The word “trauma” is used to describe emotionally painful and distressing experiences or situations that can overwhelm a person’s ability to cope – where high levels of emotional, psychological or physical distress temporarily disrupt their ability to function normally in daily life. Trauma is common. At some point in their lives, any number of people will survive one or several traumatic incidents. This could result from acts of violence, child abuse, domestic violence, rape, a car accident, a natural disaster or life-threatening illness.
“Trauma is common. At some point in their lives, any number of people will survive one or several traumatic incidents”
Trauma Therapy versus Trauma-Informed Care
Trauma Therapy and Trauma-Informed Care are two different approaches to mental health and trauma therapy. Both types of care require a thorough understanding of trauma. However, trauma-focused care is more about treating specific trauma or traumas, while trauma-informed care is practiced with an informed awareness of the possibility of trauma in the patient’s life and how it can impact all aspects of their life.
“Trauma Therapy and Trauma-Informed Care are two different approaches to mental health and trauma therapy.”
“trauma-focused care is focused on the traumas themselves, where a therapist will work to understand the impact of specific traumas on an individual’s life.”
As the name suggests, trauma-focused care is focused on the traumas themselves, where a therapist will work to understand the impact of specific traumas on an individual’s life. The role of the therapist is to help the person to process the traumas and identify positive or negative ways that they have learned to cope. They will help the person understand his/her situation and teach strategies to express themselves and cope with potentially stressful situations. The therapist can offer the individual tools to help them manage ongoing difficult feelings, negative thoughts and unhelpful behaviours.
Trauma-informed care is not about any one trauma. Rather, it is an approach through which a therapist can recognise the impacts trauma has had on a person. This method can be used in any setting, even when a person is not directly discussing their trauma. One of the main goals of trauma-informed care is to avoid retraumatising the person. It is an approach in the human service field that assumes that an individual is more likely than not to have a history of trauma. Thus, the intention of Trauma-Informed Care is not to treat symptoms or issues related to any form of trauma but rather to provide support services in a way that is accessible and appropriate to those who may have experienced trauma.
“Trauma-informed care is not about any one trauma. Rather, it is an approach through which a therapist can recognise the impacts trauma has had on a person.”
What is the meaning of retraumatising?
For some PTSD sufferers it can feel like their past traumatic events are recurring all over again. This usually happens as a response to an emotional or sensory trigger, and it can happen without any warning. This recurrence is known as retraumatisation. After retraumatisation, sufferers of PTSD will be particularly vulnerable. They are likely to experience more anxiety and stress.
The core principles of trauma-informed care
Trauma-Informed Care follows five core principles that serve as a framework for how service providers and systems of care can work to reduce the likelihood of re-traumatisation. These principles are applicable across a variety of service settings. The five core principles of trauma informed care are:
1. Safety: Establishing and maintaining physical and emotional security of the patient
2. Trust: Confirming trustworthiness and preserving appropriate boundaries while clearly stating what is expected.
3. Choice: Granting choices and prioritising control
4. Collaboration: Maximizing collaboration and the sharing of power to ensure patient participation
5. Empowerment: Focusing on an individual’s strengths and offering empowerment and skill-building for individuals to fall back on when they stop receiving therapeutic support.
There are several psychotherapy treatments for trauma but only a handful are backed up by extensive research and can be considered to be evidence-based. Among these, there is no single best option as different individuals may find that they respond better to one type of treatment over another. Here are the top treatments for trauma-related concerns.
- Cognitive Behavioral Therapy (CBT)
CBT focuses on recognising problematic thinking patterns and working to change them, which helps in changing behavior patterns. This treatment requires a person to engage in weekly appointments to learn skills that can be used to manage their symptoms.
- Prolonged Exposure Therapy (PE)
This is a particular type of CBT that primarily applies behavioral therapy techniques. In PE, individuals are gradually exposed to their trauma-related memories, emotions, thoughts, and physical sensations. Since avoidance is a common symptom of trauma, PE helps people stop avoiding their trauma reminders.
- Cognitive Processing Therapy (CPT)
CPT focuses on reevaluating how a person thinks following a traumatic event. This treatment targets the way people view themselves, others, and the world around them. Often, problematic or irrational thinking keeps a person “stuck” and makes recovery from trauma challenging. The CPT protocol helps a person assess their trauma and the impact it has on their thinking.
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
TF-CBT works to improve a range of trauma-related outcomes in minors (children and teens) and treatment involves both the child and a caregiver or trusted adult. TF-CBT is cited as one of the most effective trauma therapy methods available to help young people recover from Post-Traumatic Stress Disorder (PTSD). TF-CBT also addresses other trauma-related challenges like anxiety, depression, and behavior problems.
- Eye Movement Desensitization and Reprocessing Therapy (EMDR)
EMDR is different than most talk therapies. It does not require a person to explain their trauma in detail. Instead, a person will do eye movements or tapping while focusing on an image related to the trauma. EMDR therapy helps a person become unstuck so their brain can go through its natural healing process. It is designed to help a person quickly resolve traumatic memories. Unlike other therapies, there is no focus on changing emotions, thoughts, or behaviors related to the trauma.
Many stressful situations can contribute to trauma. Some are easier to recognise than others. While some people may not believe that they have experienced a traumatic situation, unhealthy coping mechanisms can reflect the reality that they have experienced trauma. Trauma therapy, be it trauma therapy or trauma-informed care, can help people safely recognise these traumatic experiences and it can be beneficial for people with a history of depression and anxiety.