Our therapists offer trauma therapy in Richmond, VA

My go-to approach for helping people in PTSD/trauma therapy is to ensure client safety, make sure that I foster a relationship built on trust, provide education for my clients on what they can expect, and make sure that I'm constantly assessing for safety and that we are progressing at a pace that is safely within their boundaries. I find the best benefit in this approach because it significantly decreases any chance of re-traumatization of the client and also helps restore trust and autonomy to the client; things that are often lost in trauma survivors. I find that clients are more successful in treatment when they are with a provider that they can trust and who they know will not “surprise” them.

I teach the following tools in PTSD/trauma therapy:

• Mindfulness training: Mindfulness training involves the use of mindfulness and grounding skills to help clients remain in the present moment, not in the past or the future. These skills are critically important in a client's healing journey as they promote healthy emotion recognition and coping skill use and raise overall levels of resiliency and distress tolerance. In mindfulness therapy, clients will also learn distress tolerance skills. These skills focus on the use of physical coping skills such as deep breathing and vagus nerve stimulation to provide psychophysiological calming and regulation.
• Psychoeducation: Providing a thorough education to clients on grief, the brain, loss, and other aspects associated with the grieving process is another important component of healthy processing because it provides clients with a context and a “why” for their thoughts and behaviors, and when we understand context, it can sometimes help us get to the root cause and prevent problems from continuing into perpetuity due to ignorance. Further, providing psychoeducation to clients is critical in helping them gain insight and understand their treatment plan and helps provide a path forward through the pain.
• Cognitive challenging/reframing: Cognitive challenging and reframing skills help clients be able to identify, recognize, and replace negative automatic thoughts about self and others that cause impairments and disruptions to their healing journey as well as daily life. Cognitive challenging skills teach clients to put their thoughts “on trial;” that is, to ask if they are rooted in evidence-based fact or in a simple worry that is not factual. If our worries are not rooted in fact, they are not rooted in reality and are therefore causing us an impairment. Then, we can reframe them to something that is more adaptive to reality. This equips clients to not second-guess themselves but provides them with rational, logical problem-solving skills that are not rooted in shame or self-criticism.
• Cognitive processing therapy: Cognitive processing therapy combines cognitive challenging and other CBT skills with mindfulness skills used to help clients gain insight into the trauma event, the impact it had on them, and how it changed their view of themselves and the world around them. CPT helps clients gain further insight into the level and depth of the trauma and multiple ways that it has impacted their lives.

I know a client is making meaningful progress in PTSD/trauma therapy when they are demonstrating more willingness to face their stressors/triggers and are utilizing coping and distress tolerance skills with more regularity and with less clinician prompting. I also know when clients are making progress when they are reporting a significant decrease in the frequency and intensity of symptoms that are causing daily distress and disruption to their schedules and routines. Clients are continuing to make progress when they are visibly more comfortable identifying and healthily processing experienced emotions and have regularly incorporated healthy coping and emotion regulation skills into their daily routines and engage in them with minimal clinician prompting. I also look for increases in self-esteem and self-confidence as well as self-efficacy.

Clients can supplement their time in PTSD/trauma therapy by making sure that they are engaging in activities that are nourishing and are not isolating themselves. PTSD/trauma support groups are a great supplement to PTSD/trauma counseling as well as regularly engaging within your social support system. Making sure you're regularly engaging in your hobbies and other value-congruent behaviors can also significantly contribute to progress made in therapy.

To prepare for their first PTSD/trauma therapy session, someone can make sure that they are sleeping and eating well and also have time before and after sessions to decompress, as processing PTSD/trauma can be emotionally intense. Also, take time to identify and explore your personal boundaries, areas of your trauma, and any symptoms that you might not feel ready or able to discuss yet. This will help you identify treatment goals as well as any boundaries you might have for therapy.