Trauma Treatment

Trauma can occur when an individual experiences a life-threatening event or witnesses someone else’s life-threatening event.  Some examples of traumatic events are: 

• Active combat
• Physical, emotional, and sexual abuse
• Serious accidents 
• Grave illnesses
• Natural disasters
• Terrorist attacks
• Mass shootings
• Relationship traumas include childhood abandonment, being abused in childhood, or being bullied.

What is Post-Traumatic Stress Disorder (PTSD)? 

After a traumatic or upsetting experience, many people experience a change in mood, problems sleeping or suffer from recurring memories of the event. This can make it difficult to manage life in the way they did before the trauma, and it can interfere with work, school, and interacting with family and friends. This is normal and often improves over several months. Sometimes, people find that these symptoms do not go away alone. When that happens, it is important to reach out to a mental health provider who can evaluate and treat PTSD. 

Read more information on PTSD and view videos on the U.S. Department of Veterans Affairs website

Traumatic events can cause lasting psychological symptoms, including the following from the National Institute for Mental Health: 

Re-experiencing symptoms 

• Flashbacks—reliving the trauma over and over, including physical symptoms such as:
  • Racing heart or sweating
  • Nightmares
  • Intrusive thoughts or fragments of memories of the trauma

Avoidance symptoms

• Staying away from places, events, or objects that are reminders of the experience 
• Feeling emotionally numb Feeling strong guilt, depression, or worry 
• Losing interest in activities that were enjoyable in the past 
• Having trouble remembering the dangerous event

Events that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, a person who usually drives may avoid driving or riding in a car after a bad car accident.

Hyperarousal symptoms

• Easily startled
• Feeling tense or “on edge”
• Difficulty sleeping and/or having angry outbursts

Hyperarousal symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating. 

Not everyone who experiences trauma goes on to develop PTSD, but for those who do, there is an effective treatment that can alleviate or reduce the intensity of symptoms.  At the Rochester Center for Behavioral Medicine, we offer a range of treatments for trauma.  These include cognitive behavioral therapy, EMDR, polyvagal therapy, and medication management.

At the Rochester Center for Behavioral Medicine, PTSD is treated with a combination of cognitive-behavioral therapy (CBT) and, when necessary, medications. This effective approach can help individuals with PTSD identify situations that trigger their “fight or flight” response. Using the cognitive-behavioral techniques of flooding and systematic desensitization, the therapist and patient can work together to safely reintroduce situations that have become too anxiety-provoking for the patient. Over time, irritability, flashbacks, and nightmares subside, the patient can return to their pre-trauma functionality, and long-term success is within reach.

Trauma-focused CBT (TF-CBT) is an evidence-based treatment specifically for children and adolescents impacted by trauma and their parents or caregivers. It is a components-based treatment model that incorporates trauma-sensitive interventions with cognitive behavioral, family, and humanistic principles and techniques. TF-CBT has proved successful with children and adolescents (ages 3 to 18) who have significant emotional problems (e.g., symptoms of posttraumatic stress disorder, fear, anxiety, or depression) related to traumatic life events. It can be used with children and adolescents who have experienced a single trauma or multiple traumas in their lives.

Eye Movement Desensitization and Reprocessing (EMDR) is a treatment modality that has been helpful to people who are suffering from the effects of trauma. After encountering a traumatic event, such as an auto accident, domestic abuse, violence, or perinatal loss, fragmented memories may intrude into daily life. This can result in feelings of helplessness or low self-esteem. Sometimes, individuals turn to alcohol or substance abuse to decrease the intrusive memories. EMDR allows the traumatic event to be fully processed so the individual is freed from re-experiencing the event in everyday life. This may result in a better quality of life and hope and well-being. It is also used in conjunction with traditional therapy.

Generally, TF-CBT is completed in 12-18 weeks as it is very structured. The clinician works with the child directly, as well as conducts parent sessions to review the information processed with the child with the parent so that the parent can help the child practice the coping skills between sessions and develop a common language for them to speak about the trauma. After the child and parent receive psychoeducation regarding the trauma itself, the child is taught relaxation skills to utilize when managing the strong reactions they may have to trauma triggers or for general anxiety. Once the stress coping mechanisms are in place, the trauma specialist will work with the child on affect regulation: understanding and managing emotions. The relaxation skills and affect regulation skills tend to help bring some relief from the day to day symptoms of trauma, however more work is needed. The clinician then moves into what is called "cognitive coping," essentially helping rewrite negative and maladaptive thoughts related to the trauma. A large portion of the treatment is utilized to help the child work on their "trauma narrative," telling and retelling their story. In the process, the clinician helps the child utilize some aspects of relaxation, affect regulation, and cognitive coping to work through the stress that arises when the child recounts the trauma. Once the narrative is ready, the child shares the trauma narrative with a caregiver or supportive person, most typically a parent or guardian. The clinician has prepared the parent/guardian/support person before sharing the narrative so that all that person should do is listen and provide support to the child without adverse reactions or arguing about the details. The final steps of TF-CBT are in-vivo exposure (whenever possible), helping the child make sense of the trauma, and working to ensure future safety. 

When experiencing trauma, the individual is flooded with strong emotions, and consequently, the brain cannot process, organize, and store the information in the usual way. EMDR allows the traumatic event to be fully processed, so the individual is freed from re-experiencing the event in everyday life. This may result in a better quality of life and hope and well-being.

Eye Movement Desensitization and Reprocessing (EMDR) is a treatment modality that has been helpful to people who are suffering from the effects of trauma. After encountering a traumatic event, such as an auto accident, domestic abuse, violence, perinatal loss, or others, fragmented memories may intrude into daily life. This can result in feelings of helplessness or low self-esteem. Sometimes, individuals turn to alcohol or substance abuse to decrease the intrusive memories.

According to EMDRIA, EMDR is an evidence-based, extensively researched, and widely recognized effective trauma treatment therapy in guidelines published by the International Society for Traumatic Stress Studies, the World Health Organization, and a growing number of national and international organizations. Treatment guidelines are based on reviews that evaluate the research of established evidence-based mental health treatments. 

All of RCBM’s EMDR therapists have completed EMDRIA-approved training.

EMDR focuses on a specific event, memory, or physical sensation related to that event/memory. In situations of panic/phobia, perceived or upcoming events that cause feelings of anxiety can be treated. Rating scales are used upon assessment.

Who is EMDR for at RCBM?

• Anxiety, panic attacks, and phobias
• Acute stress disorder
• Recent trauma
• Patients who are stabilized on their medication regimen 
• Stabilized depression
• Grief and loss
• Post-traumatic stress disorder (PTSD)
• Sexual assault
• Substance abuse and addiction
• Violence and abuse
• Survivors of violence and accidents

Who Does NOT Qualify for EMDR at RCBM:

• Current or recent suicidal ideation
• Severe depression
• Anorexia nervosa
• Chronic pain that limits or inhibits eye movements/tapping
• Psychosis
• Current mania
• Recent medication change
• Recent hospitalization

If you are a current patient at RCBM, please discuss with your clinician about treatment options at RCBM and how you can include trauma therapy in your treatment plan. If you are new to RCBM, you can initiate the admission process by completing a new patient registration form. Once you submit the form, we will match you with one of our qualified therapists specializing in trauma. Please keep in mind that you must be a resident of Michigan and willing to visit the office if needed. We are dedicated to supporting your mental health journey and look forward to working with you.