a friend.
Types Of Therapy For Trauma
When it come to considering the types of trauma therapy available, it is particularly important to rely on treatments that are evidence-based. Here are the three most effective types of trauma therapy, as determined by science.
EMDR
EMDR stands for “eye movement desensitization and reprogramming.” Among the different types of therapy for trauma, this treatment is the most heavily based in addressing the neurological impact of trauma. According to clinical psychologist and EMDR specialist Dr. Arielle Schwartz,
“Traumatic memories can get compartmentalized in the right hemisphere of the brain. EMDR Therapy helps you to build bridges and access your resources. This occurs by re-activating the neural networks associated with a traumatic event and finding a reparative experience that can facilitate integration throughout the brain.”
In other words, EMDR works by strengthening the neural networks in the brain connected to positive memories, activating the neural networks that store traumatic events, and then reprogramming those neural pathways to reduce the traumatic response. Typically, this is done through “bilateral stimulation” while recalling memories.
Bilateral stimulation, which refers to engaging both sides of the brain, can be accomplished in numerous ways. These include activities such as tapping, the playing of tones, or the shifting of eye movement back and forth. While research is beginning to look into the application of EMDR treatments in online formats, this is currently one of the types of therapy for trauma generally reserved for application in person.
Cognitive Processing Therapy
CPT, or Cognitive Processing Therapy, is one of two well recognized, evidence-based types of trauma therapy rooted in a cognitive behavioral approach. So what does that mean?
Imagine that you get into a car accident. You walk away just fine, but your car is totaled. What happens next time you get behind the wheel?
If you are like most of us, you experience symptoms such as heightened anxiety, hypervigilance (you pay extra close attention to every vehicle around you), avoidance (you stay away from areas that remind you of the accident), intrusive thoughts (you keep thinking about the accident even when you don’t want to), and you may have dreams about the accident. Over time, this experience dissipates and you begin to return to your “normal.”
However, sometimes something blocks that natural ability to heal, and those symptoms continue for months after the event. CPT aims to eliminate those blocks and restore the healing process.
Cognitive processing therapy begins by teaching about trauma and providing skills to improve coping with symptoms of trauma. However, the heart of CPT is identifying and challenging those “stuck points” that prevent you from recovering. As Brooke Scrowl of My LA Therapy puts it:
“Cognitive Processing Therapy is focused on challenging your negative and unhelpful thoughts, attaining a healthier perspective, and allowing you to move on with your life.”
It does this by identifying common distortions in thinking, engaging your trauma narrative, and then challenging problematic thinking and underlying negative beliefs as they arise. As these harmful beliefs begin to change, the experienced trauma is slowly integrated and begins to lose its power.
Prolonged Exposure Therapy
Prolonged Exposure Therapy (PE) is the second of the two most evidence-based types of trauma therapy also rooted in a cognitive behavioral approach. While still addressing problematic thoughts, PE places an emphasis on diminishing the reaction to trauma-based triggers through progressive exposure. Like CPT, it begins with education about trauma and the development of initial coping strategies for working through and managing the trauma response. Later stages of treatment focus on imaginal exposure, where the client retells the story of the trauma while applying learned skills to decrease the reaction, and “in-vivo” exposure, where the client uses learned skills to begin to confront locations, situations, and objects that have triggered a trauma response in the past.
The benefits of prolonged exposure therapy commonly include a reduction of symptoms over a short period of time, effectiveness over tele-health based treatment, and an extensive history of demonstrated effectiveness across multiple types of trauma. In fact, according to trauma psychologist Dr. Elyssa Barbash,
“The treatment was originally developed for use with survivors of rape, but over two decades of research has shown PE to be highly effective in the treatment of trauma and PTSD for individuals with varying traumas. PE is endorsed by the Institute of Medicine report and SAMSHA as one of the leading treatments for trauma and PTSD, and is also one of the leading treatments recommended by the VHA-DOD Clinical Practice Guidelines.”
Choosing The Right Types Of Trauma Therapy
At Tempest Counseling, your clinician will work with you to determine the best approach for treating your unique needs. While EMDR is currently best provided in person, both CPT and PE can be effectively provided online through your client portal.
As you choose a trauma therapist, it is important to remember that evidenced-based treatments set the bar for quality therapy. These three treatment protocols — EMDR, CPT, and PE — are currently the highest, scientifically backed standard for effective trauma treatment.
