Trauma Treatment Program
At Front Range Treatment Center
Trauma Treatment
At FRTC, we are trauma specialists, and experienced in treating every form of trauma. We primarily use a trauma treatment called Prolonged Exposure (PE).
This treatment is sometimes delivered alone, and is sometimes combined with dialectical behavior therapy (DBT) into a unified treatment program (DBT-PE). Our comprehensive DBT-PE program for adults includes individual DBT therapy, DBT skills classes, DBT phone coaching (where you can reach your DBT therapist between sessions), and a proven treatment for trauma.
What is Trauma?
Simply put, trauma is the lasting effects of one or more negative experiences. Trauma can have devastating effects, but there are effective treatments available. If you are struggling with the effects of trauma, from a single intense event (such as in PTSD), or exposure to repeated, complex-trauma, our trained trauma therapists can help.
Some people live with the effects of trauma from a single, intense event, such as an assault, accident, or combat. Such an event can occur at any age. When this results in a specific set of symptoms, the person is diagnosed with PTSD. Other persons struggle with complex trauma: the exposure of children to multiple traumatic events, often over a period of many years. Such trauma can result from several discreet events, or years of abuse or neglect.
There are excellent trauma treatments available, whether you’re struggling with PTSD or complex trauma.
Our clinicians are experienced in working with trauma. We only use trauma therapy techniques backed by research, which means that you are more likely to get the results you hope for.
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PTSD stands for post-traumatic stress disorder. The symptoms of PTSD are defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
PTSD includes a number of symptoms that might arise after experiencing a traumatic experience. To qualify as PTSD, these symptoms must last longer than one month, and the symptoms must be severe enough that they cause impairment in one’s life. To meet criteria for PTSD, someone must experience the following symptoms:
Experiencing a trauma: one must have experienced a traumatic experience. This can sometimes include watching someone else get hurt, or almost get hurt.
Re-experiencing symptoms: these are different ways in which people might “relive” the trauma, which can include nightmares, intrusive thoughts of the experience, or flashbacks (where you think the event is reoccurring).
Avoidance: people with PTSD tend to avoid things, events, or places that remind them of their traumatic event(s). Sometimes, people also avoid stressful or unknown situations in general, because these anxiety-provoking situations also sometimes lead to distress. People with PTSD also avoid talking about, and even thinking about their traumatic experience.
Negative thoughts or mood symptoms: This can include depressed mood, feeling empty or numb, paranoia, difficulty remembering things, and struggling with shame and guilt.
Arousal: These symptoms include hypervigilance (being “on the lookout” for signs of danger), having a hard time concentrating or sleeping, feeling or acting aggressive, being startled easily, and abusing substances.
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Prolonged Exposure (PE) is a very effective treatment for Post-Traumatic Stress Disorder.
The basic idea underlying exposure therapies is that repeated exposure to the thoughts, feelings, and situations around a trauma memory reduces the distress around the memory.
Most people that experience a trauma avoid things that remind them of the trauma, but this prevents them from learning that the danger has passed.
The client in Prolonged Exposure (PE) therapy first learns some skills to handle distressing situations. Then, they are "exposed" to trauma-related memories, situations, and sensations. It can be unpleasant and uncomfortable, but the exposures are introduced gradually and with the support of the therapist, and the client should never feel overwhelmed.
With time, the client finds they experience less distress when recalling these memories. The clients "learn" that the things they previously avoided are, in fact, not dangerous. As this occurs, the other symptoms of PTSD tend to reduce as well.
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DBT-PE combines Dialectical Behavior Therapy (DBT) with Prolonged Exposure Treatment for Trauma. In DBT-PE, exposure is primarily completed in vivo, meaning during structured therapy sessions, with a trauma therapist. These sessions are usually 90 minutes long, which allows time for emotion to return to baseline and for the client to discuss the experience.
DBT-PE is delivered in several stages:
Stage 1: DBT
The client begins DBT to learn DBT skills. After the client has sufficient skills and has met specific emotional and behavioral milestones, they can move into the trauma treatment portion.
Stage 2: Prolonged Exposure
Pre-Exposure: The client is prepared for the PE phase.
Exposure: The client engages in exposure activities, both within and outside of sessions.
Consolidation: The client solidifies progresses and develops a relapse-prevention plan.
Stage 3: DBT
The client returns to DBT, to complete that portion of treatment.
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The American Psychological Associations’s Clinical Practice Guideline for the Treatment of PTSD recommends that, when treating PTSD, clinicians use one of the following types of trauma treatment.
cognitive behavioral therapy (CBT)
cognitive processing therapy (CPT)
cognitive therapy (CT)
prolonged exposure therapy (PE)
At FRTC, we primarily rely on prolonged exposure therapy, because it has been well-studied when paired with DBT. However, we also use other cognitive-behavioral treatments when addressing trauma.
Why isn’t EMDR on this list? EMDR is a form of exposure, plus the use of a light-box device. However, the use of the light-box is controversial, and we don’t believe it is necessary.
Prolonged Exposure has strong, unambiguous research support. In contrast, the evidence for EMDR suggests “EMDR appears to be no more effective than other exposure techniques, and… the eye movements integral to the treatment, and to its name, are unnecessary.”
According to the American Psychological Association’s Society for Clinical Psychology, “The efficacy of EMDR for PTSD is an extremely controversial subject among researchers, as the available evidence can be interpreted in several ways. On one hand, studies have shown that EMDR produces greater reduction in PTSD symptoms compared to control groups receiving no treatment. On the other hand, the existing methodologically sound research comparing EMDR to exposure therapy without eye movements has found no difference in outcomes. Thus, it appears that while EMDR is effective, the mechanism of change may be exposure – and the eye movements may be an unnecessary addition.”
For a thorough discussion, see Science and Pseudoscience in the Development of Eye Movement Desensitization and Reprocessing: Implications for Clinical Psychology.
