This document summarizes a presentation on effective trauma treatment. It discusses that trauma treatment involves three phases: engagement and safety, processing traumatic memories, and enhancing daily living. Throughout treatment, the goals are to enhance a client's ability to manage arousal states, increase personal control and self-efficacy, and maintain adequate functioning. Treatment also aims to help clients approach rather than avoid triggers, and for therapists to manage transference and countertransference. The presentation addresses clinical considerations like engagement, safety, containment and addressing the complex role of the body in trauma.

1. Effective Trauma
Treatment:
The Long and
Winding Road
Presented by:
Sophia Deborah Erez, MS, LPC, MFT
Shared Hope International
November 30, 2011
Slide by Sophia Deborah Erez © 2008 520.302.5859

2. What are your perceptions of recovery?
Slide by Sophia Deborah Erez © 2008 520.302.5859

3. Slide by Sophia Deborah Erez © 2008 520.302.5859

4. Slide by Sophia Deborah Erez © 2008 520.302.5859

5. Three Phases of Trauma
Treatment
1. Engagement,
Safety and
Stabilization.
2. Processing
Traumatic
Memories
3. Enhancing Daily
Living
Slide by Sophia Deborah Erez © 2008 520.302.5859

6. Treatment throughout all phases:
1. Must enhance the client’s ability to manage
extreme arousal states.
2. Should enhance the client’s sense of
personal control and self efficacy.
3. Must assist the client in maintaining an
adequate level of functioning consistent with
his and her past and current lifestyle and
circumstances.
Slide by Sophia Deborah Erez © 2008 520.302.5859

7. Treatment throughout all phases:
4. Must enhance the client’s ability to
approach and master rather than avoid
experiences ( internal bodily-affective states
as well as external events) that trigger
intrusive re-experiencing, emotional
numbing, and hyperarousal or hypoarousal.
Slide by Sophia Deborah Erez © 2008 520.302.5859

8. Treatment throughout all phases:
5. Therapists must be aware of and effectively
manage clients’ transferential reactions and
countertransference.
Slide by Sophia Deborah Erez © 2008 520.302.5859

9. What stages of recovery does
your program assist?
1. Engagement, Safety and Stabilization.
2. Processing Traumatic Memories
3. Enhancing Daily Living. (Integration with self and community)
Slide by Sophia Deborah Erez © 2008 520.302.5859

10. Slide by Sophia Deborah Erez © 2008 520.302.5859

11. Women, Abuse and Trauma
Therapy
Slide by Sophia Deborah Erez © 2008 520.302.5859

12. Stages
1. Stabilizing and managing responses
• Establishing safety
• Psycho education
• Managing trauma responses
2. Processing and grieving traumatic memories
• CBT
• EMDR
• Body and Sensorimotor Psychotherapy
3. Reconnecting with the world
Slide by Sophia Deborah Erez © 2008 520.302.5859

13. Treatment Considerations
Engagement
– What does the client want?
– What is their willingness to change?
– Motivational interviewing
Safety
– Physical safety
– Address suicidality and self harming behaviors
– Harm reduction
– Address medical needs
– Address substance abuse and addictions
– Therapeutic relationship
Slide by Sophia Deborah Erez © 2008 520.302.5859

14. Treatment Considerations
Containment
– Affect regulation skills
– Positive affect tolerance
– Does the client have the skills to tolerate disturbing material
without resorting to harmful coping mechanisms?
Slide by Sophia Deborah Erez © 2008 520.302.5859

15. What clinical considerations
apply to your clients?
1. The complex role of the body.
2. Trauma bonding.
3. Betrayal of the social contract.
4. And . . .
Slide by Sophia Deborah Erez © 2008 520.302.5859

16. Five Principles
to break free
from the cycle
of shame and
self harm.
Presented by:
Sophia Deborah Erez, MS, LPC, MFT
Shared Hope International
November 30, 2011
Copyright © 2000 by Autumn Burris.
Slide by Sophia Deborah Erez © 2008 520.302.5859

17. Five principles . . .
1. The behaviors we do that appear to
sabotage our well-being are often our
best attempt at creating safety in the
present moment.
Slide by Sophia Deborah Erez © 2008 520.302.5859

18. Five principles . . .
2. We do these things because,
historically, they worked. Ironically, we
know they worked because we are alive
today and often struggle with how these
behaviors are no longer helpful.
Slide by Sophia Deborah Erez © 2008 520.302.5859

19. Five principles . . .
3. We cannot expect to stop utilizing the
templates our nervous systems have
learned to trust unless we have access to
at least one other template that works just
as well.
Slide by Sophia Deborah Erez © 2008 520.302.5859

20. Five principles . . .
4. The healing process includes:
– honoring what has outlived its usefulness
– learning to pause when feeling
threatened
– and accessing healthier, more effective
ways of sensing safety in the present
moment.
Slide by Sophia Deborah Erez © 2008 520.302.5859

21. Five principles . . .
5. The more moments we
have of sensing safety in
healthy ways, the more
likely these "new"
templates will became the
default response in times
of crisis and the more we
learn to trust ourselves.
Slide by Sophia Deborah Erez © 2008 520.302.5859

22. “You did then,
what you knew how to do
and when you knew better . . .
you did better!”
Maya Angelou
Slide by Sophia Deborah Erez © 2008 520.302.5859

23. Negative Positive
I don’t deserve love
I am a bad person
I am terrible
I am worthless (inadequate)
I am shameful
I am not loveable
I am not good enough
I deserve only bad things
I cannot be trusted
I cannot trust my judgment
I cannot succeed
I am not in control
I am powerless
I am weak
I cannot protect myself
I am stupid
I deserve love; I can have love
I am a good (loving) person
I am fine as I am
I am worthy; I am worthwhile
I am honorable
I am loveable
I am deserving; I am a good person
I deserve good things
I can (learn to) trust myself
I can trust my judgment
I can succeed
I am now in control
I now have choices
I am strong
I can (lean) to take care of myself
I have intelligence
Slide by Sophia Deborah Erez © 2008 520.302.5859

24. Negative Positive
I am insignificant (unimportant)
I am a disappointment
I deserve to die
I deserve to be miserable
I cannot get what I want
I am a failure
I have to be perfect
I am permanently damaged
I am ugly
I should have done something
I did something wrong
I am in danger
I cannot stand it
I cannot trust anyone
I cannot let it out
I do not deserve
I am significant (important)
I am okay the way I am
I deserve to love
I deserve to be happy
I can get what I want
I can succeed
I can be myself
I am (can be) healthy
I am attractive/loveable
I did the best I could
I learned (can learn) from it
It is over. I am safe now
I can handle it
I can choose who to trust
I can choose to let it out
I can have (deserve)
Slide by Sophia Deborah Erez © 2008 520.302.5859

25. Negative Positive
I am broken
I do not belong
I am capable of healing
Slide by Sophia Deborah Erez © 2008 520.302.5859