Trauma Therapy

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Trauma Therapy

“The very making of an appointment with a total stranger to deal with the greatest intimacies and vulnerabilities of one’s life is an act of profound faith.”

Diana Fosha (2000, p5)

What to expect from Trauma Therapy

Initially I offer an informal phone or face to face consultation of 20 - 30 minutes free of charge. This is an opportunity to ask any questions you may have about Trauma, PTSD or the process of therapy. If you would then like to go ahead with therapy, we would arrange assessment appointments at a mutually convenient time either by phone, zoom if appropriate or, depending on restrictions, face to face either in Aberystwyth, Swansea or Carmarthen. Since we have expanded, the assessments may be either with myself, or with another of our trauma-informed practitioners.

The first sessions are dedicated to a full assessment, which includes background, trauma history and symptoms. This is important in order to determine what type of trauma we are looking at, i.e. whether it is a single incident, or complex in nature, and whether there are any co-occurring disorders such as anxiety, depression, addictions or dissociation for instance.

We also determine what strengths, resources and support someone has, as well as eliciting together what your hopes and goals for therapy may be. These could include a reduction of symptoms such as flashbacks and sleep problems, processing the trauma or cognitive restructuring. These elements will help in determining an individually based plan and help us move forward in a safe way.

Following assessment, trauma therapy is comprised of three phases:

• Stabilisation

• Trauma Process

• Integration and Recovery

Stabilisation

This includes Crisis Management, Psychoeducation, Containment and Emotion Regulation strategies. Stabilisation has been shown to have a treatment effect in its own right, and some people, depending on their goals, feel they have improved enough to not need any further therapy. The stabilisation phase equips clients to regulate their emotions more effectively, to manage symptoms such as panic attacks, and can lead to more healthy interpersonal relationships. How long this phase lasts is again very individually determined and depends on the resources someone may have available prior to attending therapy.

Trauma Process

The trauma process itself directly addresses and revisits the trauma or traumas, confronting painful memories and feared situations. Most trauma processes include an element of exposure, that means clients revisit a trauma in detail, which is something they may have avoided for a long time. At Traumaform our therapies include:

Integration and Recovery

The Integration phase serves to imbed behavioural and neurological changes by continuing with cognitive restructuring, preventing relapse and leading to post-traumatic growth. A person whose distressing memories, symptoms of PTSD and unhelpful patterns of behaviour have been reduced, is able to move forward in life more freely from the things that have been holding them back, and more able to reach their potential. It is an ongoing process.

EMDR

EMDR (Eye Movement Desensitisation and Reprocessing) is an information processing therapy for PTSD, Complex Trauma and other disorders, utilising bilateral stimulation through eye movements or tapping that help clients cope with distressing memories.

EMDR was developed by Dr Francine Shapiro in the 1980’s and since its inception research has found strong evidence for its safety, effectivity and efficiency. During therapy the client focuses on a specific thought, image, emotion, or sensation while simultaneously watching the therapist's finger or baton move in front of his or her eyes, or by tapping.

EMDR weakens the impact of negative emotions and distressing memories. See www.emdrassociation.org.uk for further information. I have completed my training in EMDR Levels 1-4 as part of an MSc in EMDR at Worcester University, a course that is accredited by the EMDR Association, and am working towards accreditation.

Getting Past Your Past is a self-help book written by Dr Shapiro that can be a useful read.

Prolonged Exposure Therapy

Prolonged Exposure Therapy (Foa and Kozak, 1985, 1986) is a bottom up trauma process recommended for PTSD 1 and other trauma related reactions such as depression or anxiety following any kind of trauma where the sufferer has sufficient recall of the trauma and can describe it with a beginning, middle and end. The purpose is an emotional processing of traumatic experiences through repeated exposure. Fear is regarded as the primary emotion in PTSD 1 which often leads the sufferer to avoid reminders of the trauma, thereby exacerbating the problem.

Prolonged exposure therapy utilises psychoeducation, breathing retraining as well as both in vivo and imaginal exposure in a systematic way in order for habituation to occur. The fear structure is activated during exposure in order for new information to be incorporated. Prolonged Exposure has a large research and evidence base and its efficacy is well documented (Foa, Hembree & Rothbaum, 2007).

To keep it simple, in this type of therapy the trauma memory is revisited in a detailed and prolonged way – this helps the brain to understand that the trauma is only a memory and is not happening now, and any danger has past. Alongside this, therapy also looks to help a person stop avoiding aspects of the trauma in a step by step way.

Cognitive Processing Therapy

CPT is a hybrid therapy that involves a cognitive as well as an exposure element.

CPT is a top down process that keeps the pre-frontal cortex connected whilst processing the emotions through exposure. The goal of CPT is recovery from trauma through a change in the survivor’s belief system in order to gain a balanced and realistic view of the event or events.

This is achieved through encouraging the survivor to stop avoiding. Emotions experienced through recollection of the trauma are helped to be processed in a healthy way.

It works by helping the client to re-interpret the event in light of context and facts of the event. It serves to diminish any difficult emotions that may have been based on misinformation or misinterpretation of the event in connection to view of self, others or the world. It thereby enables the survivor to avoid overgeneralising from a single event/person/disaster to the world at large (Resick et al).

Brainspotting

“Brainspotting is a new psychotherapy approach that hypothesises that the field of vision can be used to locate eye positions that correlate to inner neural and emotional experience. After these eye positions, or Brainspots, are located, they may (by maintaining eye fixation) lead to a healing and resolution of issues that are held deeply in the non-verbal, non-cognitive areas of the neurophysiology. BSP utilises both focused activation and focused mindfulness as its mechanisms of operation.

It aims at full, comprehensive discharge of activation held in the brain and body. BSP is a model that incorporates systemic activation and resources applied based on both diagnostic and developmental consideration. The BSP model is developed as both relational as well as technical, with philosophical and physiological underpinnings. It is an open, inclusive, yet framed model that invites the therapist to make use of their prior study, experience and practice wisdom.” (David Grand)

www.bspuk.co.uk

For list of therapists in Wales and rest of UK please follow link:

http://www.bspuk.co.uk/therapists/list-of-therapists/wales/

Brainspotting has been described as a new revolutionary technique that focuses on mind-body processes and works on the theory that “Where you look affects how you feel”. It allows for deep emotional processing of a trauma where the therapist is attuned to the client and will be with them along the way. Watch the video by David Grand, Brainspotting founder, to find out more.

Image Rescripting and Reprocessing Therapy

Image Rescripting and Reprocessing Therapy (IRRT) is an integrative Cognitive Behavioural approach originally designed as treatment for adult survivors of childhood abuse (Smucker, Dancu, Foa & Niederee, 1995), and is recommended for Type II clients where emotions such as anger, blame, grief, guilt and shame are predominant, rather than fear.

With its elements of imaginal exposure, mastery imagery and cognitive restructuring, IRRT seeks to modify images during rescripting and reprocessing of a trauma, and works at the schema level, thereby tapping into the 7 key areas affected by Complex PTSD. The goals of IRRT include the reduction of physiological arousal, eliminating the re-experiencing of distressing imagery, developing more adaptive schemas and beliefs associated with the trauma or traumas as well as to increase the client’s self-nurturing abilities and coping skills; in this sense IRRT is said to go beyond extinction models to facilitate change at the schema level. Since its conception IRRT has been utilised to treat many other forms of trauma as well as co-occurring disorders and is expanding its evidence base (Brewin et al, 2009).

To keep it simple – in this type of therapy an individual is again helped to revisit a trauma, often this may be a childhood trauma, and with guidance from the therapist in a structured and systematic way, is enabled to confront the perpetrator in their imagination and gain mastery over situation and the memory. This therapy helps to process a trauma emotionally as well as cognitively.

Narrative Exposure Therapy

Narrative Exposure Therapy is a treatment for trauma survivors during which the client constructs a chronological narrative of their life in an attempt to integrate often fragmented memories of traumatic experiences into a coherent life story. In the initial sessions clients will lay their “life-line”, making use of flowers (for positive events) and stones (traumatic events) along a rope or ribbon.

Therapy then focuses on reliving these events taking account of physiological, emotional and cognitive elements experienced at the time and interweaving these with the “here and now”, thereby acting as constant reminders that these experiences are in the past and only memories. In the presence of the therapist these memories are reprocessed.

After therapy a copy of their autobiographical life story is given to the client, this document may also be used for human rights advocacy.

As NET involves narrating the entire life story, it is particularly suited to treating Complex Trauma. It was developed by Schauer, Neuner and Elbert and is being used in the treatment of refugees and the victims of torture” otherwise it sounds like refugees are the perpetrators! with projects all over the world. See www.vivo.org for further information.

Alpha-stim – microcurrent treatment for anxiety, depression and insomnia

Alpha-stim treatment available at Traumaform. What is Alpha-stim?

The alpha-stim leaflet states:

“Alpha-Stim is a clinically proven medical device that relieves anxiety, insomnia and depression using electromedical technology. Alpha-Stim generates a unique patented waveform no other device can offer. Much like every white pill is not the same, the uniqueness of Alpha-Stim’s waveform produces results vastly different from any other medical device. Unlike medications which are introduced to your body in a chemical form and then broken down to smaller components such as electrons, Alpha-Stim begins at the electron level, allowing your body’s cells to return to their natural functioning state. AlphaStim provides long lasting, cumulative relief without the risk of negative effects such as tolerance and addiction to medications.”

See here for full leaflet

Heartmath Technology – reduce stress – available at Traumaform

According to heartmath research: “Science has now shown us that the rhythm of our heart beat affects how we think and feel.”

“Coherence is an optimal physiological state shown to prevent and reduce stress, increase resilience, and promote emotional wellbeing. Coherence is measured through Heart Rate Variability (HRV) – a unique window into the quality of communication between the heart and brain which directly impacts how we feel and perform.”

www.heartmath.com

Post-traumatic Growth

Post-traumatic Growth refers to the phenomenon that between 30-70% of individuals who have survived trauma, report positive changes as a result of the struggles involved in the trauma. Post-traumatic Growth has been defined as the “experience of individuals whose development, at least in some areas has surpassed what was present before the struggle with crises occurred. The individual has not only survived, but has experienced changes that are viewed as important and that go beyond the status quo” (Tadeshi and Calhoun, 2004). That is not to say that individuals would not prefer that the trauma hadn’t taken place, yet some positives are often taken from it.

Research has found that these changes occur broadly in the areas of emotional growth, closer relationships, altered perspective on life, changes in self-concept, living in the moment, and appreciation (Joseph,S, 2013). Follow the links for further information.

For more information plese click on: Trauma-Recovery or here: Positive-Psychology

Professionals

Trauma Supervision

Traumaform offers trauma-informed supervision by qualified Supervisors who have completed additional online training such as the Advanced Certificate in Clinical Supervision to include in person and online and phone counselling. This is mapped to both the BACP (British Association of Counselling and Psychotherapy) and the ACTO Association for Counselling and Therapy Online https://www.acto.org.uk/ core competencies.

Please email georgina@traumaform.hush.com to find out more.

Vacancies

Traumaform is currently recruiting for a number of posts as below - if you are interested in applying, please email enquiries@traumaform.hush.com

Part-time 20 hour a week Personal Assistant to the Director

Hours: Part-time 20 hours per week (to be arranged)

Location: Llanybydder and remote working, some travel

Salary: £ 20,000.00 pro rata

5 weeks annual holiday, travel expenses for any travel that exceeds 20 miles, and Pension.

Closing date: 30.10.23

Interviews: November2023

Start date: December 2023

For job-specification and application form please email enquiries@traumaform.hush.com

Full-time Trainee Trauma Therapist Placement - Ceredigion

Hours: Full time 37.5 hours per week, may include out of hours and weekend working. Generally 9 – 5 pm but room for flexibility

Location: potential travel Aberystwyth/Cardigan/Lampeter and remote working

Salary: £ 19,500.00 – £ 26,500.00 pro rata

In addition to this the Level 7 Post-grad Diploma in Traumatology and PTSD will be fully funded with a value of £ 3950.00.

The PG-Dip training course commences in January 2024 and finishes April 2025. Half a day a week can be utilized from working hours towards this. It will be expected that any extra course work will be carried out in own time.

For a full-time post a Laptop and phone will be provided.

External supervision will be provided according to BACP guidelines.

5 weeks annual holiday and Pension, travel expenses for any travel that exceeds 20 miles, and Pension.

Closing date: 15.11.23

Interviews: December 2023

Start Date: January 2024

For job-specification and application form please email enquiries@traumaform.hush.com

Part-time Trauma-informed Counsellor- Ceredigion

Hours: 22.5 hours per week, may include out of hours and weekend working

Location: potential travel Aberystwyth/Cardigan/Lampeter/Carmarthen

Starting Salary: £ 22,000.00 pro rata

Fully funded Inhouse and external Trauma Training in Narrative Exposure Therapy and Brainspotting provided.

External supervision will be provided according to BACP guidelines.

5 weeks annual holiday, travel expenses for any travel that exceeds 20 miles, and Pension.

Closing date: 15.11.23

Interviews: December 2023

Start Date: January 2024

For job-specification and application form please email enquiries@traumaform.hush.com

Workshops and Trainings

Traumaform offers a series of workshops to cover the basis of trauma-informed therapy, both in person and online.

These trainings consist of a series of 6 x 5 hour workshops to include:

Introduction to Trauma and PTSD
Introduction to Diagnoses and Assessment
Introduction to Psychoeducation
Introduction to Stabilisation and Emotion Regulations Strategies
Introduction to Safe Trauma Therapy
Introduction to Vicarious Trauma

Trainee Counselling Placements

In 2019 Traumaform C.I.C., now an Organisational Member of the BACP, started to take on Trainee Counsellors and Psychotherapists on Placement. This gives those training to be counsellors/psychotherapists the opportunity to practice their skills, become proficient at their specific therapeutic practice and gain the 100 or more client hours necessary for completion of their Diploma Courses, as well as working towards their accreditation with the BACP or equivalent in the future.

As the placement positions are voluntary and not paid, this allows for our clients to access therapy at significantly reduced cost, but not at reduced competence. It is often said that counsellors and psychotherapists in training do their best work in the first year, although this may be anecdotal evidence only!

Our first Trainee Counsellor and Psychotherapist to start with us in May 19 was Dr Clare Scott, who has come to the end of her placement with us after completing her Diploma in Adlerian Therapy, and joined us as Affiliate Counsellor offering trauma-informed face to face sessions in Carmarthen as well as online. Clare also facilitates our Writing for Wellbeing Group. Our second Trainee Counsellor to join us in June 2019 was Karolina who completed her Diploma in Transactional Analysis and placement with us and has also joined us as Affiliate Counsellor working in Aberystwyth face to face, and also offering online therapy.

Our next Trainee on Placement was Jill Cassidy who has now joined us as part-time Trainee Trauma Therapist studying for a Post-grad Diploma in Traumatology and PTSD after completing her training with the Adlerian Counselling Society - Jill lives in North Wales but travels down to Aberystwyth for any face to face clients but is also now able to work with clients online inline with BACP regulations. Angela Evans has also joined us as part-time Trainee Trauma Therapist studying for the Post-grad Diploma after completing her placement and training as Integrative Counsellor. Angie is based in South Wales and sees clients in Haverfordwest and online.

Lucia Ortega joined us last year on placement whilst completing her Diploma in Person-centred counselling and is in the process of joining us as Affiliate Counsellor.

The newest placements with us and current trainees are Miriam Smith (person-centred), Clive Nolan (Transactional Analysis), and Carroll Locke who is currently developing her knowledge and experience through attending the Post-grad Diploma in Traumatology and PTSD.

Miriam and Clive can offer face to face sessions in Aberystwyth and online, with Carroll currently providing online only.

If you are interested in a placement with us, please email me directly as below and I will send you an application form initially.

Please contact georgina@traumaform.hush.com

Generic Counselling

What is Transactional Analysis?

Transactional Analysis has three simple yet empowering principles:

I’m okay - you're okay.
We can all think.
We all make decisions early in life and we are capable of changing them later in life.

We all have three 'ego states' - Parent (learned messages from our caretakers), Child - our learned responses to those messages, and Adult - our rational responses to ‘here and now’. According to Transactional Analysis, at least one of the ego states at a time is active within us as a response to triggers of our daily lives.

When we are young, we internalise relationships with our carers and people around us, and carry a lot of that into our adult lives. Trauma, whether it’s a one time or recurring incident, can undoubtedly form how we view the world and ourselves. The whole world can become a threatening place in our eyes, in everything we do.

In therapy, by looking within, we can find ways to give ourselves the safety, love, nourishing we need and deserve. In other words, we go back in time and hug our hurt self, so we can build a future that allows us to function and live a fulfilling life. We cannot change our past, but we can find ways to heal from awareness, acceptance, forgiveness and self-love.

If you are interested in learning more about Transactional Analysis, I will be happy to introduce its concepts in our work together.

What is Adlerian Counselling

What is Person Centred Counselling

What Is Occupational Therapy?

Occupational therapy is a form of therapy for individuals experiencing emotional distress, which interferes with their ability to perform daily tasks associated with living a normal, healthy life.

Daily tasks fall into four main areas:

Self Care: personal hygiene, grooming, and healthy eating
Productivity: employment, attending learning centers or volunteering
Leisure: personal hobbies, playing sports, team activities, and spiritual activities.
Relationships: work colleagues, family, friends or partners

Occupational therapy uses goal-focused activity to address issues of:

Anxiety
Stress
Self confidence
Self esteem
Problem solving
Emotional intelligence
Phobias

Our life is in balance and this balance can be maintained when we establish roles and routines to incorporate these activities in long-term ‘occupations’ based on our values and interests: