Treatment Approaches

Bridging responses: A front-line worker’s guide to supporting women who have post-traumatic stress

Therapeutic options

Fortunately, there are a variety of treatments for PTSR. Treatment usually involves some form of psychotherapy, and may also include medication, at least for a period of time.

Research has demonstrated that there are specific psychotherapy approaches and techniques that are especially effective in treating PTSR. For this reason, it’s important to find qualified and professionally trained therapists who are experienced in providing specialized trauma therapy.

Generally, psychotherapy or psychoanalysis that probes and explores trauma memories is not considered helpful and may in fact be harmful. These forms of psychotherapy may cause clients to become overwhelmed with traumatic responses, memories and feelings before they are able to tolerate them.

Therapeutic approaches that are considered the most effective include: cognitive behaviour therapy (including exposure and anxiety techniques); eye movement, desensitization and reprocessing therapy (known as EMDR); some body therapies; and some psychoeducational group therapies specifically geared to dealing with trauma.

Therapy for trauma survivors should be phase-oriented. The initial stage should focus on helping survivors manage responses and increase their safety, and on psychoeducation about trauma and its after-effects. For more information on therapy for trauma survivors, see Dr. Lori Haskell’s First Stage Trauma Treatment: A guide for therapists working with women (in press), also published by the Centre for Addiction and Mental Health (listed in the references at the back of this guide).

When medication might be helpful

When people have been identified as having PTSR, they can, in many cases, experience relief from the responses with the aid of medication. These responses, which can be overwhelming, include sleeplessness, depression and panic attacks. It’s important to refer clients to psychiatrists and medical doctors who have specific expertise in the appropriate treatments for complex PTSR.

The importance of referrals

Once front-line workers start screening for trauma in the lives of women at your service, you will likely be astounded with the frequency of the disclosures and the need to find suitable therapy.

Develop a list of qualified organizations and resources to which you can refer clients. It may help to contact the organizations and ask about their services, whether they have waiting lists, whether they offer individual or group therapy and what stage of trauma treatment they offer.

Collaborative approaches

Some services for women may want to team up with a trained trauma therapist. Rather than refer women individually for therapy (which is not always available or affordable), the service can have the trauma therapist conduct skill-based therapy groups that provide women with basic tools they need to cope with trauma, such as being able to:

• separate the past from the present (grounding)
• exercise control and choice
• stay connected or regain connection to positive others
• recognize, whenever possible, the connection between past experiences and present behaviours and feelings.

For example, some addiction services recognize that many women who have substance use problems also have a history of trauma and abuse. These services collaborate with specially trained trauma therapists to provide on-site specialized groups for women dealing with these complex issues.

A hopeful concluding note

Fortunately, a great deal has been learned about post-traumatic stress in the last several years. There are increasingly effective ways to offer support and relief. As a result, many people can be helped with the appropriate treatment, especially if there is early recognition and intervention.

In working with women who are coping with trauma, it’s important to offer hope. As service providers who often have first contact with women experiencing post-traumatic stress, you play a critical role in identifying the signs. You can also offer support to clients who experience post-traumatic stress, and facilitate referrals for specialized therapeutic help for healing and recovery.

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