What is Trauma Treatment and finding a Trauma Psychologist
Trauma Treatment & Therapy
Understandably, finding a trauma psychologist is a common request. In Australian surveys, up to 75% of individuals experienced in potentially traumatic event in their life.
People often seek out trauma therapy to better identify, make sense of, and come to terms with feelings and emotions arising from a traumatic or highly distressing event. These emotions can vary and often include those associated with the stages of acute grief, such as shock and/or denial, anger and/or rage, grief and/or sadness.
Some individuals may also experience more specific symptoms such as feeling unsafe or hypervigilant, having nightmares or flashbacks, or experiencing a tendency to avoid situations that might remind them of the traumatic event. All of the above are likely to impact one’s daily functioning and emotional well-being.
Sometimes, individuals are seeking assessment and further treatment for their experiences relating to Post Traumatic Stress Disorder (PTSD) or the increasingly recognised Complex PTSD (cPTSD). This treatment may be recommended by, or in conjunction with other health care providers such as your General Practitioner (GP) or Psychiatrist. The evidence-based trauma treatment includes:
Dialectical Behaviour Therapy (DBT) skills, such as developing skills in identifying and regulating intense emotions, nightmares or flashbacks. This might include grounding tools, mindfulness practice, emotional regulation and / or distress tolerance skills.
Eye Movement Desensitisation Reprocessing (EMDR), which helps the brain make better sense of and process the traumatic memories, and targets Post Traumatic Stress Disorder (PTSD) symptoms
Trauma-focused Cognitive Behaviour Therapy (CBT) to help us notice patterns of unhelpful thoughts and behaviours, and implement strategies to achieve more helpful ways of thinking, behaviours and emotional responses, particular those in relation to the traumatic event(s)
Schema Therapy, which helps us understand and manage changes in our schemas, emotional and cognitive responses following traumatic experience(s)
Cognitive Processing Therapy (CPT), which seeks to identify specific thoughts and beliefs about the self and the world related to trauma, and helps us move away from the avoidance-based strategies that tend to get us stuck to the trauma
Narrative Therapy for Trauma involves building a meaningful and chronological self-account of the events related to trauma with the guidance and support of a compassionate therapist
Other approaches such as Interpersonal Therapy and Mentalisation Based Therapy, Attachment focused, Supportive therapies
phases of Trauma therapy
In most situations, the role, timing and intensity of therapy needs to be considered as part of a thorough clinical assessment that considers the therapeutic fit (between you and the therapist), current life-stage needs and stability resources, as well as the availability of other safety and crisis resources in your treatment team.
We often consider the BlueKnot Foundation’s recommendations in relation to timing as it is the Australian national Centre of Excellence for complex trauma.
One common recommendation is staging of treatment depending on phase of recovery. It is a simplified way of describing shared goals and considerations during treatment. It is important to note that recovery is not a linear process and the labels of “1” “2” and “3” do not indicate that this is the only way to progress.
In Phase 1, Safety and Stabilisation are the key goals. This is often the most appropriate starting point if a person has not undergone any prior treatments or assessment as the needs may be uncertain. Other times, a person may return to this stage as they cross a period of crisis or change in risks. Goals during this stage may include:
Building an appropriate team and safety plan around you with resources, if appropriate, such as a crisis plan, knowing how to access care in both home or hospital if needs arise
Medical interventions is often part of the considerations. Given that medications is outside of the role of psychologists, it is important to consult and collaborate with your medical team members (GP, psychiatrist, paediatrician) to discuss medical treatment options, that might be helpful in achieving your goals around safety and stabilisation.
In Phase 2, specific processing of Trauma involves regular and sometimes intensive work around the impact of trauma. The impact, or disintegration, might contribute to disturbance for a person’s sense of self, life narrative, identity or even experience of day-to-day such as dissociation and sleep. This sometimes, but not always, involves traumatic memory or memories, and should be embarked upon with the professional support and awareness. Therapy intensity should be reviewed and titrated according to your needs and goals, with safety as a priority.
For some people, events arising during the processing phase and transiently require the person and their team to reevaluate their needs for stabilisation and safety. This is because, like any journey within healthcare (like surgery or medications), there are challenges involved as the treatment can involve stress and challenges. The key is to titrate this stress to allow for growth and safe-enough repairs.
In Phase 3 of Trauma work, individuals are often moving towards ways of living and thriving after the impacts of trauma. This can include tasks related to integration and reintegration and perhaps, a refreshed sense of themselves or life narrative.
The results of this phase is often related to improved connection with others or external life domains, as well as increased ability to experience the self in a safer way. Some clients may reflect a reduction of symptoms related to their trauma, or an increase in their capacity for pleasure, or improvement in their ability to stay present in the moment or their body.
Finding a Trauma Psychologist in Melbourne
For persons who have experienced traumatic events or interpersonal relationships, approaching a therapist can be understandably daunting. Collaboration, psychoeducation, person-centred care, and multidisciplinary care and evidence-based approaches are particularly important.
For most clients however, their uncertainty around “fit” can only be answered after one or several sessions with their psychologist or clinician. It is important in the early sessions for you to consider if the therapeutic approach and style of the psychologist feels reasonable for you to continue, and to discuss your needs and boundaries early on if possible.
If you would like to learn more about how Trauma therapy can help, you can seek consultations with our team of Melbourne Psychologists, Clinical Psychologists and Therapists.