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Therapeutic Response to Trauma

Instructor: Gaines Arnold
This lesson looks at how a therapist should respond when they have a client who has experienced trauma. The term trauma is defined, different types of therapy are outlined, and an overall response to trauma is discussed.

A Walk by the River

Buckley was only nine years old and naïve, but he wanted to seem older, so he ran with a group from his neighborhood who were already teenagers. They seemed to accept him, and Buckley's mother allowed him to play with the older kids because it seemed to make him happy.

One day, one of the boys told the others that he'd heard there was a dead body down by the river. With a group of the older boys, Buckley walked down to the spot, about a mile away. He didn't want to seem chicken. He was worried that if he stayed home, they wouldn't include him anymore. When the group got to the river, they split up to find the place. Buckley walked with one of the older boys he didn't know very well, but he felt safe because they had always treated him like a younger brother. The older boy walked with Buckley until they could no longer hear the others, then he knocked Buckley to the ground and sexually assaulted him. Buckley brushed off the dirt as he cried, pulled up his pants and ran home.

The Face of Trauma

Many people have experienced a traumatic event just like Buckley did, and they have been forced to live with the recurring nightmare. Trauma can come from the death of a loved one, an accident (such as a car accident), abuse, neglect, news that they are facing a terminal disease, and many other sources. It is a real and significant issue in the lives of those who face it.

From the Merriam-Webster Dictionary, trauma is defined as 'a disordered psychic or behavioral state resulting from severe mental or emotional stress or physical injury.' This definition is all-inclusive. When Buckley was sexually assaulted by an older peer, he experienced not only the physical aspect of what was actually happening, but also a loss of trust that added to the trauma and emotional response that extended the trauma. In his case, the trauma incorporated all three. No matter what the cause, a therapist must know how to respond.

Trauma Therapy Theory

Because the fact of trauma is so widespread and diverse, therapists can use different types of tools that to treat it. Trauma has been studied for many years, yielding many effective treatment options.

  • Trauma-focused cognitive behavioral therapy (TF-CBT): CBT in itself is very effective for many different classifications of mental illness and emotional issues. In CBT, the therapist seeks to help the client reframe their negative responses and build positive coping skills. In TF-CBT, the specific trauma is addressed, and the sufferer is provided with a safe space to explore their response to the trauma.
  • Play therapy: Children use play to express themselves. Play therapy, developed many years ago by Sigmund Freud, gives children a safe space to explore their trauma by allowing them to do it with toys, and other instruments of play, rather than words.
  • Trauma-informed care (TIC): This approach to therapy means that the therapist acknowledges the presence of past trauma in present mental and emotional difficulties.
  • Animal-assisted therapy: Animals have been used in therapy for years. They can help reduce the effects of trauma, as well as sense when an individual is suffering from the effects of their trauma, as with service animals that assist those with PTSD. By focusing on the animal instead of on the trauma, the client can feel the soothing effects of having a caring presence near.

There are many other therapies used to help victims of trauma, and the one a therapist chooses will be determined by what they have found to be effective in their practice.

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