PTSD Counseling: Treatment Options And How To Get Started

PTSD counseling can involve working with a mental health professional to process trauma and reduce the symptoms that may follow a distressing experience. Several evidence-based approaches exist, and counseling is often one of the most commonly recommended interventions for post-traumatic stress disorder. If you're ready to explore support, connecting with a licensed therapist may be a meaningful first step.

Understanding PTSD symptoms

Post-traumatic stress disorder (PTSD) can develop after a traumatic experience, such as trauma from childhood, a serious injury, or a life-threatening situation. Some symptoms may emerge within weeks of an event, while others can take years to appear. In general, there tend to be four main groups of PTSD symptoms, and PTSD in teens can be an important concern for parents or guardians to watch for.

Intrusive memories

Recurring and unwanted reminders of a traumatic event can show up in several ways. Symptoms may include:

• Recurring and involuntary memories of the traumatic event
• Nightmares regarding the event
• Severe anxiety or physical reactions when exposed to a reminder of the experience

Avoidance

People may go out of their way to steer clear of anything connected to the trauma. Symptoms can include:

• Avoiding places, people, or situations that may serve as reminders
• Trying to avoid thinking or talking about the event

Negative changes in mood

Shifts in how someone views themselves and the world can also occur. These may include:

• Despair about the future
• Negative thoughts or feelings about oneself and low self-esteem
• Loss of interest in previously enjoyable activities

Changes in physical and emotional reactions

Heightened alertness and shifts in physical responses are common as well. Examples can include:

• Being easily frightened or feeling "jumpy"
• Persistent vigilance against danger and potential threats
• Issues with sleep or difficulty focusing

What to expect in PTSD counseling

When someone first begins PTSD counseling, a therapist will often start with an assessment or intake process. This may involve filling out forms and talking through the types and severity of symptoms someone has been experiencing. This early step can help the therapist understand your history and tailor an approach that fits your needs.

Ongoing sessions tend to be collaborative. A therapist may help you develop coping skills, process difficult memories at a comfortable pace, and work toward regaining a sense of control. Many trauma-focused therapies follow a structured format, though the specifics can vary depending on the approach.

Because different therapies use different methods, it can be helpful to understand the options available before starting.

Evidence-based PTSD treatment options

Several evidence-based treatments are recommended for PTSD by organizations like the American Psychological Association and the U.S. Department of Veterans Affairs. People respond differently to different approaches, so it can help to explore more than one option. Some of these treatments may take the form of individual therapy or PTSD group therapy.

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy (CBT) tends to focus on developing effective strategies to help the client regain control over their life and reduce anxiety. A therapist practicing CBT may methodically break down the causes of the client's emotions and help them understand that experiencing the trauma was not their fault. Much like those participating in other forms of therapy, CBT clients may learn to evaluate their thoughts and feelings and replace negative patterns with more helpful ones. This type of treatment is often used by a therapist for complex post-traumatic stress disorder, as well as for other anxiety-related conditions.

Cognitive processing therapy (CPT)

Focusing specifically on trauma, cognitive processing therapy (CPT) can be similar to CBT in that both normally aim to help clients transform unhelpful thought patterns. Where CBT tends to be broadly applicable to many conditions, CPT tends to be focused on PTSD.

Prolonged exposure therapy

People with PTSD may avoid situations, activities, and thoughts that remind them of a traumatic experience, which can prevent them from living life fully. Prolonged exposure therapy aims to help decrease the intensity of the feelings associated with the traumatic experience by teaching you to gradually approach memories, feelings, and situations you have been avoiding.

The method used in prolonged exposure therapy is typically called gradual exposure. This process may not be easy, but it can offer a road to eventual recovery.

EMDR therapy

Often used to process distressing memories, eye movement desensitization and reprocessing, or EMDR therapy, is generally an eight-phase treatment that can help those affected by PTSD process traumatic events and resolve lingering emotional, mental, and bodily distress.

This treatment may also be useful for those who experienced trauma before they were able to verbalize or understand what was happening. During EMDR therapy, the client usually relives distressing experiences while the therapist directs their attention using guided eye movements.

The back-and-forth movement of the eyes can mimic the processing response the brain goes through during REM sleep and may allow the client to be exposed to the trauma without having a strong psychological reaction. Over time, this may help lessen the impact that these memories once had, particularly those related to intrusive memories and avoidance.

Alongside these therapies, some people find that medication can play a supporting role.

The role of medication in PTSD treatment

For some people, medication may be considered alongside therapy to help manage PTSD symptoms when clinically appropriate. Selective serotonin reuptake inhibitors (SSRIs) are among the medications a qualified psychiatric provider might consider based on a full clinical evaluation. However, it's important to note that not everyone needs or benefits from medication.

BetterHelp now offers psychiatry services through UpLift, an additional care option available alongside therapy that can be part of a holistic mental health care experience. Any use of medication should be supervised by a qualified medical professional, and it can help to talk with your provider about possible side effects. Medication availability and coverage may vary by member location, clinical appropriateness, and individual pharmacy/insurance benefits. Prescribing decisions are made by the treating clinicians. We do not guarantee that any specific medication will be prescribed or covered by a member's insurance plan. If you'd like to explore this option, you can learn more about getting started with psychiatry services. Once someone understands their treatment options, the next step often involves finding the right professional to work with.

*Based on finalized paid psychiatry visits with a copay. Insurance availability, coverage, and costs vary by state, plan, provider network, and provider availability.

How to find a qualified PTSD counselor

Finding the right professional can make a meaningful difference in PTSD treatment. It often helps to look for a licensed therapist who has training and experience in trauma-focused approaches. Specialization in PTSD or trauma can be valuable, since these clinicians tend to be familiar with the evidence-based treatments discussed above.

When considering a potential counselor, you might ask a few questions to see whether they may be a good fit. Here are some things it can help to look for:

• Licensure as a mental health professional in your state
• Training in trauma-focused treatments such as CPT, prolonged exposure, or EMDR
• Experience working with people who have similar experiences to yours
• An approach that feels nonjudgmental and collaborative
• Comfort answering your questions about their methods and process

Online platforms can also help match you with a qualified therapist—BetterHelp, for example, draws on a network of more than 30,000 qualified providers—which may be helpful if you're not sure where to begin. Many people find that accessing care online offers added flexibility.

How online therapy can help with PTSD

Online therapy can be a convenient option for people seeking PTSD support. For those experiencing avoidance symptoms that make leaving home difficult, or hypervigilance that makes new environments feel overwhelming, the comfort of a familiar setting may make it easier to begin.

In addition, research suggests that therapy delivered remotely can be effective for treating symptoms of PTSD.

If you're ready to take a step toward support, connecting with a licensed therapist online may be a helpful place to begin.