Trauma training is not currently
a universal requirement in counselor education
programs, which puts both untrained counselors
and their clients in harm’s
way; this is an ethical breach that can be closed
by providing all counseling students with adequate
trauma training, sensitizing them to the skillful
assessment of trauma, principles of culturally-responsive
client-centered trauma resolution, and the need
for relevant continuing education and self-care
to avoid counselor im-pairment and client harm.
will address the need for universal trauma training
in counselor education, explore the difference
between “recovery” and “resilience”,
and begin listing common factors in fostering
recovery and resilience from trauma for client
and counselor wellness. The aim of this article
is three-fold: 1) to begin establishing the
common factors of adequate trauma training for
counselor education curriculum development,
2) to begin developing national standards for
counselor education trauma training, and 3)
to continue reducing health disparities for
marginalized popu-lations who do not readily
have access to specialized services outside
of community mental health outreach.
Trauma has been
described as the body’s natural response
to an overwhelming situation (Levine, 1997,
2008, 2010). Due to neurochemical cascades that
occur during overwhelming experiences, there
are physical, mental, and emotional effects
that need to be addressed appropriately and
adequately in order for the body to release
stored survival energy and return to baseline
functioning (Berceli, 2003; https://www.pnirs.org/;
Levine, 1997, 2008, 2010; Schore, 1994, 2003),
such that the trauma survivor can return attention
to developmental tasks across the lifespan.
Trauma that resolves without professional intervention
often does so in part because the survivor’s
social support system provided the necessary
empathy and support for that individual’s
body to release the stored survival energy in
good timing, such that the individual was able
to resume attention to developmental tasks rather
than get “stuck” in survival mode
(Dobson & Perry, 2010; Harvey, 1996; Porges,
2004). Such individuals may be described as
“resilient”, often without recognition
the role of sufficient social support plays
to help them bounce back from a threatening
situation (Doidge, 2007).
been defined as a “set of qualities that
foster a process of successful adaptation and
transformation despite risk and adversity”
(Benard, 1995), whereas recovery “connotes
a trajectory in which normal functioning temporarily
gives way to threshold…usually for a period
of at least several months, and then gradually
returns to pre-event levels” (Bonanno,
2008). Resili-ence to like-kind trauma is more
often noted in individuals with a secure attachment
history; those who have in-utero substance exposure,
an insecure attachment history, and/or score
highly on the Adverse Childhood Experiences
Scale tend to have a lower threshold for more
extreme response to subsequent trauma, with
a longer recovery period and more pronounced
mental health impacts (Anda, Edwards, Felitti
& Holden, 2003; Anson, Chasnoff, Hatcher,
Iaukea, Randolph & Stenson 1998; Baker,
Blakely, Perry, Pollard & Vigilante, 1995;
Blaustein & Kinninburgh, 2010; Bowlby, 1988;
Chasnoff, Schmidt, Dchwartz, Telford & Wells,
2012; Cloitre, Cohen, & Koenen, 2006; Cohen,
Deblinger, & Mannarino, 2012; Dobson &
Perry, 2013; Gold, 2000; Gil, 2006; Heller &
La Pierre, 2012; Karen, 1998; Perry, 1997, 1999;
Raider & Steele, 2001; Schore, 1994, 2003;
posit that trauma is a fact of life, as is resilience,
and are investigating thera-peutic interventions
to develop evidence-based practices for recovery
addressing single-incident shock trauma (e.g.,
car accidents); developmental and relational
trauma (e.g., in-utero substance exposure, neglect,
abuse, betrayal, domestic violence, and oppression);
and complex trauma (e.g., violence, war, migration,
and natural disasters) across the lifespan,
around the world (Albuquerque, Mercante, Nasello,
Newberg, Peres, Peres, & Sima, 2007; Ayala
& Groves, 2015; Bates, Brown, Money &
Moore, 2011; Berceli, 2003, 2010; Blaustein
& Kinniburgh, 2010; Briere & Scott,
2012; Briere, F, H. R & Rome, 2015; Beutler,
Levant & Norcross, 2005; Chard, Monson &
Resnick, 2008; Cohen, Deblinger, & Mannarino,
2012; Fosha, 2000; Freyd, 1996; Gamble, Lev,
Perlman & Saakvitne, 2000; Gil, 2006; Heller
& LaPierre, 2012; Herman, 1997; Kline &
Levine, 2008; Levine, 1997, 2010; MacFarlane,
van der Kolk & Weisaeth, 1996; MacKinnon,
2012; Newberg, 2007, 2009, 2012; Ogden, 2015;
Rothschild, 2000; Schnur & Sori, 2013; Siegel,
2012; Siegel & Solomon, 2003; Weaver, 2010;
serving a broad spectrum of populations can
expect to be assessing and treating trauma survivors
throughout their careers, to aid recovery and
foster resilience for long-term wellness.
also known as secondary trauma or trauma exposure
response, appears to be a leading cause in counselor
burn-out and compassion fatigue (Aconson &
Pines, 1988; Adams, Boscarino, & Figley,
2004; Burk & van Dernoot Lipsky, 2009; Figley,
1993; Figley, 1995; Panos, 2007; Perry, 2014).
The risks for vicarious trauma are highest among
practitioners with the least training in trauma
resolution (Figley, 1995; Herman, 1997; Perry,
2014; http://www.aaets.org/index.htm). Some
indicators of the unresolved trauma exposure
response are: feeling helpless and hopeless;
a sense one can never do enough; hypervigilance;
diminished creativity; inability to embrace
complexity; minimizing; chronic exhaustion;
somatic complaints; inability to listen; dissociative
moments; sense of persecution; guilt; fear;
anger and cynicism; inability to empathize/numbing;
addictions; and grandiosity (Burk & van
Dernoot Lipsky, 2009). Any subset of these concerns
could result in counselor impairment, and thus
merit an organized plan for protection of client
could develop and adopt standards for student
training that would introduce all counselors-in-training
to the common factors of both trauma, and trauma
resolution, thus laying the foundation for safe
entry into a career of serving traumatized clients
to foster recovery and resilience while protecting
practitioners from vicarious trauma. The highest
quality education would include: an overview
of trauma research from conception -not birth-
(Chasnoff, et. al., 1993, 1998, 2002; 2004,
2005, 2006, 2007, 2008, 2009, 2010, 2012; Karen,
1994; Kelly and Verny, 1981; Perry, 1995, 1997,
2004; Porges, 2004; Schore, 2003; Stern, 1985)
to death; discussion of the compounded multicultural
implications of trauma (Brown, 2014; Chard,
Monson, Resick, 2008; Chasnoff, Messer, Schmidt,
Telford & Wells, 2009; Chasnoff, Farina
& Leifer, 2004; Chester, Goldman & Robin,
1996; Comas-Diaz, 2006; Harvey, 1996); a survey
of intervention modalities (including video
examples) to inspire continuing education; and
skills practice to assess counselor integration
and capacity prior to program advancement.
As the field
of traumatology coalesces in response to advances
in neuroscience, imaging tech-nology, attachment
research, and epigenetics, counseling practices
may also enhance efficacy by integrating trauma
resolution training in continuing education
for licensed counselors (http://www.aaets.org/index.htm;
Brown, 2014). Trauma is now recognized to be
part of the hu-man condition, and thus is widely-experienced
in varying degrees by a majority of counseling
clients, but most significantly among the most
marginalized. This author postulates that the
es-sential common factors derived from various
trauma resolution techniques can be integrated
into current counseling practices by most counselors
with appropriate supervision, thus improving
client outcomes and quality of life, as well
as reducing relapse rates for many presenting
problems, while increasing counselor protection
from the work-related hazard of vicarious trauma.
list of common factors in trauma includes:
- the universal nature of
overwhelm occurring unexpectedly throughout
- the unjust fact of trauma
occurring more in systematic oppression
of marginalized popula-tions;
- the body-based experience
of overwhelm impacting brain and emotional
development and functioning, especially
when left unresolved;
- the depletion of positive
affect and felt safety in relationships;
- relational trauma being
harder to resolve due to broken trust in
needed others, therefore re-quiring that
counselors be trauma-trained in order to
do no harm and increase efficacy of treatment.
list of common factors in trauma resolution
counseling may include:
- skillfully assessing and
accessing client-specific capacity for recovery
and resilience in re-sponse to overwhelm
via trust-based therapeutic rapport (Ayala
& Groves, 2015; Benard, 1995; Blaustein
& Kinniburgh, 2010; Cloitre, Cohen &
Koenen, 2006; Fosha, 2000; Heller &
LaPierre, 2012; Levine, 2010; Najavits &
Strupp, 1994; Rothschild, 2000; Seigel &
Solomon, 2003; Weaver, 2010);
- awareness of the neurodevelopmental
impacts of in-utero and early childhood
trauma (Chasnoff, et.al., 2002, 2004, 2006,
2007, 2008, 2009, 2010, 2012; Perry, et.
al., 1999, 2010, 2012, 2013; Schore,1994,
- leveraging interpersonal
neurobiology to co-regulate the client’s
nervous system (Amini, Lannon, and Lewis,
2001) through left-eye to left-eye contact
- following the client/s
pacing unless the client/s accelerate into
distress, which is re-traumatizing (Levine,
2003, 2010; Raider & Steele, 2001; Rothschild,
2000; Schore, 2003);
- slowing the client and
session down when trauma is being processed
(Levine, 2003, 2010; Rothschild, 2000; Weaver,
- referencing the client/s
body as a resource for soothing, regulating,
and discharging over-whelm as part of the
corrective emotional experience (Bates,
Brown, Money & Moore, 2011; Berceli,
2010; Fosha, 2000; Levine, 2003, 2010; Rothschild
2000; Weaver, 2010).
- following the body’s
cues for discharge of stored survival energy
as evidenced by trembling, especially in
the legs as the fight/flight/freeze response
is released from the body (Berceli, 2010;
Levine, 2003, 2010; Rothschild; 2000; Weaver,
h) following the body’s cues for discharge
of emotional overwhelm as evidenced by patterns
in movement, (e.g. protective and defensive
postures, attempts to regain balance and
control, changes in breath; micorexpressions
of shock, terror) (Berceli, 2010; Levine,
2003, 2010; Rothschild, 2000; Weaver, 2010);
- reducing verbal processing
to minimum, concrete, here-and-now awareness,
talking “through” pain, not
“about” pain (Levine, 2008;
- the value of accurate
empathy and normalization in supporting
the body’s natural discharge of overwhelm
(Farber & Lane, 2002; Najavits &
research of trauma interventions expands, counselors
will be able to implement appropriate interventions
for the developmental needs of their clients
in their settings, thus aiding clients in recovery
and fostering their long-term resilience to
the highest degree possible, while protecting
the counselor from the trauma exposure response.
resolution models in mental health practice
today are: Accelerated Experiential-Dynamic
Psychotherapy; Accelerated Recovery Program;
Acceptance and Commitment Thera-py; Dialectical
Behavioral Therapy; Emotion-Focused Therapy;
Eye Movement Desensitization and Reprogramming;
Hakomi; Mindfulness-Based Stress Reduction,
NeuroAffective Relational Model; Neurogenic
Yoga; Neurosequential Model of Therapeutics;
Occupational Therapy; Sen-sory Awareness; Somatic
Experiencing; Theraplay; Trauma-Focused CBT;
and Trauma Releas-ing Exercises. Given the variance
in evidence collected to date on this short
list, counselors are cautioned from getting
minimum training and supervision while expanding
scope of competence; over-eager application
of a technique without proper theoretical understanding
and skills integration can do more harm than
is a common topic of discussion in counselor
education, staff meetings and conferences, and
yet many practitioners underestimate the importance
of following through with a comprehensive plan
at effective intervals to foster their own resilience
and therefore protect themselves and their clients
from the effects of vicarious traumatization.
This author is investi-gating common factors
for counselor care to effectively process and
resolve the clinical presen-tation of trauma
in a variety of settings and populations. The
field of Somatic Psychology, with governing
bodies such as the United States Association
of Body Psychotherapists, publishes research
on the body-based effects of trauma work and
how to discharge the negative effects for counselor
well-being. From this lens, a beginning list
for ongoing holistic self-care to protect counselors
from trauma exposure response would include:
preventative personal therapy with a qualified
role model who integrates trauma resolution
in practice (http://usabp.org/), rather than
waiting for negative effects to begin;
b) an ongoing psychospiritual embodiment practice
to regulate physiology and reduce inflam-mation
from stress (Berceli, 2010; http://usabp.org/;
Newberg; 2009; https://www.pnirs.org/);
c) ongoing sufficient healthy social support
to meet needs for mutuality, connection, ease
and joy (Herman, 1997; Newberg, 2009);
d) beneficial nutritional habits to maintain
healthy baseline (Newberg, 2009; https://www.pnirs.org/);
e) ongoing access to nature to regulate physiology
f) application of daily mindfulness for self-monitoring
and numinous renewal (Newberg, 2009);
g) continuing education and networking with
trauma experts to ethically expand scope of
is concerned with the rates of compassion fatigue,
vicarious traumatization, and lim-ited reflexive
self-awareness regarding lack of preventative
self-care evident in mental health agency settings
and their practitioners. Such tendencies may
occur in part because counselor education does
not sufficiently prepare and train students
for the amount and variety of traumas they will
be helping clients process over the course of
their careers, and clinical supervision training
does not adequately prepare supervisors to empathically
and ethically monitor their su-pervisees with
regard to trauma resolution. Without sufficient
focus on the self of the practitioner and the
effects of trauma exposure, counselors are ill-prepared
for what they experience in the field, and often
wait until they are unhealthy, if at all, to
begin integrating self-care in a meaningful
way. Not only does this detract from the counselor’s
well-being, but it necessarily detracts from
the human services that impaired clinician can
render. In an age of managed care, when high
caseloads and mass trauma effect so many communities,
we must organize to take care of those who aim
to take care of others, and be embodied role
models for those we serve.
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