Healing Developmental Trauma provides therapists the tools and knowledge to support clients in transformational growth. It brings a specialized psychobiological approach to working with relational and attachment trauma.
This non-regressive model orients towards resources rather than deficiency and dysfunction. It helps clients establish connections to the parts of their self that are organized, coherent and functional while understanding how survival styles distort their present experience.
The Therapist’s Role
Therapists have a vast impact on their clients’ lives. They help them better understand themselves and their thoughts and feelings that affect their actions. They also teach them skills to use to manage their mental health healthily.
They are tasked with effectively understanding their client’s problems and developing a treatment plan collaboratively. This requires them to be flexible and resourceful, so they can tailor their approach to meet each client’s needs and abilities.
As such, therapists need to be proficient in many different treatments. They must also be familiar with their indications, contraindications, and whether they can (or should) be combined with other medicines, including pharmacotherapy. Additionally, they must know how to implement the treatment properly. This is a challenging task, and it’s vital to assess therapist competence in the context of training. It would be unacceptable for a surgeon to learn a new surgery without seeing it performed.
The Client’s Role
Several studies have shown that the client’s role is crucial to the therapy’s outcome. This is especially true when dealing with complex trauma.
Talking about sensitive and disturbing aspects of their lives to strangers can be extremely difficult for many clients. However, therapists undergo extensive training to listen empathically and compassionately while being safe from client issues.
This is known as the therapeutic alliance or rapport. It’s been found that it accounts for 40-75% of the therapy outcome. Accord reflects trust, commitment, and discipline, all necessary for the therapy process. Shopping around for a therapist who can meet your needs is essential. This is particularly important if you’re transferring from another provider. The transfer process can be complicated by varying factors, such as how the previous therapist handled abuse reporting, payment of fees, and keeping secrets.
The Therapist’s Practice
The NeuroAffective Relational Model (NARM) provides a robust theoretical and practical map to navigating the complexities of attachment, relational and developmental trauma. NARM combines psychodynamic psychotherapy with bottom-up and top-down approaches to help clients heal from trauma and build their capacity for healthy relationships.
Therapists and counselors are employed in various settings, including hospitals, clinics, and private practice. They treat multiple problems like depression, anxiety, schizophrenia, and substance abuse.
A significant challenge is maintaining professional boundaries in a therapeutic relationship. Boundary crossings include:
- Inappropriate self-disclosure.
- Social or romantic relationships with patients.
- Incidental encounters outside the office.
- Dual relationships.
- Other violations are articulated in state and federal law and professional codes of ethics.
The therapist’s skill can be evaluated through treatment evaluation instruments, but these have several inherent shortcomings. First, trainees rarely see treatments practiced from beginning to end; it would be like a surgeon being trained in a new surgical operation without ever seeing it performed.
The Therapist’s Relationship
A solid therapeutic relationship is consistently linked to positive treatment outcomes regardless of the treatment method used. The therapist’s relationship factors—such as maintaining empathy, compassion, and positive regard for clients, agreeing on therapy goals, getting client feedback throughout treatment, and repairing ruptures—are at least as important as the treatment technique used (APA Task Force on Relationship-Based Practices and Responsiveness, 2018).
The POTT model also stresses a trained conscious use of the therapist’s personhood, life experience, and socio-cultural perspectives to empathically relate to, understand, and access the personal struggles of their clients. This is called realism.
Clients are often highly intuitive and pay close attention to the therapist’s behavior—from cutting their hour short or leaving early to not returning a phone call quickly. Maintaining a genuine, honest, and authentic self in the presence of a client is essential to forming a healthy bond over time. This is the foundation of trust. It is also the basis for addressing any misunderstandings or miscommunications that arise in the course of treatment.