Trauma and memories of emotionally painful and distressing experiences can overwhelm individuals throughout their entire lives, including their social skills, cognitive abilities, and ability to cope with daily activities. This can lead to developing coping mechanisms that provide immediate psychological relief, including drug and alcohol abuse, gambling, eating disorders, and self-harm. However, these self-medicating habits can worsen the symptoms of trauma and lead to worsened outcomes.
Individuals looking into trauma treatment might come across two terms that are sometimes incorrectly used interchangeably: trauma-specific treatment and trauma-informed care. This brief article will explain the difference between these treatment approaches, their key principles and interventions, and their role in addiction treatment.
Key points of this article:
- Trauma-informed care and trauma-specific treatment are not the same.
- Trauma-informed care focuses on a universal treatment framework, whereas trauma-specific treatment focuses on specific treatment methods and trauma symptoms.
- Both treatment approaches are important and necessary.
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What is Trauma-Informed Care?
Trauma-informed care is a universal approach to treating individuals with trauma to avoid retraumatization and insensitivity and promote empowerment. It’s more than a specific therapy or healing approach and doesn’t have to directly discuss the trauma during each treatment session. It’s about creating physical, psychological, and emotional safety for trauma survivors as they rebuild a sense of control and overcome trauma’s impact on their lives and daily coping mechanisms.
Core Principles of Trauma-informed Care
- Understanding trauma and its impact: It wasn’t until the late 1990s and early 2000s that the medical field started researching trauma and its impact on physical, mental, emotional, spiritual, and economic stability. This broadened how mental health providers were trained and taught them how to recognize behaviors that developed as coping skills, such as substance use, eating disorders, or self-harm.
- Creating a safe and trusting environment: Many outdated therapy methods focused on exposure and reenactments that retraumatized individuals and led to worsened outcomes. Trauma-informed heavily emphasizes safe and trustworthy physical and emotional environments that meet basic needs, provide safety nets and boundaries, and are consistent and respectful.
- Supporting autonomy: Helping individuals regain a sense of control and understand how trauma impacts their lives gives them the confidence to create and stick to realistic goals.
- Sharing decision-making: Mental health treatment works best when everyone works together. This means the person getting treatment, their family, the treatment providers, and others who support them all collaborate on treatment goals, interventions, and aftercare plans.
- Embracing cultural differences: Trauma-informed care carefully considers how trauma impacts different demographics, including culture, age, race, gender, and economic status. Grouping individuals without considering these key factors can lead to inadequate care and support.
- Integrating diverse treatment methods: Trauma-informed care acknowledges the benefits of evidence-based therapy methods and holistic healing modalities, such as breathwork, yoga, and adventure therapy. Limiting treatment to specific methods can isolate people who need alternative approaches and care.
- Encourages interpersonal healing: Trauma-informed care unites individuals with similar struggles and provides a safe, authentic, and positive environment. However, not all experiences are the same or have similar outcomes, so it’s important to maintain individualism within group settings.
- Reinforces positivity: Trauma-informed care emphasizes that recovery and healing are 100% possible. No matter how vulnerable or afraid individuals are, using a trauma-informed approach instills hope throughout a person’s entire journey.
What is Trauma-Specific Treatment?
Trauma-specific treatment involves directly treating traumatic stress and co-occurring disorders (substance use and mental health disorders) that develop during or post-trauma. These treatment methods usually focus on processing trauma within each session and identifying the ways an individual has learned to cope. Most trauma-specific treatment methods are designed to help anyone who has experienced trauma, regardless of whether they have been diagnosed with post-traumatic stress disorder (PTSD). These include:
For Adults & Adolescents:
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): TF-CBT is designed to help children, adolescents, and their families cope with the effects of trauma. It integrates cognitive-behavioral techniques with trauma-focused interventions to address symptoms of trauma, such as intrusive thoughts, avoidance behaviors, negative beliefs, and emotional regulation difficulties. TF-CBT typically involves individual sessions for the child or adolescent, as well as separate sessions for their caregiver(s), with a focus on enhancing communication, safety, and coping skills within the family system.
- Seeking Safety (SS): Seeking Safety is an integrated treatment approach designed to address trauma and substance use disorders concurrently. It emphasizes establishing safety and coping skills to manage trauma-related symptoms and substance use cravings. Seeking Safety sessions cover a range of topics related to trauma and addiction, such as safety, grounding techniques, cognitive coping strategies, and interpersonal skills. The goal is to promote stability and reduce the risk of relapse while addressing the underlying trauma.
For Adults:
- Cognitive Processing Therapy (CPT): CPT is a subtype of cognitive-behavioral therapy(CBT) developed to treat PTSD. It focuses on challenging and modifying maladaptive beliefs and thought patterns related to the traumatic event(s) to promote cognitive restructuring and emotional processing. CPT typically involves identifying and evaluating trauma-related thoughts and beliefs, challenging cognitive distortions, and developing alternative, more adaptive ways of thinking about themselves and the world.
- Eye Movement Desensitization and Reprocessing (EMDR): EMDR incorporates elements of cognitive-behavioral therapy with bilateral stimulation (such as eye movements, tapping, or auditory tones) to help individuals process traumatic memories and reduce symptoms of PTSD. During EMDR sessions, individuals recall distressing memories while simultaneously engaging in bilateral stimulation to desensitize traumatic triggers and reduce symptoms.
- Prolonged Exposure Therapy (PE): PE is a cognitive-behavioral therapy approach used to treat PTSD by helping individuals confront and process traumatic memories and reduce avoidance behaviors. It involves gradually exposing the individual to trauma-related stimuli or memories in a safe and controlled manner while also teaching coping skills to manage distress. PE typically includes imaginal exposure (recounting the traumatic event in detail) and in vivo exposure (confronting trauma-related triggers in real-life situations) to facilitate emotional processing and reduce symptoms of PTSD. PE is only recommended for adults.
For Children:
- Child-Parent Psychotherapy (CPP): CPP is an evidence-based therapy approach for young children (birth to five years old) who have experienced trauma, particularly relational trauma or attachment disruptions. It focuses on strengthening the parent-child relationship and promoting the child’s emotional regulation and sense of security. CPP sessions typically involve both the child and their caregiver(s) and utilize play-based activities and reflective interactions to address the impact of trauma on the parent-child relationship and support healing and resilience.
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Why Both Are Needed
Even though trauma-specific treatment methods lead to improved outcomes, research shows that regardless of the technique, the client’s relationship with their therapists, psychiatrist, clinicians, and other providers is the most important factor affecting the outcome. In some cases, people may not be ready to address their traumatic experiences in another clinical setting, such as an addiction treatment center, and others may not be properly assessed for trauma or PTSD if the clinicians aren’t trained or experienced with trauma-informed care. It’s important to offer both to increase the chances of successful recovery and healing.
Trauma-Informed Addiction Treatment Near Boston, MA
If you or someone you know is struggling with addiction and trauma and hasn’t found a treatment center capable of treating both, contact East Coast Recovery Center in Cohasset, MA, just outside Boston. Our experienced clinicians, staff, and administrators are well-trained in trauma-informed healing approaches, including EMDR, CBT, DBT (dialectical behavior therapy), and holistic healing methods. Call, email, or fill out a form to get started.
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