What should I look for? I need trauma therapy in the UK

The following is not the view of any of the mentioned professional bodies, but general guidance to inform an individual to make a sensible treatment decision. it will hopefully assist people in making informed decisions when looking for single event, complex, developmental, attachment, invalidation, military service or other forms of trauma in the UK. (or from UK providers if living abroad).

Obviously you should only consult a therapist who has specialist training and accreditation in trauma work. General therapy and clinical trauma therapy have many major differences.

What kind of trauma are you looking to get help with?

Generally trauma can be split into single event trauma (PTSD) and complex trauma (C-PTSD). Within each there are a couple of sub categories to think about. The first main question though is:

Is the trauma therapist a specialist in single event (PTSD), complex trauma (C-PTSD) or both? This is important because the treatment protocols and therefore competencies are NOT the same.

If the issue is PTSD (single event trauma):

• Is it military service related or similar (police, paramedics etc)

• Or is it more typically civilian life related?

In working with a trauma event, it is important to have knowledge of the cultural specifics of the type of trauma. The environment, social connections, culture and mindset of your average military person or veteran is quite different to that of a civilian, and it is the job of the therapist to be culturally competent.

If the issue is complex trauma (C-PTSD):

• Within complex trauma there are different cultural competencies to consider such as ethnicity, gender, sexuality, faith and so on. 

• There are also different types of complex trauma, although it should be noted that these often have a great deal of overlap.

Some types of complex trauma include:

• Developmental trauma -  trauma that effects natural mental and physical development throughout the life cycle, most commonly childhood and adolescence. This may include neglect, ACE (Adverse Childhood Experiences) and odd upbringings such as faith cults.

• Attachment trauma -  trauma cause over time by having unnatural or dysfunctional relationship types as parents, carers, role models or peers.

• Invalidation trauma - often associated with gender, sexuality and neuro divergence issues, this kind of trauma results from being "othered", blamed, judged or simply not accepted as a result of some real or perceived difference.

• Sexual abuse trauma - this can happen at any age and often lasts over time or repeats.

• Physical abuse trauma - again not age specific

• Psychological or emotional abuse - again this can be developmental or occur later in life in relationships

It should be noted that complex and developmental trauma in particular is not about always bad things that happened, but also good things that were missing!

What to look for in a therapist

It is very important that the therapist is not just a general therapist, but has specialist knowledge of trauma work. This is as recommended in the UK NICE guidelines.

It is recommended that you do not just take the therapist's word for it, but look for specific training and accreditation for specialised trauma accreditation. This will mean that they have completed recognised training programmes and passed accreditation for using that knowledge. If they have not qualified or been accredited in some way, then they may have a special interest in the area of trauma, but they are not an accredited or certified trauma clinician.

Are they certified in single event (PTSD) trauma, complex trauma (C-PTSD) or both? And are they also certified in any specific sub categories that you feel are vital to your individual experience?

Have they got cultural competency or knowledge of areas such as faith, gender, sexuality or military service that are important to your experience? Note - no therapist can have perfect knowledge of your unique life and identity, so here wer are looking for key issues and "good enough" principle!

Do they meet the practice standards for the state or country they practice in. In the UK they should be EITHER on s statutory register of therapists OR a voluntary Professional Standards Authority Accredited Register for a core therapy. They should also be disclosure checked for working with vulnerable adults and children (DBS in England and Wales, PVG in Scotland). They should also be insured and ICO data protection registered.

Are they a "one trick pony" or have they got multiple skills that can be used to help you? Complex trauma in particular needs to be carried out according to an overall structure to prevent harm and ensure safety (usually the 3 stage method or similar). Each stage contains elements of change process and multiple therapy models can be employed. It is preferable for the therapist to have a few options for each of these stages so as to adapt to your needs. Even in single event PTSD, where the process design is simpler, it is good to have more than one tool to achieve memory reconsolodation for example (EMDR / Hypnosis / NLP etc).

Meaningful registrations for trauma therapy

There are plenty of therapy professional bodies that represent different types of therapist in complementary, mind-body, psychological therapists and so on.  Each has their advantages and disadvantages.

The Regulation structure in the UK however means that the therapist should EITHER be on a statutory register, or a voluntary PSA AR (professional standards authority accredited register) for at least one core therapy method. This will mean that they are held accountable to UK wide recognised standards of public protection.

Above and beyond having their core therapy registrations and insurance they should have specific trauma accreditations or qualifications. 

The main five accreditation bodies to consider are all international:

1.  PESI Evergreen Trauma I (PTSD) and II (Complex) Clinical Trauma Specialist certifications (Accepting of many appropriate evidence based models)

2. ATI / TTI Individual, Family and Advanced Clinical Trauma Certifications (Very results and evidence based)

3. Academy of American Traumatic Stress Experts - various levels from certification through to Fellow (Non Political)

4. PESI recognised partners, for example Caroline Spring's Trainings meet vigorous standards

Also meaningful qualifications / awards without necessarily having ongoing yearly registrations:

1. Any of the above certificates that qualify accreditation even if no longer maintained

2. TSS Post Graduate Certification in Traumatic Stress Studies

3. Any post graduate university award or vocational externally accredited alternative (UK level 7)