Therapy for Trauma in Providence

Therapy for Trauma in Providence: Understanding PTSD and Finding Effective Treatment

If you've experienced something traumatic—whether it was a car accident, sexual assault, combat, a natural disaster, or any other life-threatening or deeply disturbing event—you know that the experience doesn't just end when the danger passes. For some people, the traumatic event continues to affect daily life weeks, months, or even years later through intrusive memories, nightmares, hypervigilance, and a persistent sense that something terrible might happen at any moment. When these trauma symptoms persist for more than a month and significantly interfere with your ability to function, you may be experiencing post traumatic stress disorder (PTSD).

PTSD is a mental health condition that can develop in people who have experienced or witnessed a traumatic event. While it's normal to feel anxious, scared, or on edge immediately after trauma, PTSD is diagnosed when these reactions don't fade with time and instead continue to disrupt your life. The good news is that effective therapy for trauma exists, and with the right treatment approach, most people with PTSD experience significant improvement in their symptoms and quality of life.

At the Providence Therapy Group, our therapists understand that trauma affects not just your thoughts but your entire nervous system, your sense of safety in the world, and your relationships with others. Located in Cumberland, Rhode Island and Providence, Rhode Island, we provide evidence-based trauma therapy for individuals throughout the Providence area who are ready to heal from traumatic experiences and reclaim their lives.

Understanding Post Traumatic Stress Disorder

Post traumatic stress disorder (PTSD) is classified in the Diagnostic and Statistical Manual of Mental Disorders as a trauma and stressor-related disorder. According to the American Psychiatric Association, PTSD can occur in people of any ethnicity, nationality, culture, and age who have experienced or witnessed a traumatic event such as actual or threatened death, serious injury, or sexual violence.

Research shows that approximately 61% to 80% of people experience a traumatic event at some point in their lives. However, not everyone who experiences trauma will develop PTSD—it occurs in about 5% to 10% of people who experience a traumatic event. The lifetime prevalence of posttraumatic stress disorder in the United States is estimated to be around 6%, with women being more likely than men to develop PTSD.

What determines whether someone will develop PTSD after a traumatic event? Multiple risk factors play a role, including the severity and duration of the traumatic experience, whether the person experienced severe injury, prior trauma exposure, lack of social support following the trauma, pre-existing mental health problems, and family history of anxiety disorders or depression. Certain types of traumatic events—particularly those involving interpersonal violence like sexual assault or physical abuse—carry higher risk for developing posttraumatic stress disorder than other types of trauma.

PTSD is associated with changes in both the functioning and anatomy of the brain, particularly in areas involved in fear processing, emotion regulation, and memory. Research has identified alterations in brain structures including the amygdala (which processes fear), the prefrontal cortex (which regulates emotions), and the hippocampus (which processes memory), helping explain why people with PTSD often feel stressed or frightened even when they are no longer in danger. Their nervous system has become hypersensitive to potential threats, and their brain continues to process the trauma memory as if it's happening in the present moment rather than being safely in the past.

The Four Categories of PTSD Symptoms

The symptoms of PTSD fall into four main categories, and to meet diagnostic criteria for posttraumatic stress disorder, a person must experience symptoms from each category for more than a month, with symptoms severe enough to interfere with daily functioning.

1. Intrusion Symptoms

Intrusion symptoms involve unwanted, distressing memories or reminders of the traumatic event that feel like they're intruding into your present life. These can include:

• Recurring, involuntary, and intrusive distressing memories of the traumatic event

• Traumatic nightmares or dreams related to the trauma

• Flashbacks where you feel as if the traumatic event is happening again

• Intense psychological distress when exposed to reminders of the trauma

• Physical reactions (racing heart, sweating, panic) to trauma reminders

These intrusive symptoms can make it feel impossible to move on from the traumatic experience because your brain keeps replaying the trauma memory involuntarily.

2. Avoidance Symptoms

People with PTSD often develop avoidance symptoms as they attempt to prevent the painful negative emotions and distressing memories associated with the trauma. Avoidance symptoms include:

• Avoiding thoughts, feelings, or memories related to the traumatic event

• Avoiding people, places, activities, objects, or situations that remind you of the trauma

• Refusing to talk about what happened

• Avoiding trauma-related external reminders

While avoidance might provide temporary relief, it actually maintains traumatic stress disorder ptsd by preventing you from processing traumatic memories and learning that trauma reminders are not actually dangerous in the present.

3. Negative Changes in Thinking and Mood

PTSD affects how you think about yourself, others, and the world. These cognitive and mood symptoms can include:

• Inability to remember important aspects of the traumatic event

• Persistent and exaggerated negative beliefs about yourself, others, or the world

• Distorted thoughts about the cause or consequences of the trauma, often leading to self-blame

• Persistent negative emotional states (fear, horror, anger, guilt, shame)

• Diminished interest in activities you used to enjoy

• Feeling detached or estranged from others

• Persistent inability to experience positive emotions (feeling emotionally numb)

These ongoing negative emotions and negative thoughts can lead to depression, social isolation, and difficulty maintaining relationships.

4. Changes in Arousal and Reactivity

PTSD changes your nervous system's baseline level of activation, leading to reactivity symptoms such as:

• Irritable behavior or angry outbursts

• Reckless or self destructive behavior

• Hypervigilance (being constantly on guard for danger)

• Exaggerated startle response

• Problems with concentration

• Trouble sleeping or staying asleep

These symptoms reflect a nervous system stuck in survival mode, constantly scanning for threats even in safe environments.

Co-Occurring Conditions with PTSD

People with PTSD often experience other mental health problems alongside their trauma symptoms. Understanding the full scope of co-occurring conditions is essential because treating traumatic stress disorder ptsd effectively often means addressing these other mental health problems simultaneously.

Common co-occurring conditions include:

Depression: The persistent negative emotions, loss of interest in activities, and social withdrawal associated with PTSD often lead to major depression. Mood symptoms including persistent sadness, hopelessness, and difficulty experiencing positive emotions frequently overlap with PTSD.

Anxiety disorders: Generalized anxiety, panic disorder, and social anxiety frequently co-occur with posttraumatic stress disorder. These anxiety disorders can compound the hypervigilance and fear responses already present in PTSD.

Substance abuse: Some people with PTSD use alcohol or drugs to cope with distressing memories and mood symptoms, leading to substance use disorders that complicate treatment.

Other trauma-related conditions: Acute stress disorder (symptoms occurring within the first month after trauma), adjustment disorders, reactive attachment disorder (particularly in children who have experienced early trauma), and disinhibited social engagement disorder can occur alongside or instead of PTSD.

Complications of PTSD can also include increased risk of suicidal thoughts and attempts, particularly when depression and substance abuse are present. This is why comprehensive treatment that addresses both traumatic stress disorder ptsd and other mental health problems is essential for recovery.

Evidence-Based Trauma Therapy Approaches

The Substance Abuse and Mental Health Services Administration recognizes several evidence-based treatments to treat PTSD. These trauma focused treatments have been validated through clinical trials and shown to be effective in helping people process traumatic memories, reduce PTSD symptoms, and regain a sense of control and safety. Professional treatment typically involves specialized forms of talk therapy that target the specific mechanisms maintaining PTSD.

Cognitive Processing Therapy (CPT)

Cognitive processing therapy is a specific type of cognitive behavioral therapy and cognitive therapy designed to treat PTSD. CPT typically consists of 12 weekly sessions and helps you identify, challenge, and reframe unhelpful beliefs related to the traumatic event. Research shows that CPT is highly effective, with studies demonstrating significant symptom reduction across military and civilian populations.

Many people with PTSD develop "stuck points"—beliefs like "I should have prevented this" or "The world is completely dangerous"—that maintain PTSD symptoms. CPT teaches you to examine the evidence for these beliefs and develop more balanced, accurate ways of thinking about the trauma and its impact. The therapy includes written processing of the traumatic experience, though some versions of CPT make this optional, and uses Socratic questioning and progressive worksheets to help you modify negative trauma-related cognitions that fuel feelings of guilt, shame, and fear.

Prolonged Exposure Therapy (PE)

Prolonged exposure therapy is a type of cognitive behavioral therapy and exposure therapy that involves gradual, repeated, and prolonged exposure to trauma-related memories and triggers to reduce fear and avoidance. Research demonstrates that PE is highly effective, with one major study showing significant symptom improvement whether delivered over 2 weeks intensively or 8 weeks in standard weekly format.

Prolonged exposure includes two main components: imaginal exposure (repeatedly revisiting the traumatic memory in a safe therapeutic setting) and in vivo exposure (gradually approaching trauma-related situations you've been avoiding in real life). Through this process, you learn that trauma memories and reminders are not actually dangerous, and your anxiety naturally decreases over time. PE typically involves 8-15 weekly sessions lasting 60-90 minutes, with homework assignments that include listening to audio recordings of your trauma narrative and completing real-world exposure exercises.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR therapy helps process traumatic memories using bilateral stimulation—typically guided eye movements, but sometimes alternating sounds or tactile sensations. The theory behind EMDR is that traumatic memories get "stuck" in the nervous system in unprocessed form, and bilateral stimulation helps the brain reprocess these memories through a predictive processing mechanism, so they become less distressing and feel more like normal memories from the past.

Recent systematic reviews and meta-analyses confirm EMDR's clinical and cost-effectiveness for treating and preventing PTSD in adults, with research showing it is comparable to other trauma-focused treatments. EMDR typically consists of 8-12 sessions and doesn't require detailed verbal discussion of the traumatic event, which can be particularly helpful for people who find traditional talk therapy approaches too difficult. EMDR is recommended as a first-line treatment by most international guidelines. EMDR Intensives, which provide concentrated treatment over several days rather than weekly sessions, can accelerate the healing process.

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

Trauma focused CBT is specifically designed for children and adolescents (ages 3-18) who have experienced trauma. TF-CBT includes components for both the child and their caregivers, addressing trauma symptoms, teaching coping strategies, processing the traumatic experience through gradual exposure, and helping the family create a supportive environment for healing. The Providence Center in Rhode Island offers TF-CBT as part of their trauma-informed services for children and families.

Additional Trauma Therapies

Other effective approaches to treat PTSD include:

Group therapy: Some trauma-focused therapies can be delivered in group formats, allowing people with PTSD to connect with others who have experienced trauma while learning coping strategies together. Group therapy can reduce isolation and provide peer support alongside professional treatment.

Trauma Systems Therapy (TST): Offered by Family Service of Rhode Island for children and adolescents in high-stress environments, combining individual therapy with systems-level support.

Skills Training in Affective and Interpersonal Regulation (STAIR): Focuses on improving emotional regulation and interpersonal skills before processing traumatic memories.

Somatic Therapy: Incorporates body-centered techniques to release physical tension associated with trauma, recognizing that trauma is stored not just in thoughts but in the body.

How Effective Are These Treatments?

Research from multiple clinical trials and network meta-analyses shows that trauma-focused psychotherapies significantly reduce PTSD symptoms, with large effect sizes and sustained benefits at follow-up. Studies consistently find:

• Approximately 49-70% of patients who complete trauma-focused therapy experience clinically meaningful symptom improvement

• These therapies improve symptoms across all PTSD symptom clusters: intrusion, avoidance, negative thoughts and mood, and changes in arousal and reactivity

• Benefits are maintained at long-term follow-up assessments months after treatment ends

• Trauma-focused psychotherapy shows superior long-term outcomes compared to medication alone, with benefits maintained better over time

A comprehensive network meta-analysis comparing different psychological interventions for PTSD found that trauma-focused treatments consistently outperform non-trauma-focused therapies, supporting their status as first-line treatments recommended by the Substance Abuse and Mental Health Services Administration and other clinical guidelines. While these treatments are highly effective, it's important to know that many patients continue to have some residual symptoms after treatment, and approximately 30-40% may not respond adequately to an initial course of therapy, necessitating additional or alternative treatment approaches.

What to Expect in Trauma Therapy

Starting trauma therapy can feel daunting, especially when you've been avoiding thoughts and feelings related to your traumatic experience. Understanding what to expect can help reduce anxiety about beginning professional treatment.

Initial Assessment

Your therapist will conduct a comprehensive evaluation to understand your trauma history, current symptoms, how traumatic stress disorder ptsd is affecting your daily life, and any co-occurring mental health conditions. This assessment may include a physical exam component if you're also seeing a primary care provider, as PTSD can manifest in physical symptoms. Your therapist will develop an individualized treatment plan tailored to your specific needs. You won't be required to share detailed information about your traumatic event right away if you're not ready.

Building Safety and Stabilization

Before processing traumatic memories, your therapist will help you develop coping strategies for managing distressing emotions, grounding techniques to use when you feel overwhelmed, and ways to maintain physical and emotional safety. For people with PTSD related to ongoing trauma or who have dissociative symptoms, this stabilization phase may take longer.

Processing the Trauma

Depending on your treatment approach, this phase involves gradually confronting trauma-related memories, thoughts, and situations. In CPT, you'll examine your beliefs about the trauma using Socratic questioning and written exercises. In prolonged exposure, you'll repeatedly revisit the traumatic memory through imaginal exposure and approach avoided situations through in vivo exposure exercises. In EMDR, you'll process traumatic memories while engaging in bilateral stimulation. While this phase can be emotionally challenging, it's done gradually and collaboratively, always keeping you in control of the pace.

Integration and Moving Forward

As you process traumatic memories and reduce avoidance, you'll work on rebuilding your life, reconnecting with activities and people, developing positive emotions and experiences despite the trauma, and creating meaning from your experiences. The goal isn't just to reduce symptoms but to help you thrive and experience positive emotions again.

Medication for PTSD

While psychotherapy is considered the primary treatment for PTSD, medication can also help control the symptoms of PTSD and is often used in combination with therapy. Research from systematic reviews shows that medications can be effective, particularly when:

• You do not have access to trauma-focused psychotherapy

• You prefer medication over psychotherapy

• You have co-occurring major depression

• You continue to have symptoms after completing psychotherapy

The most commonly prescribed medications for posttraumatic stress disorder are selective serotonin reuptake inhibitors (SSRIs). The U.S. Food and Drug Administration has approved two SSRIs specifically to treat PTSD: sertraline (Zoloft) and paroxetine (Paxil). Other medications with research support include fluoxetine (Prozac, another SSRI) and venlafaxine (Effexor, a serotonin-norepinephrine reuptake inhibitor). These medications work by modulating brain chemicals that affect mood symptoms, anxiety, and stress response, helping reduce PTSD symptoms including intrusive memories, hyperarousal, and emotional numbing.

Prazosin is often prescribed specifically to help with sleep issues related to nightmares and trouble sleeping. Treatment typically requires 8-12 weeks at an adequate dose to determine effectiveness, and your doctor may need to adjust the dose gradually.

A network meta-analysis comparing pharmacological, psychotherapeutic, and combination treatments found that while medications can reduce mood symptoms and other PTSD symptoms, psychotherapy demonstrates superior long-term maintenance of benefits. At the end of treatment, all three approaches show similar effectiveness, but psychotherapy shows significantly better outcomes than medication at long-term follow-up. Many people with PTSD benefit from a combination of psychotherapy and medication, particularly when depression or anxiety disorders are present alongside trauma symptoms.

Finding Trauma Therapy in Providence, Rhode Island

If you're in the Providence area seeking professional treatment for trauma, several options are available:

The Providence Therapy Group provides individual therapy for trauma and PTSD at our Cumberland, Rhode Island or Providence, Rhode Island locations, with both in-person and telehealth options available. Our therapists use evidence-based approaches including cognitive behavioral therapy and trauma-informed care to help you heal from traumatic experiences.

The Providence Center offers a wide range of trauma-informed services for children and families, including Trauma-Focused Cognitive Behavioral Therapy and other evidence-based treatments to treat PTSD.

Brown University Health operates an Adult Partial Hospital Trauma Track for individuals needing intensive care for severe PTSD symptoms when outpatient therapy alone isn't sufficient.

Family Service of Rhode Island provides Trauma Systems Therapy for children and adolescents in high-stress environments, addressing both individual therapy needs and systems-level factors.

Many local providers offer both in-person and telehealth sessions, making trauma therapy more accessible throughout the Providence area and surrounding Rhode Island communities. Platforms like Zencare and Psychology Today can help you find trauma-focused therapists in Providence who accept your insurance and specialize in the type of treatment you're seeking.

Supporting a Loved One with PTSD

If someone you care about is experiencing posttraumatic stress disorder, your support can be an essential part of their recovery. Here are ways to help:

Educate yourself about PTSD. Understanding that symptoms like irritability, emotional numbness, and avoidance are part of a mental health condition—not personal rejection—can help you respond with compassion rather than frustration. Learning about traumatic stress disorder ptsd helps you recognize when your loved one needs professional treatment.

Encourage them to follow their treatment plan. Help them make appointments with healthcare professionals, remind them to take prescribed medications if they have mood symptoms being managed pharmacologically, and support their engagement in therapy without pressuring them to share details of their trauma if they're not ready.

Listen without judgment. Let your loved one know you're available to talk when they want to, but don't push them to share. Sometimes people with PTSD need to talk about their traumatic experience; other times they need distraction and normalcy.

Be patient with symptom fluctuations. PTSD symptoms may worsen during anniversaries of the traumatic event or when stress is high. Understand that recovery isn't linear.

Avoid triggers when possible. If you know certain situations, sounds, or reminders trigger your loved one's PTSD symptoms, work together to minimize exposure to these triggers while they're working on processing the trauma in therapy.

Encourage participation in support groups. Connecting with others who have experienced trauma can reduce isolation and provide validation. Peer support groups can be beneficial for individuals with PTSD, complementing their professional treatment.

Take care of yourself. Supporting someone with PTSD can be emotionally demanding. Make sure you're also getting support, whether through your own therapy, support groups for family members, or other forms of self-care.

Know when to get emergency help. If your loved one is experiencing suicidal thoughts or expressing intent to harm themselves, call the 988 Suicide and Crisis Lifeline (dial 988) or take them to the nearest emergency room. The crisis lifeline is available 24/7 and provides free, confidential support.

Frequently Asked Questions About Trauma Therapy

What type of therapy is best for trauma?

The most effective therapies for treating PTSD are trauma-focused psychotherapy approaches including Cognitive Processing Therapy (CPT), Prolonged Exposure Therapy (PE), and EMDR. Research shows these trauma focused treatments are more effective than general talk therapy approaches because they specifically target how traumatic memories are stored and processed in the brain. All three have strong evidence supporting their effectiveness and are recommended as first-line treatments by clinical practice guidelines from organizations including the Substance Abuse and Mental Health Services Administration.

Is CBT or EMDR better for PTSD?

Both cognitive behavioral therapy approaches (like CPT and PE) and EMDR are highly effective to treat PTSD, with research showing comparable outcomes. A 2023 meta-analysis found no significant differences in effectiveness between different trauma-focused treatments. The best choice depends on individual preferences—some people prefer EMDR because it requires less detailed verbal discussion of the trauma, while others prefer the structured cognitive therapy approach of CPT. A mental health professional can help you determine which approach might work best for you.

What are the 7 symptoms of PTSD?

While PTSD symptoms fall into four main categories rather than a list of seven specific symptoms, key symptoms include: (1) intrusive memories or flashbacks of the traumatic event, (2) nightmares related to the trauma, (3) avoidance of trauma reminders, (4) negative thoughts and mood changes, (5) feeling emotionally numb or unable to experience positive emotions, (6) hypervigilance or being constantly on guard, and (7) exaggerated startle response or difficulty sleeping. To be diagnosed with PTSD, these symptoms must persist for more than a month and significantly interfere with daily functioning.

What are the 20 symptoms of PTSD?

The symptoms of PTSD are comprehensive and affect multiple areas of functioning. They include: intrusive memories, nightmares, flashbacks, distress at trauma reminders, physical reactions to triggers, avoiding thoughts of trauma, avoiding external reminders, inability to remember parts of trauma, negative beliefs about self and world, distorted blame, persistent negative mood, loss of interest in activities, feeling detached from others, inability to feel positive emotions, irritability and anger, reckless behavior, hypervigilance, exaggerated startle, concentration problems, and trouble sleeping. People with PTSD typically don't experience all symptoms equally but must have symptoms from each of the four main categories.

Will I ever be normal after PTSD?

Yes. While traumatic stress disorder ptsd can feel overwhelming, most people who receive evidence-based treatment experience significant improvement. The course of posttraumatic stress disorder varies—some people recover within 6 months of treatment, while others need longer. Research shows that approximately 49-70% of people with PTSD who complete a full course of trauma-focused therapy experience clinically meaningful symptom improvement. Recovery doesn't mean forgetting what happened, but rather processing traumatic memories so they no longer control your life. Many people who have experienced trauma go on to live fulfilling lives and even experience post-traumatic growth.

What does a PTSD episode look like?

A PTSD episode might involve flashbacks where the person re-experiences the traumatic event as if it's happening now, panic attacks triggered by trauma reminders, intense emotional reactions (rage, terror, panic) that seem disproportionate to the current situation, or dissociative symptoms where the person feels disconnected from their body or surroundings. During an episode, the person's nervous system is in survival mode, responding to a perceived threat even when they're objectively safe. Physical symptoms may include racing heart, rapid breathing, sweating, and trembling.

How can I heal from trauma?

Healing from trauma typically requires professional treatment with a mental health professional trained in trauma therapy. While self-help strategies like maintaining social connections, regular exercise, stress management techniques, and avoiding substance abuse can support recovery, they usually aren't sufficient on their own to treat PTSD. Evidence-based trauma therapy helps you process traumatic memories, change unhelpful thought patterns through cognitive therapy techniques, reduce avoidance, and develop healthy coping strategies. Research consistently shows that trauma-focused psychotherapy is the most effective approach for PTSD treatment.

What does EMDR therapy do?

EMDR therapy helps your brain process traumatic memories that have gotten "stuck" in your nervous system. Using bilateral stimulation (typically eye movements), EMDR allows you to reprocess these memories so they become less distressing and feel more like normal memories from your past rather than something still happening to you. The predictive processing model suggests that bilateral stimulation helps integrate traumatic memories into existing memory networks. EMDR doesn't erase the memory but changes how your brain stores it, reducing its emotional intensity and the physical well being impacts of carrying unprocessed trauma.

What type of therapy do you need for PTSD?

The recommended first-line treatment for PTSD is trauma-focused psychotherapy, particularly Cognitive Processing Therapy (CPT), Prolonged Exposure (PE) therapy, or EMDR. These therapies have strong research support and show superior reduction in PTSD symptoms compared to medications or non-trauma-focused therapies. The choice between these approaches depends on factors including availability of trained therapists, your preferences regarding treatment structure, and whether you prefer more cognitive therapy work (CPT), exposure therapy techniques (PE), or less verbal processing (EMDR). A trauma informed approach to treatment is essential regardless of the specific therapy chosen.

What to do to calm PTSD?

When PTSD symptoms are activated, grounding techniques can help calm your nervous system. These include: using your five senses to connect with the present moment (naming things you can see, hear, touch, smell, taste), practicing deep breathing exercises, using progressive muscle relaxation, engaging in physical movement like walking, reaching out to supportive people in your life, and using coping strategies you've learned in therapy. However, these calming techniques are most effective when combined with professional treatment that addresses the underlying trauma rather than just managing acute symptoms.

Taking the First Step Toward Healing

If you're experiencing symptoms of posttraumatic stress disorder, know that you don't have to live with these symptoms indefinitely. Effective treatments exist, and with the right support, you can process traumatic memories, reduce PTSD symptoms, and rebuild a sense of safety and connection in your life.

At the Providence Therapy Group, we provide compassionate, evidence-based trauma therapy in a safe environment where you can work through traumatic experiences at your own pace. Located in Cumberland, Rhode Island, we serve individuals throughout the Providence area with both in-person and telehealth options. Our therapists are trained in trauma informed approaches that acknowledge the impact of traumatic experiences on every aspect of your life.

Taking the first step to reach out for professional treatment takes courage, especially when trauma has made the world feel unsafe. But reaching out is the beginning of reclaiming your life from traumatic stress disorder ptsd. You deserve support, and healing is possible.

Contact the Providence Therapy Group to schedule a consultation and begin your journey toward recovery.