It can be hard to know where to start when you’re seeking treatment for trauma or PTSD. It’s often confusing to understand the level of care you might need, what therapeutic styles will work for you, and whether or not you are ready to confront the experiences that negatively impact your life. Additionally, trauma symptoms, like low motivation, substance use, anxiety, and depression may add a layer of challenges to the healing process.
Seeking care as a young adult, however, is an admirable and worthwhile endeavor that you don’t have to handle alone. (In fact, 70% of our incoming clients report trauma upon intake, and studies have shown that over 60% of adolescents have experienced a traumatic event before young adulthood.)
Investing in your mental health now will have long-lasting ramifications for your future. That’s why intensive outpatient care could be a good fit for those who haven’t had the success they’d like with individual therapy or are stepping down from more intensive care. Facing PTSD and trauma can help you gain the relief, contentment, autonomy, and independence in adulthood that will help you thrive.
Below, Senior Therapist Alexa Connors, LMSW, outlines everything young adults should know before starting intensive trauma treatment.
What does PTSD or trauma look like in young adults?
Symptoms of PTSD and trauma can come up for clients in a variety of ways. Some key indicators include a sudden change in mood and activity, where you’re no longer engaging in things you once liked, you’re having intrusive and specific repetitive thoughts or nightmares, or you’re having feelings of disassociation (feeling like you’re watching yourself from above, or on TV). These symptoms could be an indication that you’re dealing with trauma, but sometimes this realization is difficult to reach in the first place, especially if you’ve been using substances or other distractions to numb your experiences.
Many traumatized clients that we first encounter report feelings of panic or acute distress, without quite knowing where these sensations are coming from. There may be nothing in your immediate vicinity that is threatening or stressful, but you feel guarded, panicky, and anxious. This is an indication that you’re experiencing triggers, which could be certain places, people, or situations. The key to the beginning of trauma awareness and treatment is that you’re not sure how it all connects, but you’re ready to approach it to build long-term healing and personal fulfillment. This is what therapists, clinical coaches, and intensive outpatient programs can help you sort through: how to understand your triggers more clearly, and start to work through them emotionally, intellectually, and physically.
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When is it time to seek professional care for trauma?
Trauma impacts a large portion of the young adult population, to an extent in which it’s easy to ignore or move past without addressing it before adulthood. Additionally, due to the nature of traumatic events, young adults may be reluctant or ambivalent about seeking care. It’s not always fun or easy to face. As a therapist, however, I believe that the sooner you seek care, the better.
I’ve noticed that most clients coming into trauma treatment have reached a point where their quality of life is suffering. They’re having repetitive nightmares, their sleep is disturbed and therefore their daily lives are getting worse. They are isolating themselves because they don’t want to deal with the triggers of social dynamics, loud sounds, gestures, or even scents. Then it’s time to seek care – you don’t have to live that way.
When it feels like you’re “stuck” or your life isn’t moving forward because of your repetitive thoughts and unwanted behaviors, then you know it’s time to seek help.
How can I know if a loved one is coping with trauma, and how can I support them in seeking care?
This is a common question from parents and family members, and again, it’s important to realize you’ve already taken a step in the right direction in researching how to help them best. Some noticeable warning signs could include a sudden withdrawal from activities, not wanting to go to school, or not wanting to show up for classes. Trauma and PTSD can look like anxiety or depression, and the symptoms overlap, but the flashbacks and suddenness of the withdrawal from daily life can set trauma apart from depression and anxiety.
Also, if you know something traumatic recently happened (for example, a school shooting, loss of a friend or family member, sexual assault, racist incident, or natural disaster) and then you start to notice symptoms, it’s a good indication that someone may be facing trauma.
It’s important to realize that it’s really hard to open up about trauma, so if someone has come to you opening up about it, that’s a big step. They might also not yet be ready to talk about it. Try to practice active listening and nonjudgment, ask them open-ended questions, and check in as often as you can. Also, sometimes it’s difficult for a young adult to want to go into intensive treatment right away, but you can at least support them in talking to a guidance counselor at school, or a licensed therapist with trauma experience.
Finally, remember to take care of yourself, your health, and your mental health. Families are often affected by trauma together, and you need all the support you can get to adequately support your child. (At the Dorm, we do recommend and provide family therapy and parent coaching during a young adult’s treatment journey, along with weekly group support options.)
How do you know if you (or a loved one) are ready to begin intensive trauma therapy?
Once you’ve decided to seek intensive trauma therapy, you’ve taken a huge step in the right direction. Now is a time to give yourself credit, take a deep breath, and realize that showing up for yourself (or your loved one if you’re helping them find care) is something to be proud of.
Once the therapeutic process begins, it’s important to understand that you need to be at an emotionally sound baseline before you begin to confront and process the negative experience(s) you endured.
A reliable therapist, coach, and community support group are important components of this process. Additionally, a program that offers both skills and process therapy is a great solution, if you’ve already tried an individual therapist or group practice without great results. Additionally, intensive outpatient care is a great solution if you’ve recently left an inpatient or hospitalization setting and are ready to begin integrated work within a community.
What we remind our clients at The Dorm is that you can’t do real intensive trauma treatment until some baselines are established:
- Sobriety: It’s best to be sober during trauma treatment. This gives your brain more flexibility to gain and implement the skills you’ll need to process trauma.
- Coping Skills: Practicing strong coping skills in the face of difficult emotions will give you the foundation you need to process and heal from trauma. Coping skills can include:
- Developing problem-solving skills, so you don’t panic when faced with a challenge
- Developing emotional regulation skills, and understanding how to self-soothe
- Gathering social support when needed, and surrounding yourself with healthy relationships
- Turning towards religious, spiritual, or intellectual endeavors that give you inspiration and moments of awe
- Individual and group support: in addition to working with a trusted therapist and clinical coach, we believe group therapy is a vital part of treatment that will help you practice new skills, bond with people facing similar challenges, and grow alongside a committed community.
- Family coaching, therapy, and support: Young adults are often still very much part of their family unit, so it’s important to be surrounded by family members that fully understand what they’re going through. At The Dorm every client’s family works with a parent coach to help them understand the treatment process.
Why is sobriety an important component of intensive trauma treatment?
In general, research shows that the outcomes in treatment are better when you’re sober. For young adults worried about sobriety, I’d say just go for it, experiment with it, and see how it feels. So many people in their twenties and thirties are surprised by how much they love sobriety once they have some time under their belt, and then they can begin to tackle the therapeutic process and life goals that will set them up for success. (Plus, sobriety is a requirement at The Dorm, so our clients gain a ton of support from the sober community at large.)
Overcoming Avoidance Through Substances
For a general understanding of why sobriety is important when seeking trauma treatment, it’s important to acknowledge the fact that the first thing we do when we’re traumatized is to avoid a situation, and substance use is a common method of avoidance. Once a client is ready to get well, however, the point of treatment becomes to progress through the emotions and feelings you should have experienced (but pushed away) at the time of the traumatic event. It’s not easy. And, of course, it’s human to want to try to avoid and push away that trauma by using substances. The problem is that they end up just making you feel worse and prolonging the feeling of being ‘stuck.’
If someone is in active substance use, it’s not a good time to do intense trauma work. Usually, there should be a few weeks of sobriety. Remember also that relapse is part of recovery, and even if you are working to moderate or eliminate substances you can still begin trauma work with skills-based therapy to build up alternate coping skills.
When young adults seek intensive trauma treatment, it’s an admirable and huge step toward long-term well-being. We help them prepare to understand that things can sometimes get a little worse before they get better (especially for those who were using substances to temporarily numb the pain), but in the long run, they’re going to function and feel so much better on a daily basis.
What’s the best type of treatment for trauma?
Several methods of individual and group therapy are used to treat trauma, including:
- Dialectical Behavior Therapy (DBT)
- Seeking Safety Groups
- Cognitive Processing Therapy (CPT)
- Eye Movement Desensitization and Reprocessing (EMDR)
What to expect during intensive trauma therapy:
Your experience with intensive trauma therapy will vary based on your previous therapeutic experiences.
If you have a measure of sobriety and recovery under your belt, say, coming from a residential program, you may be able to dive right into group therapy, clinical coaching, community activities, and holistic treatment.
If you’ve never done treatment before, however, we would work with you to first build coping skills that will be the foundation of your future processing and healing. Then, we would help you integrate these skills in group and community settings before we began intensive process work.
The reason that we want to get you set up with those critical coping skills is that if you’re triggered during therapy, you’ll have a higher chance of being able to effectively manage distressing events and symptoms.
How does group therapy help with trauma?
Group therapy is crucial to developing new skills and fully processing experiences and emotions. Getting support and energy from peers not only breaks down social barriers, but emotional barriers that you may be hesitant to face on your own or not even aware of. For instance, if a peer is sharing an experience or personal insight that brings up a lot of emotion for you, it’s an indication that you might be going through something similar. By telling our stories and getting feedback, we learn better and grow more quickly.
There are also different types of group therapy. Two main categories are skills-based groups and processing groups. Skills groups would include building mindfulness practices, cognitive skills, or social-emotional skills. Process groups are more internal and emotional. We review symptoms, experiences, and challenges together as a group, with the help of a trained therapist.
During intensive trauma therapy, we introduce clients to skills-based groups to help them build coping skills within a peer community, and then we’d add in some processing groups such as seeking safety to support their healing journey (on top of individual and family therapy).
Finally, for clients who have gained greater well-being and skills in these groups, we would move them into the Seeking Safety Grad Group, or Survivors of Sexual Assault/Abuse, to continue to build relationships, resilience, coping skills, and self-awareness.
Do I need to be part of an intensive outpatient program (IOP) to receive intensive trauma therapy?
A lot of time trauma symptoms will come up in conjunction with other diagnostic issues, such as substance use disorders. If this is you, and if you’ve already worked with individual therapists without the results you want, a program could be a better solution.
If you’ve been hospitalized, or have been close to being hospitalized and don’t want to go in that direction, IOP care can also be a great option for you. Along the same lines, IOP is great for stepping down from inpatient care, if you want to continue your intensive therapy in a more integrated, community-based environment.
