Group stabilising treatment

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Ethy Dorrepaal, Kathleen Thomaes, Nel Draijer · Netherlands

What it is

A trauma-informed CBT group, not a trauma-focused one. It combines three elements:

Format

• Format.
• 20 weekly group sessions of 2 hours each.

Who practises it, and how they are trained or regulated

• Stabilisation and symptom reduction: psychoeducation, emotion-regulation skills and cognitive techniques. Vroeger en verder sits here.
• The group was added to the client's ongoing individual treatment as usual; the frequency of that treatment is not stated. The manual is a structured session-by-session script with weekly topics, skills training, assignments and homework pages. Participants have their own workbook, which comes with a website of relaxation and breathing exercises.
• The developers say to combine group skills training with individual contact. They cite a meta-analysis finding that group treatment with no individual contact was the least effective format.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• 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?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• 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

• The reframe heard as justifying harmful behaviour. Stress both columns. It is working when members spontaneously say "that's my old survival mode".
• Members hearing "your thoughts are wrong" as blame. Frame thoughts as learned, not chosen. It is working when members can catch an automatic thought.
• Relaxation-induced anxiety or dissociation. Shorten the exercise, keep eyes open, switch to active grounding. It is working when members report lower tension after practice.
• Rejecting positive feedback, or feeling unsafe when praised. Keep feedback small and factual. It is working when members can note contradicting evidence without dismissing it.
• shame ("so I'm damaged") or fatalism ("my brain is broken"). Answer that alarm systems can retrain. It is working when members can name their own symptom areas in their own words.

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.