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Cognitive Behavioral Therapy (CBT) for Trauma

Cognitive Behavioral Therapy (CBT)

The most preferred type of psychotherapy (talk therapy) among clinicians and certified counselors is Cognitive behavioral therapy (CBT). It can be used to treat many issues by helping the patient be able to identify them and cope in a healthy way. It focuses on the relationships between an individual’s thoughts, emotions, and behaviors.


Trauma does not have one face, in fact it is very complex. People’s traumatic experiences can be similar or vastly different. Trauma is a response to a shocking life altering event. Some examples of situations that can be considered traumatic are a car accident, sexual assault, natural disasters, near death experience, war, and death of a loved one. Avoidance, shock, and denial are expected reactions from the individual involved. Traumatic events can have short or long term effects on individuals. 

There are three forms of trauma an individual can experience: acute, chronic, and complex. In the following sections we will explore what they are.

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Acute Trauma

Acute Trauma typically results from a single threatening event, such as rape or a natural disaster. This event threatens the individual’s emotional and/or physical security, and creates a lasting impression on their mind affecting their thought process and behavior. Symptoms include:

  • Confusion
  • Anxiety
  • Dissociation
  • Lack of trust
  • Irritation/aggression
  • Inability to truly rest
  • Fear of going to the place where the traumatic incident occurred
  • Feeling keyed up or hypervigilant
  • Becoming more withdrawn

Chronic trauma

Chronic trauma often results from an individual being exposed to long term distressing events that they experience as being out of their control over an extended period of time such as, long term illness, sexual abuse, war, domestic violence, etc. Additionally, untreated acute trauma or several events of acute trauma can lead to chronic trauma. Symptoms include:

  • Unpredictable emotional outbursts
  • Anxiety
  • Flashbacks
  • Fatigue
  • Headaches
  • Body aches
  • Nausea
  • Trust issues
  • Inability to hold down a job

Complex Trauma

Complex trauma stems from exposure to varied and multiple traumatic events or experiences. Typically they involve interpersonal relationships, making the individual feel trapped and helpless. This is referred to as relational trauma.  Mentally, it has a severe impact. Individuals who experience neglect, childhood abuse, domestic violence, traumatic invalidation and constant familial conflict are at risk for developing complex trauma. Symptoms include:

  • Health complications
  • Inability to have secure relationships
  • Performance at work/school
  • Difficulty regulating emotions
  • Disassociation
  • Sense of guilt or responsibility
  • Hopelessness/despair 

Childhood Trauma

Childhood trauma, like any trauma, can stem from any form – acute, chronic, or complex. Children and young adolescents can have extreme and differing side effects to trauma than adults. Children can experience trauma indirectly, such as, watching a loved one suffer or exposure to violence in the media can manifest their trauma. Older children are more prone to exhibit behaviors similar to adults, such as developing disruptive, destructive, and disrespectful behaviors. Some common symptoms exhibited by children affected by trauma can be:

  • Wetting the bed
  • Becoming unusually clingy 
  • Acting out the event
  • Becoming mute or more shy
  • Avoidance of anything that can trigger them
  • Attention problems
  • Appetite changes
  • Development of new fears
  • Loss of interest
  • Sleep problems
  • Irritability/anger issues
  • Headaches/stomach aches

The relationship between a child and their caregiver is vital to their emotional and physical health. If the relationship is broken, they will go on to have problems throughout their life that severely impact their ability to trust, manage emotions, and interact with people and the world around them.

Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder (PTSD) develops when someone has experienced a physical, mental, or emotional trauma – in other words, a life altering dangerous event. Similarly, this event can be indirect or direct. PTSD can affect any age, ethnicity, culture, race, and gender. Post-Traumatic Stress (PTS) is a normal adaptive response to a stressful or traumatic event. PTSD develops over time from prolonged Post-Traumatic stress (PTS). When the individual is unable to deal with the aftermath of the traumatic event, they exhibit disturbing thoughts and feelings related to it. If left untreated PTSD can cause numerous long term health, mental and emotional problems. Some symptoms include:

  • Intrusive thoughts
  • Nightmares
  • Flashbacks
  • Avoidance
  • Resistance about talking about the event
  • Forgetfulness
  • Trouble concentrating
  • Distorted beliefs about oneself or others
  • Ongoing fear
  • Loss of interest
  • Disassociation
  • Emotional dysregulation
  • Reckless behavior
  • Hyperawareness
  • Sleep problems

In order for a person to be diagnosed with PTSD, their symptoms have to last for more than a month, cause significant distress, and impact the individual’s daily functioning. Symptoms can develop well after the event and can persist for several months or years. Cognitive Behavioral Therapy (CBT) has been the most effective treatment for individuals with PTSD, both short and long term.

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CBT Treatment Process for Trauma

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

TF-CBT focuses on addressing the needs of children, adolescents, adults, and families who have been affected by a traumatic event. It is used when the individual has experienced a single or repeated traumatic experience that has led to the development of PTSD. It is a short-term intervention that spans from 8 to 25 sessions. The sessions can be completed as an outpatient, more severe cases would include inpatient care. Techniques would include a focus on cognitive behavioral adjustments for the individual by helping them modify their negative thought process and better understand the interactions between their thoughts and feelings.

Cognitive Behavioral Therapy (CBT) for Trauma

Aside from helping the patient understand the relationship between themselves, their thoughts and their feelings, CBT is used to dive deep into the trauma itself. In most cases, this is something most survivors do not want to do. However, it is imperative to face their trauma(s) in order for them to begin the journey to healing from it. Exposure to the trauma or emotions associated with it is often used to reduce avoidance and maladaptive associations. Of course, this is done with the patients best interest in mind and is a controlled exercise by the clinician or counselor. It is also planned between the therapist and patient, with an end goal in mind to give the patient a sense of predictability and control to increase their confidence. By the end of treatment, the individual is able to understand their emotions and thoughts better and they are able to cope with them in a healthy way.

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If you or a loved one suffer from trauma, it may seem like a hopeless journey full of pain and disappointments. But there is hope! Find a mental health professional that treats trauma.


Anthony Bart
Author: Anthony Bart

Anthony Bart is a huge mental health advocate. He has primarily positioned his marketing expertise to work with mental health professionals so that they can help as many patients as possible. He is currently the owner of BartX, TherapistX, and TherapyByPro.

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