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. Your mind and body may continue responding as if danger is still present.
You may experience 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 the event. You may understand exactly why you are struggling. You may also have difficulty connecting your current reactions to what happened.
Therapy can help you understand these responses without reducing you to what you survived.
Trauma and PTSD Are Not the Same
Trauma refers to the emotional, psychological, and physical effects of experiences that overwhelmed your ability to cope or respond. People can experience significant trauma-related distress without meeting the diagnostic criteria for post-traumatic stress disorder.
PTSD is a specific diagnosis. It can develop after exposure to actual or threatened death, serious injury, or sexual violence. Symptoms must meet particular diagnostic criteria and persist long enough to interfere with important areas of life.
Many people experience distress after a traumatic event. Not everyone develops PTSD. A diagnosis is not necessary before you seek therapy.
We can begin by discussing what you are experiencing and how it affects 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 or systems that were supposed to provide safety.
You do not have to prove that an experience was bad enough to discuss how it affected you.
How Trauma and PTSD May Appear
Trauma responses can affect thoughts, emotions, behavior, relationships, physical health, and the nervous system.
Experiences may include:
unwanted memories, nightmares, or flashbacks
feeling as if 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
These responses often developed as attempts to survive, protect yourself, or adapt to difficult circumstances. They may continue after the original danger has passed.
Understanding the purpose these responses once served 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.
Avoidance can gradually make life smaller. It may reinforce the belief that memories, emotions, or situations are impossible to tolerate. It can also interfere with relationships, work, sleep, healthcare, and activities that once mattered to you.
Trauma therapy does not require confronting everything at once. We can begin by noticing patterns of avoidance and understanding what they protect you from. Change can happen gradually at a pace that remains manageable.
Trauma-Informed and Trauma-Focused Therapy
Trauma-informed therapy and trauma-focused therapy are related but different.
A trauma-informed approach considers how past experiences may affect safety, trust, choice, relationships, and the therapeutic process. It emphasizes collaboration, consent, transparency, and respect for your limits.
Trauma-focused therapy addresses trauma memories, beliefs, emotions, and patterns more directly. This work may involve examining how the experience changed your understanding of yourself or the world. It may also involve approaching memories or situations that have been avoided.
Not every session needs to focus directly on the traumatic experience. Treatment can move between present-day concerns, practical coping, relationship patterns, nervous system responses, and deeper processing.
You Control the Pace
You do not have to describe every detail of a traumatic experience during the first session. You may never need to provide a complete chronological account.
We will begin by understanding what brings you to therapy, what currently feels difficult, and what you want from treatment. We can also discuss what helps you feel grounded and what makes therapy feel safer or more manageable.
You decide what you are ready to discuss. I will not push you to disclose details before you feel prepared. I will also be honest when avoidance appears to be limiting your life or interfering with your goals.
We can slow down when something feels too intense. We can also consider a different approach when a strategy does not feel useful.
Building Safety and Regulation
Some people begin trauma therapy by developing ways to respond to intense emotions, intrusive memories, dissociation, or physical activation.
This may include:
recognizing personal triggers and warning signs
orienting to the present environment
using grounding and sensory strategies
understanding nervous system responses
developing emotional-regulation skills
strengthening routines that support sleep and physical health
identifying supportive people and resources
practicing boundaries and communication
increasing tolerance for difficult emotions
creating a plan for periods of increased distress
Safety does not mean avoiding every uncomfortable experience. It means developing enough support, awareness, and choice to engage in therapy without becoming repeatedly overwhelmed.
Processing Trauma
Trauma processing can involve making sense of what happened and how it continues to affect you. It may include examining beliefs about safety, trust, responsibility, control, vulnerability, or self-worth.
People often carry shame or responsibility for events they did not cause. Others struggle with decisions they made while trying to survive. Therapy can provide space to consider these experiences within the context in which they occurred.
Processing does not erase memory or require forgiveness. It may help the memory feel less immediate. It may also reduce the degree to which the past controls present choices.
The goal is not 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. These experiences may begin during childhood or occur within relationships where escape felt difficult.
The effects may extend beyond fear-based symptoms. You may struggle with emotional regulation, trust, identity, shame, boundaries, relationships, or a persistent sense of worthlessness.
Some people use the term complex PTSD to describe these experiences. Diagnostic systems define complex PTSD differently. We can discuss symptoms and treatment needs without requiring you to adopt a particular label.
Therapy may require more time when trauma has shaped development, attachment, identity, or long-standing patterns of survival.
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 interactions within healthcare.
Trauma responses can make future appointments, procedures, examinations, or medical decisions more difficult. Chronic illness and pain may also keep a person in regular contact with reminders of what happened.
Therapy can address fear, mistrust, grief, anger, changes in identity, and the emotional burden of navigating healthcare. It can also support preparation for future appointments and communication about your needs.
Trauma, Identity, and Minority Stress
Trauma does not occur outside the social world. Identity, culture, discrimination, community, access to care, and systemic conditions can influence both the original experience and what happens afterward.
LGBTQIA+ people may experience rejection, harassment, violence, forced disclosure, conversion efforts, or discrimination. People may also encounter trauma related to racism, disability, poverty, religion, immigration, or other parts of life.
An affirming approach recognizes these contexts. Therapy should not frame understandable responses to harmful conditions as personal defects.
Trauma Across the Lifespan
I provide individual therapy for:
adolescents and teens ages 13 through 17
emerging and young adults
adults in midlife
older adults
Trauma may appear differently across the lifespan. Adolescents may experience changes in behavior, school performance, relationships, emotional regulation, or trust. Adults may struggle with work, intimacy, parenting, caregiving, health, or recurring patterns connected to earlier experiences.
Older adults may encounter new trauma or find that past experiences return during retirement, illness, grief, caregiving, or changes in independence. There is no age limit for addressing trauma.
Caregiver involvement for adolescents is considered according to age, clinical needs, safety, privacy, legal requirements, and individual circumstances.
My Approach to Trauma Therapy
My work is grounded in a humanistic and person-centered understanding of care. I approach trauma through collaboration, curiosity, compassion, and respect for autonomy.
Therapy may integrate cognitive and behavioral strategies, acceptance-based work, emotional-regulation skills, mindfulness, self-compassion, body awareness, and practical problem-solving. The approach can change as your needs change.
Some sessions may focus on coping with what is happening now. Others may involve understanding patterns or processing past experiences. We will continue evaluating what feels useful and what needs to be adjusted.
You are encouraged to ask questions, disagree, and tell me when something does not fit. Visit the Approach to Therapy page to learn more about how I work.
Online Therapy for Trauma and PTSD
Appointments take place through secure video. Online therapy may increase access to an appropriate trauma therapist when local options are limited. It may also reduce barriers related to transportation, chronic illness, disability, caregiving, or work.
Telehealth is not appropriate for every person or every stage of trauma treatment. We will consider privacy, current safety, dissociation, available support, technology, and your ability to remain present during sessions.
You must be physically located in a state where I am authorized to provide therapy at the time of your appointment. Visit the Online Therapy and Telehealth page for current availability and 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 a PTSD diagnosis. We can discuss your symptoms and determine whether further assessment may be useful.
A formal diagnosis may be required when insurance is used. Any diagnosis will be discussed as part of your care.
Will I have to describe the trauma in detail?
Not immediately. You control what you disclose and when you disclose it. Some approaches involve discussing or writing about traumatic experiences more directly. Other parts of therapy may focus on current symptoms, coping strategies, beliefs, relationships, or physical responses.
We will discuss the purpose of an intervention before using it.
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, and patterns that are 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. It also involves persistent difficulties with emotional regulation, self-concept, and relationships. It is recognized as a separate diagnosis within the International Classification of Diseases. It is not a separate diagnosis within the current Diagnostic and Statistical Manual of Mental Disorders.
A diagnostic label can guide understanding. It does not capture every part of a person’s experience.
Can trauma therapy make symptoms feel more intense?
Discussing trauma can sometimes increase emotional or physical activation. This does not mean therapy should repeatedly leave you overwhelmed.
We will monitor how the work affects you during and after sessions. Pacing, preparation, coping strategies, and recovery time are part of treatment planning.
Do you prescribe medication for PTSD?
No. As a licensed clinical social worker, I do not prescribe medication. You may speak with a physician, psychiatrist, or another qualified prescriber if you want a medication evaluation.
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 symptoms, goals, history, current circumstances, available support, and preferred approach.
A focused traumatic event may require different treatment than repeated or developmental trauma. We will review progress and treatment needs throughout our work.
What if trauma is connected to suicidal thoughts?
Suicidal thoughts can occur alongside trauma and PTSD. You can discuss them honestly in therapy. Visit the Therapy for Suicidal Ideation page to learn more about risk assessment, collaborative safety planning, and outpatient care.
Therapy with Z does not provide emergency or immediate crisis response. Call 911 or go to the nearest emergency department if you are in immediate danger or unable to remain safe. You may also call or text 988 in the United States.
Is online trauma therapy appropriate for everyone?
No. Some people need in-person treatment, more frequent support, intensive outpatient care, partial hospitalization, residential treatment, or emergency services.
Appropriateness is assessed individually. It 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.
Begin Therapy for Trauma and PTSD
You do not have to recount everything that happened before asking for support. We can begin with what is affecting you now and determine what may help.
If you believe my approach may fit what you need, you are welcome to request an appointment or contact me with questions.