What Is Trauma Focused Therapy?
Trauma Focused Therapy (TFT) utilizes the following treatments, either on their own, or in combination :
1) EXPOSURE THERAPY – this type of therapy encourages the person to confront the stimuli connected to the trauma which s/he fears. The exposure may be IMAGINAL (ie a mental picture of the feared stimuli is imagined, often using hypnotherapy to stimulate imagery and visualization) or IN VIVO (ie in real life). Repeated exposures to the feared stimuli lessens the emotional impact it has on the individual.
2) SYSTEMATIC DESENSITIZATION – this is similar to the above but the individual is gradually introduced to the feared stimuli (ie stimuli which remind the individual of the trauma and trigger memories of it). The person is taught relaxation exercises to utilize whilst having the memories of the trauma which has the effect of inhibiting the fear response. Again, this therapy can be combined with hypnotherapy.
3) BIOFEEDBACK – this technique uses electrophysiological instruments to provide feedback to the trauma sufferer about physiological states connected to anxiety, fear and panic (eg of heart rate) which helps him/her in relaxation training (the instruments show the individual when s/he is using relaxation techniques effectively).
4) DIALECTICAL BEHAVIOUR THERAPY
5) ACCEPTANCE AND COMMITMENT THERAPY (ACT) – this technique is based upon the idea that much of human suffering is the result of trying to control internal states (ie feelings and emotions). We try to avoid unpleasant feelings like sadness and guilt – this has been termed ‘EXPERIENTIAL AVOIDANCE’. According to this therapy, we should not try so hard to avoid our unpleasant feelings, but, instead, accept our personal, internal experiences and make a commitment to live our lives in accordance with our personal values, irrespective of how it makes us feel.
6) STRESS INOCULATION TRAINING – this technique includes education, muscle relaxation, training in breathing techniques which induce relaxation, role playing, guided self-dialogue, thought stopping and assertion training.
7) COGNITIVE BEHAVIOUR THERAPY (CBT)
8) COGNITIVE PROCESSING THERAPY (CPT)
RECENT DEVELOPMENTS IN TRAUMA FOCUSED THERAPY :
a) Cognitive Behaviour Therapy (CBT) is now being used to specifically treat those who suffer from trauma related nightmares
b) Trauma Focused Therapy is now making use of VIRTUAL REALITY innovations (eg during Exposure therapy – see above)
c) Trauma Focused Therapy is now being delivered over the internet
THE ROLE OF MEDICATION :
it has been found through research that trauma tends to be treated even more effectively if the above therapies are combined with appropriate medication
TIME FRAMES FOR TREATMENTS : generally, trauma focused therapy involves about 8-12 sessions which are usually carried out at weekly intervals. However, some studies have demonstrated that just 1-4 sessions can lead to significant improvements. Sessions usually last from 60-90 minutes and the individual undergoing the treatment is given homework to complete between sessions.
EVIDENCE : Overall, the evidence for the effectiveness of trauma focused therapy is compelling. Numerous studies, which have been well controlled and have adhered to high methodological standards, have shown it to work.
David Hosier BSc Hons; MSc; PGDE(FAHE).