Alternative Title

Examining trainee therapists' responses to client discussions of trauma in psychotherapy: a qualitative content analysis


Current psychology literature offers several definitions for trauma as well as recommended psychotherapy approaches. As trauma presentation and impact can vary greatly across individuals, choosing a specific treatment approach can be quite challenging, especially for training therapists whose clinical judgment and experience to guide decision-making is limited. As such, little is understood about how novice clinicians reconcile definitional and treatment model conflicts when providing trauma treatment. This exploratory qualitative study analyzed the trauma treatment sessions of 5 training therapists. The process and content themes that emerged from the training therapists' responses were categorized as follows: (a) establishing a mutual understanding of the client's experience, (b) providing guidance and support, (c) encouraging alternative processing, (d) affecting session flow, (e) coping, and (f) client struggles/difficulty. These findings were discussed within the context of current trauma treatment recommendations. Patterns that emerged in the therapists' responses suggested that in their efforts to process trauma, the trainee therapists provided validation of the clients' experiences, offered guidance and support to examine the trauma in an alternative way, helped them identify coping skills and sources of support, and emphasized client resilience through strength-focused responses; however, in doing so, they inadvertently engaged in a variety of behaviors, such as relying too heavily on facts and thoughts about the trauma, shifting session focus away from the trauma, or using interfering verbalizations (e.g., multiple questions at once), all which appeared to undermine client emotional engagement with traumatic material in the coded sessions. Thus, this study's results suggested that training therapists appear to need to be better educated academically and clinically to identify trauma and common treatment barriers that arise, so that they can better plan and implement effective trauma treatments with a clinical population. Specific supervision and training goals that are objective, skill-based, and potentially can be used to enhance training therapists' clinical treatment of trauma, are offered. Future research appears needed to identify what components of recommended trauma treatment training therapists are using, including how training therapists apply Cognitive-Behavioral treatments, and elucidate aspects of trauma treatment that may contribute to and prevent therapy drop

Library of Congress Subject Headings

Dissertations (PsyD) -- Psychology; Psychotherapy -- Study and teaching; Psychic trauma -- Treatment

Date of Award


School Affiliation

Graduate School of Education and Psychology



Degree Type


Degree Name


Faculty Advisor

Hall, Susan;