Abstract
Our society is becoming increasingly aware of the impact of trauma, and many helping professionals are seeking resources to support trauma survivors. Anna Baranowsky and J. Eric Gentry provide a clear and flexible framework for those engaged in the healing process of trauma in the newest edition of Trauma Practice: A Cognitive Behavioral Somatic Therapy. The authors state that “we heal our past by relaxing our bodies in the present” (p. 191), and this approach to healing is clearly emphasized throughout the book. The practice-oriented text provides an overview of trauma practice and two specific models of trauma work, as well as psychoeducation and resources such as worksheets and videos to support beginning helpers and expert traumatologists alike.
The first model of trauma practice presented is cognitive behavioral somatic therapy (CBST), which blends somatic and emotion-relational interventions, as well as cognitive and behavioral interventions. Noted are the four common components of most trauma treatments: a strong therapeutic relationship, building relaxation and self-regulation skills, in vivo or imaginal exposure, and cognitive restructuring. The authors posit that “by helping trauma survivors to develop skills and practices that interrupt and then minimize the activation of their threat response systems, we have found their symptoms begin to ameliorate and their sense of comfort and well-being flourish” (p. 3).
To achieve this, Baranowsky and Gentry describe the phases of CBST. Phase 0, the foundation stage, emphasizes the preparation needed to begin actively addressing trauma, including therapist's ability to maintain self-awareness and self-regulate during exposure to the client's trauma. This phase also includes an overview helpful to the client and therapist on the physiological reactions to trauma as well as basics of trauma work. Phase 1, the stabilization phase, supports the client in “creating the environment of safety necessary for trauma work” (p. 50). Phase 2, trauma work, is the space in which the client and therapist actively address the trauma experience to promote healing. The final phase, Phase 3, is called “reconnection,” in which trauma survivors work on cultivating “meaningful relationships and engagement in life activities” (p. 148). The authors provide specific interventions for Phases 1–3, outline the length of time it takes to complete the intervention, indications for use, any contraindications, and more. The interventions are primarily structured though the use of scripts, worksheets, or additional resources. The phases are intended to be linear, although there may be times in which it would be helpful to revisit skills, information, or interventions of previous stages.
In addition to CBST, the text also offers an alternative approach to trauma treatment called “Forward-Facing trauma therapy” (FFTT), created by J. Eric Gentry. FFTT addresses the symptoms of trauma through skill-building and cultivation of “intentional living” (p. 5) as opposed to reliving traumatic experiences. This approach is intended to be used in a variety of settings, including outside of formal therapy. FFTT focuses more on posttraumatic growth and meaning making than CBST, in that FFTT is more future-oriented and explicitly supports clients in making intentional choices in alignment with their morals or creating a vision statement.
A helpful component of this text is that many of the worksheets and interventions would support individuals experiencing other symptoms, such as anxiety, in addition to those managing the impact of trauma. While some work may need to be done to adapt interventions outside of the context of trauma, many fundamental approaches to treatment, such as an emphasis on the embodied experience, cognitive understanding, and the therapeutic relationship remain the same. The book offers several relaxation scripts that would be beneficial to anyone practicing self-care and self-compassion or interested in cultivating body-based awareness.
The authors created a practice-focused resource did through providing information helpful to therapists and clients alike, as well as formalized worksheets and interventions. A major strength of the book was the accessible and engaging text. Despite the strengths, the structured approach may not work for all clients who have experienced trauma, and the interventions provided in the text could lead to a therapist-driven practice if the primary focus in sessions was placed on completing the worksheets or activities. This potential challenge could be mitigated soliciting continuous feedback from clients, as the text strongly suggests.
While some interventions discussed in the book should be limited to the context of mental health therapy, all individuals in the helping professions should be trauma informed. With relation to pastoral care and counseling, trauma and spirituality may have a reciprocal relationship, in that they can mutually influence each other in positive or negative ways. Staying within the structure of their role and competency areas, those in pastoral care or counseling may be particularly interested in the integrative model of the text which combines somatic, behavioral, cognitive, and emotional-relational approaches. The text rarely mentions spirituality or pastoral themes, but it does acknowledge the interconnectedness of the human experience and encourages an integrative approach. For clients who are interested in explicitly integrating spirituality, this book may not be the most obvious resource; however, skilled professionals would be able to work within the structure of the resources to increase spiritual integration.
Trauma Practice: A Cognitive Behavioral Somatic Therapy may be most useful for emerging therapists who have a grasp of the theory of trauma work but are looking for additional resources to provide a structured approach for clients. It is best suited for therapists who are comfortable with a directive yet client-focused style and who use interventions with intentionality. Included in the text are useful reminders of care for the self of the therapist, as well as self-awareness. Overall, the authors clearly achieve their goal of providing an informative, accessible, practice-based resource for therapists working with survivors of trauma.
