How does therapy work? The basics.

Therapy is a type of treatment that involves talking to a trained professional in order to improve mental health and well-being. There are different types of therapy, including cognitive-behavioral therapy (CBT), psychodynamic therapy, and family therapy, among others. However, most therapies share some common elements that contribute to their effectiveness. Part of therapy is engaging with trauma, which all therapists are, to some degree, trained to address and respond to appropriately. Across the medical and health care field, as well as a number of other fields, this is called “trauma informed care.” A trauma therapist is a licensed mental health professional who specializes in working with individuals who have experienced trauma. Trauma therapists are trained to diagnose and treat mental health conditions related to trauma, such as post-traumatic stress disorder (PTSD), anxiety disorders, and depression. Trauma therapists may use a variety of evidence-based techniques, such as cognitive-behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), and dialectical behavior therapy (DBT), to help clients process their trauma and manage their symptoms.

Therapy works by creating a safe and supportive environment in which the client can discuss their thoughts, feelings, and behaviors with a trained professional. The therapist listens carefully to the client and provides empathy, validation, and feedback, which can help the client gain insight into their problems and develop new coping strategies. Secondly, therapy works by helping clients identify and change negative thought patterns and behaviors that may be contributing to their problems. Through various techniques and exercises, such as cognitive restructuring or exposure therapy, clients can learn to reframe negative thoughts and develop more adaptive coping strategies. Thirdly, therapy works by providing a space for clients to explore and work through past traumas or unresolved emotional issues. By examining past experiences and relationships, clients can gain a better understanding of themselves and develop healthier ways of relating to others.

A clinician who is trauma-informed has a more general understanding of trauma and its impact on individuals and communities. A trauma-informed provider may work in a variety of fields, such as education, healthcare, or social services, and has been trained to recognize the signs of trauma and respond in a way that is sensitive to the needs of trauma survivors. Trauma-informed care is based on the understanding that trauma is prevalent in society, and that individuals who have experienced trauma may be triggered or re-traumatized by certain environments or interactions. A trauma-informed approach seeks to create a safe and supportive environment that fosters healing and recovery. This last piece is universal across all therapists — the aim of a therapist within the therapeutic container is to create a safe and supportive environment that fosters healing and recovery. This is Therapy 101.

The essential difference between a trauma-informed provider and a “trauma specialist” is analogous to a medical doctor and a first responder. A medical doctor is highly trained and specialized in diagnosing and treating a specific set of conditions, and may work in a hospital or clinical setting. A first responder, on the other hand, is trained to recognize and respond to emergencies in a variety of settings, such as a fire, a car accident, or a natural disaster. While a first responder may not have the same level of training as a medical doctor, they are still equipped with the knowledge and skills to provide immediate support and care to those in need.

A “trauma therapist,” several of whom work at Progress Counseling, is like a specialist within the larger field — the whole therapy field is aiming to be “trauma-informed” while a “trauma therapist” works on trauma in particular. In fact, some “trauma therapists” will specialize within that specialty: domestic violence, self-harm, recovery from different forms of abuse, and so on.

The contrast between “trauma informed care” and “trauma therapy” is meant to illuminate here the ultimate aim of therapy as a whole. Within the safe, supportive container of the therapeutic relationship, a person may experience healing — in all its different forms. For a trauma therapist, this takes on the form of integrating the traumatic experiences that are often held as activating memories, flashbacks, and other painfully experienced (and re-experienced) sensations. Across all forms of therapy, a therapist can provide clients with practical skills and tools to manage their mental health and improve their overall well-being. These may include relaxation techniques, communication skills, stress management strategies, and mindfulness exercises, among others. Overall, therapy works by providing clients with a supportive and non-judgmental space to explore their thoughts, feelings, and behaviors, and to develop new coping strategies and skills to improve their mental health and well-being.

Aaron Kelsay, LPC, CADC I
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