The trauma/PTSD therapies that have the most RCT support are Prolonged Exposure Therapy (PE), Cognitive Processing Therpay (CPT), and Eye Movement Desensitization and Reprocessing (EMDR).

I became an expert in PE inside after working on multiple NIMH/DOD funded PE trials between 2006-2012. I have treated a range of trauma survivors (SA/PA/CSA/CPA, IPV, combat, suicide, acute and chronic). I am also well-versed in ACT, CBT, DBT and Psychodynamic as general psychotherapy approaches.

My depth and breadth of professional and personal experience has led me to conclude that effective and compassionate trauma treatment requires:

1. A willing patient
2. A willing therapist
3. A solid and secure therapeutic relationship
4. A comprehensive assessment to identify severity of trauma/PTSD symptoms, rule in/out other mental health conditions, developmental/attachment history, and underlying intrapsychic/behavioral and external/systemic factors preventing natural trauma recovery.
5. In-session exposure (“direct contact” if the “exposure” word makes you cringe) to the client-identified worst trauma memories.
6. Between session engagement in relatively “safe” and values-aligned activities that provide corrective learning.
7. Somatic/body-focused interventions
8. Social support (supportive partners, families, friends, workplaces)
9. A supported clinician who is engaging in self-care and personal growth work and who has has easy, affordable access to supervision/consultation.
10. TIME (4 therapy sessions at minimum to long-term) & MONEY (Clinicians need to be paid a liveable wage and according to their experience and expertise)

Do you agree? Disagree? Have something to add? I’d love to hear your thoughts!