What is the difference between a trauma therapist vs regular therapist?
I get asked this question fairly often.
A trauma therapist has specific training and experience in assessing, identifying and treating trauma-related responses in a person. This response can involve how the individual may react to various aspects in life. And this means it can involve excessive worries, feelings of shame, avoidance behaviors, relational difficulty, indecisiveness, chronic health problems, academic or work issues, and even strong reactivity to mild situations. At times, the person may also realize they are hypervigilant and more sensitive to stressors due to their nervous system being more heightened or “wound up.” Thus, a trauma therapist often will help the client identify from the bottoms up approach why their nervous system is acting this way when their “brain” or mind is aware that they are “okay.” For some clients with trauma history, I understand that “slowing down” or mindfulness can also be uncomfortable. So I am careful assume that they can “just slow down” but tries to find other ways that can be helpful and feel safe for their vigilant nervous systems.
In the DSM, trauma is defined as a distressing experience which is perceived as life threatening. Traumatic experiences can involve big “T’s” which means major traumatic events or small “t’s” which refers to cumulative experiences that threaten the well-being of the person but may not be presented as major trauma. A history of pervasive childhood neglect or suffering falls into this latter category. An incident of being in a car accident falls into the former category. Often times, there’s a history of both in people’s lives and it is not always clear cut. And individuals often will find ways to function and cope in daily lives. But how we function can be healthy or unhealthy. With unhealthy coping, safety behaviors become the daily life routine. Safety behaviors keep us protected and “safe” but in the long run increases reliance and anxiety about life. They often restrict life in the long run, although necessarily at first to help individuals with trauma feel safe and function. Eventually biased thinking patterns can surface because of this pattern and left unchecked, it can create unhealthy thinking patterns.
A common misconception is that trauma therapy requires immediate retelling of traumatic events. This is not the case. In fact, doing so too soon can be re‑traumatizing. I am sure this belief has deterred many from coming to therapy. A trauma therapist is often going to approach a client to help them build emotional and physical safety first (whether in the sessions or in the client’s life), while helping the client to identify their trauma triggers and responses. Sometimes this means we may address pressing issues that are happening first, but over time I will also help them assess if there’s a link between how they react now to how their suffering and adversities may have impacted them. This work involves the art and skill of an experienced therapist to discern what is healthy and how to parallel path to address both the present and the past.
As I learn a client’s history at the beginning, I may need to know historically if there were traumatic experiences in their life. Even in the phase of trauma processing, the client likely may not need to share details of their trauma to work towards healing unless they want to do so. But the outcome is that they learn to slowly build a relationship of trust vs fear in how they approach their traumatic events. And the negative impact of the trauma will have lesser negative impact on the person.
People ask if trauma therapy matters. You may have heard from folks who have been in therapy for awhile but yet feel stuck with behaviors that are not working for them. This often leads to learned helplessness. They begin to doubt themselves more, as they try even harder to make changes. Trauma therapy helps to address the root causes of unhealthy coping while fostering awareness, healing, and eventually self‑trust. An experienced trauma therapist will incorporate trauma informed interventions for clients to achieve these outcomes.
Clients also may want to just address their present day challenges without doing trauma work. I always let clients know that it’s not always necessary to address trauma when coming into therapy. It depends on what they are looking to do and phase of therapy they are ready for at this time. But it is an option that can help improve mental health in the long run.
Karen Lau, LCSW 1/1/2026