Therapy for Trauma and PTSD
Individualized online therapy for adolescents, adults, and older adults affected by trauma, PTSD, or difficult past experiences
When the Past Still Feels Present
Traumatic experiences can change how you understand safety, trust, relationships, your body, and yourself. The event may be over while your mind and body continue responding as though danger is still present. You may experience unwanted memories, nightmares, physical reactions, emotional numbness, or a constant need to remain alert. Certain sounds, places, people, sensations, or situations may trigger reactions that seem sudden or difficult to control.
Some people remember what happened clearly. Others recall only pieces or experience uncertainty about parts of an event. You may understand exactly why you are struggling, or you may have difficulty connecting your current reactions to what happened. Therapy can provide space to understand these responses without reducing you to what you survived.
Trauma and PTSD Are Not the Same
Trauma refers broadly to the effects that overwhelming or threatening experiences can have on psychological, emotional, physical, and relational well-being. People can experience significant trauma-related distress without meeting diagnostic criteria for post-traumatic stress disorder.
PTSD is a specific mental health diagnosis associated with exposure to actual or threatened death, serious injury, or sexual violence. Diagnosis involves particular patterns of symptoms, duration, and impact on functioning. Many people experience distress after traumatic events without developing PTSD, and you do not need to determine whether you have PTSD before seeking therapy. We can begin by understanding what you are experiencing and how it is affecting your life.
Trauma Can Take Many Forms
People may seek trauma therapy after experiences such as:
abuse, assault, or interpersonal violence
accidents, injuries, or natural disasters
childhood abuse, neglect, or instability
frightening medical procedures or hospitalizations
sudden loss or exposure to death
repeated relational harm or betrayal
community violence or discrimination
military service or emergency-response work
witnessing harm to another person
caregiving during a prolonged illness or crisis
a mental health crisis, suicide attempt, or hospitalization
repeated experiences that created fear, helplessness, or loss of control
Some traumatic experiences happen once. Others continue over months or years. Trauma may occur within relationships, institutions, communities, or systems that were expected to provide safety. You do not have to prove that an experience was “bad enough” before discussing how it affected you.
How Trauma and PTSD May Appear
Trauma-related responses can affect thoughts, emotions, behavior, relationships, physical health, and your sense of safety in the world.
Experiences may include:
unwanted memories, nightmares, or flashbacks
feeling as though an event is happening again
avoiding thoughts, emotions, people, places, or situations
feeling constantly alert or prepared for danger
being easily startled
irritability, anger, or emotional reactivity
difficulty concentrating or making decisions
disrupted sleep
shame, guilt, blame, or negative beliefs about yourself
difficulty trusting other people
emotional numbness or disconnection
loss of interest in relationships or activities
feeling detached from your body or surroundings
physical tension, pain, nausea, or changes in breathing
anxiety, depression, or suicidal thoughts
difficulty remembering parts of an experience
using work, substances, isolation, or constant activity to avoid reminders
Many of these responses developed as attempts to survive, protect yourself, or adapt to difficult circumstances. They may continue even after the original danger has passed. Understanding what these responses may have been trying to accomplish can create a more compassionate place to begin.
Avoidance and Feeling Stuck
Avoiding reminders of trauma can provide temporary relief. You may stay away from certain places, shut down emotions, avoid relationships, or keep yourself constantly occupied. Over time, avoidance can make life smaller. It may reinforce the sense that certain memories, emotions, sensations, or situations are impossible to tolerate and interfere with relationships, work, sleep, healthcare, or activities that matter to you.
Trauma therapy does not require confronting everything at once. We can begin by noticing patterns of avoidance, understanding what they may be protecting you from, and deciding together where change might be useful. Progress can happen gradually without making overwhelming yourself the measure of whether therapy is working.
Trauma-Informed and Trauma-Focused Therapy
Trauma-informed therapy and trauma-focused therapy are related, but they are not the same thing. A trauma-informed approach recognizes how past experiences may affect safety, trust, choice, relationships, communication, and the therapeutic process itself. Collaboration, informed consent, transparency, autonomy, and respect for your limits are part of how therapy is conducted rather than techniques reserved for particular sessions.
Trauma-focused therapy addresses traumatic experiences and their continuing effects more directly. Depending on the approach and your needs, this may involve working with memories, beliefs, emotions, patterns of avoidance, physical responses, or changes in how you understand yourself and the world.
Not every session needs to focus directly on trauma. Treatment may move among present-day concerns, coping and regulation, relationships, practical problems, nervous system responses, and deeper processing. What we focus on can change as your needs change.
You Control the Pace
You do not have to describe every detail of a traumatic experience during the first session, and therapy does not necessarily require a complete chronological account of everything that happened. We can begin by understanding what brings you to therapy, what currently feels difficult, what you want from treatment, and what helps you feel safer or more able to remain engaged.
You have choices about what you disclose and when. I will not push you to provide details simply because I believe trauma therapy is supposed to look a particular way. I will also be honest when avoidance appears to be limiting your life or interfering with goals that matter to you. We can talk about why I am recommending something, what it is intended to accomplish, what alternatives may exist, and whether you want to proceed.
Pacing is collaborative rather than passive. We can slow down when something becomes too intense, continue when difficult work remains manageable and purposeful, and change approaches when something is not helping.
Building Safety and Regulation
Some people begin trauma therapy by developing ways to respond to intense emotions, intrusive memories, dissociation, physical activation, or periods when it becomes difficult to remain connected to the present. This may involve recognizing personal triggers and warning signs, orienting to the present environment, exploring grounding or sensory strategies, understanding nervous system responses, developing emotion-regulation skills, strengthening supportive routines, identifying people and resources you can turn to, practicing boundaries and communication, or increasing your capacity to experience difficult emotions without becoming overwhelmed.
Safety does not mean avoiding every uncomfortable experience or eliminating distress before deeper work can begin. It means developing enough awareness, support, choice, and capacity to participate in therapy without repeatedly becoming overwhelmed. Different strategies work for different people. We can explore options, notice how you respond, and keep, adapt, or discontinue practices based on what we learn.
Processing Trauma
Trauma processing can involve making sense of what happened and understanding how it continues to affect your life. Depending on your experiences and the approach we use, this may include examining beliefs about safety, trust, responsibility, control, vulnerability, or self-worth; working with memories and emotional responses; noticing patterns of avoidance; or exploring how past experiences influence present relationships, choices, and reactions.
People sometimes carry shame or responsibility for events they did not cause. Others struggle with decisions they made while trying to survive circumstances in which their choices were limited. Therapy can provide space to understand those experiences within the context in which they occurred rather than judging past actions solely from the safety or knowledge available in the present.
Processing does not erase memory, require forgiveness, or guarantee that an experience will no longer matter. It may help the memory feel less immediate, reduce distress associated with reminders, change beliefs that developed because of what happened, or reduce the degree to which the past determines present choices. The goal is not necessarily to return to the person you were before the trauma. Our work can focus on helping you live more fully as the person you are now.
Complex and Repeated Trauma
Complex trauma generally refers to repeated, prolonged, or interpersonal traumatic experiences, particularly when those experiences occur within relationships or circumstances where safety, autonomy, or escape may be limited. These experiences may begin during childhood or occur later in life.
The effects can extend beyond the symptoms commonly associated with fear and traumatic memories. You may experience difficulties with emotion regulation, trust, relationships, boundaries, identity, shame, self-worth, or feeling safe with other people. When trauma has shaped development, attachment, identity, or long-standing patterns of survival, therapy may require more time and may need to address several interconnected areas rather than focusing on a single event.
Some people use the term complex PTSD, or C-PTSD, to describe these experiences. Diagnostic systems do not classify complex PTSD in the same way. We can discuss symptoms, experiences, and treatment needs without requiring you to adopt a particular diagnostic label.
Medical Trauma and Chronic Health Conditions
Medical trauma may develop after frightening procedures, severe illness, hospitalization, injury, inadequate pain control, loss of bodily autonomy, or harmful experiences within healthcare. Trauma responses can make future appointments, procedures, examinations, or medical decisions more difficult. Chronic illness and pain may also require ongoing interaction with healthcare systems or expose you repeatedly to reminders of frightening experiences.
Therapy can provide space to address fear, mistrust, grief, anger, changes in identity, uncertainty, and the emotional burden of navigating healthcare. It may also support preparation for future appointments, communication about your needs, self-advocacy, and decisions about care while recognizing that psychological support does not make physical symptoms or medical realities less real.
Trauma, Identity, and Minority Stress
Trauma does not occur outside the social world. Identity, culture, discrimination, community, access to care, socioeconomic circumstances, and systemic conditions can influence both traumatic experiences and what happens afterward.
2SLGBTQIA+ people may experience rejection, harassment, violence, forced disclosure, conversion efforts, discrimination, or other threats to safety and belonging. People may also encounter trauma related to racism, disability, poverty, religion, immigration, or other aspects of their lives and identities. An affirming approach recognizes these contexts rather than treating understandable responses to harmful experiences or environments as personal defects.
Your identities do not need to become the focus of therapy simply because they are important parts of who you are. When identity-related experiences are relevant, therapy can provide space to explore safety, relationships, belonging, discrimination, community, self-understanding, and the ways those experiences intersect with trauma.
Trauma Across the Lifespan
I provide individual therapy for adolescents age 13 and older, adults, and older adults. Trauma can affect people differently across the lifespan. Adolescents may experience changes in behavior, school performance, relationships, emotion regulation, identity development, or trust. Adults may notice effects in work, intimacy, parenting, caregiving, health, relationships, or recurring patterns connected to earlier experiences. Older adults may encounter new trauma or find that previous experiences become more prominent during illness, grief, caregiving, retirement, changes in independence, or other transitions.
These are possibilities rather than assumptions about how trauma should affect someone at a particular age. There is no age limit for addressing experiences that continue to affect your life. For adolescent clients, caregiver involvement is considered according to age, clinical needs, safety, privacy, applicable requirements, and individual circumstances.
My Approach to Trauma Therapy
My approach is humanistic, person-centered, strengths-based, trauma-informed, collaborative, and integrative. Trauma treatment should not require you to surrender autonomy in order to receive professional guidance. I want you to understand the treatment you are participating in, the options available to you, why I may recommend something, and what we hope an intervention will accomplish.
Depending on your needs and goals, our work may draw from person-centered therapy, MI, CBT, DBT, ACT, CFT, MBCT, EMDR, mindfulness, somatic and mind-body practices, behavioral strategies, and other evidence-based and research-informed approaches. Different interventions have different purposes, and no single method is appropriate for every person or every traumatic experience.
We can approach treatment with curiosity. If an intervention helps, we can consider what made it useful and whether that tells us something about other approaches that may fit you. If something does not help, feels inaccessible, conflicts with your values, or makes it harder for you to participate meaningfully in therapy, we can use that information too. You are encouraged to ask questions, disagree, request another approach, and tell me when something does not fit.
Trauma therapy can involve difficult work, and collaboration does not mean I will never challenge you. It means that challenge occurs within a therapeutic relationship where your autonomy, consent, feedback, goals, and understanding of your own experience remain important.
Online Therapy for Trauma and PTSD
Appointments take place through secure video. Online therapy may increase access to trauma treatment when appropriate local options are limited or when transportation, chronic illness, disability, caregiving, work, geography, or other circumstances make office-based care difficult.
Telehealth is not appropriate for every person or every stage of trauma treatment. We can consider privacy, current safety, dissociation, available support, technology, your ability to remain engaged during sessions, and other factors that may affect whether outpatient telehealth is an appropriate setting for your care.
Therapy with Z provides online psychotherapy in Oklahoma, Florida, South Carolina, and Idaho. You must be physically located in a state where I am authorized to provide psychotherapy at the time of your appointment. Visit the Online Therapy and Telehealth page for current availability and more information about virtual sessions.
Frequently Asked Questions
Do I need a PTSD diagnosis to begin trauma therapy?
No. You may seek therapy for trauma-related distress without having a PTSD diagnosis. We can begin by discussing what you are experiencing and determine whether further assessment may be useful. A formal diagnosis may be required when insurance is used, and any diagnosis will be discussed as part of your care.
Will I have to describe the trauma in detail?
Not necessarily. You have choices about what you disclose and when. Some therapeutic approaches involve discussing, writing about, or otherwise engaging more directly with traumatic experiences. Other parts of treatment may focus on current symptoms, coping strategies, beliefs, relationships, behaviors, or physical responses.
We will discuss the purpose of an intervention before using it so that you can make an informed decision about participating.
What if my memories are incomplete?
Incomplete, fragmented, or uncertain memories can occur after trauma. Therapy does not require you to recover every memory or establish a perfect account of what happened. We can work with the experiences, symptoms, emotions, beliefs, and patterns affecting you now. Therapy should not pressure you to produce memories that are unavailable.
Is complex PTSD different from PTSD?
Complex PTSD includes the central features of PTSD along with persistent difficulties involving emotion regulation, self-concept, and relationships. It is recognized as a separate diagnosis within the International Classification of Diseases but is not a separate diagnosis within the current Diagnostic and Statistical Manual of Mental Disorders.
A diagnostic label can sometimes help organize information and guide treatment. It does not capture every part of a person's experience.
Can trauma therapy make symptoms feel more intense?
Discussing or processing trauma can sometimes increase emotional or physical activation. Difficult work is not necessarily harmful, but therapy should not repeatedly leave you overwhelmed without considering what needs to change.
We can pay attention to how the work affects you during and after sessions. Pacing, preparation, coping strategies, recovery, and your feedback can all inform treatment planning.
Do you prescribe medication for PTSD?
No. As a licensed clinical social worker, I do not prescribe medication. If you are interested in medication evaluation or management, you can speak with a physician, psychiatrist, or another qualified prescriber. Coordination with another healthcare professional may occur when appropriate and authorized by you.
How long does trauma therapy take?
There is no universal timeline. The length of therapy depends on your concerns, goals, history, current circumstances, available support, preferred approach, and response to treatment. Treatment focused on a particular traumatic event may look different from therapy addressing repeated, developmental, or long-standing trauma. We can review progress and treatment needs throughout our work.
What if trauma is connected to suicidal thoughts?
Suicidal thoughts can occur alongside trauma, PTSD, depression, and other forms of distress. You can discuss suicidal thoughts honestly in therapy. We can explore what you are experiencing, assess safety, identify protective factors and supports, and collaboratively determine appropriate next steps.
Therapy with Z does not provide emergency or immediate crisis response. If you are in immediate danger or unable to remain safe, call 911, go to the nearest emergency department, or call or text 988 in the United States.
Is online trauma therapy appropriate for everyone?
No. Some people may need in-person treatment, specialized assessment, more frequent support, intensive outpatient care, partial hospitalization, residential treatment, emergency care, or another level of support. Appropriateness is assessed individually and may change as symptoms or circumstances change.
How do I begin?
You may request an appointment through the secure scheduling system. Current rates, insurance information, and payment options are available on the Rates and Insurance page.
Related Resources for Trauma and PTSD
Explore additional coping skills that may help you respond to difficult emotions, reconnect with the present moment, and care for yourself during periods of distress.
The Container Exercise: A visualization practice for temporarily setting aside distressing material when you need to focus on the present.
Self-Soothing: A DBT skill that uses comforting sensory experiences to support emotional regulation.
Self-Compassion Break: A mindfulness practice for responding to difficult emotions and self-criticism with kindness and understanding.
These resources are optional. A practice that feels helpful for one person may not feel comfortable or appropriate for another. For additional grounding and emotional regulation strategies, visit the Coping Skills & Exercises library. You can choose practices that feel appropriate for your needs, preferences, and sense of safety.