First-Stage Trauma Treatment

The first-stage of treatment is dedicated to reducing and stabilizing clients’ responses to trauma in order to improve the quality of their everyday life. This is often the most complex and lengthiest stage of the therapeutic work.

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The goal is to help survivors of abuse-related trauma to recognize that their difficulties do not stem from their own personal deficiencies, rather from the adaptations they were required to make to survive the violence they have experienced.

Essential Components of First-Phase Trauma Treatment

  • Establishing a therapeutic alliance
  • Promoting client safety
  • Addressing the client’s immediate needs
  • Normalizing and validating the client’s experiences
  • Educating the client about post-traumatic stress and treatment
  • Using a gender-sensitive approach so that the damaging ways that traditional socialization and gender inequality affect women’s lives are recognized in therapy
  • Nurturing hope and emphasizing client’s strengths
  • Collaboratively generating treatment goals
  • Teaching coping skills and managing post-traumatic stress responses (intrusive ideation, hyperarousal, avoidance, dissociation)

Key Goals for Helping Women in First-Phase Trauma Treatment

  • Increasing clients’ sense of control over their lives, by familiarizing them with post-traumatic responses and the reasons for those adaptations
  • Helping clients learn coping skills. Some clients will need to tend to neglected medical problems and learn the basics of self-care; for example, proper eating and sleeping habits.
  • Helping women recognize that their lives are profoundly shaped by the contexts within which they live. This includes an understanding that prejudice based on gender, race, class, ethnicity, sexual identity, age and disabilities can contribute to, or is the basis of, the difficulties women experience.
  • Increasing clients’ sense of safety in their work, home and living environments by helping them to identify areas of potential danger or victimization and take active steps to protect themselves.
  • Helping clients identify their own responses to trauma and reframe them in a less blaming way.
  • Helping clients see how their current life struggles have been affected by the trauma and its after-effects.
  • Supporting clients as they attempt to form healthy relationships with other people.

(Adapted from Lori Haskell, 2003-First Stage Trauma Treatment: A Guide for Mental Health Professionals Working with Women, pg 65-66)

Asking the Question

All women who access mental health and/or addictions services should be routinely screened for abuse. Asking the question about abuse does not mean that a helping professional needs to start practising exploratory work.