Trauma & PTSD

Conditions we treat

The DSM-5-TR groups these as trauma- and stressor-related disorders. A diagnosis is made only by a licensed clinician after a full evaluation.

Posttraumatic stress disorder (PTSD)

After exposure to actual or threatened death, serious injury or sexual violence (experienced directly, witnessed, learned about happening to someone close, or encountered repeatedly through work, as first responders and others do), symptoms in four areas last more than a month: intrusion (memories, nightmares, flashbacks), avoidance, negative changes in thinking and mood, and changes in arousal and reactivity. The DSM-5-TR also describes a dissociative subtype and a version for children six and under.

Complex trauma and developmental trauma

Trauma that was repeated or prolonged, often beginning in childhood and often at the hands of someone who should have been safe. Alongside PTSD symptoms, people commonly struggle with managing emotions, a damaged sense of self, and trust in relationships. The DSM-5-TR treats this within PTSD; the World Health Organization's ICD-11 names it complex PTSD. Either way, it responds to phased, trauma-focused treatment.

Acute stress disorder

Intrusive memories, negative mood, dissociation, avoidance and hyperarousal in the first three days to one month after a traumatic event. Early treatment can reduce the chance that it becomes PTSD.

Adjustment disorders

Emotional or behavioral symptoms (low mood, anxiety, acting out) that start within three months of an identifiable stressor such as a divorce, job loss, diagnosis or move, and are out of proportion to it or impair daily life. See our page on stress and life transitions.

Reactive attachment disorder (RAD)

In young children who experienced severe neglect or repeated changes in caregivers: consistently withdrawn, rarely seeking or responding to comfort, with limited positive emotion and unexplained irritability, sadness or fearfulness even with caregivers.

Disinhibited social engagement disorder (DSED)

Also following severe neglect: a child who readily approaches and goes off with unfamiliar adults, with little of the normal wariness. We work with children, foster and adoptive families on both attachment conditions.

Prolonged grief disorder

Added to the DSM-5-TR in 2022 and grouped here: intense yearning or preoccupation with a person who died that persists a year or more (six months in children) and disrupts life. See our grief and loss page.

How we treat it

The treatments with the strongest evidence for PTSD are trauma-focused: EMDR, cognitive processing therapy (CPT), prolonged exposure, and TF-CBT for children and teens. Our clinicians are trained in EMDR, CPT, TF-CBT and trauma-informed care, which means treatment moves at your pace, starts with safety and stabilization, and never forces you to disclose more than you're ready to. Many of our therapists have specific experience with military members, veterans and first responders.

• EMDR
• Trauma-informed therapy
• Cognitive behavioral therapy (CBT)
• Dialectical behavior therapy (DBT)
• Play therapy
• All approaches

Where to get help for trauma & PTSD

Available at every Oceanic® office and through our telehealth team.

Diagnostic descriptions on this page are summarized in plain language from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR, 2022). This page is educational. It is not a substitute for evaluation by a licensed clinician, and only a licensed clinician can make a diagnosis.