5 Common Evidence-Based Treatments for Trauma

Trauma, no matter where it comes from or what form it takes, is real. And so are its effects on your life.

Today, as treatment professionals continue to learn how widespread trauma and trauma-related disorders truly are, more and more therapies become available to treat it. You might access these in individual therapy, or in residential trauma treatment.

You may know your trauma’s cause, or discover it in the process of healing from addiction. In either case, these treatments can help you work through trauma and manage its symptoms so you can start living a better, freer life.

How Trauma Affects Your Recovery

Trauma occurs when something you experience overwhelms your ability to cope. That’s why the causes and effects of trauma vary greatly from one person to the next. What severely affects one person might not matter much to another, and vice versa. One of the most widely used definitions of trauma¹ comes from the Substance Abuse and Mental Health Services Administration (SAMHSA):

“Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.”

Some studies show that people who have a substance use disorder plus trauma² face more challenges in recovery than those without a history of trauma. This is why, if you’re considering inpatient addiction treatment, it’s important to find a trauma-sensitive rehab.

If trauma is a factor in your substance use, it’s important to address not just the symptoms of your addiction, but also the trauma itself. Mental health experts agree that the need to address trauma is “an integral part of the healing and recovery process.”³

Getting treated for trauma can help you gain perspective on, and ultimately change your relationship with your trauma and the ways it impacts your life. And rehab is a safe place to do so with the guidance and care of trained professionals.

Trauma-Specific Therapies

You might come across these therapies in your search for treatment, or during your time in rehab. Keep in mind that this list isn’t exhaustive. Different rehabs have different therapies available, depending on their program and which treatment professionals they have on staff.

1. Cognitive Processing Therapy (CPT)

What it is: CPT is a type of talk therapy that’s proven effective for reducing symptoms of trauma. According to the American Psychological Association (APA), CPT is a strongly recommended treatment for PTSD in adults.⁴

The APA explains that “CPT is generally delivered over 12 sessions and helps patients learn how to challenge and modify unhelpful beliefs related to the trauma.”⁵ The goal of CPT is to help you think about and relate to your trauma in a new way. Some experts think that doing this can decrease any ongoing negative effects of trauma you might be experiencing.

What to expect during treatment: The Society of Clinical Psychology explains that CPT “focuses initially on the question of why the trauma occurred and then the effects of the trauma on the clients’ beliefs⁶ about themselves, others, and the world through the use of progressive worksheets.” In this therapy, it’s common for patients to write detailed accounts of their trauma, which they’ll then reflect on with the help of their therapist.

Karen Kattar, a psychologist with the Department of Veterans Affairs, says that during CPT, you’ll “look at the evidence for why you’ve drawn the conclusions that you have about what happened to you. And a lot of the times those thoughts are, ‘It’s my fault’ or ‘I should have done something differently’ and it brings about these emotions of shame and guilt. And some of the conclusions that you’ve drawn may actually not be true.” CPT helps you change how you think about your trauma. And this can empower you to take positive steps forward.

2. Prolonged Exposure Therapy (PE)

What it is: Just like traditional exposure therapy helps people confront their fears, prolonged exposure therapy (PE) helps you “gradually approach trauma-related memories,⁴ feelings and situations.” Instead of avoiding anything that reminds you of your trauma, PE helps you process your experience and learn that your trauma-related memories aren’t dangerous. This form of cognitive behavioral therapy can be a bit more intensive and usually happens in weekly individual sessions for about 3 months.

What to expect during treatment: Because exposure sounds intimidating and can be anxiety-inducing, a PE therapist should first work with you to create a safe space. They can do this by giving you an overview of what to expect and by teaching techniques to manage your anxiety.

When you’re ready, there are 2 types of exposure you’ll work through during treatment:

• Imaginal exposure: You’ll describe the traumatic event during therapy with guidance from your therapist, then process the emotions that come up. These sessions are usually recorded so you can listen back on them to practice managing your anxiety.
• “In vivo” or real-life exposure: Using a plan you created with your therapist, you’ll face specific cues and triggers as homework. This could include slowly starting to encounter specific places or people, confronting your fear and then learning how to cope with feelings that arise.

3. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

What it is: TF-CBT is “a psychosocial treatment of 8-24 sessions designed to treat PTSD and related emotional and behavioral problems² in adults, children, and adolescents.”. Although TF-CBT was originally designed to treat children, “current treatment guidelines agree on recommending TF-CBT as first-line treatment for PTSD”⁷ in adult survivors of childhood abuse, according to experts in an article for the Clinical Psychology Review.

What to expect during treatment: TF-CBT incorporates techniques of traditional CBT and exposure therapy. Sessions may include these components:

• psychoeducation (common reactions to trauma exposure)
• coping skills (relaxation, feelings identification)
• gradual exposure (imaginary, in-vivo or “real life”)
• cognitive processing of trauma-related thoughts and beliefs
• caregiver involvement (parent training, conjoint child-parent sessions)

4. Eye Movement Desensitization and Reprocessing (EMDR)

What it is: While the goal of other treatments is to process and alter your emotions, thoughts and responses to trauma, EMDR is a one-on-one therapy that focuses directly on changing the way a traumatic memory is stored in the brain.⁸ It does this through the use of eye movements and other rhythmic bilateral (left-to-right) stimulation (BLS), like sounds or taps.

What to expect during treatment: During EMDR, you’ll recall a triggering memory (which you identified beforehand with your therapist) while paying attention to the BLS at the same time. Eventually, you’ll learn to focus on a positive belief while remembering the trauma.⁹ After each session, you’ll reassess your symptoms and decide if you need to process other memories or triggers. In general, during EMDR you don’t talk about the details of your trauma out loud and you won’t have any homework outside of your therapy sessions.

5. Seeking Safety

What it is: Seeking Safety is a present-focused treatment model that helps you find relief from trauma and substance use disorders by prioritizing safety. An attractive quality of this therapy is how flexible it is. According to SAMHSA, “it can be used for groups and individuals, with women and men, in all settings and levels of care, by all clinicians, for all types of trauma and substance abuse.”²

What to expect during treatment: Seeking Safety doesn’t make you talk at length about the details of your traumatic memories. This treatment’s main goal is to teach general coping skills through casual, group, or individual discussions on 25 topics. Some of the coping skills taught include taking good care of yourself or asking for help. These topics address the cognitive, behavioral, and interpersonal aspects of trauma. Per SAMHSA’s protocol for trauma-informed care,² “This treatment model builds hope through an emphasis on ideals and simple, emotionally evocative language and quotations.”