What to Look for in a Trauma-Informed Therapist: EMDR vs. Talk Therapy

Finding a therapist is one thing. Finding a trauma-informed therapist who actually understands trauma and knows how to treat it is another. If you’re looking for trauma therapy in Scottsdale, you may have noticed that therapists use terms like trauma-informed, trauma-focused, EMDR, and talk therapy. Read on to learn what those terms actually mean and how to know which approach might be right for you.

The good news is that you don’t have to become a trauma expert before you make an appointment. A good trauma therapist should be able to explain their training, the approaches they use, what therapy may look like, and why they recommend a particular approach for your situation.

At Claibourne Counseling, our therapists provide trauma-focused therapy in Scottsdale for adults, teens, and children, using approaches including EMDR, CBT, mindfulness, and narrative therapy.

The term trauma-informed gets used a lot in mental health. But there’s an important distinction between being trauma-informed and providing trauma-focused therapy.

A trauma-informed therapist understands that a person’s history can affect how they experience safety, relationships, emotions, stress, and even the therapy process itself. They take that into account rather than assuming every client will respond to therapy in the same way.

Trauma-focused therapy goes a step further by specifically addressing the effects of traumatic experiences.

That might include approaches such as EMDR or other trauma-focused therapies, depending on the therapist’s training and your individual needs.

When you’re looking for a trauma therapist, don’t be afraid to ask:

• What training do you have in trauma therapy?
• What types of trauma do you work with?
• What treatment approaches do you use?
• How do you decide which approach is appropriate?
• What should I expect during the first few sessions?

You shouldn’t have to guess what your therapist means when they say they “work with trauma.”

A good fit isn’t necessarily the therapist with the longest list of credentials. It’s someone whose training, experience, approach, and personality fit what you’re looking for.

Look for a therapist who can clearly explain:

• Specific trauma training – “Trauma-informed” is useful information, but you can also ask what specific trauma training the therapist has completed.

For example, some therapists pursue additional training in EMDR, trauma-focused CBT, complex trauma, PTSD, or other specialized approaches.

• Experience with the kind of trauma you’re dealing with – Trauma isn’t one-size-fits-all. Someone may be working through a single traumatic event, childhood trauma, chronic or complex trauma, an accident, abuse, betrayal, grief, or something else entirely. Your therapist should be interested in your experience, rather than trying to force your story into a particular treatment model.
• A treatment plan that makes sense to you – You should understand what you’re working toward and why your therapist is recommending a particular approach.
  That doesn’t mean your therapist needs to have every session mapped out months in advance. Therapy is collaborative, and the approach may change as you learn more about what you need.
• A therapist you feel comfortable with – This one matters more than people sometimes realize. Starting therapy can feel vulnerable enough without wondering whether your therapist understands you. Claibourne itself emphasizes therapist fit and notes that not every client/therapist combination works.You don’t need to feel completely comfortable on day one. But you should feel like you’re being heard, respected, and taken seriously.

To better explain the difference between EMDR and talk therapy, meet Janet. She’s a fictional example, but her experience reflects that of many clients we’ve worked with over the years.

Janet had never been to therapy before. She’s in her 60s now and is finally really getting to know herself. She’s spent a long time considering therapy and her daughter finally talked her into it. She’s known something wasn’t quite right, but the idea of sitting across from a stranger and talking about the hardest parts of her life just wasn’t how she was raised.

She was also skeptical. Wouldn’t talking about everything just make her feel worse? So when Janet finally decided to try therapy, she started with talk therapy. And that was a good place for her to start.

She needed to get comfortable with her therapist. She needed to understand what was happening and figure out what she wanted to change. She needed to realize that therapy wasn’t going to mean someone digging through her entire past and judging every decision she’d ever made.

Eventually, her therapist introduced the possibility of EMDR. Surprised, Janet’s first reaction was basically, “Wait. You’re telling me I don’t have to spend an entire session explaining every detail of what happened?”

Talk therapy can involve a lot of…well…talking. You might talk through experiences, identify patterns, understand your thoughts and emotions, develop coping skills, and work with your therapist to make changes in your life. EMDR can involve talking, too, but the processing portion is more structured.

During EMDR, a therapist guides you through specific steps while you focus on aspects of a distressing memory or experience and engage in bilateral stimulation, such as guided eye movements, sounds, or taps. 

There’s an important misconception to clear up here about EMDR. It’s not just about getting rid of traumatic or distressing memories. EMDR may also be used to address the ways past experiences continue to affect you in the present, including physical or emotional reactions, behaviors, negative beliefs about yourself, low self-esteem or negative self-image, and long-standing patterns such as people-pleasing or difficulty feeling safe.

EMDR can also address experiences and concerns connected to the past, present, and future. Your therapist may help you work through something that happened years ago, something that is currently triggering a reaction, or a situation you anticipate and want to feel more prepared to handle. EMDR doesn’t necessarily mean immediately diving into the most painful experience you’ve ever had.

The beginning of EMDR looks a lot like talk therapy. Before active processing begins, your therapist may spend time getting to know you, taking a history, identifying what’s affecting you now, developing a timeline, teaching coping and grounding skills, and making sure you have the ability to tolerate distress before moving into processing.

That’s part of good trauma therapy. A trauma therapist also isn’t necessarily trying to work through every traumatic experience you’ve ever had. Instead, treatment can focus on what is affecting you and what is being activated in your life now.

Sometimes understanding where a reaction comes from is enough to make a meaningful difference. Other times, you may understand exactly why you react the way you do and still find yourself having the same physical, emotional, or behavioral response. That’s where the difference between understanding something intellectually and actually changing the way it affects you can become so important.

You can understand your history and recognize your patterns. You can even know exactly where a particular reaction came from and still feel your body respond before your logical mind has a chance to catch up. This is one of the ideas explored in Bessel van der Kolk’s The Body Keeps the Score. The book examines how trauma can affect the brain and nervous system and why simply knowing why you feel or behave a certain way doesn’t necessarily make the response disappear.

In other words, insight and processing aren’t always the same thing. Knowing why something happens doesn’t mean the reaction will automatically stop happening.

This is one reason trauma treatment isn’t necessarily about repeatedly talking through what happened. Some approaches, including EMDR, are designed to help people process experiences in ways that involve more than simply putting the experience into words. 

We’ll talk about the ideas in The Body Keeps the Score in more depth in a future blog, including what the book actually says about the relationship between trauma, the brain, and the body…and some other resources that may be easier places to start if you want to learn more. Stay tuned.

You may have heard that EMDR is faster than talk therapy and it can be tempting to say, “Yes! EMDR is the faster, more efficient option!” But therapy isn’t quite that simple. We’re human beings and we’re more nuanced than that.

Research supports EMDR as an effective trauma-focused treatment for PTSD, but that doesn’t mean it will be faster or better for every person. Research comparing EMDR with other trauma-focused approaches doesn’t establish one universal winner. 

What can be different is the experience. EMDR tends to be more structured and focused on processing specific distressing memories or experiences. Traditional talk therapy may involve more open-ended conversation and exploration.

Neither approach has to be an either/or decision. Janet didn’t have to choose between “talk therapy forever” and “EMDR immediately.” She started with what felt manageable. As she became more comfortable with therapy and her therapist, she explored another approach. That gentle process turned out to be important, because sometimes the hardest part of starting therapy isn’t the therapy itself. It’s deciding you’re finally willing to try something.

This is probably the most important thing to know if you’re sitting there Googling trauma therapist Scottsdale and feeling overwhelmed by all the terminology.

You don’t need to arrive at your first appointment knowing whether you need EMDR, CBT, talk therapy, or something else.

That’s part of what your therapist is there to help you figure out. At Claibourne Counseling, therapists use individualized approaches and may incorporate EMDR, CBT, mindfulness, narrative therapy, and other modalities depending on the client’s needs and goals.

The first step can simply be having a conversation about what’s going on and what you’re hoping will change. If you’re looking for a trauma therapist in Scottsdale, Claibourne Counseling offers in-person therapy in Scottsdale and online therapy for Arizona residents.