CBT for trauma and PTSD

Trauma can affect life in different ways

• Memories, nightmares or a feeling of reliving what happened arrive without warning.
• Reminders are avoided, even when that means losing important parts of everyday life.
• The body remains alert to danger, making sleep, concentration or relaxation difficult.
• Guilt, shame, anger or a changed sense of self persist after the event.

What trauma-focused CBT may involve

Trauma-focused CBT is more than recounting a difficult event. It begins with a shared understanding of current symptoms, coping and safety. Treatment may then help a memory feel located in the past, examine meanings attached to what happened, and gradually reclaim situations that are safe but have become associated with danger.

The work should have a clear rationale and be undertaken with consent. It does not require disclosing every detail immediately, and concerns about pace or the online setting should be part of the assessment.

Why fit and timing matter

We would consider current safety, stability, support, privacy for online sessions and whether another service should be involved. If trauma-focused CBT is not appropriate at this point, that is a useful clinical conclusion rather than a failure to begin.