Learn how therapists choose between EMDR, CPT, DBT, and other trauma treatments. Explore guidelines, client considerations, and integrative models.

Introduction

With multiple trauma treatments available, therapists often ask: How do I choose the right one for each client? This guide explores evidence-based recommendations and clinical considerations for matching modality to client needs.

Evidence-Based Guidelines

  • APA (2017): Recommends trauma-focused CBT and EMDR.
  • VA/DoD (2023): Strongly supports CPT, PE, and EMDR.
  • WHO (2013): Endorses CBT and EMDR worldwide.

Matching Treatment to Trauma

  • Single-event trauma: EMDR, CPT, or Prolonged Exposure (PE).
  • Complex trauma: DBT for stabilization, then EMDR or CPT.
  • Somatic symptoms: SE, Polyvagal, or body-based therapies as adjuncts.

Client Readiness and Preference

  • Clients overwhelmed by details → EMDR.
  • Clients with self-blame → CPT.
  • Clients with dysregulation/self-harm → DBT first.

Case Example: Integrated Care

Marcus, 36, a veteran with PTSD and alcohol use.

  • Began with DBT skills for regulation.
  • Transitioned to EMDR for trauma memories.
  • Concluded with IFS for relational healing.

Outcome: Reduced symptoms, improved functioning, and greater self-awareness.

Conclusion

Choosing trauma treatment is about matching the right tool to the right client. Evidence-based therapies like EMDR, CPT, and DBT provide strong outcomes, but integration often yields the best results.