drheatherpoma

12 Feb, 2024

Blog

Trauma therapy is an area where psychological treatment can be extremely helpful. However, many people have a lack of understanding of what trauma therapy is, what it involves, and when it is helpful. Before we can discuss trauma therapy, however, we have to define the more basic term, trauma.

**Please note, that this article may be triggering to some people who have or are experiencing trauma.**

What is Trauma?

Trauma is a complex and multilayered response to a deeply distressing or disturbing event that overwhelms an individual’s ability to cope. It can cause feelings of helplessness, diminish a person’s sense of self and ability to feel a full range of emotions. It is not so much the event itself that defines trauma, but a person’s subjective experience of the event.

Events that can cause trauma include, but are not limited to, natural disasters, physical or sexual assault, war, torture, or the sudden death of a loved one. Some event must occur that causes someone to believe that they, or others they are close to, are in danger of imminent harm. That might be harm to life or limb, such as during military maneuvers. It might be a threat to personhood or security, such as an attempted sexual assault. It might mean watching someone else’s suffering, such as a comrade-in-arms or a dying child. However, it’s important to recognize that what might be traumatic to one person may not affect another person in the same way. This difference is because the impact of the event is influenced by a person’s history, beliefs, and coping mechanisms.

Trauma can manifest in many ways and can involve a variety of emotional, physical, and psychological symptoms. Common symptoms immediately after a traumatic event can include anxiety, depression, numbness, insomnia, and a persistent feeling of dread. Psychologists do not consider these symptoms to be problematic unless they persist for six months or more. Most people recover from trauma that they experience, after a time. Some, however, do not naturally recover. They avoid situations that remind them of trauma, are triggered by reminders of their traumatic experiences, and re-experience the trauma in various ways, including flashbacks or nightmares about these difficult events. These individuals are said to have developed PTSD (Post-Traumatic Stress Disorder).

What is PTSD?

Trauma can have long-term effects that might lead to post-traumatic stress disorder (PTSD), which involves prolonged reactions such as flashbacks, severe anxiety, and uncontrollable thoughts about the event. For these people, the normal symptoms that occur immediately following a trauma (such as difficulty driving by the scene of a terrible car accident they experienced) persist over time, or even get worse. For example, the person avoiding the site of their car accident might eventually avoid driving altogether. In order to be diagnosed with PTSD, symptoms must persist for at least 6 months following the trauma.

What is Trauma Therapy?

Trauma Therapy is an essential branch of psychological treatment that addresses the profound impact traumatic experiences can have on individuals

Photo by Alex Green on Pexels.com

Trauma therapy is an essential branch of psychological treatment that addresses the profound impact traumatic experiences can have on individuals. Over recent decades, this field of research has advanced significantly, with copious research increasing understanding of and mitigating the effects of trauma. Effective trauma treatments have arisen from this research base, and several specific modalities have risen to prominence due to their efficacy.

One such compelling treatment is Eye Movement Desensitization and Reprocessing (EMDR), a therapy designed to alleviate the distress associated with traumatic memories. By engaging the brain’s information processing system, EMDR assists people in reprocessing the trauma so that it can be integrated into their personal narrative in a less disruptive manner.

Cognitive Processing Therapy (CPT) is another method that has proven to be particularly effective in treating trauma¹. It is a cognitive-behavioral therapy that focuses on how traumatic events are construed and coped with by individuals. CPT helps patients learn how to challenge and modify unhelpful beliefs related to the trauma, ultimately aiding them in creating a new understanding of the traumatic event that leads to reduce symptoms of the trauma.

Prolonged Exposure Therapy (PE), another modality commonly employed, involves exposure to thoughts, feelings, and situations related to the traumatic event. Although facing these can be difficult, PE enables individuals to gradually approach trauma-related memories and stimuli, reducing their power over the individual’s life.

The process of trauma treatment typically involves a methodical progression, wherein patients must confront and interact with their traumatic experiences. This therapeutic journey aims to understand the impact of trauma on one’s life and relationships, thereby advocating for an amended approach to things that serve as triggers. Clients commonly report an initial uptick in symptoms, yet with steadfast treatment, clients generally report a gradual alleviation of symptoms, signaling healing and recovery.

How do I know if trauma therapy is for me?

If you find that your symptoms related to a trauma are impacting your daily functioning, you should consider trauma therapy. Even if the event was less than 6 months ago, trauma treatment can help individuals struggling with their symptoms. New research suggests immediate reactions, such as playing tetris after a traumatic event, can lessen the likelihood of developing PTSD², so seeking treatment immediately for the mental health effects, particularly if there are also physical health symptoms, can be helpful.

Healing from trauma is possible, though it often requires professional support. Therapies such as Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR), and certain types of medication can effectively treat PTSD symptoms. Additionally, support from family and friends, and engagement in a community can also play a significant role in recovery. Understanding trauma, recognizing its effects, and seeking appropriate treatment often move clients toward recovery and self-empowerment. This journey requires patience, understanding, and self-compassion, but through proper care and support, individuals can work through the effects of trauma and move towards healing.

What is PTSD Treatment like at Overcoming: Psychological and Relational Therapy Solutions, LLC?

Dr. Heather Poma exemplifies a practitioner who is well-versed in the nuances of trauma treatment, holding certification from the VA in Cognitive Processing Therapy as her primary modality of choice. Her expertise is not limited to this particular therapy, as she also boasts proficiency in Couples’ Therapy for PTSD, Cognitive Behavioral Therapy for Insomnia, and a diversity of other trauma-focused interventions. This extensive training ensures that Dr. Poma can provide comprehensive, individualized care to those she treats, using a multi-modal approach that best fits the unique needs of each patient.

Trauma therapy with Dr. Poma starts with the intake, in which there are often assessments targeted at trauma symptoms to complete even before the first therapy session. In the first session, Dr. Poma will ask you to give a brief summary of the traumatic event that occurred in your life. Most of the focus of this session will be on how those events have affected your life and functioning. Most trauma therapies to require clients to relive aspects of their traumatic memories, but one of the versions of CPT (CPT-C) does not have this requirement. Part of the initial evaluation is assessing what form of therapy would be best for you and your particular symptoms, experiences, and memories of the event. We will mutually develop a treatment plan that will work for you in the initial sessions, then begin trauma treatment. Most clients see an increase in their symptoms early in therapy, followed by a significant decrease that, for many, is long-lasting. Please reach out to Dr. Poma if you are interested in setting forth on this journey together. To learn more about Trauma treatment at Overcoming: Psychological and Relational Therapy Solutions, see our Trauma page (overcomingtherapist.com/trauma).

Gordon J. G. Asmundson, Audur S. Thorisdottir, Jacob W. Roden-Foreman, Scarlett O. Baird, Sara M. Witcraft, Aliza T. Stein, Jasper A. J. Smits & Mark B Powers (2019) A meta-analytic review of cognitive processing therapy for adults with posttraumatic stress disorder, Cognitive Behaviour Therapy, 48:1, 1-14, DOI: 10.1080/16506073.2018.1522371 ↩︎
Butler, O., Herr, K., Willmund, G., Gallinat, J., Kühn, S., & Zimmermann, P. (2020). Trauma, treatment and Tetris: video gaming increases hippocampal volume in male patients with combat-related posttraumatic stress disorder. Journal of psychiatry & neuroscience : JPN, 45(4), 279–287. https://doi.org/10.1503/jpn.190027 ↩︎

drheatherpoma

25 Jan, 2023

Blog

When I say that I specialize in couples’ therapy, what do I mean by that? How do I conceptualize what couples’ therapy looks like? What should you expect of couples’ therapy at overcoming? This post plans to answer all these questions.

I am a specialist in couples’ therapy for a few reasons. First, it’s something that I do often and really enjoy it. Practically, doing something often and well, as well as having it be a modality you’re passionate about, makes me somewhat of an expert. However, I have some additional credentials to show prospective clients that this is an area that I have expertise in. I’m licensed in my home state of Ohio as an Independently Licensed Marriage and Family Therapist-Supervisor. Not only am I a capable therapist, the state of Ohio trusts me to be able to supervise other Marriage and Family Therapists as well. I am also board certified as an expert in Couple and Family Psychology by the American Board of Professional Psychology. This involved a rigorous process of first being judged to have appropriate training in this area, then having my work reviewed and an oral exam by a panel of experts in this area. Thus, I am recognized by the marriage and family therapy world and the psychology world as an expert in this area. Finally, I’m certified in Hope-Focused Couples’ Therapy and Prepare-Enrich, as well as having training and experience using other forms of couples’ therapy as well, including Couples Therapy for PTSD, Integrative Behavioral Couples Therapy, Emotion-Focused Therapy techniques, Behavioral Couples’ Therapy techniques, and Gottman techniques.

During therapy with a couple, instead of seeing either partner as my client, I instead treat the relationship as my client. This often means that I ask both members of the couple to do things that are difficult for them individually, but are beneficial to the relationship. Couples’ therapy often focuses on issues from the couples’ past, including trauma or infidelity, that impact their current relationship. Couples’ therapy often integrates the sexual aspect of the relationship. Couples’ therapy is often a difficult process, so I encourage couples to spend time positively together outside of therapy, doing things such as date nights and having administrative meetings to help their home run more effectively. I encourage couples to have daily check-ins with one another as well.

At Overcoming: Psychology and Relational Therapy Solutions, LLC, we focus on a thorough assessment. For couples’ therapy, the typical process starts with one partner calling and doing a short (10-15 minute) phone conversation. However, you can email and start the process that way as well. I’ll ask both partners to fill out paperwork, and may have some feedback prior to our initial session. Often, the next step is that I have a 1-hour session with you as a couple. During this session we discuss your relationship history and difficulties currently leading you into therapy. We discuss confidentiality and the philosophy of couples’ therapy as well as privacy concerns unique to seeing couples. During this session, the couple is evaluating whether they think I can help them, and I am making a similar evaluation of whether I think my form of couples’ therapy would be effective for this couple. Assuming that we agree that I can be helpful to this couple, I will send some individualized assessment measures to each partner. Then I meet with each partner individually for an official intake session, lasting 1 hour, during which I will discuss your individual relationship history and family of origin. Sometimes this takes more than one session. From then on, I typically meet with couples together unless there are situations that merit meeting with one partner individually for a time. Typical couples’ therapy sessions are 45-50 minutes long. I typically assign homework every week of exercises to do individually or as a couple.

I hope if you’re considering seeing me for couples’ therapy, this post has been helpful in making the determination of whether I’m the right therapist for you. I do see couples that are separated geographically through telehealth. As a PsyPact provider, I can practice in most states (for the current list, see https://psypact.org/page/psypactmap). Please reach out if I can help you in this way.

drheatherpoma

2 May, 2022

Blog

In the past month, I’ve completed a year long process in becoming certified by the American Board of Couple and Family Therapy (ABCFT). This is a board of professional psychologists who recognize their peers who are experts in the field of couple and family therapy. I’m proud to be newly a part of this program, I am pleased to be seen as an expert in the field. I have worked really hard on this process for several years, pursuing training experiences working with many different types of couples’ counseling. I am grateful to the Board and I’m looking forward to working with them for many years to come.

You can get information on this accomplishment by looking at the ABCFP website here:

https://abpp.org/Applicant-Information/Specialty-Boards/Couple-and-Family-Psychology.aspx

I’ve worked with couples since before entering graduate school. I actually volunteered at the SmartMarriages Conference prior to attending graduate school, so started out with a good basis in marriage education. I have been involved with the Hope Project for many years. This is a clinical research project that has worked to develop and refine an evidence-based treatment in marital therapy. Operated out of Regent University in Virginia Beach, VA, this program offers couples therapy to those who agree to be part of the project. You can get more information about being a part of the project as a couple or getting training in this area as a therapist at www.hopecouples.com. The Hope Couples project is also offered by the Charis institute, which focused on bringing churches, counselors, and other helpers together to support marriage holistically throughout the community; you can get more information as well as sign up for continuing education opportunities at https://charis.regent.edu/

After not only counseling couples but also supervising other therapists conducting marriage counseling through the Hope Program, I sought out additional training from an AAMFT-approved supervisor and also sought out VA experience working with couples through the Family Services program within the Dayton VA as well as seeking additional training in IBCT and in Couples’ Therapy for PTSD while there, using these areas of training to help veterans and their partners.

After internship, I was supervised for an extra year, completing a postdoc so that I could be licensed as both a marriage and family therapist as well as a psychologist, and eventually gaining credentialing to supervise other MFTs in Ohio. Couples therapy has been part of my passion from my earliest days in the field, and is something I hope to continue to focus on throughout my careers. In recent years I’ve gotten specific training on working virtually with couples and on issues such as infidelity. Please reach out if you’d like to learn more about couples counseling with me.

#HopeCouples #MMATECenter #OvercomingTherapist #ABPP #ABCFP #CouplesTherapy #MarriageTherapy #MaritalTherapy

drheatherpoma

16 Aug, 2021

Blog

Star Behavioral Health Providers Training

In February I completed a training with Star Behavioral Health Providers (SBHP). This training is intended for civilians who are interested in working with military and veterans. Although I have a leg up because of my background in the military, I’m learning a lot of more recent data from when I was discharged and working with the military every day as a mental health specialist. The information that they’re covering covers these areas:

– sleep disorders

– brain injury and concussion

– alcohol and drug use

– military family life

– Post-Traumatic Stress Disorder (PTSD) assessment and treatment

– suicide

– ethical issues specific to military/veteran populations.

I’m excited to get updated information about trauma, more understanding of the newer research on TBIs, getting more information about sleep disorders and substance use in this population, and suicide. I’m particularly excited that they are covering information important in working with military families. As someone who works with military individuals and people with trauma and has a great interest in families, I’m so glad to see this issue being covered more.

Some take home points in each area:

Sleep disorders have a lot of overlap with most other mental health issues. In many cases the sleep disorders resolve if we address the mental health issue, but if they don’t resolve there are very effective treatments for them on their own. Many individuals have sleep disorders such as sleep apnea that need to be addressed medically before we point to a mental health issue.

Most brain injuries in military populations are NOT incurred during deployments-they’re often in training accidents or motor vehicle accidents. There is a large overlap with TBI and other mental health conditions; many people struggle with both.

Most individuals with a substance use problem also have experienced a traumatic event in their life, indicating that SUDs are related to trying to cope with difficult events.

We need to carefully assess for suicidality and work with a client to help them come up with a plan that works for them to get through a suicidal crisis. Working on a coping plan together means working with them to see what kinds of music will help them when they are stressed, because music is a “mood amplifier.” We need to make our plan as easy as possible and assess for how likely people are to follow through and figure out where the safety plan would be kept and make the plan uniquely tailored to them, letting them write it out themselves. The areas to use in making a safety plan are looking at warning signs, internal coping strategies, distractions, family/friends, emergency contacts, and safe environment.

Ethical topics covered included dual relationships and dilemmas regarding disposition-driven diagnoses.

And my specific interest, in military families there is indication that more time deployed indicates more likelihood of divorce, but that there are several factors that make couples less likely to struggle in this area. If military spouses use task-oriented coping, have a sense of social support from family and friends, and have a perceived sense of military community. Military children are generally resilient; although they have more stressors than nonmilitary families, they also have access to additional resources and supports. Things that military families experience that most others don’t include frequent moves (PCSes), difficulty finding spouse employment opportunities, frequent deployments, extended separation, and transitioning out of the military. Things to build family resilience include improving physical and mental health, improving communication and problem-sharing, improving support system, and improving organizational patterns and identifying meaning and purpose to a military family identity.

Over the next few weeks, I’m going to try to add some of the resources that have come from this training to our website, with a collection for each area of training, since it’s all top of mind right now. Because of my focus in military families on this post, I want to link to some family resources today.

Here’s a link to some apps that are free to download for military families with children based on sesame street. https://sesamestreetformilitaryfamilies.org/mobile-apps/ If you click the link at the top left (“for military families”), you can access a lot more information for military families.

Operation Purple-free summer camps for military children:

https://www.militaryfamily.org/programs/operation-purple/operation-purple-camp/?gclid=Cj0KCQiAvbiBBhD-ARIsAGM48bxiK27NcK0bfmio1uJ7yVYQkzYdmFo4A7kIQfO6BLPX7MVxCqmp4H0aAte3EALw_wcB

FOCUS (Families Overcoming Under Stress) trains military families (including couples and children) on issues such as emotion regulation, communication, problem-solving, goal setting, managing deployment, and includes a free mobile apps and online training. https://focusproject.org/

I hope this helps some of you that are looking for resources!

And I wanted to show myself as an Army mental health specialist, and encourage you to reach out for support if you need it. The above resources are all free and available for any military families.

#SBHP #militaryfamilies #training #PTSD #sleep #SUDs #TBI #concussion #sleepdisorders #trauma #music #resilience #FOCUS #OperationPurple #SesameStreet