Trauma Focused Therapy

Trauma-focused therapy aims to help individuals who have experienced traumatic events, in childhood in particular. It’s usually intended for children and adolescents, and sometimes their families as well. A trauma-focused approach to mental health care embraces an understanding of the emotional, neurological, psychological, social, and biological effects of trauma. Trauma-informed therapists help promote healing by providing mental health services and treatment based on each individual's trauma history.

What is trauma?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines trauma as “exposure to actual or threatened events involving death, serious injury, or sexual violation in one (or more) of the following ways:

• Directly experiencing the traumatic events;
• Witnessing the traumatic events in person as they occur to others or
• Experiencing repeated or extreme exposure to adverse details of the traumatic events.

Trauma can come about after someone experiences physical, emotional, or psychological danger or harm. Even being close to or witnessing these sorts of traumatic experiences can lead to the development of trauma and related mental health responses.

• Childhood neglect
• Sudden separation from a loved one
• Natural disasters
• Accidents
• Assault
• Poverty and food insecurity 
• Violence in one's community
• Living with someone who experiences unmanaged substance use and/or mental health disorders 
• Experiences of sexual, emotional, or physical abuse. *

Trauma effects

Regardless of the type or cause, trauma can be a pervasive problem that can have both short- and long-term effects on a person’s functioning and/or emotional, physical, or social well-being. Trauma-focused care focuses on addressing the potential effects of a past traumatic event, which may include but are not limited to:

• Shock and denial due to trauma
• Unpredictable emotions due to trauma
• Flashbacks and nightmares due to trauma
• An inability to feel comfortable due to trauma
• Physical symptoms like stomach aches and headaches due to trauma
• Confusion due to trauma
• Exhaustion and fatigue due to trauma
• Anxiety due to trauma
• Difficulty concentrating due to trauma
• Risky behavior, such as substance misuse due to trauma

The toll that trauma takes on an individual’s well-being can be significant. However, people who have had traumatic experiences can also be highly resilient and may develop a sense of perseverance and strength in the face of challenges with the right support. Healing from trauma and living a fulfilling life can be possible with the help of trauma-focused therapy. See below for distinctions between the effects an individual may experience during childhood and adulthood after experiencing trauma at a young age.

Research also suggests that the more a child is exposed to stress and trauma, the greater their risk of experiencing trauma-based chronic health conditions and risky behaviors later in life. Childhood PTSD (childhood post-traumatic stress disorder) is an example of a diagnosable mental health condition and stress disorder that could occur in some children who have had an ACE. There are various types of therapy that may be used to help a child recover from trauma depending on the type of traumatic experience, from Trauma-focused therapy to reunification therapy.

Trauma-focused therapy techniques

Trauma-focused therapy takes into account the potential effects of past trauma(s) when administering therapeutic treatment to a child or adolescent. It was originally designed to help those who had experienced sexual abuse. Still, it has since been expanded to support children and teens who have experienced any number of traumatic situations. It’s a shorter-term type of therapy and is usually done with a parent or caregiver present. There are typically three phases of trauma-focused therapy. 

The first part of trauma therapy is usually helping the child and their parent(s) understand what normal reactions to trauma can look like, which may help increase understanding in the parents and reduce feelings of guilt in the child. Next, the therapist may help the child learn to get comfortable identifying and expressing their emotions. Then, they can teach them relaxation techniques for calming symptoms of trauma that may arise. After that, the cognitive behavioral therapy portion usually begins, which aims to help adolescents in particular learn to identify and shift distorted thoughts about the experience of trauma or about themselves.

Trauma-focused therapy

"Is therapy right for me if I’ve experienced trauma?" The way people choose to move through the trauma they’ve experienced is based on individual decisions and up to them. However, many people find engaging in some form of trauma-focused therapy to be beneficial.

Although trauma-focused therapy, in particular, is often discussed in reference to children, various forms are geared toward adults as well, from dialectical behavior therapy (DBT) to eye movement desensitization and reprocessing (EMDR) therapy. A therapist who is trained based on these types of modalities can generally offer a nonjudgmental, welcoming space where the individual can freely express and process their emotions and learn techniques for managing distress and moving forward toward healing.

Those who prefer to meet with a therapist to address trauma face-to-face can contact their insurance company for a list of in-network providers or ask their primary care doctor for a referral. Those who prefer to meet with someone from the comfort of their own home might consider online therapy. With a platform like BetterHelp, you can get matched with a licensed therapist who you can meet with via phone, video call, and/or in-app messaging. If your child aged 13–19 has experienced trauma, TeenCounseling can offer the same services with parental consent. Research suggests that online therapy can be as effective as in-person sessions for addressing post-traumatic stress disorder and similar conditions in many cases, so it may be worth exploring if you prefer this format.