At CMC, clients have the option to treat any unresolved trauma while they address their substance problems. Often, unresolved trauma is the driver behind people’s choices to use substances and it frequently leads to difficulty making changes.
Post-traumatic stress disorder (PTSD) does not, on its own, fade with time and can significantly impact a person’s ability to cope and enjoy life. PTSD is, however, highly treatable. There are skills you can learn to manage your anxiety.
You have already survived; now let’s help you thrive.
Clinicians in all of our programs are trained in the gold standards for treating complex trauma and PTSD, and we will work with you to decide which is the best option for you. We offer Prolonged Exposure therapy (PE & COPE), Skills Training in Affective and Interpersonal Regulation (STAIR), Cognitive Processing Therapy (CPT), and Eye Movement Desensitization and Reprocessing (EMDR).
Clients who have completed treatment for PTSD at CMC have experienced statistically significant (p < .05) decreases across multiple symptom categories and average PTSD symptom severity, as measured by the Post-Traumatic Stress Disorder Symptom Scale Interview (PSSI) for the DSM-5, decreased by 84%.
At CMC:Berkshires, 80% of our clients who met criteria for PTSD and completed trauma treatment no longer meet a clinical cut-off for PTSD by the end of treatment (clients received an average of 13 specific sessions for trauma treatment in addition to usual CMCB programming).
If you or someone you love is experiencing symptoms of unresolved trauma, we encourage you to explore options for treatment. Addressing the root problem will help you take back your life and work toward healing.
Why Should You Consider Treatment?
Many people will experience a traumatic incident in their lives, yet most people do not develop PTSD. Why is it that one person develops PTSD in response to a trauma, while another experiencing a similar event does not?
People develop PTSD for many reasons, and some are more at risk than others. For example, people who develop PTSD after a trauma in adulthood often have a history of childhood trauma (e.g., physical or sexual abuse, neglect) or other prior experience with trauma. Other risk factors include anxiety and a tendency to rely heavily on avoidance behaviors (such as substance use and isolation) to cope.
Trauma and substance misuse in particular have a unique relationship. Studies have found that anywhere from 30–60% of people who struggle with substance problems also suffer from PTSD.
PTSD is maintained primarily through avoiding reminders of the trauma. While avoiding triggers and using substances reduce anxiety in the moment, the long-term consequences of avoiding trauma reminders can be significant. First, when you close off parts of the world in order to avoid triggers, life becomes very constricted. Isolation, poor overall functioning at work and in relationships, and other problems like depression and anxiety are some outcomes of untreated PTSD. Second, using substances to manage trauma-related symptoms can add a host of other problems that may ultimately result in physical and emotional dependence on drugs and alcohol.
Treatment at CMC
At CMC, we know that one size does not fit all and that having a choice among effective, empirically based options predicts positive outcomes. In all of our programs we have a team of expert psychologists who are deeply trained in evidence-based approaches to treat PTSD and complex trauma. We will work with you to come up with treatment options that best suit your needs.
Taking the first step toward treating the impact of trauma on your life is a very important moment. While it can feel inspiring to finally ask for help, this step is often accompanied by questions, concerns, and uncertainties. If you decide you want to consider treatment for PTSD, we will complete a full assessment that is designed to be collaborative, encouraging, informative, and meaningful. An effective plan for change begins with a clear and in-depth understanding of you and the circumstances that have brought you to the point of considering additional support.
We rely on accurate assessment to guide and individually tailor your therapy. Your consultation will include a variety of standardized questionnaires as well as a comprehensive interview with a psychologist. This allows us to understand you in a more complete way, including your life circumstances and experiences, relationships, strengths, vulnerabilities, and goals.
The initial consultation will conclude with a collaborative discussion, where we will make recommendations to help you understand all of your options, including individual therapy or group therapy—in addition to other resources outside of CMC, if appropriate. We can collaborate with other treatment providers working with you and will invite their input in developing a plan. If together we decide an outside referral is the best option for you, we will work to help you identify and connect with the best possible outside support to meet your needs.
Prolonged Exposure (PE)
Prolonged Exposure (PE) is a time-limited, evidence-based treatment that aims to reduce anxiety and improve your quality of life. Treatment consists of approximately eight to fifteen 90-minute sessions involving psychoeducation, breathing retraining, ongoing out-of-session practice, and imaginal and in vivo exposure. By exposing yourself directly to trauma reminders both in and out of session, you will gain experience confronting situations and memories that you have previously worked to avoid. You will come to learn that you can actually tolerate these situations and the feelings they provoke, a process called habituation. You will gain a new sense of competence and confidence as a result. Through guided imaginal exposure (repeatedly revisiting the traumatic memory) in session, you will come to realize that your trauma was a specific event occurring at a specific time and place in the past. In addition, you will also gain a new perspective on the memory and see that although memories can be very scary, they are not dangerous.
Cognitive Processing Therapy (CPT)
Cognitive Processing Therapy (CPT) is a time-limited, evidence-based treatment of approximately 12 hour-long sessions, scheduled once or twice a week. CPT helps people recover from the effects of a traumatic event by examining the impact of this event on their lives and then identifying and changing unhelpful beliefs and emotions (“stuck points”) related to the event, themselves, others, and the world. CPT begins with psychoeducation about PTSD and barriers to recovery, including the role of avoidance and stuck points. Patients are then asked to complete a brief writing assignment about how the traumatic experience(s) affects them, to help identify these stuck points. (Patients may choose to write an account of the traumatic event itself, but this is optional.) CPT helps individuals evaluate their beliefs about the trauma and consider alternative viewpoints of the event and the circumstances around it. As CPT progresses, individuals begin focusing on their beliefs within five specific domains: safety, trust, power and control, self-esteem, and intimacy. People often find that these areas of their lives have been meaningfully affected by traumatic events. Patients are asked to complete worksheets about their thoughts between sessions. CPT has shown to be effective for a variety of people, including individuals who struggle with substance use and those who have had several traumatic experiences. No matter the trauma or the ways it may be interfering with your life, CPT can help lessen feelings of anxiety, anger, guilt, and shame; reduce distress related to memories of traumatic events; and reclaim your life from the effects of trauma—even when this seems impossible.
Eye Movement Desensitization and Reprocessing (EMDR)
Eye Movement Desensitization and Reprocessing (EMDR) is an integrative trauma treatment supported by research. The model on which it is based, Adaptive Information Processing (AIP), posits that many of the symptoms that follow a traumatic or adverse life event are due to inadequate or incomplete processing of the event. During EMDR treatment, traumatic memories are processed as the therapist leads the patient in sets of eye movements (or other forms of bilateral stimulation) with appropriate shifts and changes of focus until distress surrounding the trauma is significantly reduced. This dual-attention method allows for natural adaptive processing of the painful memory while feeling safely grounded in the present. Common trauma symptoms for which EMDR therapy is used include: distressing recall of images or related memories, current attempts to avoid reminders of the event or triggers, mood symptoms, heightened anxiety and fear, hypervigilance, somatic complaints, negative self-concept, guilt and shame, flashbacks or nightmares related to the experience, heightened irritability and anger, difficulty sleeping, social disconnection or withdrawal, difficulty concentrating, and in some cases dissociation.
Skills Training in Affective and Interpersonal Regulation (STAIR)
Skills Training in Affective and Interpersonal Regulation (STAIR) is an evidence-based, time-limited treatment that addresses PTSD and complex trauma. STAIR teaches people skills, which a traumatized individual might not have learned due to early traumatic experiences or which may have diminished due to prolonged or chronic trauma later in life. STAIR is a two-phase treatment, each phase consisting of approximately 8 sessions. The first phase focuses on handling negative feelings, managing distress, and developing emotional awareness. Phase I also prepares you to work effectively in the more emotionally demanding Phase II, which involves discussion and analysis of painful memories of childhood trauma. The goal of Phase II, or Narrative Story Telling (NST), is to organize your memories of trauma and resolve your feelings about them, so that you are able to control the memories rather than the memories controlling you. In addition, the process of describing your past is a means by which you will be able to identify beliefs about yourself, as well as patterns of relating that might have been adaptive in abuse circumstances but are not helpful in current relationships. The skills training from Phase I will help you leave behind old patterns of functioning and develop interpersonal behaviors and emotion management strategies that are consistent with your current life goals. We offer both group and individual STAIR services.
Dialectical-Behavior Therapy - Prolonged Exposure (DBT-PE)
Dialectical-Behavior Therapy - Prolonged Exposure (DBT-PE) was developed for individuals suffering with PTSD, who could benefit from prolonged exposure therapy, but are not yet equipped with effective skills for managing painful emotional states. One way clients with PTSD typically learn to manage painful emotions is through avoidance. Unfortunately, while avoiding reminders of trauma can provide relief from distress in the short-term, it tends to prolong emotional suffering over time. In fact, avoidance (e.g, avoidance of trauma memory, avoidance of environments that are similar to location of trauma, etc.) has been identified as one of the factors maintaining PTSD symptoms. This is, in part, because avoidance strategies block new learning from occurring. Exposure strategies focus on guiding clients through approaching feared trauma related stimuli (that are uncomfortable for client due to trauma history, but are objectively safe). It is through this exposure experience, that clients learn and find out for themselves what happens when they refrain from avoiding feared situations (often learning that the situation was uncomfortable, but safe).
While highly effective, exposure therapy (approaching trauma related stimuli rather than avoiding), typically stirs up high levels of distress. With repeated exposure, clients habituate and emotional distress becomes easier to tolerate. However, for some clients the initial stages of treatment can feel intolerable. This is especially so when clients lack effective emotion regulation skills. Therefore, in DBT-PE, the Dialectical Behavior Therapy phase of the treatment protocol focuses on establishing a toolbox of healthy coping skills. These skills are designed to help clients stay connected to meaningful experiences in life (e.g., prolonged exposure therapy) even when they become emotionally painful. In DBT-PE, clients enter the exposure phase of therapy and begin addressing trauma once they have exhibited the ability to tolerate heightened distress levels.