Progressive counting

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Ricky Greenwald · Northampton, Massachusetts

What it is

Progressive Counting is a trauma-memory resolution procedure developed by Ricky Greenwald (Trauma Institute & Child Trauma Institute, Northampton, Massachusetts, USA). It is a modification of the counting method (CM), designed by psychiatrist Frank Ochberg in the early 1990s, in which the clinician…

Format

• Greenwald's personal-trainer metaphor: get the client motivated, safe and strong enough to do well in the trauma work. He also argues that "the best stabilization intervention is trauma healing", and that in intensive format most coping-skill work becomes unnecessary. Do not read this as permission…
• Format and dosing.

Who practises it, and how they are trained or regulated

• Safety and stabilisation: case management, parent training, problem-solving, consequential thinking, avoiding high-risk situations (book ch. 8). Move on when the client is safe enough and no longer deteriorating.
• Version followed: Ricky Greenwald's Progressive Counting (PC) as delivered inside his phase model of trauma-informed treatment (the "Fairy Tale Model"), per Greenwald (2013) Progressive Counting Within a Phase Model of Trauma-Informed Treatment (table of contents and publisher page), the Trauma Institute & Child Trauma Institute (TICTI) client FAQ and PC pages, Greenwald's own spoken account (inSocialWork podcast…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• : ongoing unsafe home situations; caregiver distress affecting the child.
• : positive memories that link into negative ones; switch to closing steps.
• : fatigue and cumulative distress across days; clients without support at home.
• : new symptoms pointing to remaining untreated memories; return to the memory list.
• : the client experiencing the formulation as blame; adjust until it feels true to them.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.