April 06, 2014 at 8:30 PM
Perhaps the most frequent theme across posts in this blog is the promotion of psychotherapy for healing – via memory reconsolidation – as opposed to only symptom management, coping skills, emotional support, etc.
This seems to strike a chord, and the blog post Got Memory Reconsolidation? has received the most “hits” (visits) of any so far. Therapists say (in various ways), “Yes! This is what I’ve been saying for years,” which makes me wonder if I’m only preaching to the choir. Therapy clients say (things like), “I got some and it was good,” or alternately, “Why haven’t I been able to get some of this?
Some therapy clients are still being told that, for them, healing is not an option, so they might as well learn to cope/live with their symptoms. This means that some professionals are not up to date. For the first time in history, we now have reliable methodology for guiding therapy clients to face their trauma/loss memories, systematically work these through, and heal, coming out stronger instead of endlessly wounded. Indeed, we have several reliable methodologies.
In our clinic – and I’m sure we’re not alone in this – we hear, over and over from our clients, “Wow, I wish I’d known about this years ago!”
Yeah. I wish you'd known about it years ago, too.
So how do we speed the transition to this new-ish way of doing therapy? How do we evolve the field so that healing is viewed as the normative activity and outcome of therapy? Here are some ideas, and I welcome your comments as well.
1. Keep on doing the work. As my institute and many others (individuals and agencies) keep on providing trauma-informed therapy, starting trauma specialty clinics, and offering intensive trauma-informed treatment... Well, if we do a good job, it will spread.
2. More field studies. At present, some of the trauma therapies most prominent in professional journals are not being used much in clinical practice – even when therapists have been trained. This is because the laboratory studies tend to use such stringent inclusion criteria for participants that the treatment may not work very well with real-world therapy clients. Of course there is an important role for efficacy studies with high internal validity, but those alone do not get treatments into the hands of therapists. If we want research to influence practice, we should be doing more research in real practice settings.
3. Educate the general public. The book, The Instinct to Heal, featured EMDR (as well as some other approaches) and sold seven million copies. I’m guessing that this led to many more people knowing about, and asking for, EMDR. Even if our own efforts to spread the work about healing fall short of this benchmark, presentations and publications for the general public do matter. The public can also educate itself, as individuals communicate via chat groups, listservs, Facebook, blogs, etc.
4. Educate the professionals. According to a recent needs assessment we conducted in Western Massachusetts, only an estimated 16% of the agencies’ clients are being treated by someone competent in trauma therapy. Even those mental health professionals who come to our training programs in EMDR or PC routinely express surprise that the trauma treatment actually works. Despite the apparent popularity of trauma-informed treatment, it’s really not that well established yet, even among mental health professionals.
My hope is that mental health professionals will come to regard healing as one of the primary activities of psychotherapy, and that potential therapy clients will know to seek out treatment approaches that are designed to facilitate healing. Effective trauma therapy is available; now let’s make sure people know about it. Before too many more years go by.
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Also, many therapists who do get trained in one or another trauma therapy do not end up using it. Why not? Discomfort, fear, and/or inadequate training.
We've a lot of work to do...