From the Guidelines
Monthly therapy sessions are not sufficient for managing reactivated trauma symptoms, and more frequent sessions, such as weekly or twice weekly, are often necessary to effectively address acute symptom flare-ups. According to the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline, as reported in the Annals of Internal Medicine in 2024 1, evidence-based approaches like Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), or Eye Movement Desensitization and Reprocessing (EMDR) are typically delivered in weekly sessions for 12-16 weeks initially.
When trauma symptoms are reactivated, increasing session frequency to weekly or twice weekly is often recommended until symptoms stabilize. Monthly sessions are more appropriate for maintenance after the initial intensive treatment phase. Key techniques such as grounding exercises, deep breathing, progressive muscle relaxation, and mindfulness practices can help manage reactivated symptoms by activating the parasympathetic nervous system and helping the brain process traumatic memories in a safe environment.
Some clients may also benefit from adjunctive medication prescribed by a psychiatrist, such as SSRIs (like sertraline or paroxetine) for ongoing PTSD symptoms, as recommended by the guideline 1. The effectiveness of therapy for trauma depends on the therapeutic relationship, consistency of sessions, and practicing coping skills between appointments. It is crucial to prioritize evidence-based, patient-centered care and shared decision making to optimize individuals’ health outcomes and quality of life, as emphasized in the guideline 1.
From the Research
Monthly Therapy Sessions and Reactivation of Trauma Symptoms
- The available evidence does not directly address the question of whether monthly therapy sessions help with the reactivation of trauma symptoms.
- However, studies have compared the efficacy of different therapies, such as Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive Behavioral Therapy (CBT), in reducing post-traumatic stress disorder (PTSD) symptoms 2, 3, 4, 5.
- These studies suggest that both EMDR and CBT can be effective in reducing PTSD symptoms, with some studies indicating that EMDR may lead to a faster recovery 3, 4.
- One study found that EMDR and trauma-focused CBT showed sustained effects at 1-4 month follow-up, which may be relevant to the question of monthly therapy sessions 2.
- Another study compared EMDR and CBT for treating panic disorder and found that EMDR was not worse than CBT in reducing panic symptoms and improving quality of life 6.
- A meta-analysis review compared EMDR and CBT for treating PTSD and found that EMDR reduced depression symptoms better than CBT in children, adolescents, and adults, and reduced anxiety in children and adolescents better than CBT 5.
- Overall, while the evidence does not directly address the question of monthly therapy sessions, it suggests that regular therapy sessions, regardless of frequency, can be beneficial in reducing PTSD symptoms and improving mental health outcomes 2, 3, 6, 4, 5.