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Trauma Informed Guilt Reduction (TrIGR) Therapy
Interested in Doing TrIGR?
Visit my Therapy page.
Want to Provide TrIGR to your Clients?
Buy the TrIGR manual and workbook. And reach out to me for a Training and/or some Consultation.
What Is TrIGR?
TrIGR is a short (4-6 session) therapy that some colleagues and I developed to explicitly address trauma related guilt and shame. It is a form of Cognitive Behavior Therapy (CBT), which is a family of therapies that has been scientifically shown to effectively treat many conditions.
Many thoughts that are born out of trauma are often not accurate, and it is really common for folks to come to inaccurate conclusions of guilt – like that they did something wrong or that they deserved the trauma. And this kind of trauma related guilt and shame is often entwined with other posttraumatic stress symptoms, and get in the way of effective treatment and recovery.
In TrIGR, clients are taught to identify their thoughts that cause feelings of guilt and shame, and to evaluate the accuracy of these thoughts. They are thus able to come to different perspectives, which reduces their posttraumatic distress symptoms.
We have found this to be the case with the many individual clients we did TrIGR with, and in the scientific studies of TrIGR we conducted.
TrIGR’s Origin Story
When I was a postdoctoral fellow at the Veterans Affairs (VA) San Diego Healthcare Center, I was trained to treat posttraumatic stress disorder (PTSD) with science-backed treatments such as Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT). These are very effective treatments and I successfully treated many of my patients with these.
However, I noticed that a substantial bunch of individuals who reported having guilt and shame dropped out early before they could benefit from the therapy.
My colleague, Dr. Sonya Norman, and I were trained in Edward Kubany's Cognitive Trauma Therapy for intimate partner violence survivors, which includes a module focused on addressing guilt and shame. This therapy has been found in research studies to be very effective, and in our experience the module on guilt and shame was where our patients tended to get the most bang for their buck. We made some adjustments to this module so that it could be applied to different types of trauma and started trying it out with our patients at the VA who seemed to stall in their recovery and reported a great deal of guilt and shame.
Many clients experienced large decreases in the intensity of their guilt and shame, and in their symptoms of posttraumatic stress like flashbacks, intrusive thoughts, being on edge and jumpy, avoidance of situations and people, and depression.
We therefore joined up with other clinical researcher colleagues to test out TrIGR in rigorous controlled scientific studies. And so far, the evidence is that TrIGR can help!
TrIGR's Scientific Backing
Norman, S.B., Capone, C., Panza, K., Haller, M., Davis, B.C., Schnurr, P.P., Shea, M.T., Brown, K., Norman, G.J., Lang, A.J., Kline, A.C., Golshan, S., Allard, C.B., & Angkaw, A. (2022). A clinical trial comparing trauma-informed guilt reduction therapy (TrIGR), a brief intervention for trauma-related guilt, to supportive care therapy. Depression and Anxiety, 39, 262-273. doi: 10.1002/da.23244.
Norman, S. B., Wilkins, K. C., Myers, U. S., & Allard, C.B. (2013). Trauma informed guilt reduction therapy with combat veterans. Cognitive and Behavioral Practice, 21, 78-88. doi:10.1016/j.cbpra.2013.08.001.
Ongoing research:
https://studypages.com/s/telehealth-therapy-study-for-veterans-experiencing-regret-remorse-or-guilt-990773/
UCSD Post-Traumatic Stress Disorder Trial → Non-Inferiority Trial of TrIGR for PTSD
What Others Are Saying About TrIGR
"..TrIGR therapy, and any tool that can be used to better manage the associated symptoms can be a source of healing and newfound freedom." ~ https://fherehab.com/learning/trauma-informed-guilt-reduction
"It benefits from the authors' insights, and case studies, using TrIGR in clinical practice over a number of years." ~ https://www.tandfonline.com/doi/full/10.1080/09638237.2021.1875425?scroll=top&needAccess=true
"Evidence published in 2022 in Current Treatment Options in Psychiatry suggests TrIGR could be effective in reducing trauma-related guilt." https://www.health.com/condition/ptsd/ptsd-symptoms
More Information, Webinars and Trainings on TrIGR
https://podiumcast.com/store/events/2019-ISTSS/201914111
https://apadiv56.talentlms.com/catalog
https://link.springer.com/article/10.1007/s40501-022-00261-7
Interested in Doing TrIGR?
Visit my Therapy page.
Want to Provide TrIGR to your Clients?
Buy the TrIGR manual and workbook. And reach out to me for a Training and/or some Consultation.
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