Trauma-informed therapy considers a client's past trauma and its effects on their behavior, mental health, and engagement in treatment. Therapists assume that a client might have experienced trauma and take care to avoid triggering or re-traumatizing them during therapy.
Trauma can come in many forms, and people respond differently to it. Not everyone who experiences a traumatic event will develop trauma. The DSM-5 defines trauma as exposure to actual or threatened events involving death, serious injury, or sexual violation. This can happen through:
The CDC and Kaiser Permanente study ongoing stressors in children, known as Adverse Childhood Experiences (ACEs). ACEs can lead to behavioral issues in children and adolescents and have lifelong effects. Adults with high ACE scores are more likely to face physical health issues, mental illness, and early death.
There are ten identified ACEs:
Recent research also suggests that racial trauma should be considered an ACE for Black children.
More than 46% of children have at least one ACE, highlighting the need for trauma-informed care. Trauma-informed therapists understand trauma's potential impact and focus on asking, "What happened to you?" instead of "What's wrong with you?"
Several types of therapy can help treat trauma. Workman highlights a few options that mental health practitioners may use to address trauma-related issues and PTSD:
PE and CPT are particularly effective, with solid research backing their use. These therapies can be completed in about three to four months, which is relatively short considering the long-term suffering that trauma can cause. They can be conducted both in-person and online.
CPT is also flexible, as it can be done without discussing the actual trauma, which is helpful if you don't remember the trauma or prefer not to talk about it. TF-CBT and EMDR are also effective in reducing PTSD symptoms, improving overall functioning, and enhancing quality of life.
Trauma-informed therapy isn't about a specific technique; it's about adapting interventions to fit each person's trauma history, triggers, and unique needs. Therapists view clients through a trauma-informed lens, considering the impact of trauma on emotions, self-regulation, and behaviour, as well as the effects of intergenerational trauma.
Critical aspects of trauma-informed therapy include:
Trauma-informed therapy is helpful for anyone who has experienced trauma, whether in childhood or as an adult. Even if you're not seeking treatment specifically for trauma, this approach can help ensure your emotional safety during sessions.
Not everyone has experienced trauma, but using a trauma-informed approach won't harm those who don't need it. That's why many therapists use this approach in all sessions, not just when the main concern is related to a specific trauma.
Trauma-informed therapy doesn't involve a specific set of techniques, but this approach is practical for both youth and adults who have experienced trauma. It can also help address feelings of guilt and shame that trauma survivors often experience.
If you believe trauma-informed care suits your needs, it's essential to find a therapist with the proper training. Here are some things to consider before starting trauma therapy.
While many therapists are trained in trauma work, not all specialize in trauma-informed care. Finding a therapist with the proper training and approach for your needs is important. When looking for a therapist, consider asking the following questions:
It's okay to ask these questions to ensure you find a therapist you're comfortable with. Just because a therapist lists trauma as a specialty doesn't mean they have the same level of training or experience in trauma-informed care.
During the first session, the intake appointment, therapists typically gather detailed information about your history to tailor the therapy to your needs. This may include questions about your trauma history. Letting your therapist know if you're uncomfortable sharing specific details is okay. A trauma-informed therapist will respect your boundaries and adjust their approach to make you feel safe.
Some therapists might not delve into the details of your trauma right away. They may want to ensure you have the skills to cope with any strong emotions that arise before exploring the trauma itself. A trauma-informed therapist will explain their approach and guide the session accordingly. If your therapist redirects the conversation, it's not because you've done something wrong; they may have good reasons and should explain them.
Therapy often involves exploring emotions and memories you may not usually confront. Think of your trauma as a wound that needs care. Just like a physical wound, it must be cleaned for proper healing, even if it is uncomfortable. Be gentle and patient with yourself as you navigate this healing journey. Remember, feeling drained after sessions is normal, but this is part of healing and growth.
If you've experienced trauma and want treatment, look for a therapist, psychologist, or psychiatrist who specializes in trauma therapy.
If you're already seeing a mental healthcare provider for your symptoms, they can refer you to a specialist. Veterans can find support through local and national organizations that offer therapy and resources for trauma and PTSD.
For BIPOC and LGBTQ+ individuals, it's essential to work with a therapist knowledgeable about discrimination, oppression, and inequality. They should be competent in discussing issues like racism, racial trauma, cultural concerns, and historical and intergenerational trauma.
The Most Inclusive Online Therapy Platforms of 2024 offer options for finding a trauma specialist. When you contact a practitioner, they may ask about your medications, medical history, and insurance plan. They will also assess whether trauma therapy is right for you and recommend the best treatment.
You and your mental healthcare provider can work together to set therapy goals and create a treatment plan that suits your needs. If you're experiencing the effects of trauma, it's okay to seek help. A trauma-informed therapist will support you, validate your feelings, and help you develop healthy coping strategies to process your trauma safely.