Trauma and PTSD Therapy
Trauma therapy helps people who are still affected by a shocking, scary or dangerous experience. At Balanced Life Counseling Services, treatment moves at a pace you agree to and may include trauma-focused talk therapy, cognitive behavioral methods or EMDR. In-person and telehealth appointments are available through our Salisbury and Bethesda offices.
Who it helps
Memories or dreams of an event that keep coming back
Feeling on edge, jumpy or easily startled
Steering around anything that reminds you of what happened
Trouble sleeping or concentrating since the event
Guilt, shame or blame that will not let up
Pulling away from people you used to feel close to
How trauma can show up afterward
The National Institute of Mental Health (NIMH) describes a traumatic event as a shocking, scary or dangerous experience that can affect someone emotionally and physically. Feeling anxious, sad or angry, having trouble sleeping, and thinking about the event over and over are common responses. So are headaches, stomach trouble, a racing heart and being easily startled.
It is natural to feel afraid during and after a traumatic situation, and most people recover over time. For some, the reactions stay. NIMH groups the symptoms of post-traumatic stress disorder (PTSD) into four kinds:
Re-experiencing: flashbacks, recurring memories or dreams, distressing thoughts
Avoidance: staying away from reminders, or from thoughts and feelings about the event
Arousal and reactivity: feeling on edge, irritability, trouble sleeping or concentrating
Thinking and mood: negative thoughts about yourself or the world, loss of interest, feeling cut off from others
When to consider seeing a therapist
NIMH advises seeking professional help if symptoms do not improve over time or begin to interfere with daily life. Symptoms usually begin within 3 months of the event, but they sometimes appear later, so it is not unusual to seek help long after the fact.
Only a qualified clinician can say whether what you are experiencing is PTSD, and you do not need a diagnosis to start. Children can react differently from adults. If you are worried about a child, see our page on child and pediatric counseling.
If you need help right now
Call or text 988 (Suicide and Crisis Lifeline), or call 911 if you are in danger.
Our office does not provide emergency services.
Approaches a trauma therapist may use
The VA's National Center for PTSD says the talk therapies with the most research support are trauma-focused, meaning the treatment focuses on the traumatic event and what it means to you. It also says there is no one treatment that is right for everyone. You and your therapist choose together.
Trauma-focused talk therapy: working through the memory and the meaning you have taken from it, in a planned and supported way.
CBT-based approaches: NIMH notes that cognitive behavioral therapy for PTSD can include gradual, safe exposure to reminders and cognitive restructuring, which helps you look at the event more realistically, especially where there is undeserved guilt or shame.
EMDR: you hold the memory in mind while following eye movements, sounds or taps. Some of our clinicians are trained or certified in EMDR therapy.
Pacing and safety come first
People often put off trauma therapy because they fear being pushed to relive the worst moment on day one. That is not how we work.
A first conversation. Your therapist invites you to share what has been going on and any goals. You choose how much to say.
Steadying skills. Before any work on the memory itself, you and your therapist talk through ways to manage distress during and between sessions.
Working with the memory. When you both agree you are ready, you begin the approach you chose. You can ask to slow down.
Checking progress. You review what is changing and adjust the plan. Weekly sessions are typically recommended at the beginning, and you decide together how often to meet after that.
Appointments, cost and how to begin
We see children, teens and adults, in person and by telehealth. Telehealth depends on where you are located during the session, so ask when you call. If the trauma is tied to public safety work, some of our clinicians are Certified First Responder Counselors. See first responder counseling.
We accept many insurance plans, and coverage depends on your plan. Fees and the Sliding Fee Program are on the insurance and fees page. When you are ready, call 443-978-8688 or send us a message.
Trauma is not only in your thoughts. Our article on how trauma shows up in the body covers the physical side.
Frequently asked questions
Do I need a PTSD diagnosis to start trauma therapy?
No. Many people come because something that happened is still affecting their sleep, mood or relationships, without knowing what to call it. Your therapist will ask about what you are experiencing during the initial assessment. NIMH notes that a PTSD diagnosis requires symptoms that last longer than a month and interfere with daily life, and only a clinician can make that call.
Will I have to tell the whole story in my first session?
No. In a first session your therapist invites you to share what has been going on and what you would like to change. You decide how much detail to give. Work on the memory itself comes later, once you have ways to manage distress and you and your therapist agree on an approach.
The event happened years ago. Is it too late for therapy to help?
It is not unusual to seek help long afterward. NIMH says PTSD symptoms usually begin within 3 months of a traumatic event but sometimes appear later. It also advises getting professional help when symptoms do not improve over time or get in the way of daily life, whenever that turns out to be.
Which type of trauma therapy is right for me?
That is decided with your therapist. The VA's National Center for PTSD says trauma-focused talk therapies have the most research support and that no one treatment is right for everyone. Your preferences matter: some people want to talk the event through, and others prefer an approach such as EMDR that involves less describing out loud.
Is trauma therapy covered by insurance?
It depends on your plan. We accept plans including CareFirst / Blue Cross Blue Shield, Cigna, Humana, Medicare, Medicaid, Tricare and UnitedHealthcare, and we ask you to verify your mental health benefits before your first visit. Without insurance, the initial assessment is $150 and a 45 to 50 minute individual session is $130. A Sliding Fee Program based on household income and family size is available.
Can I do trauma therapy by telehealth?
We offer telehealth as well as in-person appointments. Whether video sessions suit the approach you choose is something to talk through with your therapist, and telehealth depends on where you are physically located during the session. Ask about both when you call, and plan for a private space where you will not be interrupted.
Ready to talk with someone?
Call 443-978-8688 or request an appointment. We see clients in person in Salisbury and Bethesda and by telehealth across Maryland.
Sources
National Institute of Mental Health: Post-Traumatic Stress Disorder
National Institute of Mental Health: Coping With Traumatic Events
VA National Center for PTSD: Eye Movement Desensitization and Reprocessing (EMDR) for PTSD
If you are in crisis or thinking about suicide, call or text 988. In an emergency, call 911.
