Counseling for PTSD

Trauma-focused PTSD counseling is a form of psychotherapy that focuses on the memory of the traumatic event. It uses techniques such as visualizing, talking, writing, or thinking about the trauma to help you process the experience and learn how to recognize and change distorted beliefs you may have about it. Therapy sessions are conducted in a neutral, safe space where you meet face to face with a trained mental health professional who helps you regain a sense of control over your life by teaching you coping skills for dealing with triggering thoughts and events.

• Cognitive behavioral therapy (CBT). Cognitive behavioral therapy is an evidence-based psychotherapy intervention that has consistently proven to be the most effective trauma-focused technique for treating PTSD. It is short-term, goal-oriented, and focuses on the relationship between thoughts, feelings, and behavior. Its premise is that people can change their lives through changing the way they think.CBT consists of several modalities or techniques that all fall under the umbrella term of cognitive behavioral therapy. 

• • Cognitive therapy (CT). Cognitive therapy typically consists of 12 weekly individual or group sessions. Its major goal is to teach you how to modify negative judgments and memories of the traumatic event you experienced in order to interrupt triggered behavior or thought patterns that are continuing to affect your life today. Your counselor will work with you in a structured way to show you how to identify, understand, and test the accuracy of your thoughts and replace toxic thinking and maladaptive behavior patterns with healthier, more realistic ones. 

• • Prolonged exposure therapy (PET). Prolonged exposure therapy typically consists of eight to 15 weekly sessions. Your counselor will work with you in the context of a safe environment to help you confront and work through your fears through gradually exposing you to simulated situations such as those that normally trigger your PTSD symptoms. The goal is to reduce avoidance behaviors and the maladaptive emotional associations to the traumatic event that causes them. The premise of prolonged exposure therapy is that repeated exposure to your triggers will desensitize you and reduce counterproductive responses, thus enabling you to gain control of your life and participate in activities you have been avoiding. 

• • Cognitive processing therapy (CPT). Cognitive processing therapy typically consists of 12 weekly sessions. The focus is on helping you modify and challenge the distorted beliefs related to the traumatic event you experienced that are keeping you stuck. Your counselor will help you identify and address the errors in your thinking by guiding you through a process of gathering evidence for and against these thoughts, reframing them, and learning to see the traumatic event from a more realistic perspective that reduces its negative effect on your life. 

• • Cognitive restructuring (CR). Cognitive restructuring focuses on helping you examine your thinking and make sense of your memories of the traumatic experience. People often remember their trauma differently than how it actually happened, block out certain parts of it, or feel guilt or shame about certain aspects that were not their fault. Cognitive restructuring can help you see what happened from a more realistic perspective and show you new ways to act in situations that have been problematic. Your counselor will help you identify faulty thought patterns and replace them with more positive and realistic ways of looking at the events and circumstances. 

• • Eye movement desensitization and reprocessing (EMDR). Eye movement desensitization and reprocessing therapy sessions are typically conducted once or twice a week for a total of six to twelve sessions. Unlike other trauma-focused therapies, it does not require talking about your experience or bringing up the emotional and psychological symptoms of the trauma. Instead, your counselor will have you concentrate on a disturbing memory while simultaneously focusing on an external stimulus. This technique causes the information to be processed with new associations and reduces the vividness and emotion associated with it. The ultimate goal is to enable you to look at the traumatic event as just another memory of something that happened in the past and that no longer has any power over you. 

• Narrative exposure therapy (NET). Narrative exposure therapy typically consists of four to ten individual or small group sessions. Your counselor will help you create a chronological narrative of your life that places emphasis on the trauma, but helps you better understand it in the context of your whole life by including positive experiences as well. Narrative exposure therapy is especially helpful for people suffering from complex trauma scenarios as a result of war, political conflict, terrorism, or organized violence. 

• Written exposure therapy (WET). Written narrative exposure involves writing about your trauma during the counseling sessions. Your counselor will give you instructions about the assignment at the beginning of the session and then leave you to complete it alone, returning at the end to discuss your reactions to what you have written. 

• Brief eclectic psychotherapy (BEP). Brief eclectic psychotherapy combines elements of cognitive behavioral therapy with a psychodynamic approach. Typically it consists of 16 weekly sessions. Your counselor will help you work through and reframe negative thoughts about the trauma, as well as painful feelings such as guilt and shame. He or she may also have you write a letter about the trauma at the end of your treatment and hold a farewell ritual to leave it in the past.
• Stress inoculation training (SIT). The premise behind stress inoculation training is that though fear and anxiety are normal responses to trauma, at the time of the traumatic event they become conditioned to respond to nonthreatening cues as well. The goal of SIT is to help you learn how to manage anxiety rather than try to eliminate it. Your counselor will teach you coping skills such as deep breathing techniques, muscle relaxation skills, and cognitive restructuring, as well as how to use the first signs of anxiety or fear as a cue to use these tools to decrease them before they have a chance to build up.

No matter how horrific your traumatic experience and resulting memories may be, there is hope that comes from God, your ultimate counselor and healer. In Psalm 61:2-3 NIV, David writes, “From the ends of the earth I call to you, I call as my heart grows faint, lead me to the rock that is higher than I, For you have been my refuge, a strong tower against the foe.”

Jesus can identify with what you are going through because He experienced every horrible thing you have endured while He was on this earth.

For we do not have a high priest who is unable to empathize with out weaknesses, but we have one who has been tempted in every way, just as we are—yet he did not sin. Let us then approach God’s throne of grace with confidence so that we may receive mercy and find grace to help us in our time of need. – Hebrews 4:15-16, NIV 

Scripture teaches us that we are not powerless over our thoughts. Changing the way you think can change your life.

Do not conform to the pattern of this world, but be transformed by the renewing of your mind. Then you will be able to test and approve what God’s will is—his good, pleasing and perfect will. – Romans 12:2, NIV

PTSD memories resulting from traumatic events can become life dominating and hard to deal with. If this is something with which you struggle, please give us a call today. We would be happy to answer your questions and/or set up an appointment. You don’t have to walk this path alone.

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Resources: 

APA’s Clinical Practice Guideline for Treatment of Post traumatic Stress Disorder (Updated June 2020).

Simone Marie (December 22,2021). What Are the Best Types of Therapy for Trauma? PsychCentral, https://psychcentral.com/health/best-types-of-therapy-for-trauma.