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Trauma-Focused Cognitive Behavioral Therapy
Trauma Focused Cognitive Behavioral Therapy is a form of cognitive behavioral therapy designed for people who have experienced some kind of traumatizing event, and have difficulty coping with the aftermath. A trauma can include combat, sexual or physical assault, being the victim of a crime, surviving a disaster, being in an accident, or any other potentially life-threatening situation. Sometimes people who experience or witness a trauma can go on to develop painful psychological symptoms such as flashbacks, nightmares, and intrusive images of the trauma. Trauma Focused Cognitive Behavioral Therapy helps people cope with and significantly reduce these symptoms through emotional reprocessing. The American Psychological Association has recently determined that licensed psychologists (as opposed to social workers and marriage and family therapists) are the most expert providers of care for trauma. There are several widely used Trauma Focused Cognitive behavioral therapies:
Prolonged Exposure Therapy: Prolonged exposure is a form of exposure therapy helps people process the trauma that occurred, and find meaning in the experience. Prolonged exposure therapy works from the premise that the brain is overloaded when a trauma occurs, and this causes problems processing and encoding the information in the brain. Prolonged exposure remedies this through the patient recounting the trauma in session, reducing the emotional dysregulation caused by memories of the trauma, and finding new ways of thinking about how it fits into one’s own personal narrative.
Cognitive Processing Therapy: Cognitive processing therapy is a trauma focused cognitive behavioral therapy that focuses more on the thoughts people have in response to their trauma. Essentially, cognitive processing therapy helps people examine their maladaptive patterns in thinking and find more effective ways of making sense of the trauma. This is achieved through homework assignments involving patients writing out their trauma narrative, and engaging in cognitive restructuring of maladaptive or problematic thinking patterns.
Seeking Safety: Seeking safety is a Trauma Focused Cognitive Behavioral Therapy that helps people learn to regulate their intense emotions in the aftermath of a trauma. By learning behavioral coping skills such as relaxation training and mindfulness, people are better able to deal with symptoms resulting from experiencing a trauma. Because the treatments described above can be stressful, Seeking safety is generally used to help prepare people for these more intensive treatments by building up their coping skills.
Eye Movement Desensitization Reprocessing (EMDR): EMDR is one of the more widely used forms of Trauma Focused Cognitive Behavioral Therapy. It works in much the same way as prolonged exposure therapy, except that in EMDR, the client is instructed to move his/her eyes from side to side in a rhythmic way while recounting the trauma. According to proponents of this controversial treatment, the eye movement supposedly helps encode the information in the brain. Unfortunately, significant evidence suggests that this addition in no way aids the treatment. Numerous studies have been conducted on this form of therapy, and have concluded it is no more beneficial than prolonged exposure, and that it is no different in the way that it works. Despite this scientific evidence, numerous therapists continue to use EMDR, either unaware of or indifferent to its lack of basis in current psychological science. Due to its dubious evidence-base, we do not use EMDR at Cognitive Behavioral Therapy Los Angeles, nor do we recommend it.
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