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The importance of having a qualified professional when addressing traumatic experiences and various modalities of treatment

Trauma informed-care means being mindful of how an individuals’ presentation in treatment may be affected by traumatic experiences.  Whether an individual has been exposed to a single event, long-term traumatic experiences or have been negatively impacted by worldly events, each person responds differently to traumatic experiences and must be treated accordingly. The term “trauma” in general spans a wide variety of circumstances. Trauma is said to occur when an individual is psychologically impacted by an event to the extent that it surpasses their ability to effectively cope. While this may lead to a diagnosis of Post Traumatic Stress Disorder, it does not have to. Thus, what is traumatic towards one individual may or may not be to another, as each person differs in his or her ability to manage stressors.  

For those individuals who have experienced trauma in their lives, they can often be re-traumatized in spite of the best intentions, by those individuals whom are not aware of how best to approach these concerns in a behavioral health setting. Traumatic experiences often serve to deprive an individual of their sense of autonomy; therefore, treatment should aim to assist a person in reclaiming their identity. A person may enter treatment uncertain as to how to classify their experiences and it is central to the healing process that a helping professional refrain from making this determination on their behalf. Trauma by definition is subjective, although some parameters exist in order to assist the professional in determining the appropriate avenue for treatment. Potential emotional and physical responses following either an isolated traumatic event or prolonged exposure often include shock, disbelief, potentially denial or dissociation, as well as anxiety, irritability and mood swings.

To the untrained individual, the above-mentioned behaviors may take on the appearance of other mental health disorders, or perhaps the individual may even be classified more generally as “difficult to work with.” Misdiagnosis does the client a disservice, as it is further deprives them of their already diminished sense of power, as well as leads a person to feel invalidated or even “crazy” to be experiencing the resulting symptoms. It is often fear of judgment or a lack of understanding that leads an individual to hide their experience and thereby, increases the potential of developing Post-Traumatic Stress Disorder due to the untreated symptoms. Just as an infection of the body can spread if left untreated, so can the distress within the mind.

It is tempting to presume that all behavioral health professionals are trained in a similar fashion, although this simply is not the case. There are several factors to be mindful of when choosing a therapist, particularly on an outpatient basis. First and foremost, you are the customer. You are requesting a service and deserve to be treated as such. Positive therapeutic change begins with a positive therapeutic relationship and while this can take time to build, it is essential that a connection and sense of trust be established prior to delving into the traumatic past. If this relationship is not built, the individual seeking services risks being re-traumatized, as they are opening old wounds without a sense of physical or emotional safety. A common mistake for both health professionals, as well as the client, is delving in to the processing aspect of traumatic events without first building a framework, including healthy coping mechanisms. Trauma work is difficult on the individual and can often lead to flashbacks and increased anxiety, as they can feel as though they are reliving the event. This process requires that the individual being treated be equipped to manage these negative emotions as they arise throughout the treatment experience. Without having fully practiced these coping mechanisms, the individual becomes increasingly vulnerable to unhealthy practices, which may include returning to substance use, self-harming behavior or seeking comfort through intimacy.

So how does one determine “a good fit” when seeking treatment for trauma? Simply put, we have to ask. You would not purchase a house without completing an inspection, so why would we not treat psychological care in the same manner. When seeking out trauma treatment specifically, it may be beneficial to inquire as to familiarity with Cognitive Behavioral Therapy, Dialectic Behavioral Therapy, Eye Movement Desensitization and Reprocessing (EMDR) or familiarity with Seeking Safety. While each treatment takes a slightly different approach, the general aim is to target the brain and how it responds to stimuli. Traumatic experiences cannot be erased, but each individual holds the ability to challenge how they automatically respond to these events. The trained trauma therapist will assist in challenging negative thoughts related to self-blame, incorporating healthier coping mechanisms, working to “rewire” how the brain instinctively reacts to specific triggers and building a sense of safety.

It may further be beneficial to inquire into licensing. Particular certifications to seek may include, but are not limited to an LPC (Licensed Professional Counselor), LCSW (Licensed Counseling Social Worker), LSW (Licensed Social Worker) and CCTP (Certified Clinical Trauma Practitioner). While this is not an all-inclusive list, it does provide the individual seeking services with a general idea as to the training of the professional and experience working in the field of behavioral health. It is important to recognize that finding “the right fit” can take time. I would encourage anyone seeking services to work with their chosen therapist to explore their specific needs and provide the opportunity to build a therapeutic relationship (I.e. give it time). Should you find that the fit is not appropriate, keep seeking. It is crucial that we do not give up on the process and that we are empowered to meet our individual needs. So how does one heal from the experience of trauma? In short, together, as finding trained support is key.