Outpatient Services

Developed by: Diana Fosha, Ph.D.

Summary:

AEDP (Accelerated Experiential-Dynamic Psychotherapy) is a transformation-based, healing-oriented model of psychotherapy developed by Dr. Diana Fosha. Our aim is to foster the emergence of new and healing emotional experiences for and with our patients. Intense emotional experience and suffering are part and parcel of being alive; they are also—if properly regulated—the pathways to resources and resilience. But when these experiences, bad or good, threaten to overwhelm us, we need others to help us regulate them. Being alone with unbearable emotions is at the root of psychopathology. When relationships fail to help regulate what is too much to bear alone, people resort to defensive strategies. Long-term reliance on these defenses disrupts growth and development, blocks access to adaptive resources, and contributes to the pain and difficulties that lead people to seek treatment. In Accelerated Experiential-Dynamic Psychotherapy, our goal is to be together with our patients as they process intense emotional experiences which were previously feared, be they painful or joyful. Furthermore, we are not just bundles of pathology: Lodged deeply in our brains and bodies lie innate, wired-in dispositions for healing and self-righting. Accelerated Experiential-Dynamic Psychotherapy also aims to activate these naturally occurring, adaptive change processes. When the self has reason to hope that a relationship has such potential, defenses can be put aside and individuals can risk leading with their genuine, spontaneous responses. It is what Accelerated Experiential-Dynamic Psychotherapy seeks to facilitate through its affirming, emotionally engaged therapeutic stance and its relational, experiential, and integrative techniques.

~Excerpt from Accelerated Experiential Dynamic Psychotherapy

Website:

Diana Fosha Ph.https://aedpinstitute.org/faculty/diana-fosha-phd/D.

Developed by: Steven C. Hayes, Ph.D., Kirk D. Strosahl, Ph.D., Spencer Smith, Ph.D., Kelly G. Wilson, Ph.D.

Summary:

Developed within a coherent theoretical and philosophical framework, Acceptance and Commitment Therapy is a unique empirically based psychological intervention that uses acceptance and mindfulness strategies, together with commitment and behavior change strategies, to increase psychological flexibility. Psychological flexibility means contacting the present moment fully as a conscious human being, and based on what the situation affords, changing or persisting in behavior in the service of chosen values. Based on Relational Frame Theory, Acceptance and Commitment Therapy illuminates the ways that language entangles clients into futile attempts to wage war against their own inner lives. Through metaphor, paradox, and experiential exercises clients learn how to make healthy contact with thoughts, feelings, memories, and physical sensations that have been feared and avoided. Clients gain the skills to recontextualize and accept these private events, develop greater clarity about personal values, and commit to needed behavior change"

~Excerpt from Acceptance & Commitment Therapy

Developed by David Grand, Ph.D.

Summary:

“Brainspotting is based on the profound attunement of the therapist with the patient, finding a somatic cue and extinguishing it by down-regulating the amygdala. It isn’t just PNS (Parasympathetic Nervous System) activation that is facilitated, it is homeostasis.” -- Robert Scaer, MD, “The Trauma Spectrum”

"Brainspotting is a powerful, focused treatment method that works by identifying, processing and releasing core neurophysiological sources of emotional/body pain, trauma, dissociation and a variety of other challenging symptoms. Brainspotting is a simultaneous form of diagnosis and treatment, enhanced with Biolateral sound, which is deep, direct, and powerful yet focused and containing.

Brainspotting functions as a neurobiological tool to support the clinical healing relationship. There is no replacement for a mature, nurturing therapeutic presence and the ability to engage another suffering human in a safe and trusting relationship where they feel heard, accepted, and understood.

Brainspotting gives us a tool, within this clinical relationship, to neurobiologically locate, focus, process, and release experiences and symptoms that are typically out of reach of the conscious mind and its cognitive and language capacity."

~Excerpted from Grand's Brainspotting Website

Developed by: Shirley Jean Schmidt, MA, LPC

Summary:

The Developmental Needs Meeting Strategy (DNMS) is an ego state therapy designed to treat a wide range of clients, symptoms, and issues. This includes adults with complex trauma wounds, such as those inflicted by physical, sexual, and verbal abuse; and with attachment wounds, such as those inflicted by parental rejection, neglect, and enmeshment. The DNMS is based on the assumption that the degree to which developmental needs were not adequately met is the degree to which a client is stuck in childhood. It starts by guiding clients to establish three internal Resources: a Nurturing Adult Self, a Protective Adult Self, and a Spiritual Core Self. Together these Resources gently help wounded child ego states get unstuck from the past by meeting their unmet developmental needs, helping them process through painful emotions, and by establishing an emotional bond. Alternating bilateral stimulation (made popular by EMDR therapy) is applied at key points in the process. The DNMS focuses special attention on healing maladaptive introjects (ego states that mimic abusive, neglectful, or dysfunctional caregivers). Since these wounded ego states cause the most trouble for clients, their healing results in a significant benefit. As introjects heal, clients report unwanted behaviors, beliefs, and emotions diminish.

Website:

Developmental Needs Meeting Strategy

Developed by: Marsha M. Linehan

Summary:

In the late 1970s, Marsha M. Linehan attempted to apply standard Cognitive Behavior Therapy (CBT) to the problems of adult women with histories of chronic suicide attempts, suicidal ideation, urges to self-harm, and self-mutilation. Trained as a behaviorist, she was interested in treating discrete behaviors; however, through consultation with colleagues, she concluded that she was treating women who met criteria for Borderline Personality (BPD).

DBT maintains that some people,due to invalidating environments during upbringing and due to biological factors as yet unknown, react abnormally to emotional stimulation. Their level of arousal goes up much more quickly, peaks at a higher level, and takes more time to return to baseline. This explains why people with Borderline Personality are known for crisis-strewn lives and extreme emotional lability (emotions that shift rapidly). Because of their past invalidation, people with Borderline Personality don’t have any methods for coping with these sudden, intense surges of emotion. DBT is a method for teaching skills that will help in this task.

Briefly, Linehan hypothesizes that any comprehensive psychotherapy must meet five critical functions. The therapy must: a) enhance and maintain the client’s motivation to change; b) enhance the client’s capabilities; c) ensure that the client’s new capabilities are generalized to all relevant environments; d) enhance the therapist’s motivation to treat clients while also enhancing the therapist’s capabilities; and, e) structure the environment so that treatment can take place.

Skills are acquired, strengthened, and generalized through the combination of skills groups, phone coaching (clients are instructed to call therapists for coaching prior to engaging in self harm), in vivo coaching, and homework assignments.

DBT also organizes treatment into stages and targets and, with very few exceptions, adheres strictly to the order in which problems are addressed. The organization of the treatment into stages and targets prevents DBT being a treatment that, week after week, addresses the crisis of the moment. Further, it has a logical progression that first addresses behaviors that could lead to the client’s death, then behaviors that could lead to premature termination of therapy, to behaviors that destroy the quality of life, to the need for alternative skills. In other words, the first goal is to insure the client stays alive, so that the second goal (staying in therapy), results in meeting the third goal (building a better quality of life), partly through the acquisition of new behaviors (skills).

~Excerpt from Behavioral Tech

Considering EMDR? What Every Client Should Know

Description of EMDR Interview with Bessel van der Kolk, M.D. (short video)

For full interview visit: Bessel A. van der Kolk Full Interview - Trauma Treatment: Psychotherapy for the 21st Century

What Is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) is a late-stage, trauma resolution method. Developed in the late 1980's, EMDR currently has more scientific research as a treatment for trauma than any other non-pharmaceutical intervention. Based on empirical evidence as well as thousands of client and clinician testimonials, EMDR has proven an efficacious and rapid method of reprocessing traumatic material.

How Does EMDR Work?

EMDR appears to assist in processing of traumatic information, resulting in enhanced integration - and a more adaptive perspective of the traumatic material. The utilization of EMDR has been shown to eliminate the need for some of the more difficult abreactive work (i.e.reliving the trauma), often associated with the psychoanalytic treatment of a variety of conditions, including generalized and specific anxieties, panic, PTSD symptoms (such as intrusive thoughts, nightmares, and flashbacks), dissociative disorders, mood disorders and other traumatic experiences. So, theoretically, EMDR is about integration- bilateral hemispheric (right/left brain) integration; triune brain (brain stem, limbic system and cerebral cortex) integration; and at least some type of mind/body integration, but practically, it’s about convincing the mind and body that the traumatic event is, indeed over. EMDR helps to put the past in the past, where it belongs, instead of staying stuck in it (feeling like it is happened all over again in the present-with the same thoughts, emotions and body sensations- that accompanied the event in the past)

How is EMDR Done?

EMDR is accomplished in Four Stages (Parnell, 2006):

1. Establishment of Safety:

* Safety within the therapeutic relationship

* Safety within each individual EMDR session

During each EMDR session, your therapist will begin by activating your own internal resources. (S)he will guide you in an imaginal, multi-sensory imagery exercise designed to activate images, emotions and body sensations of safety, protection, nurture and comfort. Once these images have been activated, the actual trauma reprocessing will begin.

2. Activating the Traumatic Memory Network:

The therapist will ask a series of questions regarding the traumatic memory. The purpose of these questions (or script) is to fully activate the entire traumatic memory network.

3. Adding Alternating Bilateral Stimulation:

Once the entire traumatic memory is activated, the therapist will add alternating bilateral stimulation via any or all of the following:

* Begin the buzzing in your hands by turning on the Theratapper

* Play alternating auditory tones via headphones or ear buds

* Begin moving his/her hands back and forth, so you may visually track the movement across the midline of your body)

4. End with Safety:

Regardless of whether the traumatic material was completely processed or not, the session will end at a pre-set time. Before you leave, you will be stable, embodied, oriented and calm. Depending on you and your therapist’s preferences, this may be accomplished in a variety of ways including, but not limited to re-activating your own internal resources, breathing exercises, prolonged muscle relaxation, etc.

"It is better by noble boldness to run the risk of being subject to half the evils we anticipate than to remain in cowardly listlessness for fear of what might happen." ~Herodotus

Is EMDR Dangerous?

You should know that this modality (EMDR for single-incident trauma) is a pretty simple protocol-easy for any literate person to master-, however, when administered by someone lacking requisite knowledge of trauma’s sequelae, this simple protocol may prove challenging, fear-inducing and-oftentimes re-traumatizing for clients. So there’s no misinterpretation of the last sentence, the EMDR protocol-original or modified is not dangerous, but any type of trauma work that deliberately activates a traumatic memory network without insisting that both client and clinician are adequately prepared to tolerate the effects of that activation is dangerous and irresponsible. It follows then, that more valuable than a clinician with a training certificate in EMDR, clients are better served by competent, clinicians who possess a thorough knowledge of trauma-its effects and aftereffects, as well as knowledge of the current evidence-based, state-of-the art trauma resolution methods, which should include, but be not limited to the EMDR. As van der Kolk points out, “EMDR is a lovely trauma processing technique and you don’t need to be a genius to learn how to do it.”

What Should I Expect from My Therapist?

As a client, you should expect that your clinician will-and does- continuously and vigilantly attend and re-attend to your safety and stabilization needs. To that end, please be aware that you are entitled to, and should expect the following:
A solid therapeutic relationship, i.e. a good rapport and adequate trust in your therapist.
An explicit crisis plan-co-written by you.

Psychoeducation regarding trauma-its effects, aftereffects and current treatment options-including the modalities utilized by your therapist.

Instruction in-and acquisition of- skills for self, affect and emotion regulation, arousal reduction and distress tolerance prior to trauma work, i.e., before any reprocessing of trauma, you should:

Feel stable

Have access to an external support system

Have a decent sense of self and identity

In a relatively healthy manner, be able to handle or manage the intensity of your own emotion.

Be sure to ask your clinician what all of this means and how (s)he intends to prepare you for reprocessing traumatic material.

Developed by: David Feinstein, Ph.D., Donna Eden, Fred P. Gallo, Ph.D.

Summary:

Building upon conventional therapeutic methods, Energy Psychology utilizes techniques from acupressure, yoga, qi gong, and energy medicine that teach people simple steps for initiating changes in their inner lives. It works by stimulating energy points on the surface of the skin which, when paired with specific psychological procedures, can shift the brain’s electrochemistry to: Help Overcome Fear, Guilt, Shame, Jealousy, or Anger; Change Unwanted Habits and Behaviors; and Enhance the Ability to Love, Succeed, and Enjoy Life. While this is still a controversial area within the mental health field (the techniques look very strange and the claims of a growing number of practitioners seem too good to be true), evidence is mounting that these techniques are significant, powerful tools for both self-help and clinical treatment.
~Excerpt from Energy Psychology

Websites:

The Energy Medicine Institute

Energy Psychology

Developed by: Eugene Gendlin, Ann Weiser Cornell, Barbara McGavin, Ed Campbell, Peter McMahon, Elfie Hinterkopf, Neil Friedman

Summary:

Focusing is a mode of inward bodily attention that most people don’t know about yet. It is more than being in touch with your feelings and different from bodywork. Focusing occurs exactly at the interface of body-mind. It consists of specific steps for getting a body sense of how you are in a particular life situation. The body sense is unclear and vague at first, but if you pay attention it will open up into words or images and you experience a felt shift in your body. In the process of Focusing, one experiences a physical change in the way that the issue is being lived in the body. We learn to live in a deeper place than just thoughts or feelings. The whole issue looks different and new solutions arise. What are the benefits of focusing? Focusing helps to change where our lives are stuck. The felt shift that occurs during Focusing is good for the body, and is correlated with better immune functioning. More than 100 research studies have shown that Focusing is teachable and effective in many settings. Focusing decreases depression and anxiety and improves the relation to the body.

Website:

The Focusing Institute

Developed by: Fritz Perls, Laura Perls, Paul Goodman

Summary:

Gestalt therapy focuses on here-and-now experience and personal responsibility. The objective, in addition to overcoming symptoms, is to become more alive, creative, and free from the blocks of unfinished issues that may diminish optimum satisfaction, fulfillment, and growth. The theory of Gestalt therapy takes as its centerpiece two ideas. The first is that the proper focus of psychology is the experiential present moment. In contrast to approaches which look at the unknown and even unknowable, our perspective is the here and now of living. The second idea is that we are inextricably caught in a web of relationship with all things. It is only possible to truly know ourselves as we exist in relation to other things. These twin lenses, here-and-now awareness and the interactive field, define the subject matter of Gestalt therapy. Its theory provides a system of concepts describing the structure and organization of living in terms of aware relations. Its methodology, techniques, and applications . . . link this outlook to the practice of Gestalt therapy. The result is a psychology and method with a rich and unique view of everyday life, the depths and difficulties which life encompasses, and “the high side of normal,” the ennobling and most creative heights of which we are capable. Gestalt therapists believe their approach is uniquely capable of responding to the difficulties and challenges of living, both in its ability to relieve us of some measure of our misery and by showing the way to some of the best we can achieve.

~Excerpt from: Assoc. for the Advancement of Gestalt Therapy

Websites:

http://www.gestalttheory.net

Developed by: Richard C. Schwartz, Ph.D.

Summary:

Internal Family Systems Therapy is a comprehensive approach to healing trauma and other related symptoms that includes guidelines for working with individuals, couples and families. The Internal Family Systems Therapy Model represents a new synthesis of two already existing paradigms: systems thinking and the multiplicity of the mind. It brings concepts and methods from the structural, strategic, narrative, and Bowenian schools of family therapy to the world of subpersonalities. Internal Family Systems Therapy provides practical methods to recognize and access the “higher” or “deeper” Self, so that the process of growth happens according to an “inner wisdom.” In accessing the Self and healing parts, a person is not pushed, rushed, or imposed upon. The process is allowed to unfold at its own speed, and according to its own pattern.
~Excerpt from The Center for Self Leadership

Website:

Internal Family Systems Therapy

Developed by: Dan Siegel, Allan Schore

Summary:

Interpersonal Neurobiology, a term coined by Dr. Dan Siegel, studies the way the brain grows and is influenced by personal relationships. Recent studies have discovered that brain growth occurs throughout the lifespan. IPNB explores the potential for healing trauma by using positive and secure influences on the brain. Conditions once thought to be permanent, now have the bright potential for healing and growth. IPNB has broad applications that are useful for parenting, mental health, addictions, education, health care, business professionals, and more.

~Excerpt from Vanguard in Action

Website for Related Interpersonal Neurobiology

http://drdansiegel.com/

http://www.allanschore.com/

http://www.mindgains.org/

Developed by: Jon Kabat-Zinn, Zindel V. Segal, J. Mark G. Williams, John D. Teasdale, Bruno Cayoun

Summary:

Mindfulness Based Cognitive Therapy is based on the Mindfulness-based Stress Reduction (MBSR) eight week program, developed by Jon Kabat-Zinn in 1979 at the University of Massachusetts Medical Center. Research shows that MBSR is enormously empowering for patients with chronic pain, hypertension, heart disease, cancer, and gastrointestinal disorders, as well as for psychological problems such as anxiety and panic. Mindfulness Based Cognitive Therapy grew from this work. Zindel Segal, Mark Williams, and John Teasdale adapted the MBSR program so it could be used especially for people who had suffered repeated bouts of depression in their lives.

~Excerpt from Mindfulness-based Cognitive Therapy

By practising in the (8 week) Mindfulness Based Cognitive Therapy classes, and by listening to CDs at home during the week, participants learn the practice of mindfulness meditation. Practices such as the Body Scan, Breathing meditation, and simple yoga allow participants to become in touch with moment-to-moment changes in the mind and the body and foster a new, ‘decentered’ perspective to their thoughts and feelings. MBCT also includes basic education about depression, and several exercises from cognitive therapy that show the links between thinking and feeling and how best participants can look after themselves when depression threatens to overwhelm them.

~Excerpt from Oxford Cognitive Therapy Centre

Website:

Center for Mindfulness in Medicine, Health Care, and Society

The Theory

According to Belleruth Naparstek, Guided imagery is intentional, directed daydreaming-blending one’s imagination with words and phrases that evoke sensory fantasy and memory. Guided imagery creates a deeply receptive mind, body, psyche and spirit state during which change becomes possible. For most of us, imagery is an accessible form of meditation yielding immediate empirically proven benefits including a wide variety of physical and psychological outcomes.

Below is an interview clip of Guided Imagery with Belleruth Naparstek:

Video Player

The ones of interest to this population include:

*Reduction of anxiety and depression

*Decrease in blood pressure

*Strengthening of immune function

*Reduction of pain

*Reduction of bingeing and purging in those with bulimia

*Improvement in attention and concentration

Imagery is effective because it basically bypasses rational thought and logical assumptions - delivering healing messages directly to the hypervigilant primitive brain. Once received, imagery disperses gentle reminders of health, strength, meaning and hope that affect unconscious assumptions and self-defeating concepts.Because it is processed through the right brain’s primitive, sensory, and emotion-based channels, it is an ideal intervention for post-traumatic stress.

Imagery works on the right-brain the home of feeling, sensing, and perceiving, rather than the thinking, judging, analyzing and deciding functions of the left brain. Since it does not depend on the brain’s logical and analytic centers, it circumvents psychological resistance, fear, hopelessness, worry, and doubt, and goes directly to attitude and self-esteem, without interference from the rather obstinate, literal mind.

Brain development studies have shown that a traumatized brain is impaired in its ability to focus on language or verbal content. Instead, it tends to focus on...processing nonverbal danger cues—body movements, facial expressions, and tone of voice—as it searches for information about danger and threat. The primitive brain in effect co-opts cognition and behavior in the service of safety and survival. Unfortunately this causes some temporary loss in ability to think abstractly, process language, and attend to ideas or word meanings. These functions are higher cortical functions- gray matter issues- which can only be attended to once the primitive brain is sufficiently calmed. It seems clear that interventions that rely on cognitive, problem-solving activities do not, and more importantly, cannot have much impact on these clients or their terror-driven behavior.

With the advancement of technology, neuroscience has shown us that traumatic changes appear in Broca’s area of the brain, where personal experience gets translated into language. It appears that survivors can see, hear, smell, taste and feel parts of the traumatic event, yet struggle unsuccessfully to translate these sensory elements into language. In addition to this “speechless terror”, some long-term trauma survivors experience an additional obstacle in their analytic ability. Due to persistently high elevation of stress hormones, causing a reduction in the size of the hippocampus, survivors are often less able to put things in context and/or make critical distinctions about what is and what is not threatening in the present. Without this necessary discernment, survivors become more and more impulsive and less and less inhibited. In effect, what survivors are left with is a constantly hyperaroused autonomic nervous system; an inability to distinguish past from present threat – necessarily producing a state of constant hypervigalence; a speechless terror accompanied by painful and traumatic sensory and body memories; and a marked inability to access any their own cognitive resources.

Quite a predicament.

What should be resoundingly apparent to the reader is that talking “about trauma”- which requires participation from the language/ logic portion of the left brain- is inadequate, oftentimes triggering, and very likely re-traumatizing to the client. A better option for therapists would be to target the client’s highly sensitive, hyperacute right hemisphere with its overfunctioning visual, sensory, and emotional channels. By accessing the limbic system and the right hemisphere of the brain, survivors are able to process the images, body sensations and feelings, attach some sort of meaning to them, and eventually move toward a more helpful and adaptive resolution of the traumatic material.

Recent RCT studies of military sexual trauma and combat trauma survivors show that Imagery offers a viable solution. Using a calming tone of voice, music and symbolic representations of safety, imagery quiets the hypervigilant primitive brain, creating an environment where the higher brain can once again function in the service of the survivor.

Naparstek posits that guided imagery provides a cushion of evocative, multisensory protective images and built-in emotional safety. Appealing memories and lush fantasies require little energy or discipline to evoke. They provide distraction from pain; carry clients beyond worry, fear and anguish she goes on to report that guided imagery has the ability to avoid the direct traps of language and literalism. A powerful healing tool, that provides a kinder, gentler and more effective route to tending to wounds of the inner self. Naparstek explains that the imaginary world developed through imagery is a generous place where clients can gain distance by locking pain away in a safe, floating it away on the wind, or erasing it from an imaginary blackboard. In this world, clients can summon protection and support from magical allies, remembered friends, favorite animals, powerful ancestors, guardian angels and other divine helpers. They can create as many layers of distance between the traumatic event and themselves as needed. All the while surrounding themselves with loving, powerful protectors.

The Tools:

How to make a Guided Meditation with Music

Developed by: Michael White, David Epston

Summary:

Narrative therapy is a respectful and collaborative approach to counselling and community work. It focuses on the stories of people’s lives and is based on the idea that problems are manufactured in social, cultural, and political contexts. Each person produces the meaning of their life from the stories that are available in these contexts.

~Excerpt from Narrative Therapy Centre of Toronto

Narrative therapy is an approach to counselling and community work. It centres people as the experts in their own lives and views problems as separate from people. Narrative therapy assumes that people have many skills, competencies, beliefs, values, commitments, and abilities that will assist them to reduce the influence of problems in their lives.

~Excerpt from The Dulwich Centre

The central idea of Narrative Therapy is: The person never is the problem. The person has a problem. A problem is something you have, not something you are. You don’t have to change your nature. You have to fight the influence of the problem on your life.

~Excerpt from Narrative Therapy with Dr. Bob Rich.

Website:

Narrative Approaches.Com

Developed by: Jacob L. Moreno

Summary:

Psychodrama employs guided dramatic action to examine problems or issues raised by an individual. Using experiential methods, sociometry, role theory, and group dynamics, psychodrama facilitates insight, personal growth, and integration on cognitive, affective, and behavioral levels. It clarifies issues, increases physical and emotional well-being, enhances learning, and develops new skills. Psychodrama can be used in a group or individually for therapy and persona growth. It can also be applied to family and couples therapy.

~Excerpt from British Psychodrama Association

Website:

American Society of Group Psychodramatists

Developed by: Ron Kurtz/ Pat Ogden

Summary:

Sensorimotor Psychotherapy is a method for facilitating the processing of unassimilated sensorimotor reactions to trauma and for resolving the destructive effects of these reactions on cognitive and emotional experience. These sensorimotor reactions consist of sequential physical and sensory patterns involving autonomic nervous system arousal and orienting/ defensive responses that seek to resolve to a point of rest and satisfaction in the body. During a traumatic event such a satisfactory resolution of responses might be accomplished by successfully fighting or fleeing. However, for the majority of traumatized clients, this does not occur. Traumatized individuals are plagued by the return of dissociated, incomplete or ineffective sensorimotor reactions in such forms as intrusive images, sounds, smells, body sensations, physical pain, constriction, numbing, and the inability to modulate arousal.

~Excerpt from Traumatology

Description of Sensorimotor Training Interview clip with Janina Fisher, Ph.D.:

Video Player

Sensorimotor Psychotherapy is a body-centered psychotherapy that makes it possible for clients to discover the habitual and automatic attitudes, both physical and psychological, by which they generate patterns of experience. This gentle therapy teaches clients to follow the inherently intelligent processes of body and mind to promote healing. It is particularly helpful in working with the effects of trauma and abuse, emotional pain, and limiting belief systems. Through the use of simple experiments, unconscious attitudes are brought to consciousness where they can be examined, understood, and changed.

~Excerpt from Path out of Pain

Somatic Trauma Therapy

Developed by Babette Rothschild, MSW

Summary:

Somatic Trauma Therapy is an integrated treatment model that draws from the most relevant theory and the most suitable techniques for the understanding and treatment of trauma and Post-Traumatic Stress Disorder. In development since 1992, Somatic Trauma Therapy is not a single method, but an integrated system of psychotherapy and body-psychotherapy that continues to evolve as new theory and techniques emerge in the field. Somatic Trauma Therapy addresses all aspects of trauma's impact -- on thinking, emotions and bodily sensations -- bringing them into sync, and relegating trauma to it's rightful place in the past.

How can Somatic Trauma Therapy help?

It is not necessary to remember a traumatic event in full, or even at all, to get help. What is important is to gain control over and reduce disturbing symptoms, improve quality of life and to re/establish a good relationship to the self. First steps of Somatic Trauma Therapy include gaining control over symptoms and re/establishing a sense of safety. Later steps involve restoring emotional resources, physical reflexes and nervous system balance. If the traumatic event is remembered, there will be further steps to help make sense of what happened and to recognize it is over. Duration of Somatic Trauma Therapy can range from a few sessions to several years depending on: the nature of the trauma(s); age at the time of the trauma(s); if the trauma(s) is isolated, intertwined with other trauma(s) or continuous; and current resources and strengths.

Website:
Somatic Trauma Therapy

Developed by: J.A. Cohen, A.P. Mannarino, Knudsen, Staron

Summary:

Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based treatment approach shown to help children, adolescents, and their caretakers overcome trauma related difficulties. It is designed to reduce negative emotional and behavioral responses following child sexual abuse and other traumatic events. The treatment—based on learning and cognitive theories—addresses distorted beliefs and an attribution related to the abuse and provides a supportive environment in which children are encouraged to talk about their traumatic experience. TF-CBT also helps parents who were not abusive to cope effectively with their own emotional distress and develop skills that support their children.

~Excerpt from Child Welfare Information Gateway.

Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is used for children and adolescents who have developed clinical levels of PTSD. In young children, this disorder is often the result of sexual or physical abuse. The program seeks to teach children skills to cope with the difficulties that this disorder creates. At the same time, therapy sessions are used to help children confront and deal with painful or scary past experiences.

~Excerpt from Child Trends

Website:
Trauma-Focused Cognitive-Behavioral Therapy

"We shall draw from the heart of suffering itself the means of inspiration and survival."

~Winston Churchill

Clinicians, there are a variety of Trauma Tools above.

Try them all; keep what is helpful.

"Failure to approach trauma related material gradually is likely to lead to intensification of posttraumatic symptomatology, leading to increased somatic, visual or behavioral re-experiences. Once the traumatic experiences have been located in time and place, a person can start making distinctions between current life stresses and past trauma, and decrease the impact of the trauma on present experience. Talking about the trauma is not enough: trauma survivors need to take some action that symbolizes triumph over helplessness and despair.”

(van der Kolk, van der Hart, Burbridge, 1995.).

"Take the first step in faith. You don't have to see the whole staircase, just take the first step."

~Martin Luther King, Jr

The Theory

EFT has been described a needleless acupuncture for the emotions. In addition to the simpler, all-purpose tapping protocol, EFT also instructs people to speak affirmations and engage in unusual, yet seemingly effective behaviors, including tapping, eye movements, humming, and counting. Gary Craig, a student of Roger Callahan, developed EFT, by combining EMDR’s eye movements and emphasis on shifting underlying cognitive belief systems with a more generalized acupressure point tapping, based on TFT. One cycle of EFT takes only a few minutes, generates little distress and it can be effective even if the client does not believe that it would be. There have been no formal research studies done to empirically prove efficacy of these acupressure techniques. However, clinicians and clients alike seem impressed with the results that they’ve been getting (author included).

According to van der Kolk, et al (1996), effective treatment requires exposure to, without total re-experiencing of, the traumatic material; too much arousal precludes assimilation of any new information. It may be that the tapping protocol in TFT and EFT provides a concrete physical stimulus drawing attention back to the here and now, anchoring clients in the present. It also appears that the physical, rhythmic stimulation has a calming and soothing effect on agitated clients. This is most likely produced by the reciprocal inhibitory relaxation response of the parasympathetic nervous system’s reducing the effects of the hyperactivated sympathetic nervous system (Carbonell and Figley, 1995). In EFT, you tap gently on certain acupuncture meridians on the face and the body as you tune into the problem you want to resolve. The tapping process, combined with your focused attention on the issue you want to resolve, can reduce physical and emotional pains, end cravings/habits, and relieve anxiety, fears and phobias, sometimes with remarkable speed and often with long-lasting positive effects.