WHAT IS TRAUMA?
- The meaning of the word “Trauma” is very subjective to individuals.
- However, it can be explained as the emotional response to any stressful event, situation or incident experienced by an individual.
- Trauma is not about the incident, but what emotion is associated with it, because the same situation might be perceived differently by two different individuals.
- Some of the major traumatic incidents include experiencing or witnessing accidents, natural disasters or any kind of abuse.
TYPES OF TRAUMA THERAPY
The primary condition individuals often experience as a result of trauma is PTSD. There are certain therapy techniques that are found to be effective in treating PTSD. However, these techniques can also help people experiencing developmental, chronic trauma.
- Eye Movement Desensitization and Reprocessing Therapy
- Trauma Informed Care
- Internal Family System Therapy
- Cognitive Behavior Therapy
- Trauma Focused Cognitive Behavior Therapy
- Prolonged Exposure Therapy
- Narrative Exposure Therapy
- Play Therapy
- Art and Music Therapy
- Inner Child Work
ROLE OF TRAUMA THERAPIST IN INDIA
Psychologists with specialized training in assisting and treating individuals who have endured trauma are referred to as trauma therapists, and they fulfill distinct roles compared to other psychotherapists.
- Focusing on a trauma-informed approach which is directed towards creating a safe space and supportive environment for the client.
- The clients are encouraged to vent out their emotional distress, where the therapists provide them with adequate support.
- Communicating with the client by using sensitive language so that words do not re-traumatize the client.
- Paraphrasing whatever the client says and reflecting it back to the client, to understand whether their situation is correctly perceived.
- Minutely observing and addressing nonverbal cues as many times, trauma survivors cannot verbalize their experiences and emotions as they feel too overwhelmed by them.
- Techniques used in the therapeutic sessions can range from being as structured as CBT, EMDR etc. to as dynamic as play therapy, art therapy and so on.
- Contributing to crisis intervention by addressing immediate traumatic experiences, assessing the extent to which an individual is affected by the traumatic incident and determining the level of support and care required to help them deal with the situation.
- Teaching strategies such as resource building, using healthy coping mechanisms to help them cope with ongoing, stressful situations.
- Teaching about boundaries and how to maintain them so that the clients can adjust to conflicting situations in the future.
STEPS TO BECOME A TRAUMA THERAPIST
- Bachelor’s Degree: Gaining a bachelor’s degree in psychology, sociology, social work or any other related field is the first step to become a trauma therapist.
- Master’s Degree: The second step is to get a master’s degree in psychology or related fields.
- Internships: While pursuing a Master’s, one must get exposed to clients. They are supposed to observe and counsel clients under supervision.
- Licensures:To practice as a Trauma Counselor, a license is not mandatory. However, RCI approved license through M.Phil is needed to practice as a trauma therapist.
- Specialization/Certification:After completing a Master’s/M.Phil and obtaining experience through internships, one is supposed to complete a certificate/diploma in any trauma related course.
CAREER PROSPECTS IN TRAUMA THERAPY IN INDIA
- Private Practice: Trauma therapists can practice in their own setting, where they can conduct individual as well as group sessions.
- Community Mental Health Centers: These centers provide a range of mental health services to people in the community. Trauma therapists at these centers often work with diverse populations, including those with limited access to care.
- Rehabilitation Centers & Hospitals: Trauma therapists may work in rehabilitation centers and hospitals, helping patients recover from physical injuries by addressing the psychological impact of trauma.
- De-addiction Centers: Substance abuse often co-occurs with trauma. Therapists in these settings can provide trauma-informed care to individuals seeking treatment for addiction.
- Crisis Centers: Crisis intervention centers may employ trauma therapists to provide immediate support to individuals in distress or those who have experienced recent trauma.
- Nonprofit Organizations: Many nonprofits and NGOs in India focus on helping survivors of trauma, such as those who have experienced domestic violence, sexual assault, or human trafficking. Trauma therapists can work for these organizations to provide counseling and support services.
- Government Agencies: Government agencies, such as child protective services, the Department of Veterans Affairs, and the military, employ trauma therapists to provide services to individuals who have experienced trauma.
- Tele-therapy and Online Platforms: With the growth of telehealth services, trauma therapists can also provide therapy through online platforms, offering accessibility to clients from various locations at their desired timing.
- Forensic Settings: Trauma therapists can collaborate with the legal system, offering expert testimony or therapy to survivors who are also perpetrators.
ENSURING CULTURAL SENSITIVITY IN PRACTICING TRAUMA THERAPY
- To understand trauma survivors, self-awareness of the therapist is very important to feel connected with their clients.
- Trauma therapists should have training or some knowledge of cultural competence, i.e., they should be able to respect, acknowledge, and understand cultural perspectives that are different from theirs. Therefore, this training helps the therapist resolve their own biases and develop cultural sensitivity.
- The choice of words plays a crucial role in dealing with trauma survivors. Use of inappropriate words can re-traumatize the client. Thus, speaking with an inclusive language helps to create a safer environment for the client.
- Using flexible treatment approaches is important. One approach that might work for a certain individual might not be appropriate for another client. The therapist must be flexible enough to use what is best suited to their respective client.
INTEGRATING EVIDENCE-BASED PRACTICES INTO THE THERAPY SESSIONS
- The client’s history, symptoms, and all other information is assessed as needed for diagnosis.
- A case-appropriate assessment tool is then administered to understand the diagnosis better. Based on the assessment, a treatment plan is developed which includes the selection of evidence-based practices, teaching coping skills, resource building and so on.
- Evidence-Based Practices for trauma include:
- Cognitive-Behavioral Therapy (CBT)
- Eye Movement Desensitization and Reprocessing (EMDR)
- Dialectical Behavior Therapy (DBT)
- Mindfulness-Based Therapies
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
- Treatment Implementation: The therapist delivers the chosen EBPs within therapy sessions. This involves teaching and practicing specific skills and techniques with the client.
- Psycho-education
- Assigning regular homework in between sessions
- Monitoring the client’s progress
- Helping the client with building their skills.
- Ethical guidelines and informed consent procedures are followed throughout therapy, to maintain client confidentiality and autonomy.
RESOURCES OUTSIDE OF THERAPY SESSIONS
People who have survived trauma have a huge impact on their lives and overcoming it may even take a lifetime effort. Therefore, they need to use resources even outside of the therapy sessions to continue their healing process.
- Self-care Practices
- Social Support
- Positive Self-talk
- Maintaining a Healthy Boundary
- Journaling
- Self-help Books
- Trauma Workbooks
- Art and Creative Expressions
- Grounding Exercises
- Relaxation Techniques / Meditation
MANAGING IMMEDIATE DISTRESS OF CLIENTS IN THERAPY SESSIONS
- Creating safe environment for the client, in a way that they feel comfortable to express their concerns.
- Always taking permission from the client before asking any questions, to make sure they do not get re-traumatized.
- Actively listening to the client and understanding their immediate triggers.
- Accessing the level of distress by asking them to rate their level of distress.
- After allowing them to vent their emotions, stabilization is important. It can be done through various grounding techniques to make the client feel connected with their body and surroundings.
- After stabilizing the client, they should be made aware of their various coping skills to help them self-regulate in case of future triggers.
- Helping the client identify their resources and reinforcing them for use.
- Discussing and planning how to set achievable goals, build a healthy support system and so on, to develop long term resilience in the client.
SELF-CARE AND WELL-BEING OF A TRAUMA THERAPIST
Every human needs social support and they need to feel belonged to this society to maintain their overall wellbeing. Therefore, along with self-care practices, reaching out for social support is also needed to maintain emotional and psychological well-being.
- Being mindful of the stressors.
- Engaging in creative activities to vent out hidden emotions.
- Practicing relaxation and grounding techniques.
- Maintaining a healthy boundary with the client by avoiding over-involvement.
- Accepting the need to take breaks.
- Avoiding session overload and maintaining the schedule.
- Seeking social support from friends, supervisors, colleagues.
- Reaching out for personal psychotherapy sessions.
- Discussing cases with supervisors as and when required.
