First of all, let’s acknowledge that everyone is different and everyone’s experience with PTSD is different and therefore everyone’s treatment will be slightly different.  The therapy that helps a retired Vietnam vet cope with decades-old trauma that still haunts him in his dreams may look a little different than the treatment of a female college student who was raped on her college campus 3 months ago.

What should I look for in a trauma therapist?

I cannot overstate the importance of finding a therapist you feel comfortable with!  It is always important in counseling, but especially when you are dealing with something as sensitive as trauma treatment to find a therapist with who you feel safe.  This person doesn’t have to be your best friend, but they do need to be someone that you feel is caring, knowledgeable, and won’t judge you.  For instance, as a Columbia, MO counseling center where one of our specialties is treating trauma, our office is intentionally set up to help put an anxious mind at ease from the hot tea station where you can get something comforting to sip on before coming into session to the essential oils we have set up in each counseling office.  It’s all of these small touches that help you feel safe talking about the scariest moments of your life.  I wrote a blog post on choosing a therapist that you may find helpful in your own search.  We know from research that the single most important factor in if a person “gets better” over the course of counseling is the fit and the relationship between the client and the therapist, so please take the time to find someone who feels like the safe space for you.

What is involved in PTSD treatment?

Again this is different for everyone.  Some of the common components include learning coping skills, telling your story, reteaching yourself what is safe vs. unsafe, confronting beliefs you’ve developed about yourself or the world around you since your trauma, and making meaning out of your experience.  I go into a little more depth about this in a blog post comparing trauma treatment to a mountain range.

What types of PTSD treatment are most effective? What is the difference between them?

There are a lot of different kinds of treatment for PTSD.  At our office, we offer several different types of therapy for PTSD including Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR), play therapy for children, sand tray work (often a component of another type of therapy) and Mindfulness training.   I have personally attended a variety of trauma training to learn the subtle differences between the therapies and learn as much as possible about who responds best to which therapy but worry it would take a book, not a blog post, to share all of the information I’ve learned over the years.  Instead, I’ll try to give you a brief snapshot of the therapies we offer in our Columbia, MO counseling clinic. Other therapies exist for PTSD including Somatic Experiencing (SE) for adults and Trauma-Focused Cognitive Behavior Therapy (TF-CBT) for younger clients. While we don’t do those in our office, we do know of other therapists in the Columbia, MO area who we trust to do these and are happy to provide you a referral if one of those is a better fit for your unique situation.

Cognitive Processing Therapy

Cognitive Processing Therapy (CPT) is one evidence-based trauma-focused psychotherapy for PTSD.  It’s common for trauma to change the way you think about yourself or the world in general. You may start to believe that what happened was your fault or that the world is an unsafe place. CPT targets these “stuck points” and helps you find a way to get unstuck and move forward.  In CPT you learn ways to cope with these upsetting thoughts and examine them in a way that will help you frame how you see the trauma in a more healthy way.  Once we begin the intervention, evidence shows that it takes anywhere from 9-24 sessions meeting twice per week for 60 minutes. I (Jessica) began using Cognitive Processing Therapy in Spring 2018 after I saw the person who developed CPT, Dr. Resick, present her research about how effective this treatment can be.  I plan to attend additional training on this treatment in the Fall, but after reading the manual and watching videos online I’ve begun using the techniques and have had great success with my first couple of clients.

Prolonged Exposure

In a nutshell, Prolonged Exposure is a very effective treatment for PTSD that encourages the clients to face the different memories and situations they’ve avoided for so long.  Avoiding thinking about your traumatic experience or things that remind you of that memory can help you survive in the short term, but those memories come back up in your life much like a beach ball you repeatedly shove under the water. Prolonged Exposure helps you regain control over your memory and find the strength to face things that have previously triggered trauma memories.  This is done by first teaching you breathing techniques and coping skills.  We then move on to the difficult part of treatment: in vivo exposure where we make a list of situations you’ve avoided and plan ways you can gradually face those fears and imaginal exposure where you tell your story over and over again in the safety of our office.  While everyone’s treatment is different, this Prolonged Exposure usually lasts around 3 months when we are ready to begin the intervention and during that time we will either meet twice a week for 45 minutes or once a week for 90 minutes. At Aspire Counseling, we have trauma therapists who provide Prolonged Exposure as a treatment option for PTSD and has had excellent success helping clients with varying degrees of PTSD and different types of trauma experiences find healing and emotional freedom.

Eye Movement Desensitization And Reprocessing

Eye Movement Desensitization and Reprocessing (EMDR) is another trauma-focused psychotherapy that helps people to recover from the symptoms and emotional distress that can come up after a traumatic experience. More and more research is demonstrating the effectiveness of EMDR.  The EMDR Institute website explains part of what makes this treatment unique: “Eye movements (or other bilateral stimulation) are used during one part of the session.  After the clinician has determined which memory to target first, he asks the client to hold different aspects of that event or thought in mind and to use his eyes to track the therapist’s hand as it moves back and forth across the client’s field of vision.”

As Jessica heard more and more about how EMDR was helping people find relief, she began to search for a therapist to join her practice who provides this type of therapy.  She brought on therapists trained in EMDR and eventually went through the training process herself. Now, Aspire Counseling has several therapists who offer EMDR services.

Trauma-Focused Cognitive Behavior Therapy (TF-CBT)

TF-CBT is the evidence-based treatment for PTSD in children.  It uses many of the same elements as adult trauma treatments including teaching your child about trauma through psychoeducation, learning coping and grounding skills, and a gentle form of exposure where the child recreates a story about the trauma.  However, Tf-CBT does treats the trauma in a very developmentally appropriate way.  Furthermore, involving parents in the counseling sessions is a key component of TF-CBT.

How do I start Trauma Therapy?

If you are looking for PTSD treatment and live in the Columbia, MO area you can either e-mail or call (573-328-2288) Aspire Counseling today.  We’ll take the time to learn bout your unique situation and needs so we match you with a therapist who will be the right fit.

About the Author

 Jessica Tappana, LCSW is the founder, director, and therapist at Aspire Counseling in Columbia, MO.  She began Aspire Counseling in May 2017 to provide quality, evidence-based mental health services to individuals in the Mid Missouri area looking for healing from trauma, grief, anxiety, and overwhelming stress.  The practice now has 4 therapists and serves all ages from early childhood through retirement. Aspire Counseling is LGBTQ-friendly and welcoming to people from all walks of life.  Jessica is proud of the care that is taken at Aspire to match each client with a therapist who is uniquely suited to meet that client’s needs based on personality, training, specialty and experience. If you’re interested in beginning your healing journey, you will find a safe space at Aspire Counseling.