For military, veterans, and first responders, group CPT sessions can play a big part in recovery from trauma, explains EHN Guardians Gateway Executive Director Shawn Carter.
The average person will face a few traumatic experiences in their lifetimes: a car accident, an assault, or a serious medical condition, for example. These events will have a lasting impact on those who go through them and the effect on their lives cannot be underappreciated.
Now imagine the experiences of acting military service members, veterans, and first responders. Throughout their careers, they will experience dozens or even hundreds of traumatic events, often facing life-or-death situations every single day. As a result, instances of trauma in these communities far exceed those of the civilian population. According to the Canadian Mental Health Association, 12% to 23% of first responders will experience PTSD at some point in their lives.
At our EHN Guardians facilities, we specialize in the treatment of military, veterans, and first responders, including paramedics, firefighters, RCMP, and front-line healthcare workers. Shawn Carter is the Executive Director of our EHN Guardians Gateway facility in Peterborough, Ontario. He has seen first-hand the impact trauma can have on the lives of our clients. But he has also seen the transformative power of therapy. In particular, Cognitive Processing Therapy in a group setting has helped simultaneously heal and connect people experiencing trauma. Here’s what he had to say.
What is trauma and how does it impact the lives of veterans, military and first responders?
SHAWN CARTER: Trauma typically refers to the emotional, psychological, and physiological responses to distressing events, often leading to long lasting effects and impacts on daily functioning.
For military, veterans, and first responders, we know that these groups face unique stressors, things like combat exposure, exposure to violence in their professions, and many life-threatening situations. And they also have the emotional toll, witnessing or participating in traumatic events.
Often times these exposures to that trauma can lead to PTSD, depression, anxiety, difficulty with relationships, and an overall loss of purpose. Those constant high-stress environments that they’re used to working in can also create a sense of emotional numbness or avoidance.
What therapies do you use in treatment at EHN Guardians Gateway?
SHAWN CARTER: At Gateway, we use a whole host of interventions that target thoughts and believe systems that form as a result of trauma. We also pay special attention to the way that the body can be healed, as well as the soul.
The majority of the interventions are cognitive-based psychological interventions, the main one being Cognitive Processing Therapy. We also incorporate interventions that help with stabilizing some of the symptoms that go along with PTSD: psychoeducation teaching skills that help them cope through some of those symptoms. In-vivo exposure therapy, prolonged exposure, EMDR are all interventions that we use.
What is CPT and how do you use it to treat trauma?
SHAWN CARTER: Cognitive Processing Therapy has its roots in Cognitive Behavioural Therapy. It’s a type of evidence-based psychotherapy that’s specifically designed for the treatment of trauma, targeting the negative cognitions that have been formed as a result of exposure to traumatic events.
So, for example, let’s say I’m a firefighter who was not able to save someone. I might think, “Had I driven faster to that particular call, I would have got there in time to have saved that person who ended up dying in that accident.”
CPT typically focuses on identifying and challenging those distorted thoughts and beliefs related to the traumatic event. It encourages people to confront and process the memories that are attached to those traumas.
How is CPT delivered differently in individual settings versus group settings?
SHAWN CARTER: In an individual format, CPT is typically delivered one-on-one with a therapist. It allows for personalized treatment that’s tailored specifically to that individual’s needs and their specific trauma experiences. And there can be a greater focus on personal experiences while also providing more privacy during the processing of traumatic memories.
There can be guilt and shame related to the trauma they’ve experienced. There’s the safety of knowing they’re in private and able to do that with a therapist.
In group therapy, there’s a supportive community environment where participants can share their experiences and learn about other people’s journeys as well. It encourages things like shared coping strategies.
To other people who’ve maybe been through similar experiences share what’s worked for them, which can be really helpful. It can offer peer support, like validation of feelings. It can reduce some of those feelings of isolation.
Both modes of delivery of CPT are effective and both have been shown to lead to a reduction of PTSD symptoms.
What unique benefits are there to providing CPT in a group setting?
SHAWN CARTER: We’ve recently completed a (not-yet-published) research study here at Gateway. In this study, we did interviews with 30 people who were nearing the end of treatment to understand what is really helping them recover. When they were talking about CPT specifically, these are the impacts that they describe, which again we witness but hearing from them offered validation of those observations.
Group CPT helps with connection. We know that things like camaraderie and connection are such important facets of these professions themselves. So, it mimics that environment where you’re going through this together like you do on the job helps.
Group CPT can be part of a shared experience. What comes along with PTSD, for example, is avoidance and isolation. Encouraging the ability to process some of these things in a group pushes clients outside of their comfort zones. It allows them to reduce that isolation and know that there are other people who’ve been through something similar.
Group CPT can help end stigma. Watching others open up in a group setting can make it a little easier for others to open up themselves, to be vulnerable and talk about their experiences, knowing that everyone in that environment is working towards recovery. The goal is to provide a non-judgmental environment where you might say something that you feel like you have guilt and shame about. But that is understood by others in the room– and not just these professionals at the front of the room running the session.
Group CPT helps increase people’s support network. Of course, people often find their individual therapist incredibly supportive, but to have other peers you’re going through the process with widens that network of support and creates bonds with people who’ve maybe experienced similar things and then similar types of jobs.
Let’s go back to our example of the firefighter who felt like they didn’t respond fast enough or could have done something different to save another human life.
To have another firefighter in the room, say, “What are you talking about? It was a winter day. You followed every protocol. Were you supposed to blast through other vehicles and injure other people to get to that person? You did everything you were supposed to do that day.”
This often holds more weight to someone who’s been in that job and knows those policies, guidelines, and procedures, perhaps more so than therapist who is only imagining that they probably did everything they should have done.
Have you or someone you loved experienced symptoms of trauma?
Contact us to find out how CPT and other treatment can help in the recovery process. Contact us at 1-778-401-9564 or tell us more about your needs to get started.