Trauma-Focused Therapy

Avoidance is the major factor that maintains PTSD and prevents recovery. Avoidance can take the form of “pushing away” memories, thoughts, and feelings about the trauma, or it can be avoidance of situations, people, and objects that are reminders of the trauma. Although this avoidance generally reduces distress in the short run, in the long run it actually prolongs and intensifies post-trauma reactions and anxiety. There are a number of effective, evidence-based treatments designed to help individuals stop avoiding and effectively reduce their PTSD symptoms.

Cognitive Processing Therapy (CPT) treats PTSD by primarily focusing on an individual’s beliefs about the traumatic event, and understanding the role that these beliefs play in maintaining painful emotions and symptoms. CPT aims to change unhelpful beliefs through cognitive restructuring, thereby reducing any unjustified guilt and hopelessness they may experience as a result of the trauma.The initial step of CPT is psychoeducation around PTSD and trauma-related beliefs and emotions. From there, the individual learns to identify unhelpful beliefs (“stuck points”), confront the memory of their trauma, approach previously avoided situations, and emotionally process the trauma. Finally, the individual learns skills and coping strategies to effectively reframe beliefs they have around safety, trust, control, esteem, and intimacy.

Prolonged Exposure therapy (PE) is a highly effective, evidence-based treatment for PTSD and co-occurring mood and anxiety symptoms. PE is supported by over twenty years of research and is based in emotion processing theory. Emotion processing theory explains how in the process of confronting the previously avoided memory, an individual incorporates new learning into their understanding of the traumatic memory. The individual learns to discriminate between the past and the present as well as safe and unsafe situations. They also learn that memories and reminders of the trauma are not themselves dangerous, while building a stronger sense of confidence and mastery. The PE protocol includes modules for psychoeducation, breathing retraining, in-vivo (real-life) exposure, and imaginal exposures.