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Monday, April 27, 2020

What is a Trauma Therapist?

My previous article focused on the importance of making sure that anyone you're considering seeing for psychotherapy is a licensed therapist (see my article: Tips on How to Check If a Therapist is Licensed). The subject of this article, "What is a Trauma Therapist?," will focus on the difference between therapists who are trauma therapists vs. therapists who are generalists.

What is a Trauma Therapist?

Psychotherapists: Generalists vs Specialists
In the medical field there are generalists, like your general practitioner, and the specialists that your general practitioner refers you to when your problem is beyond the scope of the general practitioner's  skills and knowledge.

So, for instance, if the general practitioner thinks you have potential heart problems, s/he would refer you to a cardiologist who has the necessary knowledge and skills you need.  To do otherwise would be irresponsible and unethical of the general practitioner.

Similarly, in the psychotherapy field there are also generalists and specialists.  Generalists are therapists who work with a variety of common problems.  For instance, if a client is having problems adjusting to a new job or a new situation in life, a therapist who is a generalist can help a client to overcome common obstacles that are creating problems for a client.  

But if the generalist discovers that there is significant underlying trauma that is affecting the client's ability to adjust to a new situation and the client isn't making progress in therapy, the generalist will often refer the client to a trauma therapist because the problem is beyond the scope of the generalist's skills and training.

Similar to the medical field, it would be irresponsible and unethical for the generalist to continue working with this client because it would be beyond the scope of his or her skills and training.

After the generalist refers the client to a trauma specialist, the client has a choice of either continuing to work with the generalist and going to the trauma therapist for adjunctive therapy or the client can stop seeing the generalist temporarily (or permanently) to work with the trauma specialist.

What is a Trauma Therapist?
A trauma therapist, like a generalist, is a mental health practitioner who completed all the requirements for state licensure and, in addition, has the training and skills to work with trauma and posttraumatic stress disorder (PTSD).

What does this mean? It means that the trauma therapist has gone beyond the training of the generalist with specialized training in trauma therapy, like EMDR therapy (see my articles: EMDR and Emotional Breakthroughs).

Is this enough? No. Many psychotherapists train to do trauma therapy, like EMDR, but they rarely use it.  This means they haven't honed their skills.

In order to develop trauma therapy skills, a psychotherapist needs to see many clients with traumatic experiences and used trauma therapy over a period of time. 

Just like developing any other skill, it's not enough to learn a type of therapy once in a workshop and get little or no practice using it with clients.  Trauma therapy skills need to be practiced over time for a therapist to become skilled at it.  

The importance of skill level was really brought home to me a few years ago when I needed to refer a friend for trauma therapy.  Since she was my friend, I couldn't see her myself, so I needed to refer her to a specialist in trauma.

Although I know many therapists who are trauma therapists, none of them took my friend's health benefits, so I made a request on my professional listserve to try to find someone who did.  In response to my inquiry, a therapist, who was unknown to me, responded that she used EMDR therapy with clients.  She also said she took my friend's health benefits, and she would be glad to meet my friend.  So, I provided this therapist's information to my friend.

It turned out that even though this therapist said she was a trauma therapist, in fact, she was a generalized with a substance abuse background.  She admitted after several weeks of treating my friend that she attended an EMDR workshop, but she never used it.  In effect, she misrepresented herself because she wanted the referral.  Not only was this clinically irresponsible, it was also unethical, and I never made any more referrals to her.  

Fortunately, I was able to find someone else who was a qualified trauma therapist and my friend did well in that therapy.  But I never forgot that experience and, since that time, I ask more detailed questions when I'm making a referral rather than relying on a therapist describing him or herself as a trauma therapist when they're not.

So, while it's important to ask specific questions about the therapist's licensure and training, it's also important to ask how much experience a therapist has with regard to actually doing trauma therapy.  This doesn't mean that you shouldn't work with a beginner who is in training. You might choose a trauma therapist in training if that therapist works for a clinic that offers low fee therapy where the trainee is getting supervision if cost is an issue for you.

Choosing Among Trauma Therapists
Not all trauma is alike.  There are different types of trauma (see my article: What is the Difference Between Shock Trauma and Developmental Trauma?).

Within trauma therapy, some therapists have more experience with some trauma versus other types of trauma.  For instance, one trauma therapist might have more experience with the trauma of parental alienation and less with sexual abuse.  So, it's important to ask about this when considering various trauma therapists.

When you're looking for a trauma therapist, you might decide to have consultations with a few therapists to determine which therapist is right for you (see my article: How to Choose a Psychotherapist).

On the other hand, if you have a consultation with a trauma therapist and you feel she's the right therapist for you, you might choose that therapist without having other consultations because having several consultations can be time consuming and expensive.  This is a personal decision and each individual chooses what feels right.

Getting Help in Therapy
While the process of finding a trauma therapist might seem daunting, in the long run you can save a lot of time and money by making sure that you're with a specialist who has the necessary qualifications to help you.

Many trauma therapists, including me, are doing effective trauma therapy online during the pandemic crisis. Online therapy is also known as teletherapy, telemental health and telehealth (see my article: The Advantages of Online Therapy When You Can't See Your Therapist in Person).

Choosing a trauma therapist, instead of a generalist, can make all the difference between effective therapy versus ineffective therapy.  

Rather than struggling on your own with unresolved trauma, get the help you need from a trauma therapist so you can work through your trauma and lead a more fulfilling life.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

One of my specialties is working with trauma (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during regular business hours or email me.