By request.... I’ve been asked to clarify the difference between Trauma Focused Cognitive Behaviour Therapy (TFCBT) and Rewind technique because apparently some are claiming that they are very similar... here’s why this is

1. Rewind technique is a technique derived from NLP & hypnosis.

TFCBT is a comprehensive psychological therapy grounded in contemporary scientific knowledge about PTSD.

IMHO this is still the seminal paper outlining the cognitive model of PTSD:

http://aidir.home.mruni.eu/wp-content/uploads/2008/11/cognitivehlers_clark_2000.pdf

Rewind is a simple technique where the person is purportedly taken into a place of ‘deep relaxation’ and then asked to rewind and fast forward through their trauma from a safe place. It is claimed to be quick and painless.

Anyone can train in rewind technique... the ‘therapist’ does not have to be a mental health professional or have any healthcare qualifications at all. They do not have to be comprehensively trained in psychological therapies.

Now I will tell you what competently delivered TFCBT looks like. Unfortunately, I am very aware that this is not necessarily how it plays out in over stretched services and I am sorry for anyone who is suffering from PTSD and is not able to get good treatment.

So... competently delivered TFCBT....

To train in CBT you generally already need to be a registered HCP and most people train in CBT before doing further training and getting specialised supervision in TFCBT if they are going to be working with people with PTSD.

Step 1 is a comprehensive assessment which may be done by the therapist or by another professional - very often people come to me already very well assessed by one of my psychiatry colleagues. But if not, I will want to clarify that their primary problem is PTSD...

PTSD is not the only reaction to a traumatic event and people can be very distressed by difficult experiences but not have PTSD. Could this be depression, anxiety, substance abuse disorder, adjustment disorder... all of which might impact the direction and priorities in therapy.

I am not going to launch into techniques without a thorough assessment.... and that assessment is also going to involve some consideration of the wider picture, potential risk issues and the personal and social circumstances of the patient and how this might effect therapy

So lets assume we are good to go with TFCBT... the model guides us that the person’s appraisal of the traumatic event itself, it’s sequelae and of their emotional responses are all likely factors contributing to a sense of current threat so I will want to explore those.

The model also recognises that trauma overwhelms our ability process info so trauma memories do not get embedded in autobiographical/past memories, can be poorly elaborated & therefore are easily triggered and have a here and now quality to them ... hence flashbacks & nightmares