Month: June 2025

Evidence-Based Therapies for Trauma: What Works and Why

When you’ve lived through something traumatic—whether a single life-threatening event or chronic exposure to adversity—healing can feel complicated and uncertain. At this point in the field of psychology, we know more than ever about how trauma affects the brain and body, and we have treatments that work. If you’re looking for therapy that’s grounded in research and focused on real results, three approaches stand out: Cognitive Processing Therapy (CPT), Eye Movement Desensitization and Reprocessing (EMDR), and Prolonged Exposure (PE).

Each of these therapies has been studied extensively and shown to reduce trauma symptoms, help people regain a sense of safety, and improve daily functioning. In this blog, we’ll walk through how each treatment works and what the research says.

1. Cognitive Processing Therapy (CPT)

What it is:
CPT is a structured, time-limited therapy that helps people identify and challenge unhelpful beliefs related to a traumatic event. It’s especially effective for anyone struggling with guilt, shame, or a sense that they or the world are permanently damaged.

How it works:
CPT is based on the idea that trauma can change the way we think about ourselves, others, and the world. These changes, often called “stuck points,” can keep people trapped in cycles of fear, self-blame, withdrawal, or avoidance. CPT helps you recognize these patterns and develop more accurate, balanced thoughts.

Why it’s helpful:
By targeting the thoughts that fuel ongoing distress, CPT reduces trauma and PTSD symptoms and helps people re-engage with life. The bulk of CPT takes an average of 12 sessions, and often is delivered in the context of individual therapy that might include other treatment goals as well.

Research highlights:
Numerous randomized controlled trials have shown CPT to be effective in reducing trauma and PTSD symptoms, with gains maintained over time (Resick et al., 2017). It’s one of the top treatments recommended by the U.S. Department of Veterans Affairs and the American Psychological Association (APA).

2. Eye Movement Desensitization and Reprocessing (EMDR)

What it is:
EMDR is a therapy that helps people process traumatic memories using bilateral stimulation—usually eye movements, sounds, or tapping. Unlike some other forms of therapy,, EMDR doesn’t require detailed descriptions of the trauma.

How it works:
EMDR targets unprocessed memories that continue to trigger distress in the present. During sessions, clients briefly recall traumatic memories while engaging in bilateral stimulation. This process appears to help the brain “re-file” the memories so they no longer feel overwhelming or intrusive.

Why it’s helpful:
EMDR is often a good fit for people who have difficulty talking about their trauma, and it’s been shown to reduce both emotional distress and physical symptoms of trauma and PTSD. 

Research highlights:
Meta-analyses have found EMDR to be as effective as trauma-focused CBT in reducing trauma and PTSD symptoms (Watts et al., 2013). The World Health Organization recognizes EMDR as one of the frontline treatments for PTSD.

3. Prolonged Exposure (PE)

What it is:
PE is a form of cognitive-behavioral therapy that helps people face trauma-related memories and situations in a safe, structured way. It’s based on the idea that avoidance keeps PTSD symptoms going.

How it works:
In PE, clients gradually confront the trauma memory through imaginal exposure (retelling the trauma in detail during sessions) and in vivo exposure (approaching avoided situations in real life). Over time, this reduces fear and increases confidence in one’s ability to cope.

Why it’s helpful:
Avoidance may offer short-term relief, but it reinforces fear and limits functioning. PE helps retrain the brain to recognize that the trauma is over and that the present moment is safe.

Research highlights:
PE has one of the strongest evidence bases for treating PTSD. Studies show large reductions in symptoms, with improvements maintained for years (Powers et al., 2010). It’s considered a gold-standard treatment by the APA and VA.

What is the best trauma therapy for you?

Each of these therapies is effective, and the best choice depends on your preferences, history, and treatment goals. Some people prefer the structure of CPT, while others appreciate the less-verbal approach of EMDR. Still others find that facing their fears directly through PE is what helps most.

What they all share is a focus on processing trauma in a way that allows healing—not by forgetting, but by reducing its power over your present life.

Trauma can leave deep imprints on the mind and body, but it doesn’t have to define your future. Evidence-based therapies like CPT, EMDR, and PE offer proven paths toward relief and recovery. If you’re considering treatment, look for a specialist trained in these approaches, and don’t be afraid to ask about the process. Healing is possible—and it starts with the first step.

Trauma therapists at Dallas CBT offer CPT, EMDR, and PE for trauma.  Call our office for more information and to connect with one of our therapists.

 

References

• Resick, P. A., Monson, C. M., & Chard, K. M. (2017). Cognitive Processing Therapy for PTSD: A Comprehensive Manual. Guilford Press.
• Watts, B. V., Schnurr, P. P., Mayo, L., Young-Xu, Y., Weeks, W. B., & Friedman, M. J. (2013). Meta-analysis of the efficacy of treatments for posttraumatic stress disorder. Journal of Clinical Psychiatry, 74(6), e541–e550.
• Powers, M. B., Halpern, J. M., Ferenschak, M. P., Gillihan, S. J., & Foa, E. B. (2010). A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Clinical Psychology Review, 30(6), 635–641.

Trauma Lives in the Body, Too

Most people know that trauma can leave emotional scars. But fewer people realize that trauma can also change how your body works—down to the level of your genes.

In recent years, scientists have uncovered powerful evidence that trauma doesn’t just live in our memories. It can change how genes are expressed in the body—a field of study called epigenetics. These changes can shape how our brains and bodies respond to stress, how we manage inflammation, and even how resilient we feel. And yes, those changes can stick with us for a long time—sometimes even across generations.

Trauma and the Stress Response

When something traumatic happens—whether it’s a single event or ongoing stress—the body kicks into high gear. This is your survival system doing its job. But when the stress is chronic or overwhelming, the system can get stuck in overdrive.

One key player in this system is the glucocorticoid receptor, which helps regulate your body’s stress hormone, cortisol. Research has shown that trauma can change the way this gene is expressed, making it harder for your body to turn off the stress response. Over time, this can lead to wear and tear on your immune system, sleep patterns, digestion, and even heart health.

How Does Trauma Affect the Body?

If you’ve ever wondered why trauma survivors often struggle with chronic pain, autoimmune issues, fatigue, or digestive problems—this is part of the reason. The biological stress from unresolved trauma can ripple through multiple systems in the body.

These epigenetic changes may help explain why some people feel like they’re constantly “on edge,” or why even small stressors feel overwhelming after a traumatic experience. In many ways, the body is reacting to the world as if the threat is still ongoing.

Trauma Across Generations

There’s also compelling research showing that these trauma-related changes can be passed from one generation to the next. Children of trauma survivors sometimes show similar epigenetic patterns—even if they didn’t experience the original trauma themselves.

This doesn’t mean trauma is destiny. But it does mean that healing isn’t just about “getting over it.” It’s about recognizing how deeply trauma affects both mind and body—and responding with care, patience, and evidence-based support.

What Can Help with Trauma?

Here’s the hopeful part: Just as trauma can shape our biology, healing experiences can too. Therapy approaches like Cognitive Processing Therapy, Prolonged Exposure, and Eye Movement Desensitization and Reprocessing (EMDR) have been shown to reduce the symptoms of PTSD and help rewire the brain’s response to stress. Early evidence even suggests that effective therapy can reverse some trauma-related epigenetic changes.

Other healing tools—like consistent social support, mindfulness practices, physical movement, and trauma-informed medical care—can also support the body’s return to a more balanced state.

If you’re carrying the invisible weight of trauma, it’s not just in your head—and you’re not alone. Healing is possible, and it often starts with understanding what’s really going on inside. Whether your symptoms are fresh or decades old, Cognitive Processing Therapy and Eye Movement Desensitization and Reprocessing (EMDR) are research-backed therapies that are a good place to start (for kids or adolescents, look into Trauma Focused Cognitive Behavioral Therapy: TF-CBT).  These therapies can help you move through the pain—on your terms, at your pace, and with support every step of the way.

Read more about therapy for trauma on our website, or contact us to get hands-on support from a trauma specialist at Dallas CBT.