At Psychustle we like to keep it real. Today I would like to share one of my greatest struggles as a relatively new therapist. We always hope that in being candid about our struggles, others facing similar challenges can find solace in knowing they are not alone.
While I do very much enjoy working with clients with trauma, I have found it to be particularly intimidating. Working with trauma definitely brings out the imposter syndrome on a different level than I have previously experienced. Part of this is personal, I will admit. I have experienced plenty of little-t-traumas in my life, but never any big-T-traumas. For this reason, I caught myself feeling inadequate as a therapist working with trauma clients. I worried about triggering the client unintentionally, saying the wrong thing, providing feedback that would damage the therapeutic relationship, etc. The more I worried, the more I felt my authentic self was retreating. I would clam up and subsequently be left feeling awkward and insufficient at the end of session.
As is usually my instinct, I began to do more research on working with trauma clients, consulted my supervisor, and spoke with some of my colleagues. I was able to develop a little toolbox of skills for working with trauma clients. It’s not a toolbox necessarily for directly treating the trauma, but rather for building on the therapeutic relationship, which is equally as important in addressing trauma as the modality chosen.
1. Avoid making statements such as “I totally understand what you’re going through.”
I owe this feedback to one of my clients, whom shared that therapists in the past have made statements like this and it has been extremely unhelpful, especially considering that she still had unaccessed traumatic memories from her childhood. “How could they understand what I’ve been through?” This resonated with me and I could see how such a statement could be very invalidating.
2. Let them know from the beginning that they are in the driver’s seat.
Most clients will not be ready to disclose the extent of their trauma from the beginning. The therapeutic bond will help to reveal that once the time is right. Remind clients that there is no pressure, and that you are there to listen and support when they are ready.
3. Be authentic.
Your client will be able to tell if you are being inauthentic. If you want more insight into something that they shared, ask. Don’t feel like you are walking on eggshells. If you second-guess every word you say, you won’t allow the therapeutic relationship to flourish.
4. Validate, validate, validate.
This in itself can be incredibly healing. Remind the client that their feelings are valid. You can use statements like “That must have been very difficult,” or “I can see how that would make you feel discouraged/angry/sad.” Moments of silence coupled with certain gestures/body language can also convey empathy and validation.
5. Have honest conversations.
Ask them from the beginning of the process what they need from you in order to feel safe and supported. If they don’t know, explore some different options with them.
One thing that is important to keep in mind is that if your client did not come to therapy to address their trauma, then we need to respect that. The trauma should be addressed only if the client is willing to.
Now, with regard to treatment planning, we will be posting a series of blog posts on approaches that are effective, however do keep in mind that it is important to have a plan in place. Most of the approaches that address trauma are pretty structured and we should determine which is the best fit and ensure that we have a plan in place that we are discussing with the client.
Finally, don’t be afraid to refer your client to a specialist if you feel it’s necessary. They may need something that you can’t offer them, such as EMDR. As much as we want to help everyone, it’s important that we keep in mind the client’s best interest.
All the best,
Your hustler,
Karina G.
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