Trauma-Focused Treatment
What Is Trauma?
Trauma can come in many different forms. There are big T traumas that include sexual assaults, military combat, natural disasters, or other experiences where your life was in physical danger. However, there are also little t traumas that include constant experiences of abandonment, rejection, or other more personal experiences of trauma. Both can cause a fight-flight-freeze trauma response.
How do we treat trauma/PTSD?
COPE clinicians utilize two primary treatments to treat trauma and PTSD symptoms: Cognitive Processing Therapy and Prolonged Exposure. Both are evidence-based treatments that are utilized across the country in academic medical centers as the front line interventions for treating trauma. They are supported by the American Psychological Association as highly effective trauma treatments and have been designated as having strong research support. They aim to help individuals reduce their trauma symptoms, build resiliency, and begin engaging in their life in new, more effective ways. See below for more information on both and to see which one is right for you, contact us below.
Cognitive Processing Therapy (CPT)
CPT is a specific type of Cognitive Behavioral Therapy that focuses on helping individuals examine the ways in which trauma has impacted their sense of self and world around them. In particular, CPT focuses on five main areas: self-esteem, sense of safety, ability to be intimate (physically and emotionally), ability to trust, and need to be in power or control. It is through examining how the trauma(s) affected these areas that individuals begin to rescript their mental narratives to create more helpful and balanced beliefs related to the trauma.
COPE clinicians use CPT techniques to work towards developing compassion, understanding, and empathy for the ways that our clients’ lives and world views were affected in order to ultimately develop effective coping skills to move their lives forward in a new direction. Research has shown that significant reductions in trauma symptoms can be made using CPT after 12 weekly 50-minute sessions.
Prolonged Exposure (PE)
PE focuses on helping individuals gradually approach (and not avoid) their trauma-related memories, feelings, and situations. It is through a unique systematic approach that individuals begin to tolerate their discomfort and learn to recognize that many trauma-related cues that they viewed as dangerous are not dangerous and do not need to be avoided. Although it makes sense why anyone would avoid trauma-related cues, particularly in the short-term, it can be detrimental in the long-term.
COPE clinicians work towards creating a safe space and work collaboratively to help individuals re-engage in their life in new ways. Research has shown that significant reductions in trauma symptoms can be made using PE after 10-12 weekly 90-minute sessions.
Our Trauma Treatment Philosophy
Our approach to trauma treatment is based on years of research showing that what is most helpful in learning how to cope and deal with traumatic stressors is being able to create new learning experiences. We often tell patients who experience a range of trauma reactions that the very reaction that helped you survive the trauma (e.g. fighting, shutting down your emotions, staying isolated, etc.) can also be the very thing that keeps you from our healing now. What worked in one context may not work in another and what worked when your life was at risk may not be working in more objectively safe situations – though that may not always feel to be the case. Thus, our goal at COPE is to 1) have compassion for the reaction that was developed in the context of the stressor, 2) examine the effectiveness of that reaction currently, and 3) develop a more balanced and accurate approach to your current life circumstances.
How Can COPE Help?
Many providers at COPE have been extensively trained in treating PTSD or trauma reactions. Psychologists at COPE primarily utilize Cognitive Processing Therapy and Prolonged Exposure for treating the trauma. Although these treatments are often less known in the community compared to other treatments (i.e. EMDR), these treatments have a strong evidence-base and are the front line treatments in various academic medical centers (e.g. VA Hospitals, UCLA, etc.) throughout the country. If interested in learning more about how these treatments may be right for you, please contact us for more information.
What About Eye Movement Desensitization Record (EMDR)?
Although EMDR is a popular treatment for trauma, we at COPE primarily utilize CPT and PE described above, as they have stronger research support and and more evidence-based interventions. Per the American Psychological Association, the research on the effectiveness of EMDR is controversial and the actual mechanisms of change may not actually be the eye movement piece of treatment, but the exposure to the trauma. Thus, we at COPE implement other trauma treatments, such as CPT and PE that directly target what has shown to be effective in trauma treatment. For more information on EMDR from the American Psychological Association
FAQ
What Is Trauma-Focused Treatment and When Is It Recommended?
Trauma-focused treatment is a therapeutic approach designed to help people process and recover from traumatic experiences. It is often recommended when trauma symptoms such as intrusive memories, emotional numbing, avoidance, hypervigilance, or ongoing distress interfere with daily life. This type of treatment focuses on addressing the impact of trauma rather than avoiding it, while moving at a pace that feels safe and manageable.
How Do Prolonged Exposure and Cognitive Processing Therapy Help With Trauma?
Prolonged Exposure helps people gradually face trauma-related memories, feelings, and situations that have been avoided, allowing the nervous system to learn that these experiences are no longer dangerous. Cognitive Processing Therapy focuses on identifying and shifting unhelpful beliefs related to trauma, such as self-blame or feelings of permanent damage. Both approaches are evidence-based and support meaningful recovery through different but complementary paths.
What Is the Difference Between Cognitive Processing Therapy and Prolonged Exposure and How Do I Know Which One Is Right for Me?
Cognitive Processing Therapy places more emphasis on examining and reshaping beliefs connected to trauma, while Prolonged Exposure focuses more on directly engaging with memories and avoided situations. The right approach depends on symptoms, preferences, and readiness. Therapists help clients understand these options and collaborate on a plan that feels appropriate rather than forcing a single method.
How Soon Do Clients Notice Shifts After Trauma-Focused Work?
Some clients notice changes within a few sessions, such as reduced emotional intensity or increased understanding of their reactions. Deeper shifts often develop over time as skills are practiced and memories are processed. Progress is gradual and varies from person to person, with therapists checking in regularly to support pacing and safety.
How Do Therapists Build Safety Before Exploring Trauma Memories?
Safety is established before any trauma processing begins. Therapists focus on building trust, emotional regulation skills, and coping strategies first. This foundation helps clients feel more stable and supported when exploring trauma-related material. Trauma work does not begin until clients feel ready and resourced.
Can Trauma Therapy Address PTSD, Nightmares, or Hypervigilance?
Yes. Trauma-focused treatment is commonly used to support PTSD symptoms, including nightmares, intrusive thoughts, avoidance, and hypervigilance. Therapy helps reduce the intensity and frequency of these symptoms by addressing their underlying causes rather than managing them alone.
Is Trauma Treatment Effective for Both Recent and Older Traumas?
Yes. Trauma-focused therapy can be effective for both recent events and experiences that occurred many years ago. The brain and body respond to trauma similarly regardless of when it happened. Treatment focuses on how trauma is impacting life now, not on how long ago it occurred.
What If I’m Not Ready for Trauma-Focused Treatment?
Not feeling ready is common and respected. Therapy can begin with stabilization, coping skills, and emotional support without directly addressing trauma memories. Readiness is not rushed, and trauma-focused work only begins when clients feel prepared and supported.
How Does Trauma Work Support Emotional Regulation?
Trauma can disrupt the nervous system, making emotions feel overwhelming or unpredictable. Trauma-focused therapy helps restore emotional regulation by increasing awareness of triggers, strengthening coping skills, and reducing reactivity. Over time, emotions often feel more manageable and less controlling.
How Can Trauma-Focused Treatment Help With Complex PTSD (C-PTSD)?
For Complex PTSD, treatment often addresses long-standing trauma, attachment wounds, and identity-related challenges. Therapy focuses on emotional regulation, relationship patterns, self-concept, and trauma processing over time. Trauma-focused approaches are adapted to move slowly and support safety, trust, and integration.