The 3 Phases of Trauma Treatment
One foundation of trauma treatment is the three-phase model. First outlined by Pierre Janet, a psychologist who studied the effects of trauma, many researchers have since gone on to study and refine the three phases. Trauma researchers such as Bessel Van Der Kolk (The Body Keeps The Score) and Babette Rothschild (Revolutionizing Trauma Treatment) and many others have found that this three phase model is particularly effective in treating trauma, PTSD and C-PTSD.
Why Three Phases?
When seeking trauma treatment, it can be helpful for clients to have an expectation of
structure and timeline with a clear beginning, middle and end. This will help set the pacing for clients who want to jump in very quickly and help ease those into it who are more hesitant. Here is what you can expect from each of the phases.
Phase 1: Safety- Stabilization- Skill Building
Phase one is the foundation building for treatment between client and therapist. Rothschild uses the analogy that phase one is like a cast, where the trauma is like the broken bone. The cast creates a safe barrier for bumps and prevents further injury while bone is healing. Similarly, phase one helps protect our nervous system so that we can heal our trauma without further injury. The main goal in phase one is to create safety and stability. This means that therapist and client will work on building trust and creating a strong therapeutic alliance. This may also include the therapist helping the client to remove themselves from unsafe or threatening conditions and living situations.
The next piece is stabilization. This may include case management and making sure the client is stable in housing, financial needs, basic needs, psychiatric medications, and more. Part of stability is also through skill building where the client and therapist will learn and practice skills like emotional regulation, grounding, and orienting to manage triggers, flashbacks and other symptoms of trauma. There will likely be an emphasis on psychoeducation about trauma and learning the client’s window of tolerance. During phase one, the client and therapist may also try to build supports and stability outside of therapy sessions through community engagement.
Once the client and clinician have built trust, and the client is safe, stable and able to use learned skills to function well inside and outside of sessions, then it’s time to move on to phase two. It’s important that this decision to move on to the next phase is made in collaboration between client and therapist. It’s also critical that safety and stability are in place, as treating trauma for someone who is in crisis or still living in a traumatic situation can be detrimental. Alternatively, some clients do not feel the need to move on to phase two, which is okay too. While processing traumatic memories is beneficial for many, it’s not always necessary.
Phase 2: Processing- Review and Reappraisal of Trauma Memories
Phase two is where the client and therapist will review and process traumatic memories.
This process of re-experiencing memories will help to reorganize and integrate traumatic memories into the autobiographical memories, allowing the client to create meaning and find resolution to their trauma. There are many ways to do this, and the therapist and client will agree on a modality that seems most appropriate for the client. This may be through verbal processing and/or other experiential ways such as EMDR, ART, or Lifespan Integration therapy.
During phase two, the therapist will help guide the client thorough their traumatic memories while offering feedback, support and ensuring the safety of the client. This will likely include a back and forth between diving into traumatic memories and being oriented with the present time and space. This can be destabilizing, so it is important for the client to use their skills, have the ability to monitor their window of tolerance and communicate with the
therapist when they need additional support.
Moving on to phase three should happen once a client feels their traumatic memories
are no longer triggering, they aren’t engaging in avoidant behaviors around their trauma, and the majority of symptoms associated with their trauma have gone away. Additionally, at this point a client will be able to engage in normal life, and recover easier from everyday stress. And remember, it’s always okay to move back to phase one at any given time. This isn’t bad thing, nor is it a failure. Healing isn’t linear, and sometimes phase two exposes areas that let us know where we need to focus more phase one work.
Phase 3: Reconnecting- Consolidating Gains- Integration
Phase three is where the client and therapist will work on a plan for transitioning out of therapy. This can feel scary, but it will be collaborative decision, with plans for follow up care as needed. In this phase, the client will continue to apply everything they’ve learned in phases one and two to their daily lives. The client and therapist will work on goals that may include things like reconnecting with relationships and social networks. It may also include creating and meeting life goals and improving their quality of life in ways that they were unable to before. At this point a client should be able to use skills to stop a flashback, panic attack and calm their anxiety. The client will also be able to manage triggers and cope with daily stressors and engage in social and meaningful aspects of their lives again.
Conclusion
Understanding the three phases of trauma treatment—stabilization, trauma narration and processing, and integration and consolidation—is essential for effective healing. Each phase plays a crucial role in addressing the complex effects of trauma, guiding individuals toward recovery and resilience. At Rooted Counseling and Wellness, we are committed to supporting you through every step of this journey, providing compassionate, trauma-informed care tailored to your unique needs.
If you’re seeking professional support for trauma recovery, our trauma therapists in Draper and South Jordan, UT and online are here to help you heal and thrive. Learn more about our experienced therapists here or contact us to set up an appointment.
Written by Elicia Pye, MSWi
References:
- Morell, M (2024). Resilience, Trauma “Types,” Diagnosis, Phased treatment [PowerPoint slides]. College of Social Work, University of Utah. https://utah.instructure.com/courses/966801/files/162969294?module_item_id=24576422
- Ogden, P., & Fisher, J. (2015). Sensorimotor Psychotherapy: Interventions for Trauma and attachment (Norton Series on Interpersonal Neurobiology). W. W. Norton & Company.
- Rothschild, B. (2021). Revolutionizing trauma treatment: stabilization, safety, & nervous system balance. W. W. Norton & Company.
