If you're living with the after-effects of trauma, you may have spent a long time wondering whether things can really change. Flashbacks, nightmares, feeling on guard all the time and avoiding reminders can wear you down. The good news is that PTSD is treatable, and there are well-studied therapies designed for it. This guide explains, in plain words, what major clinical guidelines recommend, how the main approaches work, where medication fits and what starting treatment usually looks like.
This post is general information, not a diagnosis or a treatment plan. A qualified professional can help you work out what fits you.
What PTSD treatment is trying to do
PTSD treatment isn't about forgetting what happened. It's about helping the memory feel like the past instead of something that keeps happening now. In general terms, good treatment aims to help you:
Have fewer and less intense flashbacks, nightmares and intrusive memories.
Feel safer in your body and less on edge.
Face reminders and situations you've been avoiding, at a pace you can handle.
Ease the guilt, shame or self-blame that often comes with trauma.
Get back to the people and activities that matter to you.
Recovery is common. The World Health Organization (WHO) notes that most people who go through a traumatic event recover naturally, and that up to 40 percent of people with PTSD recover within one year. For many others, the right help makes a real difference.
The U.S. National Institute of Mental Health (NIMH) recommends working with an experienced mental health professional and explains that the main treatments are psychotherapy, medication or both.
Trauma-focused therapy is the core of most guidelines
Clinical guidelines are summaries written by expert panels after reviewing the research. Two well-known sources point in the same direction.
The NICE guideline on post-traumatic stress disorder (NG116), from the UK's National Institute for Health and Care Excellence, recommends offering adults with PTSD an individual trauma-focused cognitive behavioural therapy (CBT) intervention when it has been more than a month since the traumatic event. It also recommends offering EMDR to adults with PTSD when it has been more than three months since a non-combat-related trauma.
The WHO fact sheet says that the psychological treatments with the most evidence for PTSD are trauma-focused CBT and EMDR.
In plain terms, "trauma-focused" means the therapy works directly with the traumatic memory and its meaning, carefully and with support, instead of only talking around it. We don't rank one approach above another here. The best fit depends on you, your history and what feels manageable.
EMDR, explained simply
EMDR stands for Eye Movement Desensitization and Reprocessing. It's a structured therapy that helps your brain process a stuck traumatic memory so it becomes less vivid and less distressing.
In an EMDR session, you briefly bring a memory to mind while your therapist guides you through bilateral stimulation, such as side-to-side eye movements or tapping. You don't have to describe every detail out loud. Before any memory work begins, your therapist spends time making sure you have ways to calm yourself and feel grounded.
If you'd like to know exactly what to expect, our post on what happens in an EMDR session walks through it step by step.
Trauma-focused CBT
Cognitive behavioural therapy looks at the links between thoughts, feelings and actions. Trauma-focused CBT applies this to the after-effects of trauma. In general terms, it can help you:
Notice and question beliefs that grew out of the trauma, such as "It was my fault" or "Nowhere is safe."
Gradually face reminders and situations you've been avoiding, so they lose some of their power.
Process the memory in a planned, supported way.
Build practical skills for handling strong emotions and body reactions.
CBT tends to be structured and goal-focused, often with small practice tasks between sessions. Many people like knowing what each session is working toward.
Other approaches that can support recovery
Trauma affects people in different ways, and some people benefit from other approaches alongside or before trauma-focused work. Our therapists also offer:
Internal Family Systems (IFS): a gentle approach that explores the different "parts" of you, such as a part that protects you or a part that carries pain, with curiosity instead of judgment.
Dialectical Behaviour Therapy (DBT) skills: practical tools for handling overwhelming emotions, distress and urges, which can help when feelings are hard to manage.
Acceptance and Commitment Therapy (ACT): focuses on making room for difficult thoughts and feelings while taking steps toward what matters to you.
Deep Brain Reorienting (DBR): a body-based approach that pays close attention to the very first reactions that happen when something reminds you of trauma.
These are described in general terms only. A therapist can talk with you about whether any of them might suit your situation.
Where medication fits
Some people use medication as part of their PTSD care, and some don't. That's a personal decision to make with a prescriber who knows your full health history. We don't give medication advice in this post.
If you're curious about medication, you can raise it with your therapist. Our nurse practitioners, who serve Kitchener, Waterloo and Cambridge, can assess concerns, prescribe medication when needed and coordinate referrals to psychiatrists as part of your care. Therapy and medication can be used on their own or together. MedlinePlus, from the U.S. National Library of Medicine, puts it simply: the main treatments for PTSD are talk therapy, medicines or both, and because PTSD affects people differently, a treatment that works for one person may not work for another.
What treatment usually looks like
Every plan is different, but PTSD treatment often follows a similar shape.
Getting to know you. Your first sessions focus on your history, what you're struggling with now and what you want to change. You set the pace. If you'd like a formal diagnosis, the psychologists on our team can assess and diagnose PTSD and complex PTSD (C-PTSD).
Safety and stabilization. Before working on memories, your therapist helps you build skills to calm your body, ground yourself and handle strong emotions. If life feels unsafe right now, that comes first.
Working with the trauma. Once you feel steady enough, therapy turns to the memories themselves, using an approach such as EMDR or trauma-focused CBT.
Moving forward. Later sessions focus on rebuilding routines, relationships and confidence.
If your trauma happened over a long period, or you experienced several traumas, the process may take more time. Our guide to complex PTSD treatment explains how therapy is often paced for complex trauma.
Can PTSD therapy happen online?
Yes, for many people. Online sessions can make it easier to start therapy if leaving home feels hard, if reminders on the drive are difficult or if your schedule is packed. You still meet your therapist face to face, just on a screen, from a private space where you feel comfortable.
Some people prefer the structure of an office, especially for memory work, and some switch between the two. NIMH offers a helpful overview of different types of psychotherapy and how to find a good fit, whichever format you choose. Your therapist can talk with you about what feels safest for you.
Choosing a therapist for PTSD
The relationship with your therapist matters a great deal. When you're looking, it can help to ask:
Do you have training in a trauma-focused approach, such as EMDR or trauma-focused CBT?
How do you make sure the pace feels safe?
What happens if I feel overwhelmed in a session?
How will we know if therapy is helping?
Trust how you feel after a first conversation. You should feel heard, not rushed. We offer therapy in person in Kitchener-Waterloo, Cambridge and Ottawa, or online anywhere in Ontario, so you can choose what feels most comfortable.
Cost and billing
Here's what to know about cost:
Sessions with our therapists range from $130 to $200, depending on the clinician.
Depending on your plan, insurance may cover some or all of the cost. Coverage varies, so it's worth checking your plan.
We direct bill many insurers, even for sessions with a registered psychotherapist (qualifying). Our team can help you check what applies to your plan.
If you're wondering what public coverage may apply, our post on OHIP and PTSD treatment coverage explains the options.
If you're in crisis
If you're having thoughts of suicide or you're in danger, please get help right away. Call or text 9-8-8 any time, day or night. If you're in immediate danger, call 911.
Your first step
You don't have to figure out which therapy is right on your own. Book a free 15-minute consultation with our admin team. They can answer your questions, explain how sessions work and help match you with a therapist trained in trauma care.
Healing from trauma takes courage, and you don't have to do it alone.