In addition to using the techniques in "Treating Trauma Responses and Simple PTSD," complex post-traumatic stress disorder is often treated with a staged approach, such that different techniques and therapies are applied at different stages of treatment.
Staged trauma treatment
Three-stage trauma treatment is an approach often suggested for addressing complex PTSD or for people who have experienced childhood abuse. Information about this approach is available in an excerpt from First Stage Trauma Treatment: A Guide for Mental Health Professionals Working with Women (CAMH). The information provided does not apply exclusively to female clients.
Stage 1: Establishing safety; understanding and managing responses
The first stage of trauma therapy involves creating physical and emotional safety, psycho-education about trauma responses including flashbacks and dissociation, understanding and regulating emotions, developing supportive relationships, managing trauma responses using pharmacotherapy and/or relaxation, mindfulness and grounding techniques. Aspects of eye movement desensitization and reprocessing (EMDR) can be used here when clients focus on creating a safe place versus the actual processing of the trauma.
Stage 2: Uncovering, remembering and mourning; modifying and processing memories of traumatic events
The second stage involves grieving and processing traumatic memories. Cognitive behavioural therapy (CBT), EMDR, psychodynamic and body psychotherapies can be used at this stage.
Stage 3: Reconnecting and addressing life issues
The third stage includes working on improving relationships, work, family, spiritual and recreational aspects of life.
For further descriptions of the three stages of trauma therapy, see:
- Treatment of Complex Posttraumatic Self-Dysregulation (Christine Courtois)
- Trauma treatment: Let's not keep it a secret (Canadian Psychiatric Association: Canadian Psychiatry Aujourd'hui)