By Shaun Hotchkiss, Trainee CBT Psychotherapist
Post-Traumatic Stress Disorder (PTSD) is more common than many people realise and often misunderstood. PTSD can develop after experiencing or witnessing a traumatic event, and can affect anyone, regardless of age, background, or circumstances. What I find most important, and hopeful, is that PTSD is highly treatable.
As a trainee CBT therapist, I’ve developed a particular interest in structured, trauma-focused work. I’m especially drawn to how evidence-based approaches like Trauma-Focused CBT (TF-CBT) and imaginal reliving can help people process distressing experiences in a safe, supportive, and structured way. When someone is living with PTSD, they might experience flashbacks, nightmares, heightened anxiety, emotional numbing, or feel constantly on edge. Understandably, many people try to push these memories away or avoid reminders of what happened, but this can keep the trauma feeling “stuck,” and continue to shape and control everyday life in distressing ways.
What I value about structured trauma-focused therapy is that it offers a way through and opportunity to regain a sense control in their thoughts and feelings. One key part of this process can involve reliving sessions, guided therapeutic work where clients revisit the traumatic memory in a safe and controlled environment. This doesn’t mean re-experiencing the trauma in an overwhelming way. It’s about gradually processing what happened, making sense of it, and reducing its emotional grip. Over time, many people find the memory becomes less intrusive in their thoughts and their unhelpful believes about themselves following the incidents changes to more helpful and rational assessments.
Research in the UK continues to support this approach. Ehlers & Clark’s (2000) cognitive model of PTSD is a foundation of many trauma-focused CBT approaches, highlighting how unprocessed trauma memories and negative appraisals can maintain symptoms. NHS guidance, including NICE (2018) recommendations, places trauma-focused CBT as a first-line treatment for PTSD, especially when symptoms have lasted longer than four weeks.
What stands out to me most in this work is the change people begin to experience, when a memory that once felt unbearable becomes something that no longer dictates their life. Structured sessions give people space to face what happened, on their own terms, and to start rebuilding parts of life that may have felt lost.
If you’ve experienced trauma and are feeling stuck or overwhelmed, know that support is available, and recovery is possible.
