Breaking Down to Build Up: Exploring the Interconnection Between Cognitions, Emotions, and Beliefs in Ethical Trauma Treatment

Ethical treatment for clients exhibiting trauma-related distress due to crisis events requires counselors to be familiar with various cognitive, emotional, interpersonal, and spiritual shifts that may occur in the wake of these life-altering experiences. This current work explores differentiations between thoughts, feelings, and beliefs in relation to unique ways clients respond to trauma, followed by a comprehensive overview of cognitive schema construction and commonly overlooked trauma wounds of guilt, shame, and moral injury. Readers will review an intrapersonal-environmental feedback loop model, which can serve as a psychoeducational and conceptual foundation for examining sources of distorted cognitions, emotional and physiological responses, behavior changes, and adapted belief systems as clients attempt to make new meaning following traumatic exposure. Finally, the authors introduce three evidence-based treatment approaches which intentionally and ethically match the greatest sources of distress in overall functioning for individual trauma survivors. These modalities include (1) schema, (2) Trauma Informed Guilt Reduction (TriGR), and narrative therapies.