Why a Trauma Therapy Specialist?

 What are the benefits of selecting a trauma specialist?

 The easy answer is effectiveness! We have known since the late 20th Century that talking therapy alone is simply the wrong response for traumatic stress. Its is a useful tool, but it is not enough on it's own.

Selecting even a very good talking therapist (counsellor, psychotherapist psychologist etc) is like selecting a guitar with one very good string, 

with all the rest missing!

 Why do you need more than just a talking therapist? The 9 Key Qualities of Trauma Care!

 Complex trauma therapy is a specialized approach to treating the effects of prolonged or repeated traumatic experiences. It focuses on healing from the deep impact of such trauma on a person's emotional, psychological, and social well-being. Talking therapists can of course provide useful support, but because this is a specialised area, well meaning and enthusiastic generalists can actually do more harm than good. This is partly why in the UK the National Institute for Clinical Excellence in their guidelines for PTSD support (including C-PTSD) clearly recommend only consulting a trained specialist. Complex trauma in particular does not behave the same as general mental health and requires a different knowledge base, wider range of skills and different application of planned and properly evidenced treatment.

Key components of complex trauma therapy include:

1. Safety and Stabilization: Creating a safe and supportive therapeutic environment is paramount. This involves establishing clear boundaries, ensuring confidentiality, and helping the individual feel secure enough to explore their experiences. Stabilization techniques, such as grounding exercises and mindfulness practices, are often used to manage overwhelming emotions and physical sensations.  This requires skills and knowledge from the area of neurobiology, relaxation therapies, physical based therapies, energetic therapies. It also requires the ability to coach clients in self regulation methods from a variety of therapies, and to be able to explain how and why they work. 

2. Psychoeducation: Providing education about complex trauma, its effects on the brain and body, and common reactions is essential. This helps individuals understand their experiences and reduces feelings of shame or self-blame.  This requires a good sound scientific training in neurobiology, health psychology, integrative medicine and the "ingredients for health" (including nutrition, movement, sleep, complementary treatments, medical testing, conversing with medical professionals etc). 

3. Emotional Regulation: Developing skills to manage and regulate emotions is a crucial aspect of complex trauma therapy. This may involve learning techniques for identifying and labeling emotions, coping with triggers, and developing healthy emotional expression.  This requires a skillset and knowledge including neurobiology, relaxation and energy therapies, physical therapies, wellbeing coaching, self management using diet and exercise and a whole wide range of other disciplines as well as social psychology / interpersonal neurobiology. It preferably includes a grounding in polyvagal theory and other cutting edge physiology.

4. Processing Traumatic Memories: Once the individual is stabilized and has developed coping skills, they may begin to process traumatic memories. This is often done gradually and at the individual's own pace. Different therapeutic approaches, such as Eye Movement Desensitization and Reprocessing (EMDR) or Somatic Experiencing, may be used to help process these memories.  Hypnosis, EMDR, brainspotting, sensorimotor psychotherapy, somatic (mind-body) processing methods, advanced mindfulness methods, NLP, MEMI and various other therapies are needed if memory reconsolidation needs to occur, and more importantly a sound understanding of the neurology and science behind what is being used, and why. Failuire to have proper specialist knowledge and training can lead to amateur and premature application of methods, leading to real harm!

5. Attachment and Relationship Repair: Complex trauma often affects an individual's ability to form and maintain healthy relationships. Therapy may focus on exploring past attachment patterns, identifying current relationship challenges, and developing skills for building and maintaining healthy connections.  Interpersonal psychotherapy, attachment psychology or social psychology, together with understanding interpersonal neurobiology is a specialist field and not part of general talking therapy training.

6. Reintegration and Empowerment: The final stage of complex trauma therapy involves reintegrating the traumatic experiences into the individual's life narrative and fostering a sense of empowerment. This may include exploring personal strengths and resilience, developing a sense of self-worth, and creating a hopeful vision for the future. Narrative therapy, parts work therapy and other advanced somatic and narrative based methods are again advanced and specialist therapy areas not used by general therapists.

7. Behavioural Change: Alongside the above main areas there are often essential life changes that need to occur in moving from trauma adaptation (survival based adaptation of behaviour and beliefs during trauma) to re-adaptation (choosing behaviours and perceptions that work in safe post trauma living). These changes require specialised knowledge of advanced behavioural change methods and the neuroligical implications of applying them successfully with trauma survivors. This means having a combination of knowledge of therapies such as DBT, RO-DBT, ACT, CBT, CT, CBASP, ABA, and being able to adapt them to the trauma survivor and their need for patience with neuro-flexibility and trauma based neuro-diverdence.  

8. Socratic Challenge: Before perceptual change can be designed hand in hand with the client, it is important to take a critical thinking / philisophical approach to challenging beliefs and ideas. This is done compassionately and without agenda, teaching the client to challenge their own  "trauma think". This leads to designing re-adaptation to move on from fear and adaptive behaviours that hold the client back, as well as uncovering and nurturing hidden qualities and aspects of identity that may have laid hidden and suppressed. This requires the ability to understand deeply how perception and behaviour change during trauma, and frankly is only possible for therapists who have completed their own trauma recovery journeys. Methods include Compassionate Inquiry (created by Gabor Mate) and philosophical analysis / therapy. There are some limited philosophical therapy training courses available, alternatively the route to knowledge is general knowledge and experience, together with specific study of philosophy of the mind, or philosophy in therapy context. Both are available from credible universities.

9. Complex trauma is notorious for co-morbidity. In other words where long term exposure to traumatic events has occured other diagnosis, both physiological and psychological are usually present, and therefore the therapist needs additional knowledge of other integrative and functional medicine, and mental health areas in order to support these cases. This is reflected in the UK NICE guidelines for PTSD where other concurrent common conditions are discussed.
   
   

It's important to note that complex trauma therapy is not a one-size-fits-all approach. The specific components and techniques used will vary depending on the individual's needs and preferences, as well as the therapist's expertise. It's crucial to find a therapist who is experienced in working with complex trauma and who can provide a safe and supportive space for healing.

How to I know if a trauma specialist has all the right skill set?

Most Certified Trauma Specialists have a broad range of therapies and skills and are able to cover most, if not all of the above categories in some way, or refer the client to a colleague or trusted source for areas they are not able to manage. 

As a guide look for:

• Recognised Clinical Certification as a Trauma Specialist. Sources include Evergreen Certifications (the certification wing of PESI), Trauma Institute International (the certification wing of the Arizona Trauma Institute), NARM (the training organisation using the Heller model), the TSS Post Graduate Certification from the Trauma Research Foundation (training wing of Bessel Van Der Kolk & colleagues), the Mindsight Institute (training wing of Dan Siegel, founder of Interpersonal NeuroBiology). Registered Certification usually requires up to date Professional trainings each and every year of the highest standard to maintain registration. This ensures that in the fast moving world of traumatology the therapist remains current with their knowledge. Most advanced certification schemes require both full clinical qualification in an appropriate core therapy model before taking the training and either Graduate or Post Graduate qualification depending on the provider.

• Certification in actual therapy methods that are appropriate such as those mentioned above. Note however that in the therapy industry many therapies are repackaged as "brand labels" and therefore there is a lot of overlap between them. A quick online search to see what a therapy is, and crucially does it have meaningful research evidence should show whether it is appropriate. Appropriate research means Peer Reviewed, Published in major journals and Replicated. 

• Qualifications vary between countries, usually qualifications or certifications in specific therapies are either recognised by major professional bodies such as the American Psychological Association (as one example), or accredited as Vocational or Academic awards from some meaningful institution at an appropriate level.  

• Core trainings held by the therapist should be at a post graduate level or equivalent and be largely practical, face to face trainings under supervision. There is nothing wrong in a therapist having additional "add on" trainings through virtual, distance or blended training, but their core, main training should always be a hands on training at a credible level. Where multiple core therapy models exist for the therapist, each should have core training and or experience / assessment.

• Professional registration: the therapist should have professional registration for all therapies provided.

• Professional insurance: the therapist should be insured for all the tehrapies provided.

• Regulation: different countries have different regulation processes or sometimes none. In the UK there are both statutory and voluntary official schemes. Therapists should adhere to the regulation requirements of their State / Country of practice. In the UK this means you must have statutory regulation if using a protected title, and outside of those titles therapists are most credible if they are registered on at least one Professional Standards Authority Accredited Register for their core therapies (voluntary approved regulation scheme in the UK).