How to Attend Trauma Counseling

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1Choosing the Right Kind of Therapy

2Preparing For Your First Therapy Session

3Undergoing Trauma Therapy

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Trauma is any event a person experiences that leaves them feeling threatened emotionally, psychologically, or physically. Those who have been traumatized by an event generally experience a feeling of helplessness. The effects of trauma may manifest immediately or make take years before they become known. Many people spend years trying to manage trauma symptoms on their own before seeking help. Trauma counseling can be an effective way to manage and recover from your trauma. You can learn how to seek trauma counseling if you want to try it to aid your recovery.

Steps

Part 1

Part 1 of 3:

Choosing the Right Kind of Therapy

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   Consider your specific needs. Traumas come in many different forms. Just because you have experienced a trauma doesn’t mean that you should attend any trauma therapist or group therapy session. While dealing with some aspects of trauma are the same, your individual trauma will dictate how your therapist approaches your recovery and treatment. You need to decide the type of trauma therapy you need. Trauma can have occurred only once or have been chronic/reoccurring. Common categories include:

   • Sexual, physical, or emotional abuse or assault
   • Neglect
   • Accident, illness, or medical procedure
   • Victim/witness to domestic or community violence
   • School violence or bullying
   • Disasters
   • Displacement
   • Terrorism, war, or military trauma
   • Exposure to homicide, suicide, or other extreme violence
   • Grief
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   Find a trauma specialist in your area. If you have experienced a trauma at some point in your life, you may find that you are experiencing negative symptoms associated with the trauma. Trauma therapy can help you on the road to recovery. Before you start therapy, you need to find a mental health professional that has experience treating trauma patients, as they have special training that will allow them to be a safe person for someone who's been through trauma. Look for mental health professionals who have licenses and degrees from accredited programs and institutions.

   • You may ask your doctor for a referral to a therapist or counselor who specializes in trauma. You can also contact local hospitals or mental health clinics to find a trauma therapist.
   • When looking for a trauma specialist, you want to make sure the therapist has experience or knowledge in your particular trauma area. Some people suffer trauma from sexual assault, car accidents, war, or being involved in terrorist attacks. You want to find a trauma therapist who can help your specific trauma.
   • Online databases are available that can help you find trauma therapists in your area. Browse Good Therapy or Psychology Today’s databases for a list of therapists in your area. Other psychology websites may also list specialists in your area.
   • Also, most insurance companies keep on file the areas of concentration of counselors in their network. Contacting your insurance company can be a helpful start.
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3. 
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   Identify right type of therapy for you. Trauma therapy comes in different forms. You can look for one specific kind of therapy program, or you can try a combination of different methods. You and your therapist can discuss the pros and cons of each, or you can choose a therapy treatment that you think will be the most beneficial to you.

   • Cognitive behavior therapy (CBT) is a common treatment for trauma. During CBT, you will be helped to replace negative thoughts with healthier thoughts. This includes exposure therapy (where you are exposed to things associated with the trauma to help lessen your anxiety) and relaxation training. CBT also helps to deal with depression or anxiety associated with the trauma.
   • Psychotherapy is another treatment option. This includes talk therapy and other therapy methods where you discuss the traumatic event, sort through memories, address your anxieties, and work on normalizing the experience.
   • Group therapy is another option. In group therapy, you join with other trauma survivors and discuss your experiences, difficulties, losses, and coping techniques. Group therapy sessions are facilitated by a trained mental health professional.
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   Choose the best program for your needs. You can go to different types of therapy programs, depending on the severity of your symptoms. Choose the therapy program that you think will be the most beneficial to you. Other considerations include what your insurance pays for and the type of treatment therapists and clinics offer in your area.

   • The most common type of therapy program is outpatient therapy sessions. This is where you attend 45 to 50 minute sessions once or twice a week.
   • You may decide you need intensive outpatient therapy. These programs may meet multiple times a week for 90 to 120 minutes.
   • You may choose to go to an in-patient facility. You can choose a day program, where you stay at a clinic from 9 to 5, three to five days a week. You may also choose to be hospitalized or stay at a long-term care facility for a few weeks.
   • Intensive outpatient therapy and inpatient hospitalization often involve commuting or travel, while outpatient therapy can usually be found locally. This is partially why outpatient therapy is more common.
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Part 2

Part 2 of 3:

Preparing For Your First Therapy Session

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   Identify your symptoms. There are different symptoms associated with suffering from trauma. Before going to therapy, you should think about your trauma symptoms and get a clear picture of how your trauma is affecting you. Sharing this with your therapist can help them get a clearer picture of your condition.

   • Determine when the trauma happened so you know how long it has been affecting you. Some people don’t experience any symptoms or negative effects of the trauma for years. Again, keep in mind that this could have been a one-time event (such as an assault) or a series of exposures that happened over a period of time (like an abusive relationship).
   • You may experience avoidance symptoms. This includes avoiding triggers or reminders of the event.
   • You may have flashbacks, nightmares, or unwanted thoughts about the event.
   • You may find that you are angrier, more irritable, more aggressive, or more reckless than usual.
   • You may be hypervigilant and alert all the time.
   • You may experience anxiety, depression, guilt, or problems sleeping.
   • You may find that you feel numb, have lost interest in activities, or a major change in behavior since the trauma.
   • You may find that you are fearful to leave the house and experience symptoms of panic when you do.
   • You may have significant trouble focusing and impaired memory as well. You may have difficulty remembering the event.
2. 
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   Get a medical exam. Before you go to see a psychiatrist, therapist, or counselor, you may want to go get a physical exam. Some medical problems cause similar psychological symptoms as mental conditions. You want to rule out any medical problems as the cause of your symptoms before undergoing therapy.

   • Many trauma survivors experience physical as well as emotional symptoms. Your physician and therapist may work together to treat your condition.
3. 
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   Find out if your insurance covers therapy. Many insurance companies will cover the cost of therapy, and some therapists accept insurance plans. Before you go to therapy, figure out what your insurance company pays for, how many sessions it will cover, what your co-pay will be, and if there are any restrictions for coverage.

   • Most insurance companies cover therapists that are in their network.
   • Therapy sessions usually cost between $50 to $150 before insurance coverage. If you don’t have insurance that will cover this, you should figure out how to pay for your sessions. There are generally community mental health centers in each municipality that offer services to uninsured individuals.
4. 
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   Find a support system. Trauma recovery is aided by learning how to function in your real life and learning how to live again. This usually involves a support system of friends and family. Figure out which family and friends you have who could be your support system on your road to recovery as you go through counseling and face your trauma.

   • For example, you may say to your family or friends, "I am not recovering from my trauma like I had hoped. I want to go get counseling, but I'm nervous and unsure. It would really help me if I could come to you for support and strength when things get tough during my therapy."
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Part 3

Part 3 of 3:

Undergoing Trauma Therapy

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   Evaluate your therapist's level of support. Trauma survivors have a unique condition that needs specific treatment. Though a qualified therapist who knows how to treat mental illness is needed, trauma survivors need therapists who are really listening to them and validating their experiences. During your first few sessions, pay attention to therapist to see if you feel like they are listening to you.

   • Many therapists offer a 20-minute consultation so you can get to know them before you commit to treatment. If you attend one of these consultations, pay attention to whether you feel seen, heard, and safe.
   • Keep in mind the first few sessions involve gathering information, building rapport, providing psychoeducation about trauma and what to expect, and setting goals for treatment. It may take some time before you feel any better or notice improvement.
   • A therapist should aim to make you feel empowered, since many trauma survivors feel powerless or like they have no control over their circumstances. Some believe a trauma therapist who focuses on empowerment rather than “curing” you is better for trauma treatment.
   • Decide if you are an equal partner in your treatment, or if the therapist has all the power. Part of trauma treatment includes you taking control of your treatment and your life.
2. 
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   Examine the traumatic experience. In trauma therapy, your therapist will gradually help you examine the experience you have gone through. This may be uncomfortable for you and take multiple sessions to fully complete, which is why it's important that you feel safe with your therapist.

   • You also will think about the role the trauma has in your life.
   • Your therapist will encourage you to make meaning out of the experience in some way.
3. 
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   Learn to trust again. One aim of therapy for trauma survivors is to help you learn how to trust again. Because of the nature of your trauma, you may be distrusting of people, groups, relationships, family members, or friends. You may even distrust the world in general. In therapy, you will work on this.

   • The goal of therapy is to help you come to a state where you can have healthy relationships with the people and the world around you.
4. 
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   Experiment with alternative therapies. Cognitive behavior therapy, psychotherapy, and group therapy are three common types of therapy for trauma counseling. Cognitive behavior therapy (CBT) is often used in trauma therapy to help you replace your negative thoughts with healthier ones. CBT is used to help you cope and manage your symptoms. It also can be used to help you build trust with others and combat any anxiety or depression you experience due to your trauma.

   • Psychotherapy, including talk therapy, is an effective therapy for trauma. In psychotherapy, you talk about your experience because talking about your trauma is part of the healing and recovery process.
   • Exposure therapy may be part of your psychotherapy treatment. Your therapist may expose you to videos or images of related traumas to help familiarize yourself with the idea to help you learn how to let go of your own trauma.
   • Your trauma therapist may suggest that you attend group therapy as part of your recovery. Group therapy is a safe space where you interact with other trauma survivors. Though your therapist may suggest group therapy for you, you are in control of your treatment plan and recovery. If you don’t feel comfortable with group therapy, you can choose not to attend.
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   Consider pharmacotherapy. Pharmacotherapy is a type of therapy where medication is prescribed to help physical or mental symptoms of trauma. Medication is usually helpful if you experience depression, irritability, hypervigilance or alertness, emotional distress, or intrusive symptoms such as sleep disturbances. Medication helps manage symptoms but does not make them go away.

   • You will work with a psychiatrist if you decide to take medication. Most of the time, medication is used in conjunction with psychotherapy.
6. 
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   Try other types of therapy. There are other kinds of therapy that might be helpful for trauma survivors. You and your therapist may discuss your treatment goals and therapy options that may help your particular situation. Other types of therapy include:

   • Art therapy
   • Dialectical Behavioral Therapy (DBT)
   • Eye Movement Desensitization Reprocessing (EMDR)
   • Play therapy
   • Hypnotherapy
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Expert Q&A

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• Question

  What should I look for when I'm choosing a trauma counselor?

  

  Ken Breniman, LCSW, C-IAYT
  Licensed Clinical Social Worker

  Ken Breniman is a Licensed Clinical Social Worker, Certified Yoga Therapist and Thanatologist based in the San Francisco Bay Area. Ken has over 15 years experience of providing clinical support and community workshops utilizing a dynamic combination of traditional psychotherapy and yoga therapy. He specializes in eclectic non-denominational yoga guidance, grief therapy, complex trauma recovery and mindful mortal skills development. He has a MSW from Washington University in St. Louis and an MA Certification in Thanatology from Marian University of Fond du Lac. He became certified with the International Association of Yoga Therapists after completing his 500 training hours at Yoga Tree in San Francisco and Ananda Seva Mission in Santa Rosa, CA.

  

  Ken Breniman, LCSW, C-IAYT

  Licensed Clinical Social Worker

  Expert Answer

  Try setting up a consultation with a therapist before you commit to treatment. Find someone who makes you feel really seen, heard, and safe. Ideally, you'll see someone who's trauma-informed, because they'll have the training to create a safe space for you without making it about themselves.

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