Intensive Trauma Therapy is a Social Justice Remedy

An essential element of social justice is repair of the harm done, so the injured person can recover from the injury and have their best opportunity to live according to their potential. Since traumatization is so often an element of social injustice, trauma healing is an essential element of the repair. And ideally, this repair should be done in such a way as to preclude further harm.

Most in the USA are now aware of how systemic racism has economically disadvantaged people of color. Less discussed but also extremely important is the medical and psychological impact of racism and social injustice, which can impair or incapacitate its victims, thus compromising quality of life, including ability to achieve their economic potential. For example, transgender children who are mistreated on account of their gender identity have a much higher risk of mental health problems, along with an attempted suicide rate of over 40%. The research on victims of intimate partner violence and child abuse also indicates massively increased risk of mental health as well as economic impairment.

The medical and economic problems associated with social injustice are not solely due to direct medical and economic causes such as lack of access to medical care and/or economic opportunities, respectively.  Psychological trauma and other adverse experiences/stressors can contribute to a wide range of medical problems, as well as relationship problems, substance abuse, depression, and other things that can limit a person’s educational and economic achievement. Therefore, along with possible educational, economic, social, and medical remedies, mental health interventions must be considered in any comprehensive approach to remedying social injustice.

I’m going to use a broad definition of traumatization here, to encompass major traumatic incidents (such as assault, rape, witnessing parental violence, etc) as well as the accumulation of lesser incidents that can, cumulatively, create a similar effect in terms of post-traumatic stress and related symptoms. The full range of traumatic/distressing incidents are commonly experienced on a frequent or even chronic basis by those experiencing discrimination, harassment, and other forms of social injustice. This broad definition is consistent with the research on adverse/stressful experiences having harmful impact on physical and mental health, regardless of whether or not those experiences qualified as major traumatic events.

There are two main approaches to treating traumatization: symptom management and trauma healing. Symptom management methods might include mindfulness, meditation, yoga, self-management practices, and medications. These can have considerable value but ultimately are ways to manage the traumatization and keep the symptoms under control. These methods require ongoing effort, and even then may not be sufficient or consistently effective. Trauma healing involves guiding a therapy client through a memory reconsolidation process using methods like EMDR or PC. Once a targeted traumatic memory has been processed and healed, it no longer causes traumatization, and the symptoms no longer have to be managed. Therefore trauma healing is the more profound, thorough, and durable way to ameliorate traumatization.

The problem with even the best trauma healing methods is that it can take months or years of conventional hour-per-week therapy to achieve the intended results. Meanwhile, the therapy client is continuing to suffer the effects of the traumatization, and may even deteriorate, perhaps incurring further traumatization-related harms such as school or work failure, relationship loss, substance abuse relapse, etc.

Intensive trauma-focused therapy entails multiple hours per day, for consecutive days as may be needed to make substantial progress. Intensive trauma therapy has several advantages, including low dropout rate and reduced total number of treatment hours; the primary advantage, though, is rapid results. For example, we estimate that our clients, who do up to 6 treatment hours per day, make roughly a year’s worth of (hour per week treatment) progress per week of intensive therapy. Although more research will be needed before third-party payors routinely cover it, intensive trauma-focused therapy is already research-supported. For example, in our program providing no-cost intensive trauma therapy for Western Mass victims of crime, we found dramatic and durable symptom reduction, as well as improved functioning and quality of life, following an average of 4.5 days of treatment.

The economy of intensive trauma-focused therapy, compared to the conventional weekly therapy format, will ultimately make the intensive treatment format more widely accessible. The rapidity of results will ultimately make intensive the preferred way to get trauma therapy done, to preclude further suffering or deterioration, and enable clients to quickly achieve the benefits of therapy and move on with their lives. Those who have suffered traumatization from social injustices deserve to have access to intensive trauma-focused therapy.