When to Consider Therapy for Trauma

Dr. Emily Livermore Profile
Dr. Emily Livermore

Dr. Emily Livermore

Licensed Psychologist

Expertise:

Trauma, Complex Trauma, PTSD, Dialectical Behavior Therapy, Cognitive Processing Therapy, Prolonged Exposure

Learn More About Dr. Livermore
  • If you've experienced trauma, this course can help you understand what you're going through and explore your treatment options. We'll start by explaining what PTSD (post-traumatic stress disorder) really means and how it's different from other related conditions you might have heard about.

    You'll learn about several proven therapies that have helped many people recover from trauma, including approaches like Prolonged Exposure, Cognitive Processing Therapy, EMDR, and others. Think of this as your guide to understanding what these treatments actually involve and how they work, so you can have informed conversations with mental health professionals about what might work best for your situation.

    This course is designed specifically for people who are considering treatment for themselves. Our goal is to give you the knowledge and confidence to advocate for your own healing journey and find the right therapeutic approach for you.

    1. Understand how PTSD is diagnosed and learn why certain symptoms may be happening, including how trauma responses can be maintained over time.

    2. Learn about how different Evidence-Based Psychotherapies for PTSD work to help people heal.

    3. Gain tools to help you decide which treatment may be right for you, and how to find therapists or programs that offer these approaches.

  • General Guidelines & Classification

    • American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Publishing.

    • American Psychological Association. (2025). Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. American Psychological Association.

    • U.S. Department of Veterans Affairs & Department of Defense. (2023). VA/DoD clinical practice guideline for the management of posttraumatic stress disorder and acute stress disorder. U.S. Department of Veterans Affairs.

    • World Health Organization. (2019). International classification of diseases for mortality and morbidity statistics (11th ed.). World Health Organization.

    Dialectical Behavior Therapy for PTSD (DBT-PTSD / DBT-PE)

    • Bohus, M. (2023). Trauma-focused dialectical behavior therapy for posttraumatic stress disorder. Guilford Press.

    • Bohus, M., Dyer, A. S., Priebe, K., Krüger, A., Kleindienst, N., Schmahl, C., & Steil, R. (2013). Dialectical behaviour therapy for post-traumatic stress disorder after childhood sexual abuse in patients with and without borderline personality disorder: A randomised controlled trial. European Journal of Psychotraumatology, 4(1), Article 21896. https://doi.org/10.3402/ejpt.v4i0.21896

    • Bohus, M., Kleindienst, N., Hahn, C., Müller-Engelmann, M., Ludäscher, P., Steil, R., Fydrich, T., Kuehner, C., Resick, P. A., Stiglmayr, C., Schmahl, C., & Priebe, K. (2020). Dialectical behavior therapy for posttraumatic stress disorder (DBT-PTSD) compared with cognitive processing therapy (CPT) in complex presentations of PTSD in women survivors of childhood abuse: A randomized clinical trial. JAMA Psychiatry, 77(12), 1235–1245. https://doi.org/10.1001/jamapsychiatry.2020.2148

    • Harned, M. S. (2022). Treating trauma in dialectical behavior therapy: The DBT prolonged exposure protocol for PTSD. Guilford Press.

    • Harned, M. S., Korslund, K. E., Foa, E. B., & Linehan, M. M. (2012). Treating PTSD in suicidal and self-injuring women with borderline personality disorder: Development and preliminary evaluation of a dialectical behavior therapy prolonged exposure protocol. Behaviour Research and Therapy, 50(6), 381–386. https://doi.org/10.1016/j.brat.2012.02.011

    • Harned, M. S., Korslund, K. E., & Linehan, M. M. (2014). A pilot randomized controlled trial of dialectical behavior therapy with and without the dialectical behavior therapy prolonged exposure protocol for suicidal and self-injuring women with borderline personality disorder and PTSD. Behaviour Research and Therapy, 55, 7–17. https://doi.org/10.1016/j.brat.2014.01.008

    • Harned, M. S., Schmidt, S. C., Korslund, K. E., & Gallop, R. J. (2021). Does adding the DBT PE protocol for PTSD to DBT improve outcomes among survivors of sexual assault? A randomized controlled trial. Behaviour Research and Therapy, 139, Article 103800. https://doi.org/10.1016/j.brat.2021.103800

    Cognitive Processing Therapy (CPT)

    • Gallagher, M. W., & Resick, P. A. (2012). Mechanisms of change in cognitive processing therapy and prolonged exposure therapy for PTSD. Journal of Consulting and Clinical Psychology, 80(2), 317–328. https://doi.org/10.1037/a0027040

    • Gradus, J. L., Suvak, M. K., Wisco, B. E., Marx, B. P., & Resick, P. A. (2013). Treatment of posttraumatic stress disorder reduces suicidal ideation. Depression and Anxiety, 30(10), 1046–1053. https://doi.org/10.1002/da.22117

    • Resick, P. A., Monson, C. M., & Chard, K. M. (2016). Cognitive processing therapy for PTSD: A comprehensive manual. Guilford Press.

    • Resick, P. A., Nishith, P., Weaver, T. L., Astin, M. C., & Feuer, C. A. (2002). A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology, 70(4), 867–879. https://doi.org/10.1037/0022-006X.70.4.867

    • Resick, P. A., Williams, L. F., Suvak, M. K., Monson, C. M., & Gradus, J. L. (2012). Long-term outcomes of cognitive-behavioral treatments for posttraumatic stress disorder among female rape survivors. Journal of Consulting and Clinical Psychology, 80(2), 201–210. https://doi.org/10.1037/a0026602

    Prolonged Exposure (PE)

    • Foa, E. B., Hembree, E. A., & Rothbaum, B. O. (2019). Prolonged exposure therapy for PTSD: Therapist guide (2nd ed.). Oxford University Press.

    • Sloan, D. M., Marx, B. P., Acierno, R., Messina, M., Wachen, J. S., Yount, R. A., Tuerk, P. W., Difede, J., Nagy, L. M., Galovski, T. E., Vasterling, J. J., & Resick, P. A. (2023). Written exposure therapy versus prolonged exposure for posttraumatic stress disorder: A randomized clinical trial. JAMA Psychiatry, 80(11), 1093–1100. https://doi.org/10.1001/jamapsychiatry.2023.2925

    Written Exposure Therapy (WET)

    • Sloan, D. M., & Marx, B. P. (2012). Written exposure therapy for PTSD: A brief treatment approach for mental health professionals. American Psychological Association.

    • Sloan, D. M., & Marx, B. P. (2019). Written exposure therapy for PTSD: A brief treatment approach for mental health professionals. American Psychological Association.

    • Sloan, D. M., Marx, B. P., & Greenberg, E. M. (2013). A test of written emotional disclosure as an intervention for posttraumatic stress disorder. Depression and Anxiety, 30(2), 127–134. https://doi.org/10.1002/da.22003

    • Sloan, D. M., Marx, B. P., Lee, D. J., & Resick, P. A. (2018). A brief exposure-based treatment vs cognitive processing therapy for posttraumatic stress disorder: A randomized noninferiority clinical trial. JAMA Psychiatry, 75(3), 233–239. https://doi.org/10.1001/jamapsychiatry.2017.4249

    • Thompson-Hollands, J., Marx, B. P., Lee, D. J., Resick, P. A., & Sloan, D. M. (2018). Long-term treatment gains of a brief exposure-based treatment for PTSD. Depression and Anxiety, 35(10), 985–991. https://doi.org/10.1002/da.22825

    Narrative Exposure Therapy (NET)

    • Bichescu, D., Neuner, F., Schauer, M., & Elbert, T. (2007). Narrative exposure therapy for political imprisonment-related chronic posttraumatic stress disorder and depression. Behaviour Research and Therapy, 45(9), 2212–2220. https://doi.org/10.1016/j.brat.2006.12.006

    • Schauer, M., Neuner, F., & Elbert, T. (2011). Narrative exposure therapy: A short-term treatment for traumatic stress disorders (2nd ed.). Hogrefe & Huber.

    • Schauer, M., Neuner, F., & Elbert, T. (2025). Narrative exposure therapy: A short-term intervention (3rd ed.). Hogrefe & Huber.

    STAIR Narrative Therapy (Skills + Narrative)

    • Cloitre, M., Cohen, L. R., & Koenen, K. C. (2002). Treating survivors of childhood abuse: Psychotherapy for the interrupted life. Guilford Press.

    • Cloitre, M., Jackson, C., & Schmidt, J. (2020). Treating PTSD with STAIR narrative therapy: Skills training in affective and interpersonal regulation combined with narrative therapy. Guilford Press.

    • Cloitre, M., Petkova, E., Wang, J., & Lu Lassell, F. (2011). An examination of the influence of a sequential treatment on the course and impact of dissociation for women with PTSD related to childhood abuse. Depression and Anxiety, 28(11), 961–967. https://doi.org/10.1002/da.20847

    • Cloitre, M., Stovall-McClough, K. C., Nooner, K., Zorbas, P., Cherry, S., Jackson, C. L., Gan, W., & Petkova, E. (2010). Treatment for PTSD related to childhood abuse: A randomized controlled trial. American Journal of Psychiatry, 167(8), 915–924. https://doi.org/10.1176/appi.ajp.2010.09081247

    • Karatzias, T., Murphy, P., Cloitre, M., Bisson, J., Roberts, N., Shevlin, M., Hyland, P., & Bradley, A. (2019). Psychological interventions for ICD-11 complex PTSD symptoms: Systematic review and meta-analysis. European Journal of Psychotraumatology, 10(1), Article 1562840. https://doi.org/10.1080/20008198.2018.1562840

    Eye Movement Desensitization & Reprocessing (EMDR)

    • Hase, M., & Schallmayer, S. (2021). The structure of EMDR therapy: A guide for the therapist. Frontiers in Psychology, 12, Article 660753. https://doi.org/10.3389/fpsyg.2021.660753

    • Landin-Romero, R., Moreno-Alcazar, A., Pagani, M., & Amann, B. L. (2018). How does eye movement desensitization and reprocessing therapy work? A systematic review on suggested mechanisms of action. Frontiers in Psychology, 9, Article 1395. https://doi.org/10.3389/fpsyg.2018.01395

    • Rasines-Laudes, P., Guardia, A., Tintle, S., Castillo, A. R., Simmons, A. N., & Johnson, D. C. (2023). Efficacy of eye movement desensitization and reprocessing in post-traumatic stress disorder. Psicothema, 35(1), 15–25. https://doi.org/10.7334/psicothema2022.343

    • Seok, J. W., Cheong, M. J., & Lee, T. Y. (2024). The efficacy of eye movement desensitization and reprocessing for treating depression: A systematic review and meta-analysis. Journal of Clinical Medicine, 13(18), Article 5633. https://doi.org/10.3390/jcm13185633

    • Shapiro, F. (1991). Eye movement desensitization: A new treatment for post-traumatic stress disorder. Journal of Behavior Therapy and Experimental Psychiatry, 22(3), 211–217. https://doi.org/10.1016/0005-7916(91)90002-9

    • Shapiro, F. (1995). Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures (1st ed.). Guilford Press.

    • Shapiro, F. (2001). Eye movement desensitization and reprocessing (EMDR): Basic principles, protocols, and procedures (2nd ed.). Guilford Press.

    • Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.

    • Yan, S., Shan, Y., Zhong, S., Miao, H., Luo, Y., Ran, H., & Jia, Y. (2021). The effectiveness of eye movement desensitization and reprocessing toward adults with major depressive disorder: A meta-analysis of randomized controlled trials. Frontiers in Psychiatry, 12, Article 700458. https://doi.org/10.3389/fpsyt.2021.700458

    Meta-Analyses & Systematic Reviews

    • Cusack, K., Jonas, D. E., Forneris, C. A., Wines, C., Sonis, J., Middleton, J. C., Feltner, C., Brownley, K. A., Olmsted, K. R., Greenblatt, A., Weil, A., & Gaynes, B. N. (2016). Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clinical Psychology Review, 43, 128–141. https://doi.org/10.1016/j.cpr.2015.10.003

    • Haagen, J. F. G., Smid, G. E., Knipscheer, J. W., & Kleber, R. J. (2015). The efficacy of recommended treatments for veterans with PTSD: A metaregression analysis. Clinical Psychology Review, 40, 184–194. https://doi.org/10.1016/j.cpr.2015.06.008

    • Lee, D. J., Schnitzlein, C. W., Wolf, J. P., Vythilingam, M., Rasmusson, A. M., & Hoge, C. W. (2016). Psychotherapy versus pharmacotherapy for posttraumatic stress disorder: Systematic review and meta-analyses to determine first-line treatments. Depression and Anxiety, 33(9), 792–806. https://doi.org/10.1002/da.22511

    • Watts, B. V., Schnurr, P. P., Mayo, L., Young-Xu, Y., Weeks, W. B., & Friedman, M. J. (2013). Meta-analysis of the efficacy of treatments for posttraumatic stress disorder. Journal of Clinical Psychiatry, 74(6), e541–e550. https://doi.org/10.4088/JCP.12r08225