Trauma

Explains what trauma is and how it affects your mental health, including how you can help yourself, what treatments are available and how to overcome barriers to getting the right support. Also includes tips for people who want to support someone who has gone through trauma.

This page is also available in Welsh.

Coronavirus (Covid-19) is affecting all our lives, and we know that our usual advice may not currently apply. Some ways of looking after yourself or getting support might not be possible or feel realistic during the pandemic.

We hope that you can still find information here that helps. You can visit our coronavirus information hub to find lots of information on coping during the pandemic.

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What treatments could help?

This page is about treatments that may help with the mental health effects of trauma. It covers:

Everyone has their own response to trauma. The treatment you are offered will depend on your particular symptoms and diagnosis (if you have one), and on your own unique needs. What helps is different person to person, and can change over time. So keeping an open mind and exploring different options can be useful.

The UK Psychological Trauma Society (UKPTS) has a list of psychological trauma services in the UK. Some are NHS and some are private sector. You can find out more on the UKPTS website.

Talking therapies

There are different types of talking therapies but they are all designed to give you space to explore difficult feelings and experiences with a trained professional.

Different people find different types of therapy helpful for trauma – there isn't one tried and tested approach. Research has shown that the relationship you have with your therapist is particularly important, regardless of the type of therapy they practise.

"I learned through therapy that I actually probably did survive because I used those coping behaviours, [which] were damaging, but they were the only ones I knew at the time."

Types of therapy some people find helpful include:

Body-focused therapies, which address how trauma affects your body as well as your mind. You can find information on some of these types of treatments on the Chiron Association for Body Psychotherapists, Sensorimotor Psychotherapy Institute and Somatic Experiencing Association UK websites.
Eye movement desensitisation and reprocessing (EMDR), which involves making rhythmic eye movements while recalling a traumatic event and is most commonly used to treat post-traumatic stress disorder (PTSD). Find out more on the EMDR UK & Ireland website.
Trauma-focused cognitive behavioural therapy, which is a form of cognitive behavioural therapy (CBT) specifically adapted for post-traumatic stress disorder (PTSD). Find out more in our pages on CBT.
Cognitive analytic therapy (CAT), which looks at how past events and relationships can affect how you think, feel and act, bringing together ideas from several different therapies. Find out more on the Association for Cognitive Analytic Therapy (ACAT) website.
Schema therapy, which helps address unmet needs and difficult beliefs about yourself. This can include working through the effects of trauma. Find out more on the Schema Therapy Institute website.

Find out more on our pages on talking therapy and counselling, including tips on how to get the most from therapy. You can also read more about what to expect from therapy for trauma on the British Association for Counselling and Psychotherapy (BACP) website.

If you're giving evidence in a criminal trial

The Crown Prosecution Service (CPS) has published guidelines for vulnerable witnesses, which includes anyone giving evidence about rape or sexual assault. They advise that having some forms of therapy before providing a statement or giving evidence could affect the chances of a successful prosecution.

This doesn't mean you can't have any talking therapy, but it could help to get information on this from an Independent Sexual Violence Advisor (ISVA). The Survivors Trust has a list of ISVAs on its website. You can also speak to Victim Support, which is a charity in England and Wales that aims to help victims and witnesses of any crime.

How EMDR helped me

"It was upsetting, but in time it was less so. The images became less vivid and I began to see the memory differently."

Read Sue's story

Arts and creative therapies

Arts and creative therapies are treatments which involve using arts-based activities like art, music or drama in a therapeutic environment, with the support of a trained professional. You don't need to have done these activities before, or have any particular skills or knowledge.

Some people say they find these sorts of therapies helpful because they provide ways of addressing painful feelings and difficult experiences without using words. This can include experiences of trauma. Find out more on our page on arts and creative therapies.

Medication

Some people find medication helpful in managing mental health problems that may be linked to trauma. Which type of drug you are offered will depend on the specific mental health problems or symptoms you're experiencing.

Before you decide to take any medication, you should make sure you have all the facts you need to feel confident about your decision. For guidance on what you might want to ask your doctor about any drug before you take it, including your right to refuse medication, see our information on psychiatric medication.

"A lot of my trauma centers around my gender and how other people perceive me. Finding good, supportive mental health professionals has really helped me understand how and why certain things affect me in specific ways."

Crisis services

Crisis services can be helpful if you're going through a mental health crisis. For example:

Samaritans are open 24 hours a day, 365 days a year. You can call 116 123 (free from any phone), email [email protected] or visit some branches in person. You can also call the Welsh Language Line on 0300 123 3011 (7pm–11pm every day).
Local support services may be available in your area, including day services, drop-in sessions or issue-specific support.
Crisis teams can support you at home during a mental health crisis.
Crisis houses offer intensive, short-term support to help you manage a mental health crisis in a residential setting (rather than in a hospital).

For more information, see our pages on crisis services.

"I finally managed to get some good therapy appropriate for my needs. Cognitive Analytical Therapy – 24 weeks of one-to-one with the NHS."

Accessing treatment

Here are some ways you could access treatment and support:

Your GP. For advice on preparing for a GP appointment, see our Find the Words guide.
Self-referral. Some areas run services which you can contact directly to refer yourself for talking therapy. Your GP might give you details, or (if you live in England) you could try the online IAPT service finder on the NHS website. Our page on talking therapy and counselling includes more information about IAPT.
Specialist organisations. See our useful contacts page for organisations that may offer therapy or other support for particular types of trauma or be able to put you in touch with local services.
Local trauma services. Some organisations offer free or low-cost trauma therapy. Your local Mind may have information about services in your area.
Private therapists. Finding a private therapist is another option some people choose to explore. Find out more on our page on finding a therapist.

"In my experience, understanding the how and why makes me feel empowered to be able to adapt my behaviour or environment to make it much less stressful and anxiety inducing."

The National Institute for Health and Care Excellence (NICE) – which produces guidelines on best practice in health care – recommends treatments for particular mental health problems rather than for trauma overall. This could affect what treatment you're offered on the NHS.

To find out about treatments for particular conditions, see our mental health A-Z.

Trauma-informed care

Some mental health services are starting to follow an approach called trauma-informed care. If a service says it is trauma-informed, this means all staff should follow principles such as:

understanding how trauma can affect people, including how mental health problems can be reactions to trauma
asking sensitively about past trauma, and offering appropriate support if you disclose it
being aware of the potential for mental health services to cause harm if delivered without trauma awareness
understanding your strengths and recognising what has helped you survive and cope
being trustworthy, transparent and involving you in your care.

"For abuse by religious cult, I found SilverCloud online Cognitive Behaviour Therapy the most use. It covers all aspects of being better: rationalising, self-care, journaling, small improvements."

What if I'm not offered the right type of treatment?

NHS bodies must follow the NHS Constitution when making decisions about treatment. This includes providing care and treatment that is appropriate to you, meets your needs and reflects your preferences. If your mental health problems relate to trauma, this should include receiving trauma-informed care.

If you don't feel like you are offered treatment that is right for you, you could talk to the provider and explain this to them. If that doesn't work you could make a complaint.

If receiving the wrong kind of care has caused you harm you might have a claim for clinical negligence. For this you would need to show that a healthcare professional failed in their duty to take care of you, and you experienced damage or loss as a result of that failure.

For more information on accessing treatment and how to get help if a treatment has harmed you, see our pages on seeking help for a mental health problem, complaining about health and social care and clinical negligence.

If you're finding it hard to access support, our page on overcoming barriers has some suggestions that could help too.