CBT for PTSD
For when a past event still shows up in the present, through flashbacks, nightmares, hypervigilance, or a sense that the world isn't safe anymore.
Signs this might be for you
- Flashbacks, nightmares or intrusive memories of a distressing event
- Avoiding places, people or situations that remind you of what happened
- Feeling constantly on edge, easily startled, or unable to relax (hypervigilance)
- Emotional numbness or feeling disconnected from yourself or others since the event
- A shift in how safe or trustworthy the world or people in it feel to you
Trauma-focused CBT works on the way a traumatic memory has been stored: often fragmented, unprocessed, and easily triggered by reminders that don't feel like memories at all, but like the event happening again. That's why flashbacks and intrusive images can feel so physically real, and why avoidance of anything connected to the trauma tends to build up, even when it costs you a great deal.
The work is paced deliberately. We start by building safety and stabilisation, including grounding techniques for moments of overwhelm, before doing any direct trauma processing. When you're ready, trauma-focused CBT involves working through the memory in a structured, controlled way so it can be processed and updated, rather than staying stuck in a raw, present-tense state. This is not the same as simply retelling the story on repeat; it's a specific clinical technique with a clear structure.
I want to be transparent about scope here. Trauma-focused CBT is well-evidenced and I use it within a High Intensity CBT framework; for some presentations of complex or developmental trauma, a longer-term or different specialist approach may be more appropriate, and I'll say so honestly during assessment rather than push ahead regardless.
What treatment actually looks like
01
Assessment
We assess the nature of the trauma, current symptoms, and safety, and discuss honestly whether trauma-focused CBT within this programme length is the right fit.
02
Stabilisation
We build grounding, emotional regulation and safety skills before any direct trauma processing begins.
03
Trauma-focused processing
Using structured techniques, we work through the traumatic memory so it can be processed rather than staying stuck in a present-tense, easily-triggered state.
04
Reclaiming and relapse prevention
We work on rebuilding a sense of safety and trust more broadly, and agree a plan for managing triggers going forward.
Stabilisation before processing
We build grounding and emotional regulation skills first, so you have tools to manage distress before we do any direct trauma work.
Structured, paced trauma processing
When you're ready, we work through the memory in a controlled, structured way, never as an open-ended retelling with no containment.
Honest scope conversations
If your presentation needs a different or longer-term approach than 12 to 20 sessions of trauma-focused CBT can offer, I'll tell you directly and help you think about next steps.
Cultural and faith context taken seriously
Where trauma is connected to racism, discrimination, or experiences within systems that weren't built with you in mind, that context is treated as clinically relevant, not sidelined.
Questions about ptsd at Pamoyo Therapy
Will I have to describe the traumatic event in detail?
Trauma-focused CBT does involve working with the memory directly, but it happens gradually, with your agreement, and only once we've built stabilisation skills first. You're never asked to "just talk about it" from session one with no preparation.
What if I don't feel ready to process the trauma directly yet?
That's completely valid, and we'd spend longer in the stabilisation phase, building safety and coping skills, until you feel more able to move forward. There's no fixed timeline you're expected to match.
Is 12 sessions really enough for trauma?
For a single-incident trauma, it can be. For more complex, repeated, or developmental trauma, it often isn't, and I'll say so directly during assessment rather than promise something I can't deliver. We might agree the extended 15 to 20 session option, or I may recommend a different route if that's genuinely more appropriate for you.
My trauma is connected to racism or discrimination. Will that be understood?
Yes. I take the impact of racial trauma and discrimination seriously as clinically relevant context, not as something separate from "real" trauma work. You won't need to educate me on the basics before we can get started.
Can trauma-focused CBT be done safely over video?
Yes, with the right pacing and grounding tools in place. We'll agree a plan for what to do if a session brings up strong distress, including how you'll ground yourself in your own space afterwards.
Is there a waiting list?
No. You can typically start your assessment within a week or two of getting in touch.
Related pages
CBT for Depression
For when everything takes more effort than it should, and the things that used to help have quietly stopped happening.
Learn moreCBT for Anxiety
Structured, evidence-based support for the racing thoughts, physical tension and avoidance that anxiety builds around your life.
Learn moreCBT for OCD
For the intrusive thoughts that won't leave you alone, and the compulsions, checking, or reassurance-seeking you use to try to quiet them.
Learn moreCBT for Panic Attacks
For when your body's alarm system fires without warning, and the fear of it happening again becomes its own problem.
Learn moreReady to talk about ptsd?
Book a free 15 minutes consultation. No pressure, no commitment, just a chance to ask questions and see if working together feels right.