Personalizing PTSD Treatment

How do I know which PTSD treatment modality is right for me?

There are a number of empirically supported treatments for trauma.  Prolonged Exposure, Cognitive Processing Therapy, Somatic Experiencing and EMDR are all well researched. It is an important question– “Which treatment is best for which person?”

There are a lot of factors to consider. Determining which approach can depend on a variety of factors, such as culture, type of trauma, learning style, and intellectual capacity to name a few. The key is having skilled clinicians that can evaluate what\’s needed for a particular individual as opposed to a one-size-fits-all approach. 

The type of trauma is especially important. For Cognitive Processing Therapy (CPT) and for Prolonged Exposure approaches, we look at Index Traumas. For example, years ago I worked with a first responder whose team was first to arrive on the Bay Bridge during the1989 earthquake collapse. He had rescued people, but also saw people that had passed. This is what we call an Index Trauma. There was a singular event and it led to PTSD. CPT and Prolonged Exposure worked well in his situation.  

Other trauma treatments lend themselves to repeated traumas. For example, early childhood developmental trauma where there is not just one index trauma, but there have been repeated injuries towards that child, whether they be psychological, physical, or sexual. There\’s no one single event. Rather, the trauma is systemic.

Holographic Reprocessing can be used in these situations. Think about a hologram. It is an image that can repeat over and over again. With this modality we can help the client understand how those pervasive patterns have led to their own “hologram” in adulthood that has become maladaptive. 

Ultimately, the best type of trauma treatment boils down to skilled clinicians understanding the individual sitting in front of them, and then providing that best match between their presenting issues and the empirically supported treatment available. 

Written by: Dr. Anna McCarthy /// Co-Founder + Clinical Director at The Mental Health Collective