Changing the Way We Heal: Trauma Therapy Intensives

Over roughly the past decade, an increasing number of clinicians, particularly those who specialize in treating trauma, have begun offering therapy in an “intensive” format. Rather than meeting for the traditional hour per week, clients doing intensives meet with a therapist from for approximately six hours, for however many days in a row they need to work through their own personal histories of painful life experiences. Clients finish their treatment once they’ve processed every memory to resolution- that is, to a point where the memories don’t cause significant distress anymore. 

There are many reasons why more and more trauma therapists are working this way. In fact, some therapists now regard the intensive format as the best way to deliver trauma therapy. To understand why, it’s useful to first understand how trauma therapy (or therapy that focuses on treating any past painful experience), whether it meets the traditional clinical definition of trauma or not, is generally conceptualized.

Let’s say you come into therapy experiencing symptoms of depression and anxiety, and you can’t get the thought “I’m worthless” out of your head. Us therapists would call that thought a cognitive distortion. It’s likely not an accurate reflection of reality, but it’s causing you to feel depressed. We know negative thought distortions like these can cause depression and anxiety, and we know changing these cognitive distortions, per theories of Cognitive Behavioral Therapy (CBT), can cure depression. In this way of thinking, if we can work with you to change the thought “I’m worthless,” then there’s a good chance the depression will dissipate.

In working to change that thought, a clinician might challenge you with contrary evidence to prove that the thought “I’m worthless” isn’t true. Sometimes, this works, and that’s great. But it often doesn’t, and, even more frustrating, you might still feel worthless (and keep experiencing those symptoms of depression and anxiety) even though you know, logically, that “I’m worthless” isn’t true. So what then? 

A trauma-informed clinician, seeing that a stubborn thought distortion and accompanying emotions aren’t budging when challenged with present evidence, gets suspicious. They’re guessing there’s probably more feeding these thoughts and feelings. Specifically, they’re thinking there’s a good chance these thoughts and feelings became deeply entrenched from life experiences in the past that left a painful mark–a kind of festering wound that was never healed. And those wounds will need to be healed for symptoms in the present to go away.

Let’s say, for this example, those feelings and thoughts of worthlessness began forming following abuse or neglect as a child. Maybe a family member called you worthless or treated you in ways that led you to believe you were worthless, and that’s still how you feel today, even though you’re older now. With PTSD, depression, and many other mental health problems, those experiences got stuck in your brain and were never processed in a healthy way. So, if we don’t treat those initial experiences that caused you to feel worthless- no matter how long ago those experiences occurred- those thought distortions and negative emotions you’re feeling in the present won’t go away. That’s because the past is feeding them, since the wound was never healed.

Trauma therapy reaches back into the past to treat those experiences, healing those wounds so they’re no longer infecting you in the present. There are four types of therapies that research has shown to be most effective in resolving those past experiences, which you can find at the top of most trauma treatment guidelines around the world: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Cognitive Processing Therapy (CPT), Prolonged Exposure Therapy (PE), and Eye Movement Desensitization and Reprocessing (EMDR). These therapies, and this cannot be emphasized enough, have been shown to eliminate symptoms from trauma, not just help you cope with them. This shocks many people, who sometimes assume they will have to cope with mental health symptoms their entire life, not heal their sources. But what’s better than coping and managing symptoms? To get rid of the symptoms entirely so you don’t have any to manage.

In creating a treatment plan with your therapist, you’ll create a list of past, formative experiences that made you feel worthless (as well as other worst moments), do preparation work so that you can process trauma safely, and then resolve each of them in systematic chronological order. This way, no early memories that can keep causing symptoms are left unprocessed. Once you’re done, those feelings of worthlessness that cause depression tend not to linger, or are reduced significantly.

Getting through your entire trauma history—so you can experience the full treatment benefits—can take a long time, and that creates some challenges. Let’s use EMDR as an example, since it’s widely considered one of the most efficient and accessible trauma therapies and doesn’t require homework. Imagine we’ve identified 16 experiences that need processing. Even in a perfect world, if you could work through one experience each week, it would take about 15 weeks—or nearly four months—to finish.

A lot can happen in four months. You may not have that much time to get relief from your symptoms—you could lose a job, face strain in your marriage or friendships, fall behind in school, or experience other major setbacks. Most family or medical leave also doesn’t last that long. And in reality, many people can’t even get to the trauma work during that time because weekly sessions often get consumed by managing immediate crises and symptoms, leaving little room for deeper processing.

Working in an intensive format for six hours a day solves all these problems. Instead of taking fifteen weeks, it would take less than three days (15 hours) or maybe faster. In trauma intensive work, it is rare for you to head home for the night without a trauma being fully processed. And even if that does happen, it’s only a night between sessions– not a full week of wait time. And usually, by the end of the first day, there’s a good chance you’ll have made it through some traumas already, so your symptoms will already have gotten some relief. And if one day you do come in with a crisis or symptoms of the moment, you can spend some time on it and then jump back into your trauma treatment and keep processing the root causes (the traumas) of those symptoms and crises.

This is the rationale for the intensive format, and clinical research, though limited on intensives, has so far backed it up.

On a concluding note, as someone who frequently works with trauma, I should mention that I’m actually not particularly fond of the word “trauma,” which is used to mean many different things by many different people. What matters isn’t whether something you experienced meets the clinical definition of trauma as defined by the DSM (our manual for mental health disorders), but simply whether an experience impacted you in a way that left you with a mark and symptoms. It’s not uncommon for people to remember something like a comment from childhood that still stings–or many that mounted up over time, often called “little t” traumas—that sometimes hurt more than even “real” trauma. That’s why, regardless of how you label painful experiences from the past, they’re worth attention and formal trauma treatment.

So, if you’ve got symptoms and triggers that don’t seem to go away with standard talk therapy, but you’re skeptical you’ve had much “real” trauma, it might be worth exploring incidents from your past that you’ve previously overlooked or minimized. Often, in trauma processing, memories you’d forgotten about come up as well, and you realize they’ve been affecting you for quite some time. So I’m a firm believer that any comprehensive therapy should usually involve some processing of past experience, and many clients find themselves pleasantly surprised when they work through their past–and discover its roots in their current functioning—in an intentional way using trauma healing techniques we know work.

Finally, the benefits of trauma intensives don’t mean abandoning the hour-per-week model of therapy. Far from it. While some people might come in for an intensive, get their work done, and exit getting all they needed, it’s far more common to take a week off from hour per-week-therapy to knock trauma off your list, and then return to your weekly therapist to integrate the gains you’ve made. People often emerge from intensives transformed dramatically, and learning to navigate the world after significant positive psychological change can be a tall order on your own. But integrating positive change into your life is a good problem to have, and having a professional to help is a great idea.

Written by William “Will” Ford, LCSW, EMDR Therapist and Clinician at Moonstone Wellness

Corner Mountain Trail, September 2025, Snowy Range, Wyoming