Kaely Ferrara

Psychotherapy for Trauma and Stressor Related Disorders

The 5 Phases of Trauma Focused Therapy

 While treatment for each person is tailored to their specific needs, the below framework is a general guide for what to expect with trauma focused treatment 


Assessment

Goal: Explore ways you have been coping with the unresolved trauma, explore problematic coping skills and any current safety concerns, create a safety plan for keeping self safe, develop a clear understanding of what your symptoms are, identify what regions of your brain are overactive versus under active, explore your strengths that may be leveraged within sessions, assess your eating habits, sleep patterns and level of physical activity, explore appropriateness for psychotropic medication, complete standardized testing, develop a diagnosis and a plan for treatment.

Exploration

Goal: Begin to learn about concepts that will be used within sessions such as how the nervous system and brain interact, identify your ‘Tolerance Zones’, explore the concept of ‘dialing up’ versus ‘dialing down’ your nervous system, explore how your nervous system responds to various sensory based coping skills, learn about ways to ‘discharge’ and ‘recharge’ energy from your nervous system, begin to explore the concept of ‘resourcing’. 

Skill Acquisition

Goal: Begin integrating activities into your routine that help ‘anchor’ your nervous system. Implementation of proactive techniques to ‘dial down’ your nervous system while in a low activated state. Begin to stretch your ‘Tolerance Zone’. Begin to practice Somatic Based techniques and establish as sense of confidence around ‘dialing up’ and ‘dialing down’ nervous system. 

Mind-Body Integration

Goal: Begin to ‘unpack’ the trauma while regulating nervous system with skills learned from Phase 3. Begin to incorporate modalities such as Cognitive Behavior Therapy (CBT), Narrative Therapy, Cognitive Processing Therapy (CPT), Dialectical Behavior Therapy (DBT), Exposure Therapy, Exposure Response Prevention Therapy (ERP), and EMDR. 

Evolution

Goal: Begin to explore identity as it relates to life post trauma, begin to align behaviors with value system, begin to explore concepts such as ‘closure’ and ‘acceptance’, show fluency around somatic sensations that suggest your body is calling forward your attention, continue to show confidence with managing body’s sensations on a routine basis.

Additional Modalities 

While neuropsychology can offer a valuable path to healing, healing is often so much more than simply rewiring our brain. I often integrate the following modalities into therapy:


  • Dialectical Behavior Therapy (DBT)- DBT Is an evidence based modality, which means that various studies have been conducted and have proven that this form of treatment has been deemed effective according to scientific standards. DBT focuses on teaching clients how to effectively cope with stress, improve social relations, and regulate when experiencing heightened emotions. 


  • Cognitive Behavior Therapy (CBT)- CBT is also an evidence based modality. CBT focuses on the ways in which our thoughts, behaviors and feelings intertwine and influence one another. CBT believes that by changing one of these arenas, such as the way we perceive the event, we can ultimately change the way we feel and respond to the event. CBT focuses heavily around exploring our perception of self and others as well as identifying ways in which unhelpful beliefs ultimately lead to painful feelings and problematic behavior choices.


  • Cognitive Processing Therapy (CPT)- Similar to CBT, CPT focuses on analyzing the beliefs that you have gathered post trauma. CPT explores how your beliefs about safety, control, self image, and intimacy have been shaped by the trauma you have endured. Some common interventions include worksheets, identifying unhelpful beliefs, and processing past traumas through writing.


  • Somatic Experiencing (SE)- SE views the body as a source of information that communicates to our consciousness through physical sensations. Clients who have experienced trauma(s) will often report feeling ‘on edge’ and will express difficulty understanding how to re-facilitate a felt sense of safety for their body. Psycho education focuses around how the body stores trauma and how to internally resource for safety. SE also focuses around exploring bodily sensations from a place of curiosity and compassion as a means of realigning body-mind connection.


  • Exposure Response Prevention (ERP)- ERP is often viewed as the gold standard for treating Obsessive Compulsive Disorder as well as other anxiety disorders or phobias. The core components of ERP involve exploration of places/situations that trigger an irrational sense of anxiety and systematically exposing oneself to the trigger. Overtime, the body will become desensitized to the original source of anxiety.


  • Psychodrama- Rather than simply talking through an experience, psychodrama is a more action based modality. As the name suggests, psychodrama is more theatrical in nature. Techniques such as role playing and re-enacting past experiences in a safe manner are key components of psychodrama.