After trauma now what? Trauma informed or Trauma-focussed psychology treatment.

If you're asking, 'After trauma, now what?' you've likely started researching your options and encountered terms such as trauma-informed care, EMDR, or trauma-focused treatment, and wondered: 'Aren't these all the same thing?'

Not quite.

Both trauma-informed and trauma-focused treatment approaches can be important parts of recovery, but they serve different purposes.

A simple way to think about it is this:

Trauma-informed therapy focuses on how care is delivered.

Trauma-focused therapy focuses on what treatment is used.

In this blog post, Dr Christine Raab outlines the different focus of these two important trauma approaches.

Trauma-informed therapy: treatment that rebuilds safety

Trauma-informed care recognises that overwhelming or distressing experiences can affect how people think, feel, relate to others, and respond to stress.

A trauma-informed approach asks:

"What has happened to you, and how has that affected you?"

Trauma-informed work prioritises:

• re-establishing safety and trust

• collaboration and choice

• emotional regulation skills

• understanding nervous system responses

• strengthening relationships and support

  
  

Importantly, trauma-informed therapy does not necessarily require discussing traumatic experiences in detail. Instead, treatment often focuses on understanding the impact of trauma, learning skills to regulate the nervous system, and taking steps towards returning to a meaningful and fulfilling life. For many people, this work can be transformative in itself.

Trauma-focused treatment for PTSD & Complex PTSD

Trauma-focused treatments directly target traumatic experiences and their ongoing impact.

They are considered evidence-based treatments for PTSD and can also be helpful for many people experiencing difficulties associated with complex trauma.

Australian PTSD treatment guidelines recommend several evidence-based trauma-focused treatment approaches, including:

• EMDR (Eye Movement Desensitisation and Reprocessing)

• Cognitive Processing Therapy (CPT)

• Prolonged Exposure Therapy (PE)

• Trauma-Focused CBT approaches

Treatment Recommendations - https://www.phoenixaustralia.org/wp-content/uploads/2022/11/PTSD-Guidelines-Chapter-6-Treatment-recommendations.pdf

These therapies target difficulties such as:

• intrusive memories

• nightmares and disrupted sleep

• avoidance of trauma reminders or triggers

• feeling constantly angry, frightened or on edge (hypervigilance)

• shame or guilt

• persistent beliefs such as "I'm unsafe", "I'm broken", "I'm responsible" or "I'm stuck"

What happens in trauma focused therapy?

Trauma-focused treatments such as EMDR and Prolonged Exposure Therapy work directly with traumatic memories and experiences. This is an important part of treatment and one of the reasons these approaches are effective for many people with PTSD and trauma-related difficulties. Treatment usually begins by developing an understanding of current symptoms, goals, strengths, and life circumstances, as well as creating a shared understanding of how post traumatic stress symptoms may be affecting present-day life. Early sessions may also include building emotional regulation skills, strengthening a sense of safety, and developing confidence in managing distress.

As therapy progresses, people are gradually supported to directly engage with traumatic memories, emotions, beliefs, and physical sensations that continue to feel "stuck." The aim is not to repeatedly re-live traumatic experiences or become overwhelmed by them. Instead, treatment is paced carefully so that people remain connected to the present while also engaging with difficult past material. In EMDR this is sometimes described as maintaining dual attention — holding awareness of both the memory and the present moment. More broadly across trauma treatments, psychologists often work within a person's window of tolerance — helping clients to not avoid material but to engage with difficult experiences at a level that is manageable.

Over time, many people notice that trauma memories begin to feel different. Rather than disappearing, they often become less emotionally intense, less intrusive, and less likely to dominate everyday life. As a result hypervigilance to current triggers reduces and people frequently describe feeling less on edge, avoiding fewer situations, sleeping better, and feeling more connected to themselves and others. The difficult experiences become integrated into a person's story without continuing to shape the present in the same way.

A note on finding the right treatment

Recovering from trauma is not only possible it is very common. In deciding on what is the right treatment approach for people at particular stages of recovery, the good news is that there are many good options. Many people move between trauma-informed and trauma-focused work during therapy. For some people, building safety and coping skills comes first.

For others, trauma processing becomes an important part of treating symptoms associated with PTSD or complex trauma. Recovery is rarely about choosing one approach forever. Often it involves finding the right support at the right time.

At MPC, all clinicians work within a trauma-informed framework. In addition, several clinicians provide treatment for PTSD and complex trauma using trauma-focused approaches such as EMDR and prolonged exposure therapy.

If you're unsure whether trauma informed therapy or trauma focussed therapy is right for you, or someone you care about, speaking with a psychologist who is expert in trauma is a good first option.

The team at Melbourne Psychology & Counselling includes psychologists with special interest in PTSD and all clinicians are trauma informed therapists. You can learn more about our approach via contact us directly.