Spiritually Oriented Psychotherapy for Trauma

Many clients rely on spiritual beliefs and religious faith as a source of strength, and trauma can challenge such resources just when they are most required. Therefore, it is important that therapists know how to facilitate restoration of a client's faith system while incorporating it into the therapy to treat the trauma effectively.

The approach demonstrated in this video is integrative, combining elements of traditional trauma-focused cognitive behavioral therapy with spiritually oriented psychotherapy.

Spiritually oriented trauma focused cognitive behavioral therapy has underlying treatment components that initially teach affect regulation before helping participants to identify links between non-trauma related cognitions, feelings, and behaviors. Trauma processing occurs by identifying and correcting trauma related cognitive distortions in a client narratives about trauma. It is important to initially assess the client's spirituality and religious beliefs at the outset of therapy and to, when appropriate, incorporate aspects of their faith during treatment.

In this video, Dr. Donald F. Walker demonstrates this approach with a young woman who was sexually assaulted and is now struggling with restoring her faith.

This video features a client portrayed by an actor on the basis of actual case material.

The approach demonstrated in this video is integrative and evidenced based, combining elements of both cognitive processing therapy (CPT) and trauma-focused cognitive behavioral therapy (TF-CBT), with an overarching emphasis on being aware of and tapping into the client's religious or spiritual beliefs and resources.

Both CPT and TF-CBT have underlying treatment components that initially teach affect regulation, before helping participants to identify links between non-trauma related cognitions, feelings, and behaviors. Later in therapy, exposure occurs in asking participants to create a narrative of the traumatic event or events that they are seeking treatment for.

In CPT, the trauma narrative is done in writing. In TF-CBT, clients typically talk about their experience. Trauma processing occurs in both treatments by identifying and correcting trauma related cognitive distortions. After this process is complete, treatment typically focuses on identity issues for survivors of trauma.

It is important to assess the client's spirituality and religious beliefs at the outset of therapy and then be aware of them during the course of therapy, as these beliefs may have been affected by the trauma.

The effects of trauma on spirituality vary from client to client and, whether the client has abandoned their beliefs or continues to rely on them for strength, attending to spirituality throughout therapy will improve outcome.

Donald F. Walker is a clinical psychologist specializing in treating trauma and in work with children and adolescents. He is the author of Spiritually Oriented Psychotherapy for Trauma and Spiritual Interventions in Child and Adolescent Psychotherapy, both published by APA. He was a professor for nine years prior to recently entering private practice in the Virginia Beach, Virginia area.

• Walker, D. F., & Hathaway, W. L. (Eds.) (2013). Spiritual Interventions in Child and Adolescent Psychotherapy. Washington, DC: American Psychological Association.
• Walker, D. F., Courtois, C., & Aten, J.D. (Eds). Spiritually-Oriented Psychotherapy for Trauma. (2014). Washington, DC: American Psychological Association.
• Walker, D. F., Reese, J. B., Hughes, J.P., & Troskie, M. J. (2010). Addressing religious and spiritual issues in trauma-focused cognitive behavior therapy with children and adolescents. Professional Psychology: Research and Practice, 41, 174–180.
• Walker, D. F., Reid, H., O'Neill, T., & Brown, L. (2009). Changes in personal religion/spirituality during and after childhood abuse: a review and synthesis. Psychological Trauma: Theory, Research, Practice, and Policy, 1, 130–145.

APA Videos

• Addressing Issues of Spirituality and Religion in Psychotherapy
  Edward P. Shafranske
• Christian Counseling
  Mark R. McMinn
• Emotion-Focused Therapy for Trauma
  Sandra C. Paivio
• Forgiveness Therapy in Practice
  Robert D. Enright
• Narrative Processes in Emotion-Focused Therapy for Trauma
  Lynne Angus and Sandra C. Paivio
• Theistic Integrative Psychology
  Scott P. Richards

APA Books

• Casebook for a Spiritual Strategy in Counseling and Psychotherapy
  Edited by P. Scott Richards and Allen E. Bergin
• Handbook of Psychotherapy and Religious Diversity, Second Edition
  Edited by P. Scott Richards and Allen E. Bergin
• Judeo–Christian Perspectives on Psychology: Human Nature, Motivation, and Change
  Edited by William R. Miller and Harold D. Delaney
• Spiritual Interventions in Child and Adolescent Psychotherapy
  Donald F. Walker and William L. Hathaway
• A Spiritual Strategy for Counseling and Psychotherapy, Second Edition
  P. Scott Richards and Allen E. Bergin
• Spiritually Oriented Psychotherapy
  Edited by Len Sperry and Edward P. Shafranske
• Spiritually Oriented Psychotherapy for Trauma
  Edited by Donald F. Walker, Christine A. Courtois, and Jamie D. Aten