What Is A Trauma Therapist?

[anthony]

I often see people confused with their therapist, especially when I see the same things posted over and over, ie. I tell them a problem and all they do is respond with, "how does that make you feel" or such statements, without actually providing any substance or input.

Ok, here is the difference. The above example will still get used in trauma therapy at times, as the client should always be given the opportunity to see if they can solve their own problem, and often do. Saying that, if that is the extent of your therapy, that is not trauma therapy. That type of therapy is the primary type, being person centered therapy. It is extremely effective for nearly every other type of therapy (relationships, teen, substance abuse, general problems and concerns, etc).

Trauma Therapy - This requires the therapist to actually have an extensive knowledge of trauma. For example, when I say I have studied PTSD for six years, that means six years of studying traumatology, which I apply only upon PTSD. The diagnosis is irrelevant for the most part, it is the underlying cause, being trauma. So a trauma therapist should have an extensive and primary focus on trauma. Why?

The answer is simple. PTSD is a complicated diagnosis, it has complicated symptoms, and gets only more complicated with complex and military based trauma. You will not be able to solve your own problem at most areas due to trauma, hence the impact of trauma. A trauma therapist will instead become more like an educator of knowledge, they will guide you and push you in the right direction, and feed you knowledge about WHY specific occur for you to then use that knowledge to find your own solution. They still should not be giving you the solution, because that would be implanting, which is a big no-no... but they should be giving you the underlying knowledge specific to your circumstance / trauma at each given point within a discussion, so using your situation + their knowledge of the underlying problem, you piece them together uniquely and apply to your situation, logic and understanding.

This way, you still solved your own issue, but you did it with a combination of your knowledge + their knowledge of traumatology = you create your own unique outcome.

If you don't have that education being implemented specifically to your situation in trauma therapy, then you are only getting "therapy", which is useless, compared to "trauma therapy", which combines traumatology education specific only to your situation.

Who is a trauma therapist?

They can be from vast educational backgrounds, PhD is incorrect if that is what you think. Nurses, social workers, psychologists, psychiatrists on rare occasions, counsellors, even doctors (MD's) become therapists... there are a vast range of tertiary qualifications that qualify as a counsellor. Talking with your friend is counselling... in its simplest form.

It has nothing to do with the qualification, it has to do with their specific field of expertise. A qualification does not make a good relationship counsellor. A specific type of person combined with a qualification makes a good relationship counsellor. Such a person often won't be as effective as another person who will be good at trauma counselling, where subject knowledge is vaster as well as personality type is required to be a little more demanding and assertive at times due to factors associated with trauma (uniquely per client basis).

What you want to find is someone who fits that field... someone who you could question with traumatology questions and they have the answers. That is a good sign they are current and know what their doing with helping you with your trauma.

It is as important that you interview your therapist as they interview you for suitability. Someone who lets you get away with things, who is warm and comfortable, is not the right person to help you if you ask them about trauma subjects applicable to your situation and they don't have the information. That information is the substance of being able to give to you in sessions, or even after sessions upon greater thought or follow-up.

That is who you're looking for, not whether they have a PhD or such title.

 

[karissa]

I like this post. It is so true. Being in intensive treatment for trauma, I have a few therapists and they are all different. I have my individual therapist. She IS "warm and inviting" but doesn't let me get away with things either. She tells me that, for example, "You need to take your meds or these things are gonna get worse" or "you need to set boundaries with your parents, that is why your symptoms are flaring up". She really cares about me and my well being and me becoming stable to live a normal life even though I may never be totally "well". When I am having a really hard time she will text me every once in a while to make sure I am ok. I see her twice a week. I also have two group therapists for a group about dealing with life after having a traumatic childhood. These therapists are always on the same page and very honest. They are highly trained in trauma therapy. They always give excellent feedback on our agendas in group. They can be really tough if someone is constantly complaining about a subject and keeps turning down advice and arent using skills or arent taking their meds. They do it without showing frustration. I have group therapy once a week. My psychiatrist is also trained in trauma therapy and, when I screw with my meds because of side effects or whatever or if i drink, she is very stern but understanding at the same time. All these therapists make me want to try my hardest to be stable. Even if I dont want to do things to help myself cause i dont care...I care what they would want for me and I try for them. They make me want to get better and I have been out of the hospital a little over a year now.

I am very lucky to have found such a great treatment team. Some people I know, have therapists who just encourage them to go back into the hospital when they are having even the slight of a hard time. I think most of the reason behind this is because the therapist or doc doesnt want to or know how to deal with their clients' symptoms. They need to encourage them to use positive coping skills unless their symptoms are really that bad off which requires hospitalization. I just had two friends today, who have horrible coping skills, sent into the same unit at a certain trauma ward. Just because they couldn't "deal". To each their own but I just thinks either their therapists aren't a good match for them, their therapists aren't competent in dealing with trauma, or the clients are hopeless cases. Or a combo of all.

It takes two to tango (i know, cheesy). But the therapist will put in as much effort as they can but it won't work unless the client puts in some effort as well. And it pisses me off when therapists let that happen and allow their clients to just rely on others to help them when they don't even try to help themselves.

 

[Babablacksheep]

Yes, it's definitely tough. It's counter intuitive. But it helps you build resilience. It helps you to rely on yourself and take responsibility for your own issues.

 

[mamachick]

Im a little confused. Where Im at, a therapist is not allowed to treat a client if they are under the care of another. There are some exceptions. You can have an individual therapist and another specifically for addiction treatment. If you are hospitalized, obviously the hospital staff therapist does individual and group but not once you are released. Then you would return to your previous therapist or if you didnt have one, you would get a referral before leaving the hospital.

If you are going to a therapist and there are issues that they feel they are not trained to deal with (such as intense trauma therapy), they would refer you out to a specialist but they are not allowed to continue to see you while you are seeing the trauma therapist. When you are in trauma therapy, all of your issues can be related to the trauma (depression, anxiety, relationships, parenting, basically anything that comes up ).Again, some exceptions. You could be referred to a trauma group, a domestic violence group, co-dependency group, etc and continue with the original therapist. This is to avoid duplication of service as well playing one therapist against another.

If you are sent for group services elsewhere, you must sign a release to share information so both therapist are aware of your treatment plan. These are basic licensing requirements for therapists.

Issue of payment-insurances are rediculous -at least sometimes.
In 2006, my insurance gave me a choice of 4 therapist to see. Two of them were not allowed to see me because of dual relationship/conflict of interest-one was my supervisor when I was getting my masters, and the other I co-facilitated groups with. The third, I knew of and had little confidence. The fourth was a close family members therapist and I knew they would tell me the same. After a year, they allowed me to see my old therapist who I had paid myself when I worked-but only 6 visits-then cut it off without exception. I felt a complete lack of support., began abusing alcohol, was assaulted and given pain pills which I took with alcohol and overdosed. Then my insurance allowed me six more visits, which I used in three months. Again, left high and dry, 3 months later I attempted suicide. Since then my insurance has not limited my visits. Its really sad that you have to be suicidal to get treatment. For fifty years I was never hospitalized, then twice in six months. I don't believe either would have happened if services were available.

When you need the help the worst, unfortunatly, it can be impossible to advocate for yourself. Im just wondering if there is something I am not aware of in receiving services for trauma. I appreciate and information.

 

[karissa]

When my ptsd breakdown hit, I was forced to find and individual therapist. I started off once a month, then once every two weeks, then once a week and now twice a week. For extra specialties in trauma, she sent me to a well known treatment program for 5 weeks (i have been there 3 times since). They had me enter a group therapy once a week focused on trauma, which I have to pay $20 a week. Since I was lucky to have to been asked to be part of the group as there are only 7 spaces open, I found the money to pay for it. After being in the group for a 2 months and living in my abusive household, and I was having bad thoughts (won't get into specifics), they sent me to the trauma unit of the hospital. I was there for 2 months. They got me community help. Helped me find an apt. I still go to group and still see my individual therapist. She is in a private practice and they don't have docs there to prescribe my meds. Her practice used to have a prescriber but she died who i was very close to...that sucked. So I had a predicament on my hands. Most places won't take you on as a patient if you don't have your doc and therapist in the same place. I wanted to keep my same therapist who i had for 4 years. So finally, my group therapist at the hospital found me a doc at the hospital. Usually there are waiting lists to get a doc there but they made an exception. Although, I pay a copay of $37 a month, it is totally worth it. It wasn't easy. I am lucky now but I had to go through a lot of hassles to finally find a cohesive treatment team without one dying or not taking my insurance or making me lose my therapist. Took a while.

 

[mamachick]

That makes sense. I am so glad that you are getting such good help/services. That is promising and encouraging. I can see that the time to do it is before things get too bad. I think I will check with my insurance about an in patient trauma treatment program. I know they have to be better recognized than a few years ago. Thanks

 

[Babablacksheep]

Someone who lets you get away with things, who is warm and comfortable, is not the right person to help you if you ask them about trauma subjects applicable to your situation and they don't have the information. That information is the substance of being able to give to you in sessions, or even after sessions upon greater thought or follow-up.

I don't understand this. What do you mean "get away with things"?

 

[karissa]

like never does anything to discourage SI, or if the therapist has given idea after idea of what to do to cope with symptoms, the client is very wilfull and will not use those skills. This type of person will always be sick if they don't have a tough therapist. If it is obvious that a client is stable enough to go and get a part time job or to volunteer and the therapist tells this to the now "lazy" client, the therapist tells them that they need to start being willing to try some ideas or the therapist won't know how to treat them anymore. If a therapist just listens to them talk about trauma or complaining about life all day and gets sympathy every session for a year, then the client will stay in that mindset and she will never get better. She will be stuck in one form of healing. The therapist needs to make a good treatment plan and if it goes off track, fine. But if the client is continually falling back and the therapist lets it happen, then its a waste of time and money. unless the only reason the client goes to therapy is to get sympathy from their therapist. That is not cool because a lot of people don't have the funds to see mental health professionals and she is wasting an appt someone else could have.
I know someone who canned 4 different therapists because they didn't "understand her". She just got some tough and very good therapists. Specific well known trauma therapists. She just wanted sympathy. Wanted an "easy" therapist.

 

[anthony]

If you are sent for group services elsewhere, you must sign a release to share information so both therapist are aware of your treatment plan. These are basic licensing requirements for therapists.

That may be true for your state, but it is not true for all countries and states across the globe. There is actually nothing wrong, for the most part, to have several therapists. Yes, a patient should disclose they have another, but it is perfectly legal in most instances... again, state and country. Whilst you should not have two trauma therapists, it is often people have a therapist who they discuss their trauma with, they may have another who they discuss relationship and family matters with, then they have their doctor who treats normal aspects, psychiatrist who looks after meds for mental health, etc etc. All perfectly and quite normal.

Some people do actually have two trauma therapists... they may work on some specific issues with a female one, then others with a male one. Again... states, countries, all different laws typically.

 

[anthony]

I don't understand this. What do you mean "get away with things"?

There are some therapists who won't standup to their clients, and when they tell them something like, "Well, I went and drank 2 bottles of JD, smoked a packet of cigs and then had a gang bang", they will just acknowledge it and move on, avoiding it. It could even be a little thing, like they are admitting they are treating their partner or child like crap, but instead of saying, "well, you have to take control of you, you own what you do" or such, they avoid it, put blame elsewhere, make excuses for them, all sorts of things.

There is no shortage of harmful stories listed across this forum people have stated over the years, where they tell their therapist something, looking for some type of guidance or acknowledgement to change, and they just avoid it, or even enable a bad behavior.

 

[Srain]

Should I be pushing for more work in my therapy??? I'm confused here.

At this point she is having me retell the things about myself even though I am recluctant to do so. The reason? I've done it time after time, her reason for me doing it: you haven't done so with me. In doing it I find I have in fact kept some "secrets" without meaning to in the past. But that damn 45mins goes by fast and I'm left with shit to go by. Then I have what I'm having now, crap, these freaking "veils", I can't remember why they happen. I'll have to go look them up again.

Rain

 

[anthony]

In doing it I find I have in fact kept some "secrets" without meaning to in the past.

I believe you answered your own question really...