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TABLE 1. Differences in Therapeutic Approaches to Trauma

Traditional approach to trauma Solution-focused approach to trauma

Therapist is the expert, gives advice to client Client is the expert, therapist asks questions
Therapist's theory of change Client's theory of change
Conversations about what the client does not want (the problem) Conversations about what the client does want instead of the problem
Client is viewed as damaged (deficit model): how is the client affected by the traumatic experiences? Client is viewed as influenced but not determined, having strengths and abilities (resource model): how did the client respond to the traumatic experiences?
Clients are (sometimes) seen as unmotivated Clients are always motivated (although their goal may differ from that of the therapist)
Remembering and expressing affect are goals of treatment Goals are individualized for each client and do not necessarily involve remembering and expressing affect
Interpretation Acknowledgement, validation, and conversations about possibilities
Past and problem focused Future and solution focused
Problem is always there Exceptions to the problem are always there
Long-term treatment Variable/individualized length of treatment
Coping mechanisms need to be learned Coping mechanisms are already present
Conversations focusing on insight and working through the problem Conversations focusing on accountability and action; insight may come during or after treatment
Sometimes feedback from client at end of therapy Feedback from client after every session
Therapist defines end of treatment Client defines end of treatment
Success is defined as the lessening or ending of the problem Success is defined as the expansion of what the client wants instead of the problem and reaching the preferred future

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