Three Phase Trauma Therapy
A key philosophy that I work with, in trauma therapy, is that it is about improving the quality of life
in the present. Whilst you have been through something, or somethings, that are awful, we cannot
change the past. We can, however, work to improve your quality of life in the present, and that
remains the focus, throughout.
It is important to me that you are always informed and an active participant in your trauma therapy,
so any decisions on the way forwards, will be decided between the two of us, and we will be able to
fully talk through what your options before you decide. I aim to be transparent, and work to ensure
you are as informed and prepared as you can be, before we do anything.
The therapy I offer is the three-phase trauma therapy model.
The three phases are:
1- Safety and Stabilisation.
2- Processing.
3- Integration.
The key part of all trauma therapy is to ensure that the therapy, the relationship and, most
importantly you, the client, are safe first. My primary function in our work is to ensure safety and a
significant part of creating safety is to pace the work. It is always better to pace the work on the
slower side, and set someone up for achieving what they want from therapy, than to pace it too
quickly, to dysregulate someone and set them up for increases in distress.
Prior to starting the three-phase model, we may conduct some assessments to understand what is
happening for you, and what your needs are.
Phase 1- Safety and Stabilisation
When someone has experienced trauma, this is a real assault to the nervous system of your body, in
addition to whatever it was you went through.
This phase of therapy looks different for everyone, but the ultimate aim is to ensure that, by the
time you are secure in this phase, you can regulate your nervous system. Initially, you will need help
from me to do this, but the more work we do, the more empowered you will be here.
A fundamental part of this phase is to be able to develop our relationship and working alliance and
ensure that it feels safe and secure for you. Alongside that, we will start to look at helping you
understand what is happening for you, and give you some tools, approaches and awareness to help
you.
Specific approaches I offer in this phase include, but are not limited to:
-Emotion Regulation- In the form of STAIR (which stands for Skills Training in Affective and
Interpersonal Regulation).
-Somatic Approaches.
-Using an Autonomic Nervous System chart, as a guideline, to help you listen to your body
responses.
-Outlining.
-Safe Person, Safe Place.
-Self Resourcing.
-Grounding Skills.
-Relaxation Exercises.
-Mindfulness.
-Focused Breathing Skills.
-Psychoeducation.
-Flashback Work.
-Nightmare Work.
-The Emergency Stop.
-Safety Planning.
-Rewind Technique.
-And Much, Much More.
We will discuss, between us, what you feel you need, and what we can do together. There is no time
limit to this phase of work, but it is, arguably, the most important part of the work, because it gives
you all the skills you need, and will allow you to improve your present life situation and how you
experience the world.
Many people choose to never move beyond this phase, because their life has improved so much.
That is more than ok; you control what you need from therapy and when. Sometimes people choose
to end therapy here, or to switch back to counselling, rather than progressing into Phase Two.
Equally, other people want to move onto Phase Two, so it’s very important that you listen to
yourself, and your needs and know that you have the choice.
Phase Two- Processing
This is where we work directly with your trauma to resolve any remaining distress. Sometimes that involves using memories, sometimes it does not. If you do not have a complete memory, then we would not be working with any memory-based approaches, and that’s ok. It’s common for trauma survivors to have memory fragments and not complete memories, which is why I offer a variety of approaches.
It’s also important to identify that not all of these models are suitable for all types of trauma. When
we discuss what they entail, we will only discuss the ones that are relevant for you and your
experience, however, if you see something here you want to know more about, you are welcome to
bring this up and we can discuss it.
The things we may wish to consider would be approaches like:
-Cognitive Processing Therapy.
-BrainWorking Recursive Therapy.
-Imagery Rescripting and Reprocessing Therapy.
-SIBAM Model.
-Bodynamic Running Technique.
-Narrative Exposure Therapy.
-Prolonged Exposure Therapy.
-Relational Work.
I have intentionally not identified the fine details of these processes, as these will be things that we
can discuss together, however, I am open to any questions about them.
Integration
When you’ve been through trauma, and it has had such a devastating impact on your life and day to
day functioning, a key part is to take what you have done in therapy, and look to integrate that into
your everyday life. This is sometimes done, without a plan, during phase one and/or two, but can
also be a phase in its own right.
Trauma can cause us to isolate and withdraw from active participation in the things that nourish us.
Things that may be explored and worked on in this phase are:
-Hobbies.
-Training/Studying.
-Jobs/Work.
-Where you live.
And anything else you’re missing in your life, or want to change in your life, but haven’t yet been
able to address.
Additionally, we may wish to look at relapse prevention and ensuring you have a secure plan in place
for when you exit therapy.
This is a phase that may be done whilst you’re in therapy, or out of therapy, or you may be
transitioning out of therapy and be wanting to lower your session frequency.
All of this is ok, and all of it is within your control and choice; there is no rush and you get to go at
your pace.