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How to become a Trauma Therapist

Today’s blog is for mental health professionals and therapists.  This might be helpful to those of you who already specialise in trauma work or those of you who like to develop some skills and understanding when it comes to trauma work, but unsure about where to start.

As an undergraduate psychology student in my early 20s, I was considering whether to train through clinical psychology or counselling psychology for my doctorate. At that time, I didn’t know much about trauma. I didn’t know about its impact on our body, especially on our nervous system, and how that affects our behaviours and reactions.

I decided that clinical psychology wasn’t the route for me then as I wanted a more trauma-informed and anti-pathology approach, which I felt aligned more with my values, rather than the medical one.

Since having mainly worked with complex trauma for the past 10 years, I have come to understand that one can’t work successfully with trauma without taking into consideration all the ways that trauma affects one’s life. This is especially true for the aftermath of trauma on the nervous system. Despite being trained in counselling psychology and as someone whose work is rooted in the humanistic approach, this understanding made me accept that the medical/clinical model cannot be ignored in its entirety when dealing with trauma. I believe we will otherwise be doing a disservice to trauma survivors who are seeking professional help.

EMDR is a trauma-informed clinical approach and is one of the primary evidence-based techniques that is used to work with trauma. I have seen its positive impact, both personally and professionally. EMDR is not talking therapy and it is quite common in trauma work for talking therapy not to be encouraged. As a mental health professional specialising in trauma, I know the value of talking therapy, especially for clients who haven’t had an opportunity to tell their stories before, or where they have never had a voice or have never been truly heard. We really can’t undermine the power of feeling heard, seen and understood. However, talking therapy surely has its limits when working with trauma, and at times can also become a barrier when it comes to post-traumatic growth and healing. This is apparent when a client’s goal is to manage their powerful triggers or unwanted behaviours. These behaviours are often reactions to their triggers, which act as the body’s response to keep them safe from perceived danger. Talking about it alone and making sense of this won’t remove or minimise the triggers. Should you wish to understand a bit more about this, you can find it here: We cannot logic our way out of Trauma – Stepping Stones Psychology.

What I hear about most from the clients I see, is that despite wanting and knowing how to manage their triggers and associated reactions, they struggle to escape the emotional intensity that comes with reliving their trauma when being triggered. It is described as the emotional impact overtaking any rational or logical thought process. This is not simply something they are feeling or perceiving as happening, but what is actually happening when the amygdala hijack occurs in the brain, causing the prefrontal cortex to lose its ability to moderate reactions.

My clients often report that the Specialist Trauma Therapy route has been the most powerful and effective therapeutic tool, they have found to work through this. This is because it is designed to de-couple the trauma from their emotional responses, such that it allows someone to still have the memory of a traumatic event whilst minimising the effect of being triggered.

To me, working with triggers through an integrative trauma-processing approach acts like a magic wand. Clients usually experience their newfound different perspectives and minimised effects already at the end of each session. Here at Stepping Stones Psychology, we offer Specialist Trauma Therapy through an integrative approach combining talking therapy, EMDR, ITATM, Inner Child work, IFS, and Somatic Trauma therapy, including incorporating aspects of Compassionate Inquiry, Sensorimotor Psychotherapy and Somatic Experiencing.

Although I am fully trained in traditional EMDR (Level 1-3), the main model I use when working with survivors of complex trauma is an integrative approach rather than stand-alone EMDR. The main integrative approach I use combines elements of EMDR with several of the aforementioned therapeutic models and is called Integrative Trauma and Attachment Treatment Model (ITATM) ®. This is an embodied approach that considers the impact of trauma on the body and the mind when working with trauma, and it was developed by Lori Gill from Attachment and Trauma Treatment Centre for Healing (ATTCH). I find this approach to be much more powerful than stand-alone EMDR and I have seen the greatest outcome when using this approach over any other I have used. Clients with complex trauma histories, who had prior experience with traditional EMDR also often reported how they found ITATM/our integrative approach much more helpful and suitable for their needs and therapeutic goals.

I am proud and honoured to be the first and only therapist in Sheffield able to offer this unique and specialist trauma therapy approach and to have been the one who brought this model to other therapists here in the UK. Lori and I have agreed to offer this training again here in the UK and hope to do it this year. If you’re interested, please get in touch. This training is suitable for those both experienced or completely new to working with trauma. It will allow you to develop some new skills and expand your knowledge when working with trauma.

Unless a client specifically requests traditional EMDR to process their trauma, I tend to work with them using ITATM. Another EMDR approach I often use as an alternative to traditional EMDR is Attachment-Focused EMDR (AF-EMDR), which Dr Laurel Parnell developed and whose in-person training I was honoured to attend. This model made sense to me in the context of working with clients who have experienced complex, chronic and repeated traumas, which are usually rooted in childhood. This is because traditional EMDR was developed for single-event traumas and to support war veterans. The trauma of war veterans, whilst severe, is very different from experiencing childhood trauma, especially from those who were meant to protect you, and if the childhood trauma was chronic and repeated.

As the trauma in complex trauma is usually relational rather than a specific incident like a car crash, AF-EMDR works with the trauma differently. The primary focus of traditional EMDR is on reprocessing specific traumatic memories whereas AF-EMDR focuses on the broader relational context of trauma, including its aim to heal the attachment wound, the core of relational trauma. For this reason, AF-EMDR places a large emphasis on helping the client make sense of and repair early attachment issues. Following this, the clients are also facilitated into forming healthier relational patterns, which they are now able to positively engage with as a result of having repaired their attachment wounds. If your primary client group are clients who have experienced attachment trauma and would like to process their trauma and minimise their ongoing triggers, I can strongly recommend AF-EMDR.

I often have clients asking me how EMDR works. I found this excellent video which breaks it up into manageable chunks: https://www.youtube.com/watch?v=DwFkQPJrGIE

Lori’s post (here: Facebook) highlights the benefits of ITATM, especially in the areas that are often negatively impacted by trauma. These include daily life skills, education, employment, the ability to remain regulated, maintaining safe housing, and utilisation of high-risk and crisis services.

I hope this post has been helpful. Please feel free to get in touch should you have any questions. I will also be completing my BPS-Accredited Clinical Supervision training next month and able to offer support this way too.

©Stepping Stones Psychology