Three-Phase Model of Change (Helping the Client To Be Seen, To Be Heard & To Reclaim Dignity)
Phase One: Understanding the Current State of Emotional Dysregulation (Mapping Risks & Jumpstarting Resilience). This phase involves both a formal diagnostic evaluation and education regarding the neurophysiology, brain and body effects of trauma and PTSD and other relevant problems you report. If addiction is present we will assess for severity and make clear recommendations regarding a course of action. Often our patients have already begun to reduce their substance use or are in early stages of recovery. This is an excellent time to engage in Phase One services. Skills that clients learn in session are often augmented by homework with phone apps, outside classes in meditation, or listening or watching relevant videos. We will make all the recommendations available to you once you have begun your work. You will learn about adaptations to trauma that may be quite familiar to you but that you have never named or studied such as dissociation, numbing, avoidance and moral injury. You will learn and practice skills that will prepare you for Phase Two.
Phase Two: Unbraiding the Story of Trauma, Loss, and Survival. This is often the most rewarding part of your therapeutic journey. It also can be the most challenging. It involves unpacking what led up to the traumatic events, that is, who you were at the time that the catastrophic events unfolded and who were the main characters who hurt you. The heart of the work is highly client-centered: where you were in your development (even as an adult), what were your values, hopes, and dreams. What assumptions about the world were shattered at the time? What decisions did you make regarding who you were going to be or not be going forward? Deconditioning techniques are usually necessary to address the extreme emotional reactivity of traumatic memories. Techniques used in Phase Two include prolonged exposure, cognitive processing therapy (CPT), and eye movement desensitization and reprocessing (EMDR). Broad philosophical approaches to change are reviewed with the client such as acceptance approaches, mindfulness, and self-compassion.
Phase Three: Finding Meaning, Purpose and Opportunities to Re-Connect. Once the heart of PTSD is treated successfully–that is, the reactivity is softened and the numbing begins to thaw–you will be invited into a Socratic exchange–a deepening conversation involving nonjudgmental questioning–regarding your place in the world and how you see yourself as a part of a greater whole. This happens with gentle guidance drawn from your core values and lessons learned from the resourcefulness of your survival instincts. Phase Three is often the most reflective and eye-opening of the three phases of therapy. We invite patients to consider what they want their legacy to be, or how they want to be remembered. These kinds of questions in Phase One may be absurd to even consider when feelings of trust and betrayal are at the forefront. But quite often we find that there have been signs all along of hope, forgiveness and acceptance within the heart of the client herself. Phase Three helps the client find a renewed passion for work or relationships, or precipitates a shift in perspective leading to an entirely different life or career path. It often involves a spontaneous and very personal understanding of some idea of spirit, soul, and sometimes engaging in formal religious practices once.
Dr. Abueg’s has expertise in all of the following psychological intervention approaches:
- Post-Traumatic Stress Disorder (PTSD) Diagnosis and subclinical presentations
- Careful, differential diagnosis of complex posttraumatic presentations with attention to multiple diagnoses
- Gentle, effective cognitive-behavioral therapy (CBT)
- Eye Movement Desensitization & Reprocessing (EMDR) Level-II Certified
- Acceptance Commitment Therapy (ACT)
- Prolonged Exposure Therapy, Seeking Safety, Mindfulness-Based Exposure Therapy
- Cognitive Processing Therapy (CPT)
- Dual Diagnosis (post-traumatic disorders and addictive behaviors)
- Depth therapy with psychoanalytic emphasis (object relations and attachment focus)
- Grief Counseling (especially protracted or complicated grieving)
- Relapse Prevention