Leading the Way in Trauma Therapy

Trauma Institute & Child Trauma Institute
Aug 21, 2017, 4:15 PM

When I started using Facebook several years ago, it was expressly for professional purposes such as networking and disseminating information relevant to trauma therapy. I avoided posting on political issues, reasoning that doing so would a) distract from the primary focus, and b) risk alienating people who disagreed with me about politics, thus losing the opportunity to reach them about traum ...

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Jul 6, 2017, 8:42 PM

Like most people, I never set out to develop a new trauma treatment. It happened more or less by accident. I had long regarded eye movement desensitization and reprocessing (EMDR; Shapiro, 2001) as the trauma treatment of choice, because it is so effective, as well as being better tolerated and more efficient than the other leading brands (Greenwald et al, 2017). The problem with EMDR is that ...

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Jun 12, 2017, 7:46 PM

One of the striking features of eye movement desensitization and reprocessing (EMDR), as well as progressive counting (PC), is that the therapy action seems to occur entirely inside the client’s mind. This has led some people to proclaim that, for these methods, the therapy relationship is superfluous.

Early on in PC’s development, I conducted brief post-session interviews to learn more about ...

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May 7, 2017, 3:10 PM

Is there a best child trauma therapy yet?

Trauma-focused cognitive-behavioral therapy (TF-CBT) appears to be the clear leader in that it has a ton of research support (Cohen, Mannarino, & Deblinger, 2017). Yet eye movement desensitization and reprocessing (EMDR) also has a fair bit of research support, and was more efficient than TF-CBT in two of the three direct comparisons.

One problem with i ...

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Apr 3, 2017, 8:56 PM

After completing trauma healing therapy (such as EMDR, PC, etc.), most clients report feeling and doing a lot better. But a few do not, for a variety of reasons addressed in a previous post. Another reason? Bad habits that maintain depression.

Trauma healing clears depression by reducing emotional pain, and by changing the thought and behavior patterns that feed it. Clients initially presenti ...

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Feb 28, 2017, 4:15 PM

It’s tough to repair a marriage following infidelity, even if both parties really want to. I’ve seen it over and over, variations on a theme:

  • Frankie cheats, and then says Sorry, and means it. But doesn’t address the root causes of the cheating, so Sorry doesn’t do much good. Johnnie wants to trust again, but knows better.
  • Or Frankie not only says Sorry but also goes to therapy and insists t ...
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Feb 4, 2017, 7:04 PM

The other day my five-year-old and her friend were excitedly planning their next get-together. Mine said, “And we’ll play hide and seek!” and her friend said, “And we’ll think all the same thoughts!”

This longing for magical closeness does not fade with age. But finishing each others’ sentences (or sandwiches) is not always all it’s cracked up to be – as Anna (in Frozen) learned the hard w ...

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Jan 9, 2017, 1:08 PM

Most of our intensive therapy clients achieve profound healing from their trauma and loss memories. This typically leads to a dramatic reduction of symptoms, which in turn enables them to pursue their goals more effectively. Once in a while, though, there’s a glitch. Days, or even weeks or months, after the trauma work is done, the client reports feeling destabilized.

There are three common re ...

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Nov 1, 2016, 1:16 PM

We’re in the golden age of trauma therapy. We have research-supported treatments that are effective, efficient, and well-tolerated by clients. A lot of traumatized people are getting a lot more better than they ever dreamed was possible.

Yet many people who contact me for help are leery, because they’ve already tried trauma therapy and had a bad experience.

So you get into a room with a therapi ...

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Sep 28, 2016, 2:54 PM

I know a lot of people think that sliding scale is a cool thing to offer. I am opposed to sliding scale. I'll tell you why: Because in my first year of private practice, a college counselor convinced me to take on one of his students at half price. Then she came in every time with some new gold bracelet or cashmere sweater, and talked about the fancy restaurants and clubs she went to, that I ...

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Sep 5, 2016, 9:36 PM

As the director of our intensive trauma-focused therapy service, I receive a lot of phone calls from people who would like to be feeling better and/or doing better. Some are in extreme distress. I’m often asked, “Should I be checking myself into an inpatient program, or going for intensive outpatient therapy?”

Here are the questions I ask, to determine how to respond:

  • Are you safe? If left to ...
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Aug 4, 2016, 3:30 PM

A slide in one of our training programs used to list prolonged exposure (PE) as “the gold standard” of trauma therapies, but then we took out the “g.” For two reasons. One is that eye movement desensitization and reprocessing (EMDR) has now surpassed PE, in acceptability to clients as well as efficiency (Greenwald et al, 2016). The other is that the gold standard trauma therapy should be usef ...

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Jun 15, 2016, 6:45 PM

It’s an old lament: They don’t like us, and we don’t like them. Practitioners and researchers, that is; us and them being whichever one you are, and aren’t, respectively. So why don’t we get along? We all care about the same things, don’t we?

Researchers complain that practitioners don’t read the research. “That’s not responsible!” they say. “They should be using what works, not just whatever ...

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May 3, 2016, 7:14 AM

Does being a transgender child entail being doomed to a life of posttraumatic stress and misery? At first glance it doesn’t look so good. Let’s start with the 41% attempted suicide rate. Yes, 41% – nearly half of transgender individuals have tried to kill themselves. Other research indicates that compared to cisgender children, transgender children have substantially higher rates of anxiety a ...

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Apr 4, 2016, 1:14 PM

Here’s the problem:

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Mar 6, 2016, 11:49 PM

The standard of care in trauma therapy includes a stabilization phase prior to engaging in the trauma resolution work. This preliminary phase gives clients an opportunity to improve their affect regulation and coping skills, in order to be more successful in facing and overcoming their trauma memories during therapy. This standard has just been challenged in a critique co-authored by 21 promi ...

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Feb 4, 2016, 7:27 AM

I like gambling; used to play in a regular poker game. But I prefer fair odds, so I’m not a fan of playing against the house. I did it only once, when I was 17: dropped 85c worth of nickels into a slot machine in Reno. That was it, until recently. I was cashing in some bottles at the supermarket and when I took my receipt to the service counter, there was the lottery ticket machine. I’d been ...

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Jan 6, 2016, 12:10 PM

Therapists often ask me which trauma treatment they should learn: eye movement desensitization & reprocessing (EMDR) or progressive counting (PC).

First of all: Yes – you should learn EMDR or PC, if you haven’t already! Efficient, effective trauma treatment methods enable therapists to systematically guide clients in healing from their psychological wounds. This is much better than merely teac ...

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Dec 5, 2015, 9:35 PM

I don’t really know. Self-help books have kind of a bad reputation, right? They’re like diets: you get the suckers to pay for each new one that comes along, and the sellers are the main beneficiaries.

Okay, I’m sure some legitimate self-help books are published, that provide useful information, and teach useful skills and attitudes. In my particular areas of interest, I can think of a few that ...

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Nov 2, 2015, 7:48 PM

Maybe this story starts when, at age 11, I tell my uncle that when I grow up, I want to make the world better. He both smiles and scoffs, knowing that I’ll learn the ways of the world and get a regular job like everyone else. I scoff back, because I know I will do it.

As a young adult, I was not sure exactly how to do this. I felt that I had missed the boat. All the boats: Freud was long g ...

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