The method I have expertise in is a five step approach using cognitive behavioural therapy, as CBT has shown to work in many specialist counselling situations. I also offer telephone counselling sessions for clients who may be agoraphobic, disabled, live in remote areas, housebound, have young children or busy work schedules or just prefer telephone counselling sessions as their therapy of choice.
Stage One: The first aim is for the counsellor in the therapy sessions is to establish a strong working relationship with the client and second to support them to tell their story in their own way and time. Feelings the client shows should be respected and supported, and the desire for physical comfort, rest and safety should be considered. The clients strengths need to be assessed by the therapist and information on trauma and PTSD given. Importantly the clients reactions should be seen as normal and natural, and their is hope in the future.
Stage Two: The client is helped to make some sense out of their own unique event, and this will help in reducing the severity of any reactions. New coping skills are taught in therapy which are directly related to their own symptoms by the counsellor. Reactions such as avoidance behaviour, arousal and re-experiencing all or parts of the traumatic event are treated with cognitive behavioural therapy techniques by the counsellor.
Stage Three: The therapist should continue to assist the client in making sense of the event through cognitive restructuring therapy helping the client to look at the event in a more rational, realistic way with the counsellor making sure the client eventually has some element of control when re telling the story. More cognitive behavioural therapy is used by the counsellor to expose the client to the trauma to help replace or rebuild shattered beliefs. At this stage there should be emerging feelings of positive learning and personal growth: unique strengths the client have should be used and encouraged.
Stage Four: With the help of the counsellor the client should be able to re-establish relationships with friends and family, and to get back feelings of trust. On re-assessment in therapy by the therapist there should be no chance of re-victimisation, and the client may even start helping others that have gone through comparable trauma, with the client regaining and rebuilding any lost confidence, self esteem or self worth.
Stage Five: Self confidence should carry on increasing, and future strategies for preventing possible relapse should be worked on by client and counsellor. Further therapy sessions, if needed, should be arranged with the counsellor.
Summary of goals
The therapist reassures the client that the reactions the are having are normal in the current situation.
The counsellor helps the client to recognise triggers and stress responses; to help them to understand why they react the way they do, and to get back some control of their life.
The therapist works with the client in therapy to make sense of their reactions and experiences, and to build up the feeling of coping and using their experiences in everyday, normal life.
The counsellor inspires hope for the future as quite often clients feel that there is none. The counsellor explains that though the client will never forget the event, and even though the incident will be a permenant part of their experience of life, they will cope and move forward.