Trauma Therapy · PTSD
PTSD treatment in Frederick, MD.
Evidence-based PTSD treatment delivered by clinicians who specialize in trauma. Here's what PTSD is, how it's diagnosed, and what treatment looks like at our practice.
What PTSD is
Post-traumatic stress disorder (PTSD) is what happens when the nervous system's response to a traumatic event does not fully resolve. The memory of the event stays "stuck" in a way that keeps it feeling present. Sounds, sights, smells, or situations that resemble the original event can trigger intense emotional and physical responses, as if the event were happening again.
The National Institute of Mental Health estimates that around 6 percent of adults in the United States will develop PTSD at some point in their life, and many more carry trauma symptoms that don't quite meet the diagnostic threshold but still meaningfully shape day-to-day life.
PTSD is treatable. The decades of research on evidence-based PTSD treatments are some of the most encouraging in mental health. Most people who complete a course of trauma-focused therapy experience significant symptom reduction, and many no longer meet PTSD diagnostic criteria after treatment.
How it is diagnosed
The DSM-5 criteria for PTSD
PTSD is diagnosed using the DSM-5 criteria. Diagnosis requires exposure to a qualifying traumatic event plus symptoms in four categories, persisting for more than one month and causing meaningful distress or impairment.
Criterion A: Exposure
Exposure to actual or threatened death, serious injury, or sexual violence — directly experienced, witnessed, learned about (involving a close family member or friend), or repeated extreme exposure (often relevant for first responders and clinicians).
Criterion B: Intrusion symptoms
Unwanted memories, distressing dreams, flashbacks, intense psychological distress at exposure to reminders, or marked physical reactions to reminders of the event.
Criterion C: Avoidance
Persistent avoidance of internal or external reminders of the event: thoughts, feelings, conversations, people, places, or activities that bring up the memory.
Criterion D: Negative changes in mood and thinking
Distorted beliefs about self or the world, persistent low mood, feelings of detachment from others, inability to experience positive emotions, or persistent shame, guilt, or fear.
Criterion E: Changes in arousal and reactivity
Hypervigilance, exaggerated startle response, irritability, sleep difficulties, difficulty concentrating, or reckless or self-destructive behavior. The nervous system is still on guard.
People can experience symptoms in some categories without meeting the full diagnostic threshold. Trauma therapy can still help in those cases. Diagnosis matters for things like insurance billing, but it does not determine whether the work will be useful for you.
Front-line PTSD treatments
The 2023 VA/DoD Clinical Practice Guideline for PTSD gives Strong For recommendations to three trauma-focused psychotherapies. The APA's 2025 PTSD guideline reaches similar conclusions. The three approaches are different in form but share the front-line evidence base:
Eye Movement Desensitization and Reprocessing (EMDR)
Our practice's primary modality. EMDR helps the brain process and resolve disturbing memories using bilateral stimulation while you hold the memory in mind. It does not require detailed verbal recounting, which makes it more accessible for many people who find narrating trauma overwhelming. More on EMDR for PTSD →
Cognitive Processing Therapy (CPT)
A structured cognitive-behavioral therapy specifically designed for PTSD. CPT works through written assignments and structured cognitive exercises that help identify and shift the "stuck points" — the beliefs that formed during or after the trauma and continue to drive symptoms. Typically delivered over 12 sessions.
Prolonged Exposure (PE)
A trauma-focused CBT that involves gradual, structured exposure to trauma memories and situations that are being avoided. PE has strong evidence for PTSD but requires the client to engage the trauma narrative in detail, which is part of why some people prefer EMDR or CPT.
Medication: SSRIs
Selective serotonin reuptake inhibitors (SSRIs) such as sertraline and paroxetine are FDA-approved for PTSD and recommended in the major guidelines. Medication is often most effective in combination with trauma-focused therapy rather than as a standalone treatment. We coordinate with outside prescribers and offer medication management directly.
What we typically lead with
Our practice leads with EMDR for most clients with PTSD. EMDR is the modality our team has the deepest training in, and the evidence supports it as a front-line option. For clients for whom EMDR is not the right fit (some forms of dissociation, certain comorbidities), we adapt and may integrate or refer for other approaches.
What PTSD treatment looks like at our practice
Treatment for PTSD typically follows a three-phase structure regardless of the specific modality: stabilization first, then processing, then integration. Each phase has a clinical purpose, and rushing past the first phase is a known failure mode that often makes symptoms worse.
Phase 1: Stabilization
Building the foundation: getting to know each other, learning grounding skills, identifying your resources, and making sure you have what you need to engage difficult material safely. For single-incident PTSD, this can be relatively brief. For complex PTSD, it can take significantly longer.
Phase 2: Processing
Active trauma work. EMDR, CPT, or PE depending on what fits you. The trauma memory is approached in a structured way, paced by your therapist to stay within your window of tolerance. Symptoms typically begin to shift during this phase.
Phase 3: Integration
Consolidating gains, addressing any remaining present-day triggers, and helping you re-engage with the parts of life PTSD had constrained. Treatment moves toward a clear ending point, with a plan for continued care if needed.
Sessions are typically weekly, 50 minutes each, though some EMDR sessions are 75 or 90 minutes when that fits the work. EMDR intensives can condense weeks of standard treatment into a focused window for clients who fit that format.
If you are in crisis right now
We are an outpatient practice and not a crisis service. If you or someone you love is in immediate danger or thinking about suicide, please call or text 988 for the Suicide and Crisis Lifeline, or go to your nearest emergency room. Help is available right now.
Looking for PTSD treatment in Frederick County?
A consultation is the most direct way to talk through what's going on and figure out the right starting place. There is no commitment to start care from a consultation.