9 Types of Therapy for Trauma

What Is Trauma Therapy?

Post-traumatic stress disorder (PTSD) develops when traumatic events are recorded in the brain as ongoing occurrences. While a traumatic event has ended, the person continues “reliving” it when encountering triggers rather than simply recalling the information. Trauma therapies help a client’s mind and body recognize that the trauma is finished and part of their history, not their present.

One of the most debilitating impacts of experiencing trauma is the creation of negative, false beliefs about oneself. These manifest through a narrow, distorted lens of horror, pain, or shame and tend to be inaccurate and overly critical. Trauma therapy will provide a more objective, compassionate, and informed viewpoint, allowing one to modify maladaptive beliefs.

While almost 90% of Americans will experience one or more traumatic events in their lifetime, only a small population of them will go on to develop PTSD.^{1, 2} For a person to be diagnosed with PTSD, their symptoms must persist for more than four weeks after a traumatic event and cause significant distress.

Trauma therapies can address challenges from various traumatic experiences, such as childhood trauma, sexual trauma, domestic violence, racism, natural disasters, and terrorism.

Is Trauma Therapy Effective?

Several trauma therapies have proven effective in treating PTSD and can help significantly reduce or eliminate debilitating symptoms caused by a single traumatic event or complex trauma (i.e., prolonged trauma). The specific ways these therapies reset mechanisms in the brain are still being explored.

Based on MRI studies of the brain, it appears that trauma affects parts of the brain responsible for storing memories, coding time frames (i.e., a beginning, middle, and end to an event), and attaching words to events.^{3, 4, 5, 6}

Trauma therapies allow clients to step into reliving the trauma while remaining anchored in the safety of the present. This “dual awareness” seems to provide opportunities for the mind and body to determine that the trauma has finished and is in the past. The therapist will then assist the client in rewriting any lingering negative core beliefs about themselves.

9 Common Types of Therapy for Trauma

Trauma relates to a loss of control one feels about painful events that occurred without their consent. Clients must feel safe with and trust their therapist for trauma work to be effective, and the therapist should explain everything involved beforehand.

To determine which kind of therapy you need, consider the therapeutic approach and your comfort level with the therapist. Your provider will be your ally and guide on your healing journey, so choose someone you can rely on.

Below are nine types of trauma therapies^{7, 8, 9, 10, 11}:

1. Eye Movement Desensitization & Reprocessing Therapy (EMDR)

EMDR therapy for PTSD desensitizes clients to their trauma memory by having them recall and relive the experience in a therapeutic setting. As they remember the event, their therapist will utilize bilateral stimulation of the brain (using lights, sounds, and/or tapping) to assist with reprocessing the memory.

2. Comprehensive Resource Model (CRM)

Comprehensive resource model therapy (CRM) begins with the therapist using a guided imagery protocol and breathwork to assist clients in connecting with their sacred place. These connections are made to the spiritual being, spirit, animal, or force of nature that supports them throughout the process. Trauma work can begin once these connections develop.

The aspects of the client that seemingly carry the pain related to the specific event will be asked to share their story. Physical and emotional reactions or memories that arise are observed with curiosity. Layers of supportive resources help the person step into the root of their trauma, allowing them to fully experience, process, and release it while recognizing new truths.

3. Internal Family Systems Therapy (IFS)

Internal family systems therapy (IFS) proposes that each of us possess a Self that is the true essence of who we are and Parts that fall into three categories–Exiles, Managers, and Firefighters. Respectively, these parts carry the pain of trauma, enact defenses to protect from the pain, and resort to extreme measures to protect against pain when the Exiles break through the Managers’ defenses.

The goal of IFS is to assist a person in connecting with the Self, allowing them to understand more about the Managers and Firefighters who seek to protect them and the pain of the Exiles. The Exiles’ pain is released through Self-led efforts, and healthy interaction between the parts can resume, resulting in significantly reduced PTSD symptoms.

4. Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) was initially developed for the treatment of depression but can also be used for addressing anxiety disorders, relationship issues, low self-esteem, and trauma. CBT is based on the premise that our thoughts and behaviors are interwoven–meaning that changes in thought patterns can facilitate behavioral improvements.

CBT targets maladaptive behaviors and beliefs that cause distress and impair the ability to function. Trauma survivors often develop extremely negative beliefs about themselves, others, and the world. In CBT, a therapist works with clients to help them learn how to identify, assess, and modify negative perceptions and actions that result in unnecessary distress.

5. Cognitive Processing Therapy (CPT)

Cognitive processing therapy (CPT) is a form of CBT developed specifically to treat trauma. CPT is a structured approach that typically occurs over 12 sessions and includes both psychoeducation and the development of coping skills. A therapist will delve into how trauma affects the mind and body, both during and after the event. They will then use cognitive restructuring to help the individual identify, assess, challenge, and change rigid, maladaptive thoughts related to the trauma.

6. Prolonged Exposure Therapy (PE)

Prolonged exposure therapy (PE) is a form of exposure therapy used to address PTSD avoidance behaviors. Trauma survivors typically avoid reminders of their trauma to protect themselves from overwhelming fear and pain. Unfortunately, doing so only further reinforces fear. Throughout treatment, the therapist employs systematic desensitization techniques through prolonged exposure to stressful trauma cues, leading to symptom dissipation.

More specifically, a therapist will teach clients relaxation and grounding techniques to use when exposed to distressing reminders (via imagination and/or in real-world situations). Thus, a person can learn that these memories do not pose a danger to them and do not need to be avoided.

7. Trauma-Focused CBT (TF-CBT)

Trauma-focused CBT (TF-CBT) is another type of CBT designed specifically for addressing trauma in children and adolescents. However, this approach has since been expanded to include adults and families. TF-CBT can be offered both individually or in groups and is facilitated by therapists who take a trauma-informed approach.

TF-CBT will typically focus on providing psychoeducation about trauma and stabilizing symptoms through relaxation and coping skills. The telling and cognitive processing of a client’s trauma story will allow them to integrate that story into their history rather than their present.

8. Brief Eclectic Therapy (BET)

Brief eclectic therapy combines aspects of CBT with psychodynamic therapy to best meet the needs of a client. Throughout treatment, a person will learn about trauma and how to employ relaxation exercises during a session while discussing their trauma. They may be asked to bring in items that remind them of the event to help them better recall it when prompted. The final sessions focus on how the trauma has affected a client and what they learned from it.¹²

9. Narrative Exposure Therapy (NET)

Narrative exposure therapy (NET) is a short-term approach specifically used for survivors of complex trauma and can be provided individually or in small groups. It centers on assisting a client in creating an account of how their trauma has been and is currently impacting their life as a way to reclaim their identity and story.¹³

A compassionate therapist supports an individual in writing a chronological story of their life that includes both traumatic and positive life events. As one tells their trauma story, they will be asked to notice their thoughts, emotions, and physical sensations in the present moment. When their story is concluded, the therapist will present them with a documented autobiography.

Additional Approaches to Trauma Treatment

Depending on an individual’s needs, some trauma therapists might incorporate other therapeutic approaches into their practice. These methods typically focus on creating safety and support by providing different ways to access and express trauma memories.

Note: If you are considering entering into a therapeutic group or another type of therapy, discuss this with your primary therapist first to ensure it will not interfere with or detract from the work you are doing together.

Below are additional approaches to treating trauma:

Play Therapy

Play therapy is an approach that is often used with children and adolescents, but may be offered in certain situations for adults. This can help a person process trauma in a non-intimidating way through the incorporation of toys, art supplies, puppets, or other positive activities.

Play provides an opportunity for the therapist to better understand the inner world of the client, while also providing a client opportunities to express their thoughts, feelings, and problems. A person can work to test out healthy behaviors and coping skills in a safe setting.

Eclectic Therapy

Therapists who use an eclectic therapy approach are trained in two or more therapeutic methods and tailor their treatment plans to clients’ unique needs. Many therapists utilize this technique, as they believe that there is no one approach suitable for every client. This offers greater flexibility when addressing trauma.

Dialectical Behavior Therapy (DBT)

Dialectical behavioral therapy (DBT) teaches a client skills such as mindfulness, self-soothing, problem-solving, boundary setting, and effective communication to help them better manage distress and regulate emotions. This approach can be beneficial for achieving safety and stabilization when addressing trauma-related symptoms in treatment.

Somatic Therapy

Somatic therapy focuses on the mind-body connection, specifically on how a client’s physical sensations indicate where traumatic memories are being stored in their body. Through purposeful attention, movement, and mind-body exercises (e.g., breathwork, meditation, guided imagery), a person will learn how to acknowledge and release their trauma.

Polyvagal Therapy

Polyvagal therapy educates a client about the nervous system while helping them recognize their reactions to their initial trauma and in present-day instances, when triggered. The therapist will teach individuals strategies to employ when anxious to help them connect with the grounded, centered part of their nervous system.

Group Therapy & Peer Support Groups

Talking with other trauma survivors can reduce a person’s sense of isolation and provide support.  In-person or online group therapy options can provide this opportunity. However, it is important to note that group therapy and support groups are two different forms of treatment.

Trauma-related group therapy will be facilitated by a licensed mental health professional.  Therapists will offer structured sessions that provide education about trauma, the teaching of distress management skills, and a sense of mutual support among members.

Alternatively, support groups are not facilitated by a therapist and are not considered therapy. Trauma-related support groups will often be geared toward people who experienced a similar type of trauma (e.g., sexual assault, combat, first responder). Meetings are informal and allow participants to speak about their trauma while receiving support and validation from peers.

Inner Child Work

When trauma occurs in childhood, a person continues to carry the wounded parts of their child-self with them into adulthood. Unhealthy beliefs and defensive survival strategies will often cause ongoing distress, both internally and in the individual’s relationships. Inner child work focuses on identifying, compassionately understanding, and addressing the needs of one’s child-self.

Art & Music Therapy

Art therapy and music Therapy utilize a person’s creativity to access and express their feelings, thoughts, and needs. Engaging in art and music is considered to be inherently healing, and can provide clients with comfort as they develop a connection with their therapist. These approaches can be particularly helpful with non-verbal clients, or those for whom identifying and expressing feelings is difficult.

How to Find a Trauma-Informed Therapist

When finding the right therapist, you should consider seeking licensed mental health professionals who are specifically trained in treating trauma. Before starting treatment, you can ask for a free consultation meeting to find out more about them and the type of trauma therapy they provide. You can also consider online therapy options if you are unable to attend in-person sessions.

Final Thoughts

Experiencing trauma can result in distressing and debilitating symptoms, but remind yourself that there is hope for healing. If you or a loved one is suffering from the aftereffects of trauma, consider seeking therapy. Trauma therapy can help you reclaim your life and a positive sense of self.