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young adult engaging in group therapy illustrating trauma and ptsd therapies at The Dorm

The Trauma and PTSD Therapies You Should Know About (Beyond EMDR)

Est. reading time: 10 mins
Posted Under: Insights

Clinically Reviewed by: Amanda Fialk, PhD, LCSW, LICSW

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Decades after PTSD was first included in the Diagnostic and Statistical Manual of Mental Disorders (DSM), EMDR (Eye Movement Desensitization and Reprocessing) emerged as a fast and innovative option within trauma and PTSD therapies. It works through bilateral stimulation – a somatic technique that helps clients reframe traumatic memories. In recent years, the approach has gained new respect and popularity, lauded in Bessel Van Der Kolk’s bestselling “The Body Keeps the Score” and even promoted by Prince Harry, who made a public nod to the therapy, saying, “One of the biggest lessons that I’ve ever learned in life is you’ve sometimes got to go back and to deal with really uncomfortable situations and be able to process it in order to be able to heal.”

However, what many people who are seeking gold-standard care for trauma and PTSD might not realize is that there are a variety of evidence-based therapies honed specifically for recovering from trauma. They can be used alone or as a complement to EMDR to alleviate symptoms that can significantly impact daily life, functioning, and the ability to maintain healthy social relationships. 

As an IOP / PHP community that treats young adults with complex co-occurring disorders, we’ve seen encouraging outcomes research supporting an integrative approach to trauma treatment that combines multiple therapeutic modalities. A comprehensive treatment plan leads to more efficient treatment and long-lasting recovery. Below, we outline several of these therapies, and describe how we incorporate many of them as part of our programming to best support our young adult client population. 

Key Article Takeaways: 

EMDR is an effective and commonly utilized treatment for PTSD that aims to change the way the memory of trauma is stored in the brain. There are a number of alternative therapies that can be used instead of or as a complement to EMDR.

Individual therapies for trauma include Trauma-informed Psychotherapy, Internal Family Systems (IFS), Exposure Therapy, and Ketamine Therapy.

Group therapy and finding a supportive community is crucial to recovery. We review several trauma-informed groups at The Dorm and our Community Clubhouse model.

The Importance of Assessment in Treating Trauma and PTSD 

At The Dorm, over half of our clients (59%) report a history of trauma upon admission. We know this through an extensive assessment process upon intake, which helps us design a treatment plan and set up the care team for each clients’ unique needs. Our trauma-informed clinicians are equipped to ask the necessary questions right from the outset, ensuring that no history of trauma or underlying symptoms slip through the cracks and we can provide the necessary treatment as soon as possible. This happens not only during the process of our clinicians’ bio/psychosocial assessment but through screening and assessment that takes place over a client’s first weeks with their treatment team. 

We recognize the uniqueness of each of our clients, understanding that not every approach works universally. That’s why we’re fortunate to offer a diverse range of individual treatment modalities and groups, including EMDR, to cater to individual needs and promote optimal outcomes. 

What is Eye Movement Desensitization and Reprocessing (EMDR) therapy?

EMDR is an effective and commonly utilized treatment for PTSD that aims to change the way the memory of trauma is stored in the brain. 

An individual is asked to recall a traumatic experience or event or distressing memories while simultaneously receiving bilateral (moving left to right) stimulation, usually created through clinician-guided eye movements. Through this process, the power of the negative emotion and vividness of the memory is decreased. While relatively “new” compared to other therapies, a variety of research studies have shown it to be effective not just for trauma but related symptoms of panic and depression. 

Beyond EMDR: Individual Treatments and Therapies for Trauma

Finding a therapist who is trained to explore trauma and knows how to navigate heavier topics is the first step in recovery. This relationship should feel very safe and will provide a cathartic feeling about sharing the deepest, potentially shameful thoughts. Once this safe relationship is established, the therapist may use a variety of clinical approaches based on your unique needs:

Trauma-informed Psychotherapy

Trauma-informed psychotherapy explores the ways in which clients are re-experiencing their triggers in a trauma-informed manner. It is a very direct modality for exploring physical, sexual, and emotional violence, and can effectively help to reduce PTSD symptoms.

Trauma-focused Cognitive Processing Therapy (CPT)

CPT is a trauma therapy stemming from cognitive behavioral therapy (CBT), but adjusted specifically to reduce symptoms of PTSD. It is extremely effective as a PTSD treatment, and is also beneficial in individuals with co-occurring borderline personality disorder (BPD).

The CPT treatment process takes about 12 weeks, and aims to examine and modify the beliefs that come with trauma. It takes the event that causes flashbacks and highlights the “stuck points” that prevent the individual from living their lives freely. 

In CPT the client works with the beliefs that were created as a result of the trauma, and challenges the thoughts that create “stuck points.” Trauma is a painful experience, and clients often find themselves reliving it and attributing meaning to it (for example, I shouldn’t go outside of the house once it gets dark because I could be sexually assaulted). A CPT-trained clinician will be able to assist with challenging these thoughts and encourage less black and white thinking, as well as help the client develop methods to improve functioning and overall quality of life

Importantly, CPT doesn’t require a client to re-hash or re-live their trauma, but encourages them to not avoid it and to do the work to address what they are feeling daily. CPT treatment is a commitment – involving weekly homework assignments instructing clients to assess the events, thoughts, and feelings that they feel are linked to their stuck points.

At The Dorm, CPT is a treatment we have seen client’s have great success with, both when used alone and in conjunction with other treatment modalities like DBT and supportive peer-group therapy. 

Internal Family Systems (IFS)

Internal Family Systems examines the different sides of an individual and how they interact with others. As humans, we have different parts to us; we can feel multiple things at once (anger, guilt, and also love), for example. 

In the family systems theory, we all play different roles such as the scapegoat, the lost child, the peacemaker, etc. When we get threatened or triggered, a certain part of us comes out to defend us that may have been helpful at a point, but now is no longer useful. IFS can help with PTSD symptoms, as well as the dissociative identity disorder (formerly known as multiple personality disorder) that comes from really significant trauma by helping to differentiate the past from the present.

Exposure Therapy

Putting oneself back in the situations that were once triggering can be a powerful therapeutic tool. Exposure therapy is about taking incremental steps to gain comfort with exposure to triggers. For example, a client at The Dorm may work on imagining the trigger during session one, then potentially moving onto other steps in further sessions. What this looks like is entirely dependent on the trauma, but this might eventually involve an individual listening to certain sounds again, or revisiting a location. 

Exposure therapy aims to decrease avoidance of an object, activity, or situation, which makes it effective for disorders like OCD, eating disorders, anxiety disorders, and PTSD, which all share the common symptom of avoidance. 

Exposure therapy is a key, integrated component of treatment at The Dorm, often facilitated by a licensed clinical coach. They are able to extend the therapeutic work and skill practice beyond the confines of the therapy office, fostering real-world application within the community environment.

Ketamine Treatment

Ketamine represents a novel treatment for PTSD and is increasingly gaining attention in recent years as a more researched and utilized option. Though still controversial for its potential ability to cause anxiety and dissociation, ketamine has been shown to rapidly reduce and resolve symptoms in major depressive disorder as well as in PTSD.

Note: Ketamine Treatment is not available at The Dorm. 

Group Programming at The Dorm that Supports Trauma & PTSD

No matter what individual psychotherapy treatment modality clients receive at The Dorm, we believe that peer-based group therapy is instrumental to the therapeutic healing process. Some examples include:

Seeking Safety 

Seeking Safety group is a strong introduction to trauma processing. Designed for clients who have self-identified as having experienced a traumatic event, it meets twice a week to support the processing of  triggers or flashbacks, and includes psycho-education to go over PTSD, self-harm, and substance use. It is both topic-driven as well as driven by the needs of individual clients.

Seeking Safety Graduate

Seeking Safety is based on Lisa M. Najavits’s curriculum for co-occurring trauma and substance use is a group that meets once a week for clients who have done some amount of trauma work. It is a safe space for clients to process triggers and be extremely open and honest. Peer to peer connection and less isolation leads to less stigmatizing, where people offer validation, comfort, empathy, and support to each other.

Advanced Processing

A process group for clients a bit further along in their therapeutic journey who enjoy being challenged by their peers to dive deeper into their thoughts and emotions. All clients with various diagnoses and clinical presentations are welcome to explore and process issues that may be causing them stress or anxiety at that moment. 

Survivors of Sexual Assault (SOSA)

A group for clients to process sexual trauma and explore how it may affect them in daily life. This group teaches clients to come up with healthy coping mechanisms to deal with distressing triggers or symptoms in an environment that provides in-depth support and peer connection. 

Introduction to Codependents Anonymous (CODA)

A group addressing codependency and how codependent behaviors can interfere with relationships. It is based off of the 12-step program co-dependents anonymous, as well as incorporates process-based discussions.

Codependents Anonymous (CODA) Graduate

A group for clients who have done some work in CODA previously. Its role as a more intensive and challenging process and discussion group allows for a deeper dive into a client’s struggles.

Dialectics of Anger 

Dialectics of Anger is a process group that helps clients work through anger related to trauma. Yes — a huge symptom of ptsd is avoidance, and often when avoidance builds up, clients suppress anger (coming from shame, guilt, hurt, sadness, etc.). No matter how much you avoid it, eventually people lash out in anger, not knowing other ways to cope. Anger group helps you process your emotions and take a step back before they escalate.

Grief & Loss

Grief & Loss is a process group focused on trauma related to loss of loved ones. Grief & Loss also provides psycho-education on the topic of grief, and helps clients develop coping skills in addition to creating a safe environment for all to share their thoughts, emotions, and struggles with loss.

Living with Chronic Conditions

A group dedicated to individuals living with chronic condition(s), who could benefit from a space to discuss the intersection of chronic health issues and mental disorders. 

The Dorm’s Research Outcomes: Discovering a Strong Correlation Between Symptom Subfactor Improvement During Trauma Treatment

As a research organization we’ve been excited and encouraged around our most recent findings relating to trauma & PTSD in young adults, which show a very high correlation between symptom reduction across five symptom subfactors, which include including impulse control, intrapersonal skills, interpersonal skills, physical symptoms, and feelings of social responsibility and connectedness. 

  • Impulse Control: Symptoms marked by self-destructive behaviors and risk-taking, including use of substances, risky sexual behavior, and non-suicidal self-injury.
  • Intrapersonal: A set of symptoms that include re-experiencing, such as flashbacks or nightmares, and a pessimistic or foreshortened view of the future.
  • Interpersonal: This set of symptoms includes being detached from others and/or displaying a restricted range of affect.
  • Physical: Including the avoidance of triggers and/or resulting agitation, numbness, palpitations, or trembling in response to reminders of traumatic events.
  • Social Responsibility: Including the experience of irritability, and/or hypervigilance in social situations.

“What we know about these subfactors is that they’re highly correlated with one another. That means that if someone’s physical symptoms of trauma are improving, the other factors are going to improve too. That’s really great news, because it demonstrates that there is more than one way to skin a cat when treating trauma, so to speak” explains Chief Clinical Officer Amanda Fialk, PhD, LCSW, LICSW. 

For example, a client who may be hesitant to approach their trauma through EMDR can begin treatment by integrating into social groups or community clubs (Interpersonal). As they build skills, form relationships, and thus start to see an improvement in some of their symptoms, they might continue their journey in another realm, such as through Yoga or Reiki (Physical). Since these factors are so interrelated, we know that trauma symptoms will begin to decline even if traditional treatments aren’t implemented right away. 

“When I saw these findings, I realized how cool this was.” said Dr. Fialk. “This shows that we can consider creative and alternative therapies for clients who are on different timelines of where they’re at with being ready for trauma therapy, and still be confident that we are treating their debilitating symptoms.”

Below are some additional examples of activities and modalities at The Dorm that support improvements in each symptom domain:

  • IMPULSE CONTROL: DBT, RO-DBT, EF, CBT. 
  • INTRAPERSONAL: Mood tracking apps, diary card, EMDR, CPT.
  • INTERPERSONAL: Social skills groups, social groups, The Clubhouse, weekly clubs, promoting friendship, hobbies, or outside activities.
  • PHYSICAL: Activities such as Yoga, meditation, sports, Reiki, coaches/therapist going out with clients into the world to do exposure therapy.
  • SOCIAL RESPONSIBILITY: Volunteer work, client initiatives, or “Dorm U” simulated classes. 

In conclusion, evidence based interventions like EMDR and CPT are undoubtedly effective treatment approaches for trauma and PTSD. They can  be used alone or in a comprehensive treatment plan that integrates additional modalities, group support, and a strong community. It’s also important to note that beginning treatment can be very intense for clients with acute trauma and PTSD, and sometimes the first step in recovery is to identify a supportive community of others who are experiencing similar emotions and diagnoses. 

“For many clients, integration in the community may be the first intervention for the treatment of trauma because socialization will help with symptom reduction, and then they become more open to groups or individual therapy,” explains Dr. Fialk. At The Dorm, we offer a variety of trauma treatments as well as the Community Clubhouse experience to offer relief and fun during the harder parts of treatment – and to practice social dynamics in a clinically-supported environment.

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