Why Proper Assessment and Preparation is Important in Trauma Therapy

It’s not hard for most people to imagine the role that trauma plays in causing serious psychological harm. The traumatic stress one experiences stemming from adverse events or conditions leads to major emotional wounds. These often do not heal over time. These wounds can cause a ton of distress as well as manifest in various ways. These can include mental health disorders, relationship issues, negative behavioral patterns, and even medical concerns.

On the road to recovery, it’s necessary to do the hard work of addressing and resolving these traumas. However, this needs to be done in a methodical way! Far too often I have seen the negative end result of eager, well-intentioned therapists who have attempted to help clients work through their traumatic experiences but instead caused more harm than good. I’ve heard from clients who, in the course of trauma treatment, got worse or even retraumatized by the counseling process itself.

A Helpful Metaphor

Imagine that your trauma is represented by a cancerous growth present in your body. We have to remove the tumor as soon as possible. This is because it has become a threat and is causing too many problems with your health. Some people may have large tumors, while others may have smaller ones. Some situations are messier with tumors of all different sizes inside. But as much as we want that tumor or tumors gone, we can’t just start making incisions in the first place we see and haphazardly cutting stuff out of the body! This could lead to a risky and potentially painful or harmful situation. Plus, it would also not be the most efficient or effective process of removal.

Instead, let’s take the time at the beginning of the surgery process to get whatever scans or MRIs we need to accurately assess what’s inside and what we’re dealing with. By doing so, we can strategize on how to cut out the tumor in the safest, fastest way possible. Then, once we are ready, have gathered our “team”, and are prepared sufficiently to ensure that the patient is healthy and strong enough to proceed. Then, we get to work!

First Things First – History-Taking, Assessment, and Preparation

So, leaving the metaphor behind and relating it back to therapy, it’s extremely important to have a solid assessment of the client’s history as well as stability and threshold for strong emotions before charging forward in reprocessing traumatic memories. After all, we need to approach a client’s treatment from the perspective of “do no harm”. As such, treatment guidelines including recommendations from the International Society for the Study of Trauma and Dissociation (ISST-D) emphasize treating complex trauma. They use a deliberate, phased approach. Different models of therapy call these things slightly different things, but in essence, the principles and tasks are the same.

In the first phase of trauma treatment, care is taken to build rapport and a sense of trust, competence, and safety.

A careful history is taken along with an assessment of a person’s strengths and needs. Often, this initial phase requires improving a person’s emotional stability with the use of coping strategies, support, and often medication.

A client who struggles with emotional dysregulation and gets easily flooded has a nervous system that is often unable to tolerate the reprocessing of traumatic memories. There needs to be enough stability and emotional wiggle room so to speak to deal with the inevitable discomfort that comes with addressing some of those painful memories. During the first phase of treatment, an effective trauma therapist will ensure that the client is ready and prepared to do the work in the session.

I tell my clients that oftentimes “you can’t clean a room without kicking up some dust”.

During the healing process of trauma treatment, there is always the possibility of stuff coming up during sessions or in-between sessions, so care is deliberately taken at the beginning of therapy to prepare clients to cope. This ensures the client can do the work in therapy a little bit at a time while keeping the rest contained, and therefore maintaining stability and a sense of feeling okay. There are various coping strategies and tools that can be useful, such as DBT skills, support groups, and mindfulness, to name a few.

Often, trauma survivors are disconnected from their emotions and have a hard time feeling their feelings. It’s not that these people don’t have emotions. Rather, they have shut down or learned to avoid their emotions and body sensations as a mechanism for survival. A part of the preparation for them is learning to feel their feelings and become able to tolerate this stuff enough to do the work. This embodiment practice is hard work and often scary for those who have spent their whole lives trying to escape from their trauma-related discomfort but important to the process of healing.

Conclusion

Thorough history-taking, assessment, and preparation are important steps of an effective, trauma treatment plan. Those who skip this crucial phase run the risk of creating situations that are uncomfortable, destabilizing, and potentially re-traumatizing. Everyone is different. So for those with a lot of inner resources and a big window of tolerance for emotions, this process can be extremely quick. For those who have more struggles in this arena, it can take a bit of time. Regardless, an experienced counselor will assess your situation and help you get ready to do the work!

Once these are done, traumatic memories can be reprocessed using a variety of techniques and therapeutic approaches that include Eye Movement Desensitization and Reprocessing (EMDR), which is an evidenced-based psychotherapy that takes into consideration all of these facets of treating trauma. As such, all clinicians at Mangrove Therapy Group have training and expertise with EMDR.

Schedule an Appointment for Trauma Treatment or EMDR in Delray Beach, FL

At Mangrove Therapy Group, we believe it’s possible for you to resolve your trauma symptoms and let go of past emotional wounds. Our team of therapists is trained and experienced in putting together a trauma treatment plan that is comprehensive, safe, and effective. All of our therapists are trained in EMDR therapy and in addressing simple and complex trauma. To start your therapy journey, please follow these simple steps:

• Contact Mangrove Therapy Group to meet with a caring therapist
• Check out our pages on What is “Trauma” and on Trauma Therapy
• Take a look at some of our blogs on EMDR for Substance Use and Addiction, EMDR for Panic Attacks, and EMDR for Body Image Issues (and Body Dysmorphia).
• Start overcoming your issues!

Other Services Offered with Mangrove Therapy Group

Trauma therapy isn’t the only service our team offers at our Palm Beach County practice. Our therapists are experts in treating addiction, depression, body image issues, anger management, anxiety, low self-esteem, and much more. Please feel free to learn more about how we can support you by giving us a call or visiting our blog page today!