What Is The Three-Stage Trauma Recovery Model? A Clinical Psychology Podcast Episode.

As a psychology Masters student at the time of writing with a massive interest in clinical psychology, I really like looking into therapies. This is even more true when I’m undergoing therapy and counselling for trauma, so when I found out my rape counselling was based on the Three-Stage Recovery Model by Judith Herman, I wanted to learn more. Granted, it took me 9 weeks to finally get round to researching the model in-depth but better late than never. Therefore, in this clinical psychology podcast episode, you’ll learn what are the three stages included in this recovery model, why are they useful and how does the model work to treat trauma. If you enjoy learning about mental health, clinical trauma work and psychotherapy then this is a brilliant podcast episode for you.

Today’s psychology podcast episode has been sponsored by Healing As A Survivor: A Personal and Clinical Psychology Guide to Healing From Sexual Violence. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.

What Is The Three-Stage Recovery Model By Judith Herman?

The more I read about trauma work and the psychological models designed to explain how to treat trauma, the more I realise how important American psychiatrist Judith Herman’s recovery model actually is. This model forms the foundation of a lot of psychotherapies as well as it is the basis of the specialist rape counselling that I underwent between September and December 2024. I technically have one session left at the time of writing but we’ve done all the therapeutic work.

Personally, whilst I’ll explain this model in a moment, as a psychology student, podcaster and writer, I find this model immensely useful. Since it explains how to deal with the trauma responses and gradually helps a client to return to a clinically normal life where they can control their actions, do the activities they want to do and they can enjoy life again.

As a client with sexual trauma, I found this model even more useful. It isn’t a linear model which bugged me and my autistic brain, but it is very helpful. It allowed me to basically get rid of my Post-Traumatic Stress Disorder, decrease my triggers dramatically and I can actually do things again with my life. For example, last week, I went out with a new friend one-on-one for the first time since my rape. That was amazing and so major for me because before the very notion of spending one-on-one time with anyone but my best friend would cause me to have a mental health crisis.

Ultimately, the three stages of the recovery model are:

·       Safety and Stabilisation

·       Remembrance and Mourning

·       Reconnection and Integration

During each of these stages, the therapist works with the client to create an environment where the client can safely process what happened to them without any sense of urgency.

This helps to ensure the recovery is sustainable as well as empowering.

What Is the Safety and Stabilisation Stage?

The first stage of the recovery model is the “Safety and Stabilisation” stage and when I’ve looked into trauma work in a psychotherapy context I’ve always heard rumours about stabilisation work, but it is only through my counselling that I was able to see what that looks like. Therefore, stabilisation work is the very bedrock and foundation of all the therapy work that happens afterwards. The client absolutely needs to feel physically and emotionally safe before they can ever hope to engage with their trauma.

There is a real-world caveat here but I’ll address it later.

In addition, a large focus for the therapist during stabilisation work is to build a rapport and ensure that clients feel comfortable with them. I always say how as therapists we are asking clients to reveal their own personal, dark moments to us, people who are effectively strangers. That takes a lot of courage and a lot of trust, so we need to earn that trust quickly and effectively.

One technique of helping clients feel comfortable is that trauma-informed counsellors must be prepared to disclose small amounts of personal information about themselves if the client asks a question. This is useful in building trust. Especially, as there is a relationship between the client and therapist called the therapeutic alliance, and if I adopt a marketing term “we buy from people we know, like and trust”. We can adapt this idea to psychology because “we like working with therapists, we know, like and trust”. Therefore, having a therapist open up to us about themselves helps us to know them so we can hopefully like them and trust them after a while too.

Judith Herman herself uses the comparison that clients like to know who’s “holding the rope” during their therapy sessions so they can develop their sense of safety. Just like how a climber likes to know who’s holding their rope (safety line) during a climbing challenge.

Moreover, stabilisation work involves reducing chaos and crisis in a client’s life so this might involve helping them to create a sense or environment of normalcy within the therapeutic environment. This helps the client to feel secure enough to explore their trauma. Especially, because trauma survivors typically feel unsafe internally (within themselves) as well as externally (in the physical world). This is why trauma-informed therapists work with clients to understand the difference between their internal and external realities and help them to learn techniques to manage hyperarousal and other trauma responses.

In another podcast episode, you’ll learn about Window of Tolerance for this reason.

On the whole, stabilisation work focuses on stabilisation techniques like psychoeducation, self-regulation and boundary-setting strategies. As well as therapists don’t force disclosures or force progress too quickly because clients need to be able to progress their trauma at their own speed. Also, therapists help clients during stabilisation work to reduce chaos and crisis in their life, create a safe space and give the clients tools to help them separate their internal and external realities. Something that is highly useful for dealing with flashbacks and other trauma responses.

What Is The Remembrance and Mourning Stage?

The second stage of Herman’s recovery model is the Remembrance and Mourning stage that focuses on reconstructing the trauma through remembrance and then mourning. Unfortunately, clients can experience this stage as a timeless descent with no clear endpoint.

Interestingly enough, I actually experienced this sense and it was painful because it felt like I was processing things, remembering a lot of awful details about my rape but I didn’t know what I was working towards. I didn’t even know where the counselling was heading towards and I felt confused that I wasn’t expressively telling her what happened during my rape.

Additionally, during this second stage, it isn’t unusual for clients to experience grief over various losses in their lives. For example, their loss of innocence, some failed relationships and even loss of family support or friends. This is important to remember when we consider that a lot of survivors, even more so for survivors abused within families, are often rejected or are faced with disbelief when they disclose their trauma. This leads clients to feel isolated as trauma can sever family ties.

This connects to the topic of Rape Grief that I talk about in another episode.

Moving onto the mourning aspect of this stage, I was no exception to this issue, a lot of clients mourn over the loss of years (or months) that their trauma has controlled their life. Clients feel like the trauma has robbed them of time that could have been spent in healthy relationships, personal growth and fulfilling careers. This is why it’s important that therapists support clients with empathy and without judgment so the client isn’t rushed.

Personally, when it came to my childhood trauma, I was angry for so long that I wasn’t able to form healthy friendships, relationships, get a boyfriend, kiss and enjoy so many normal things that normal teenagers are allowed to do. I mourned that loss for so, so long. Equally, when it came to my sexual trauma, I mourned for months that I was going through my PTSD, intense social anxiety, depression and all my other trauma responses. I mourned for the lost friendships, the lost ability to do fun things and I mourned for the impact it had/ has (still present tenses to be fair) on my writing, podcasting and everything else that I flat out love.

During this second stage, the therapist’s main job is to help a client process these losses and provide a safe space for a client to recount their trauma without the pressure of time or any expectations. Clarity, courage and trust are all needed for therapists and clients throughout this stage.

What is The Reconnection and Integration Stage of The Recovery Model?

In the final stage of the model, therapists work with clients to help them work towards reconnecting with their world as well as integrating their trauma into a new sense of self. For example, during this stage, clients regain trust in their relationships because they’ve learnt how to extend their trust and when it’s best not to extend trust to someone. As well as this stage involves something called “reparenting”. I first came across this term in my counselling during August 2023 and this is a term that describes the therapist’s role in modelling healthy boundaries as well as relationships. When it comes to trauma survivors, this can include relearning what are, how to have and how to recognise healthy sexual relationships. Something that myself and a lot of different survivors find immensely difficult, because this “reparenting” is often the first time that someone has spoken to us about what on Earth healthy relationships look like.

In addition, a major part of reconnection during this stage is the survivor developing and maintaining their ability to form and sustain healthy relationships. This doesn’t only mean sexual relationships, but it can include friendships and familial relationships too. I talk a lot about these aspects of my trauma recovery in my book Healing As A Survivor. Also, for survivors of sexual abuse and sexual violence, a lot of survivors have to rediscover their sexual identity and sexual preferences, which is immensely challenging, because this only adds to the struggle that survivors have around their sense of self.

Furthermore, you tend to be able to see progress in this stage of trauma recovery in a few different ways. For instance, as clients progress, they can enjoy intimacy or new experiences without associating it with their abuser or feeling like they need to be protected from their abuser. And the reason why these are amazing, wonderful moments for survivors is because they show the client is growing in their autonomy and ability to live with the fear and trauma responses that have ruled their life for so long.

I know for me, being able to go out with a newish friend one-on-one was an amazing experience, because for the past 7 months that would have been flat out impossible. It would have caused me to have a panic attack, a breakdown and I would have had constant trauma responses. That had happened a good few times.

However, this is a difficult and scary stage of trauma recovery because it’s an immensely weird and disorienting feeling to know that you don’t need to be protected from your attacker. Also, it is so disorienting to feel safe secure to experience life and pleasure without trauma responses. I talk more about this in my healing book, but I found it weird because I had been having severe PTSD for 7 months and then it wasn’t.

It was weird to experience such an extreme change.

Clinical Psychology Conclusion

As much as I love the trauma recovery model because I have experienced it in the real world and I know how it can transform lives for the better, it isn’t the best applied psychological model. Since the model itself proposes that these stages are very linear, but in reality, you tend to work through all these stages at the same time to different extents. When I was talking to my counsellor about this model, she explained how we work a lot on Stage 1 at the beginning but during stabilization work, you are processing the trauma too, and doing a little integration work too. Whereas towards the end of the therapy, you’re working more on integration work and less on processing trauma and stabilisation work, but those stages are still present too.

Ultimately, the Three-Stage Recovery Model is a humane and thorough model that provides a helpful framework for trauma therapy. It focuses on client safety and respecting client autonomy during the healing process because the model stresses it is the client that controls their pace, not the therapist. Then the therapist facilitates the client’s recovery by respecting the complex nature of trauma and provides the client with a safe space. As well as therapists and clients need to understand what can be achieved in the limited number of sessions that a mental health service provides so it’s easier to maintain realistic therapeutic goals.

Yet we need to remember as aspiring and qualified psychologists that trauma work is not easier on us.

I know I always talk about how important focusing on our clients are but honestly, we are so important too. We cannot help people if we don’t look after ourselves and if our mental health isn’t as good as it could be. Therefore, clinical supervision and self-care are critical for therapists because trauma work takes an emotional toll on us so we need to practice good self-care and we need to balance what our clients need with our capacity. As well as trauma-informed therapists should receive ongoing professional support so regular discussions in supervision and peer consultations can be useful in maintaining their effectiveness and well-being. Finally, a supportive work environment is important too so therapists and clients can work in a safe environment and have the time needed for meaningful, sustained healing.

That will ultimately change our client’s life for the better.

I really hope you enjoyed today’s forensic psychology podcast episode.

If you want to learn more, please check out:

FREE 8 PSYCHOLOGY BOOK BOXSET

Healing As A Survivor: A Personal and Clinical Psychology Guide to Healing From Sexual Violence. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.

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Have a great day.

Clinical Psychology References and Further Reading

Herman, J. L. (1998). Recovery from psychological trauma. Psychiatry and Clinical Neurosciences, 52(S1), S98-S103.

Herman, J. L. (2015). Trauma and recovery: The aftermath of violence--from domestic abuse to political terror. Hachette uK.

Herman, J. L., & van der Kolk, B. A. (2020). Treating complex traumatic stress disorders in adults: Scientific foundations and therapeutic models. Guilford Publications.

Mendelsohn, M., Herman, J. L., Schatzow, E., Coco, M., Kallivayalil, D., & Levitan, J. (2011). The trauma recovery group: A guide for practitioners. Guilford Press.

Zaleski, K. L., Johnson, D. K., & Klein, J. T. (2016). Grounding Judith Herman’s trauma theory within interpersonal neuroscience and evidence-based practice modalities for trauma treatment. Smith College Studies in Social Work, 86(4), 377-393.

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