Trauma treatment that meets you where you are — and takes you somewhere different.
Trauma is one of the most pervasive and consequential forces in psychiatric illness — present not just in PTSD, but woven through depression, anxiety, personality, relationships, and the ways people come to understand themselves. At Wave Psychiatric Group, our board-certified psychiatrists bring specialized training in evidence-based trauma treatment to a practice that takes the full complexity of traumatic experience seriously.
Understanding trauma and its effects
Trauma is not defined by the event itself but by the impact of the event on the person who experienced it. Two people can live through the same circumstances and be affected in profoundly different ways — a difference shaped by the nature and duration of the experience, the developmental stage at which it occurred, the presence or absence of supportive relationships, prior trauma history, biological vulnerability, and the meaning the person makes of what happened to them. This variability is not a measure of resilience or weakness. It is a reflection of the complexity of human experience and the highly individual nature of traumatic response.
The effects of trauma on the mind and body are real and measurable. Trauma dysregulates the stress response system — altering the functioning of the hypothalamic-pituitary-adrenal axis, sensitizing threat appraisal circuits, and producing changes in the structure and function of brain regions involved in fear, memory, and self-regulation. It disrupts the capacity for safe connection with others. It alters the way a person experiences their own body. It shapes the narratives people construct about who they are, what they deserve, and what the world is like — often in ways that made sense at the time of the original experience and now cause suffering in contexts where they no longer apply.
Trauma does not always announce itself as trauma. Many people who present with depression, anxiety, chronic pain, relationship difficulties, substance use, or a pervasive sense of emptiness or disconnection carry traumatic histories that have not been identified as the organizing clinical issue. Part of what our psychiatrists do at every initial evaluation is take a thorough history that creates space for trauma to be recognized — not because trauma explains everything, but because it is frequently missed and its recognition often changes what treatment looks like in important ways.
Types of traumatic experience we treat
Trauma takes many forms, and the clinical presentations associated with different types of traumatic experience are meaningfully distinct. At Wave, we treat adults who have experienced the full range of traumatic events, including the following.
Single-incident trauma
Discrete traumatic events — accidents, natural disasters, medical emergencies, sudden loss, assault, or witnessing violence — can produce acute stress responses and, in a significant proportion of cases, PTSD. Single-incident trauma tends to be somewhat more circumscribed in its psychological impact than chronic or developmental trauma, and exposure-based treatments have their strongest evidence base in this population.
Complex and repeated trauma
Repeated or prolonged traumatic experience — including childhood abuse or neglect, domestic violence, prolonged medical illness, or sustained exposure to danger — produces a more pervasive impact on personality, attachment, affect regulation, and identity than single-incident trauma. The presentation is often more diffuse, with symptoms that span multiple diagnostic categories and a functional impairment that extends well beyond the specific PTSD symptom clusters. Treatment of complex trauma requires a more graduated, relational approach that builds safety and stabilization before moving into direct trauma processing.
Childhood and developmental trauma
Adverse childhood experiences — including physical, emotional, and sexual abuse; neglect; parental mental illness or substance use; domestic violence; and other forms of early adversity — shape neurodevelopment, attachment patterns, stress system biology, and psychological structure in ways that produce vulnerability to a wide range of psychiatric difficulties across the lifespan. Adults presenting with complex depression, anxiety, personality pathology, chronic relationship difficulties, or treatment resistance frequently carry significant childhood trauma histories that are central to understanding their presentation.
Medical trauma
Serious medical illness, invasive procedures, time in intensive care, traumatic childbirth, and the experience of life-threatening diagnosis can all produce traumatic stress responses that are frequently overlooked in both medical and mental health settings. Medical trauma warrants the same clinical attention as other forms of traumatic experience.
Sexual trauma
Sexual assault, sexual abuse, and sexual coercion produce traumatic responses that can be profound, complex, and accompanied by layers of shame, self-blame, and relational disruption that require a clinical approach sensitive to these specific dimensions. Our psychiatrists approach sexual trauma with the care, directness, and absence of judgment that this work requires.
Vicarious and occupational trauma
First responders, healthcare workers, military personnel, journalists, and others whose work exposes them repeatedly to traumatic events or the suffering of others can develop secondary traumatic stress and PTSD through vicarious exposure. This form of trauma is increasingly recognized and remains inadequately addressed in many clinical settings.
Post-traumatic stress disorder — diagnosis and presentation
PTSD is the most well-defined psychiatric diagnosis arising from traumatic experience, though it is far from the only way trauma manifests clinically. The current diagnostic criteria for PTSD require exposure to actual or threatened death, serious injury, or sexual violence — either directly, as a witness, by learning it happened to a close person, or through repeated professional exposure to traumatic details — followed by symptoms across four clusters.
Intrusion symptoms involve re-experiencing the traumatic event through involuntary memories, nightmares, flashbacks, or intense psychological and physiological distress when exposed to trauma-related cues. Avoidance symptoms involve persistent efforts to avoid trauma-related thoughts, feelings, people, places, activities, or situations. Negative alterations in cognition and mood include distorted beliefs about oneself or the world, persistent negative emotional states, diminished interest in activities, detachment from others, and inability to experience positive emotions. Alterations in arousal and reactivity include hypervigilance, exaggerated startle response, irritability or aggressive outbursts, reckless behavior, and sleep disturbance.
PTSD frequently co-occurs with depression, anxiety disorders, substance use disorders, and chronic pain — each of which requires attention in a comprehensive treatment plan. It is also frequently present in patients who do not meet full diagnostic criteria but whose traumatic experiences are nevertheless significantly shaping their psychiatric presentation — a clinical reality that diagnostic thresholds do not always capture adequately.
Our approach to trauma treatment
Trauma treatment at Wave is individualized, paced carefully, and grounded in a clinical formulation that accounts for the nature of the traumatic experience, the current level of safety and stabilization, the patient's history of prior treatment, and their goals for care. We do not apply a single protocol to every patient with a trauma history. We work collaboratively with each person to determine the approach — or combination of approaches — that is most likely to be safe, effective, and sustainable for their specific situation.
Prolonged Exposure
Prolonged Exposure is one of the most extensively researched and robustly effective treatments for PTSD. Developed by Edna Foa and colleagues, PE involves two primary components: imaginal exposure, in which the patient recounts the traumatic memory in detail within the therapeutic session, allowing habituation of the fear response over time; and in vivo exposure, in which the patient gradually approaches trauma-related situations, people, and places that have been avoided. Through repeated exposure without the feared consequence, the traumatic memory loses its capacity to generate overwhelming fear and avoidance, and the patient regains access to the parts of their life that trauma had foreclosed.
PE has been validated across a wide range of trauma populations — combat veterans, sexual assault survivors, accident victims, and others — and is endorsed as a first-line treatment for PTSD by the VA, the Department of Defense, and the American Psychological Association.
Accelerated Resolution Therapy
ART is a structured, relatively brief psychotherapy that uses guided eye movements alongside imagery rescripting to process and reframe distressing traumatic memories and their associated sensations. It shares mechanistic overlap with EMDR but is more structured and often faster in its clinical application, frequently producing meaningful symptom relief within one to five sessions for targeted traumatic memories. ART is used at Wave for both PTSD and the broader range of distressing trauma-related memories and somatic experiences that do not necessarily meet full PTSD criteria.
Psychodynamic psychotherapy
For patients with complex or developmental trauma — whose difficulties are not circumscribed to specific traumatic memories but are woven into the fabric of their personality, their relationships, and their sense of self — the relational and exploratory dimensions of psychodynamic psychotherapy provide a therapeutic container that exposure-based approaches alone may not. Psychodynamic trauma therapy works within the therapeutic relationship itself to address the attachment disruptions, defensive structures, and relational patterns that complex trauma produces, in a way that is attuned to the patient's pace and capacity for engagement with difficult material.
Cognitive-Behavioral Therapy
CBT approaches to trauma address the distorted beliefs and avoidance patterns that maintain PTSD and trauma-related anxiety. Cognitive Processing Therapy — a CBT-based protocol developed specifically for PTSD — focuses on identifying and modifying the stuck points in thinking about the trauma and its meaning that sustain emotional distress. It is a well-validated treatment with particular evidence in sexual assault and military trauma populations.
IFS for trauma
Internal Family Systems therapy offers a particularly compassionate framework for trauma work — understanding traumatic symptoms not as pathology but as protective adaptations that parts of the self developed in response to overwhelming experience. The IFS approach to trauma involves developing a relationship of curiosity and care toward these protective parts, ultimately creating the internal safety needed to approach and heal the underlying wounds they protect.
Medication management
Several medications have meaningful evidence as adjunctive treatments for PTSD. SSRIs and SNRIs are FDA-approved for PTSD and are first-line pharmacological agents, with evidence for reduction of intrusion, avoidance, and hyperarousal symptoms. Prazosin — an alpha-1 adrenergic antagonist — has evidence specifically for trauma-related nightmares and is used at Wave when indicated. Medications are prescribed as part of a comprehensive treatment plan — not as a substitute for trauma-focused psychotherapy, which remains the treatment with the strongest evidence for durable recovery.
Pacing, safety, and the therapeutic relationship
Trauma treatment requires careful attention to pacing. Moving into direct trauma processing before adequate safety and stabilization are established — before the patient has sufficient internal and external resources to tolerate the intensity of the work — can produce retraumatization rather than healing. Our psychiatrists assess readiness for trauma processing carefully and build the therapeutic relationship and stabilization skills needed before proceeding into more direct exposure or processing work.
This is particularly important for patients with complex or developmental trauma, significant dissociative symptoms, active suicidality, or current unsafe circumstances. For these patients, the early phase of treatment focuses on safety, stabilization, and the building of affect regulation capacity — the foundation that makes deeper trauma work possible and safe.
We are also attentive to the relational dimensions of trauma treatment. Many patients with significant trauma histories — particularly interpersonal trauma — have understandable difficulties with trust, vulnerability, and the experience of being seen and known by another person. The therapeutic relationship is not incidental to trauma treatment. For many patients it is central to it, and our psychiatrists approach it with the care and intentionality it deserves.
Integrative approaches
Several integrative interventions are relevant to trauma treatment and are incorporated into clinical planning at Wave where appropriate.
Sleep disruption is nearly universal in PTSD and significantly impairs recovery. Addressing sleep as an explicit treatment target — through behavioral interventions, medication where indicated, and specific attention to nightmare frequency and intensity — is an important component of comprehensive trauma treatment.
Mindfulness-based approaches have emerging evidence in trauma populations and can be valuable tools for developing the capacity to tolerate difficult internal experiences without being overwhelmed by them — a skill directly relevant to the exposure work that is central to trauma-focused treatment. They are introduced carefully, as mindfulness practices can be activating for some trauma survivors, particularly in the early phases of treatment.
Exercise has meaningful evidence for reducing PTSD symptom severity, with mechanisms involving stress system regulation, autonomic nervous system balance, and the processing of trauma-related somatic activation. It is discussed as an adjunctive recommendation in the context of comprehensive treatment planning.
Insurance and fees
Wave Psychiatric Group accepts Aetna, Optum / UnitedHealthcare Behavioral Health, Meritain Health, Oxford Health Plans, ComPsych, UC SHIP, and others for diagnostic assessment appointments. Self-pay rates are also available.
Call us at 323-688-6380 or complete our intake form and our team will verify your benefits before your first appointment.
Frequently Asked Questions
Do I have to talk about the traumatic event in detail to get better?
Not necessarily — and not before you are ready. Different therapeutic approaches engage with traumatic material in different ways and at different levels of directness. Prolonged Exposure and ART involve relatively direct engagement with traumatic memories, while psychodynamic therapy and IFS work with the impact of trauma at a more relational and structural level. Your psychiatrist will discuss the full range of options with you and help you find an approach that is both clinically appropriate and a fit for where you are right now. No treatment at Wave involves being pushed to disclose more than you are ready for.
How is PTSD different from a normal stress response after a traumatic event?
Acute stress reactions following traumatic experiences are normal and expected — distressing, disorienting, and disruptive, but a natural part of the human response to overwhelming events. PTSD is diagnosed when these symptoms persist beyond a month, cause significant functional impairment, and meet the specific diagnostic criteria for intrusion, avoidance, negative alterations in cognition and mood, and alterations in arousal. Many people recover from traumatic events without developing PTSD. When symptoms persist and interfere significantly with functioning, a psychiatric evaluation is the appropriate next step.
Can trauma cause depression and anxiety even without PTSD?
Yes — and this is one of the most clinically important points about trauma. Many people with significant trauma histories never meet full criteria for PTSD but experience depression, anxiety, chronic shame, relational difficulties, somatic symptoms, and other presentations that are meaningfully driven by their trauma history. Recognizing trauma as a central organizing factor in a patient's presentation can fundamentally change what treatment looks like — even when PTSD per se is not the diagnosis.
Is trauma treatment available via telehealth?
Most of our trauma treatment modalities — including the clinical interview, psychotherapy, and medication management — are available via secure telehealth video for patients anywhere in California. Some components of trauma-focused treatment benefit from in-person contact, particularly in the early phases of establishing safety and the therapeutic relationship. Your psychiatrist will discuss the most appropriate format for your specific situation.
How long does trauma treatment take?
Duration depends on the nature and complexity of the trauma, the specific treatment approach, and the individual. Structured protocols like Prolonged Exposure and ART are typically time-limited — PE is usually completed within eight to fifteen sessions for a defined traumatic event. ART can produce meaningful relief for specific memories in one to five sessions. Psychodynamic and IFS-based approaches to complex trauma tend to be longer-term, reflecting the depth and pervasiveness of the work involved. Your psychiatrist will discuss realistic expectations at the outset of treatment and revisit them as your work progresses.
What if I have tried trauma treatment before and it did not work?
Prior treatment experiences that were not helpful are worth understanding carefully. Sometimes a trial of trauma treatment was not effective because the approach was not well-matched to the presentation, because the pacing moved too quickly before adequate stabilization, or because comorbid conditions were not adequately addressed. Our psychiatrists will review your prior treatment history as part of your initial evaluation and use that information to inform what approach is most li