Trauma and PTSD Therapists in Imperial, PA

Photo of Daniella Parrish, MSCP, LPC, LBS, Licensed Professional Counselor
Daniella Parrish
Licensed Professional Counselor, MSCP, LPC, LBS
Verified Verified
Imperial, PA 15126
Waitlist for new clients
My experience includes but is not limited to: Autism Spectrum Disorders, Intellectual Disability, ADHD, Anxiety, Depression, Mood Disorders, Oppositional Defiance, Disruptive Behaviors, behavioral modification, Relationship Issues/Communication and Family Therapy, trauma.
Welcome! I am a Licensed Professional Counselor and a Licensed Behavioral Specialist. I have over 10 years experience in providing therapy services to clients from early childhood age to adult. I work with individuals, couples and families in reaching their goals and maximizing their unique strengths and potential. I am focused on providing a supportive, safe and comfortable environment to work with my clients in utilizing their strengths in overcoming challenges they may face. My goal is to help you build confidence, develop a better quality of life, and develop strength based, individualized goals and interventions.
My experience includes but is not limited to: Autism Spectrum Disorders, Intellectual Disability, ADHD, Anxiety, Depression, Mood Disorders, Oppositional Defiance, Disruptive Behaviors, behavioral modification, Relationship Issues/Communication and Family Therapy, trauma.
Welcome! I am a Licensed Professional Counselor and a Licensed Behavioral Specialist. I have over 10 years experience in providing therapy services to clients from early childhood age to adult. I work with individuals, couples and families in reaching their goals and maximizing their unique strengths and potential. I am focused on providing a supportive, safe and comfortable environment to work with my clients in utilizing their strengths in overcoming challenges they may face. My goal is to help you build confidence, develop a better quality of life, and develop strength based, individualized goals and interventions.
(412) 254-8009 View (412) 254-8009
Photo of Myleah Diehl, NCC, LPC, Licensed Professional Counselor
Myleah Diehl
Licensed Professional Counselor, NCC, LPC
Verified Verified
Imperial, PA 15126
My ideal client would likely suffer from PTSD, anxiety, negative self-talk, and struggles with daily functioning at times. My goal is to help the client obtain their goals of normal daily functioning. My ideal client is brought into therapy and focused on utilizing the tools given in therapy to apply to daily life. A client must want change and be willing to put in the work to obtain it. I am interested in clients who are motivated and engaged to do more.
My ideal client would likely suffer from PTSD, anxiety, negative self-talk, and struggles with daily functioning at times. My goal is to help the client obtain their goals of normal daily functioning. My ideal client is brought into therapy and focused on utilizing the tools given in therapy to apply to daily life. A client must want change and be willing to put in the work to obtain it. I am interested in clients who are motivated and engaged to do more.
(412) 415-7279 View (412) 415-7279
Photo of Katelyn King, LCSW, Clinical Social Work/Therapist
Katelyn King
Clinical Social Work/Therapist, LCSW
Verified Verified
Imperial, PA 15126
I am adept at supporting clients with anxiety, depression, and trauma-related symptoms, seeking greater self-awareness, clarity, and insight about their current struggles and how to shift them. My ideal client is motivated to change and is interested in co-creating the goals to work towards that change, with the ultimate aim being to reduce distress and build/nurture a rich and meaningful life. I often suggest homework to help practice the skills we are learning together in session. I integrate extensive clinical experience, specialized training, & my unique personality (including a healthy dose of confidence, humility, and humor).
I am adept at supporting clients with anxiety, depression, and trauma-related symptoms, seeking greater self-awareness, clarity, and insight about their current struggles and how to shift them. My ideal client is motivated to change and is interested in co-creating the goals to work towards that change, with the ultimate aim being to reduce distress and build/nurture a rich and meaningful life. I often suggest homework to help practice the skills we are learning together in session. I integrate extensive clinical experience, specialized training, & my unique personality (including a healthy dose of confidence, humility, and humor).
(412) 465-6378 View (412) 465-6378
Photo of Elizabeth Simmons, LCSW , DBT-C, Clinical Social Work/Therapist
Elizabeth Simmons
Clinical Social Work/Therapist, LCSW , DBT-C
Verified Verified
Imperial, PA 15126
I specialize in trauma, personality disorders, addiction disorders, LGBTQIA+ issues, body positivity, HIV/AIDS, forensic issues, immigrant/refugee issues, women's issues, and civil rights/social justice.
I will teach you how to live fully in each moment, be unapologetically and authentically you, cope with stress more effectively, regulate your emotions, and improve your relationships with others. My ideal client is ready to work with me, as i support and guide them. I will work with you if you feel like you're doing mostly ok, and I will work with you if you feel like you are a mess and don't even know where to start. Healing is hard work, but it's so worthwhile and I'd love to help you get to the other side and be able to live your best life as your best, most authentic self.
I specialize in trauma, personality disorders, addiction disorders, LGBTQIA+ issues, body positivity, HIV/AIDS, forensic issues, immigrant/refugee issues, women's issues, and civil rights/social justice.
I will teach you how to live fully in each moment, be unapologetically and authentically you, cope with stress more effectively, regulate your emotions, and improve your relationships with others. My ideal client is ready to work with me, as i support and guide them. I will work with you if you feel like you're doing mostly ok, and I will work with you if you feel like you are a mess and don't even know where to start. Healing is hard work, but it's so worthwhile and I'd love to help you get to the other side and be able to live your best life as your best, most authentic self.
(412) 293-0459 View (412) 293-0459
Photo of Savanna Stanton-Ameisen, LPC, Licensed Professional Counselor
Savanna Stanton-Ameisen
Licensed Professional Counselor, LPC
Verified Verified
Imperial, PA 15126
I specialize in working with children, adolescents, adults, and families who struggle with eating disorders, substance use disorders, trauma, depression, anxiety, and personality disorders.
My ideal client would be someone motivated to engage in motivational interviewing and change work.
I specialize in working with children, adolescents, adults, and families who struggle with eating disorders, substance use disorders, trauma, depression, anxiety, and personality disorders.
My ideal client would be someone motivated to engage in motivational interviewing and change work.
(412) 538-6393 View (412) 538-6393
Photo of Sarah Sprenkle, MS, LPC , NIT, Licensed Professional Counselor
Sarah Sprenkle
Licensed Professional Counselor, MS, LPC , NIT
Verified Verified
Imperial, PA 15126
Do you feel disconnected from yourself and your feelings, possibly due to trauma? Do you lack understanding of the cause & need education on how the brain responds to trauma? Do you have relational issues or anger management struggles that lead to addictive behaviors? Do you struggle with self-worth issues and feel tired, frustrated, and confused? In therapy, you will learn to identify trauma responses, build tolerance for difficult or uncomfortable feelings, & utilize various coping skills & grounding techniques. Gain confidence, take risks to address complex issues & learn how to create healthy boundaries for relationships.
Do you feel disconnected from yourself and your feelings, possibly due to trauma? Do you lack understanding of the cause & need education on how the brain responds to trauma? Do you have relational issues or anger management struggles that lead to addictive behaviors? Do you struggle with self-worth issues and feel tired, frustrated, and confused? In therapy, you will learn to identify trauma responses, build tolerance for difficult or uncomfortable feelings, & utilize various coping skills & grounding techniques. Gain confidence, take risks to address complex issues & learn how to create healthy boundaries for relationships.
(412) 903-3246 View (412) 903-3246
Photo of Josie Albrecht, LPC, Licensed Professional Counselor
Josie Albrecht
Licensed Professional Counselor, LPC
Verified Verified
Imperial, PA 15126
As a trauma therapist and embodied human, I recognize the importance of bottom-up therapies, working from our visceral responses to facilitate healing and change.
I enjoy working with clients who want to get to the root of their struggles. These clients would like to gain insight into their symptoms, something difficult that has happened to them or to explore cycles and patterns that aren’t serving them. The clients I see often have attended therapy in the past. The clients I see also often present with attachment-based traumas, symptoms of post-traumatic stress, and difficulties in their personal and work relationships.
As a trauma therapist and embodied human, I recognize the importance of bottom-up therapies, working from our visceral responses to facilitate healing and change.
I enjoy working with clients who want to get to the root of their struggles. These clients would like to gain insight into their symptoms, something difficult that has happened to them or to explore cycles and patterns that aren’t serving them. The clients I see often have attended therapy in the past. The clients I see also often present with attachment-based traumas, symptoms of post-traumatic stress, and difficulties in their personal and work relationships.
(412) 388-2194 View (412) 388-2194
Photo of Andrew Oostdyk, LSW, Clinical Social Work/Therapist
Andrew Oostdyk
Clinical Social Work/Therapist, LSW
Verified Verified
Imperial, PA 15126
Through my work at Veterans Affairs and the patient population of first responders at Recovery Centers of America, I have a specialty in trauma-informed care.
My ideal client is one with motivation for self-care, openness to change, and a desire to learn more about themselves and others. My ideal population consists of adults with a mental health diagnosis of anxiety, depression, PTSD, substance use disorder, and other increasingly complex diagnoses. However, I am also devoted to assisting those seeking help without a defined diagnosis and who are beginning therapy without a clear vision of treatment needs. I welcome working with anyone who may benefit from my skillset who is dealing with life’s many challenges and searching for a clearer definition and understanding of their stressors.
Through my work at Veterans Affairs and the patient population of first responders at Recovery Centers of America, I have a specialty in trauma-informed care.
My ideal client is one with motivation for self-care, openness to change, and a desire to learn more about themselves and others. My ideal population consists of adults with a mental health diagnosis of anxiety, depression, PTSD, substance use disorder, and other increasingly complex diagnoses. However, I am also devoted to assisting those seeking help without a defined diagnosis and who are beginning therapy without a clear vision of treatment needs. I welcome working with anyone who may benefit from my skillset who is dealing with life’s many challenges and searching for a clearer definition and understanding of their stressors.
(412) 844-5749 View (412) 844-5749
Photo of Gregory Mairs, LMFT, Marriage & Family Therapist
Gregory Mairs
Marriage & Family Therapist, LMFT
Verified Verified
Imperial, PA 15126
I have an extensive professional history of working with families and couples in crisis. Many of us struggle in our relationships & find that clear communication is challenging for many reasons. The barriers may include issues with past trauma or failed attempts to find the right words during a conflict. I bring the structural therapy tools to help a family, couple, or individual recognize the triggers of their conflicts, explore past trauma & the impact it may have on the current relationship/situation, help the individual challenge automatic negative assumptions, & find a response which leads to clear communication.
I have an extensive professional history of working with families and couples in crisis. Many of us struggle in our relationships & find that clear communication is challenging for many reasons. The barriers may include issues with past trauma or failed attempts to find the right words during a conflict. I bring the structural therapy tools to help a family, couple, or individual recognize the triggers of their conflicts, explore past trauma & the impact it may have on the current relationship/situation, help the individual challenge automatic negative assumptions, & find a response which leads to clear communication.
(412) 517-7484 View (412) 517-7484
Photo of Faith Niemcewicz, LPC, Licensed Professional Counselor
Faith Niemcewicz
Licensed Professional Counselor, LPC
Verified Verified
Imperial, PA 15126
With a degree in trauma & 2+ years in trauma-informed programs, I am well-versed in various forms of trauma and ways to cope with traumatic experiences, PTSD symptoms, etc.
Do you need support in stress management, life transitions, trauma, depression/anxiety, developing effective coping strategies, etc? Do you want to feel more "free" emotionally, mentally, & physically, wanting to improve your life for yourself and possible future relationships/children/family? My ideal client is motivated to engage in treatment and reach their goals of becoming more psychologically flexible and strengthening their connections with themselves and those meaningful relationships around them.
With a degree in trauma & 2+ years in trauma-informed programs, I am well-versed in various forms of trauma and ways to cope with traumatic experiences, PTSD symptoms, etc.
Do you need support in stress management, life transitions, trauma, depression/anxiety, developing effective coping strategies, etc? Do you want to feel more "free" emotionally, mentally, & physically, wanting to improve your life for yourself and possible future relationships/children/family? My ideal client is motivated to engage in treatment and reach their goals of becoming more psychologically flexible and strengthening their connections with themselves and those meaningful relationships around them.
(412) 435-1325 View (412) 435-1325
Photo of Aditi Kahn, LSW, Clinical Social Work/Therapist
Aditi Kahn
Clinical Social Work/Therapist, LSW
Verified Verified
Imperial, PA 15126
My area of expertise is trauma & I approach it from a strength and a person-centered perspective.
My educational background in human rights & social justice has equipped me with skills to work with a diverse range of clients. I derived great satisfaction from assisting women who were facing challenges related to domestic violence or marital issues. My ideal clients are women who need to be reminded of their strength & value in this world. My approach involves empowering women through assertiveness training & connecting them with community resources to aid them towards independence. I help them recognize & develop their inner strengths, equipping them with tools to manage & overcome problems independently.
My area of expertise is trauma & I approach it from a strength and a person-centered perspective.
My educational background in human rights & social justice has equipped me with skills to work with a diverse range of clients. I derived great satisfaction from assisting women who were facing challenges related to domestic violence or marital issues. My ideal clients are women who need to be reminded of their strength & value in this world. My approach involves empowering women through assertiveness training & connecting them with community resources to aid them towards independence. I help them recognize & develop their inner strengths, equipping them with tools to manage & overcome problems independently.
(412) 960-2988 View (412) 960-2988
Photo of Brittany Shaffer, MSW , LSW, Clinical Social Work/Therapist
Brittany Shaffer
Clinical Social Work/Therapist, MSW , LSW
Verified Verified
Imperial, PA 15126
I specialize in working with clients who have experienced childhood trauma, domestic/intimate partner violence or relationship challenges, chronic pain/illness, and substance use issues. I also appreciate the beautiful tangents, metaphors, and insights from my work with neurodiverse clients. Much of my work focused on helping clients examine how trauma has shaped their lives, decisions, & current circumstances and find ways to heal. Finding meaning and insight from the connections and patterns we can see in the past and present is key to informing the work we can do together to pursue a more intentional and satisfying future.
I specialize in working with clients who have experienced childhood trauma, domestic/intimate partner violence or relationship challenges, chronic pain/illness, and substance use issues. I also appreciate the beautiful tangents, metaphors, and insights from my work with neurodiverse clients. Much of my work focused on helping clients examine how trauma has shaped their lives, decisions, & current circumstances and find ways to heal. Finding meaning and insight from the connections and patterns we can see in the past and present is key to informing the work we can do together to pursue a more intentional and satisfying future.
(412) 732-7626 View (412) 732-7626
Photo of Hannah Gilmore, LSW, MSW, Clinical Social Work/Therapist
Hannah Gilmore
Clinical Social Work/Therapist, LSW, MSW
Verified Verified
Imperial, PA 15126
Our wounds, losses, and trauma can trap us in painful patterns of avoidance, anger, fear, sadness, guilt, and shame.
Whether you are coming to therapy for anxiety, depression, grief, relationship issues, a life change, or just a general sense of unease, facing these issues can be scary. Healing isn’t easy because it involves confronting our pain and hurts. Healing can also be full of joy, hope, connection, and freedom as we experience new possibilities of being and relating. My approach is warm, relational, and integrative. I strive to offer a space where you can feel safe enough to look inward – to gently and compassionately welcome all parts of yourself with less judgment and shame.
Our wounds, losses, and trauma can trap us in painful patterns of avoidance, anger, fear, sadness, guilt, and shame.
Whether you are coming to therapy for anxiety, depression, grief, relationship issues, a life change, or just a general sense of unease, facing these issues can be scary. Healing isn’t easy because it involves confronting our pain and hurts. Healing can also be full of joy, hope, connection, and freedom as we experience new possibilities of being and relating. My approach is warm, relational, and integrative. I strive to offer a space where you can feel safe enough to look inward – to gently and compassionately welcome all parts of yourself with less judgment and shame.
(412) 214-8615 View (412) 214-8615
Photo of Khalida Sethi, LCSW, Clinical Social Work/Therapist
Khalida Sethi
Clinical Social Work/Therapist, LCSW
Verified Verified
Imperial, PA 15126
We would learn to honor how trauma appears in the body and slowly work to release that.
My ideal client would be ready for a challenge. Someone who wants their worldview expanded, prepared to find internal and external connection with the world. My ideal client would be someone who also wants their race, sexuality, or gender affirmed by their clinician.
We would learn to honor how trauma appears in the body and slowly work to release that.
My ideal client would be ready for a challenge. Someone who wants their worldview expanded, prepared to find internal and external connection with the world. My ideal client would be someone who also wants their race, sexuality, or gender affirmed by their clinician.
(412) 900-4852 View (412) 900-4852
Photo of Lizzie Birmingham, LSW, Clinical Social Work/Therapist
Lizzie Birmingham
Clinical Social Work/Therapist, LSW
Verified Verified
Imperial, PA 15126
My ideal population is adults struggling with anxiety, depression, PTSD, stress, or substance use - however I believe that everyone deserves to have a therapist who is dedicated to them, and I would never turn away a client unless their needs were out of my scope of practice. My ideal client is someone who is motivated for therapy and is willing to learn.
My ideal population is adults struggling with anxiety, depression, PTSD, stress, or substance use - however I believe that everyone deserves to have a therapist who is dedicated to them, and I would never turn away a client unless their needs were out of my scope of practice. My ideal client is someone who is motivated for therapy and is willing to learn.
(412) 776-0794 View (412) 776-0794
Photo of Courtney Utz, LPC, Clinical Social Work/Therapist
Courtney Utz
Clinical Social Work/Therapist, LPC
Verified Verified
Imperial, PA 15126
Courtney Utz is a Licensed Professional Counselor in Pennsylvania who has been practicing since 2009. Courtney's background is in child and family therapy, early childhood, and perinatal behavioral health. She is able to support both parents and children to have a healthy relationship. She also has experience in working with trauma as well as perinatal mood disorders including post-partum depression and anxiety. Courtney's personal passions include spending time with her family as well as reading and fitness.
Courtney Utz is a Licensed Professional Counselor in Pennsylvania who has been practicing since 2009. Courtney's background is in child and family therapy, early childhood, and perinatal behavioral health. She is able to support both parents and children to have a healthy relationship. She also has experience in working with trauma as well as perinatal mood disorders including post-partum depression and anxiety. Courtney's personal passions include spending time with her family as well as reading and fitness.
(412) 538-6153 View (412) 538-6153
Photo of Erin Eckman, MSW , LSW, Clinical Social Work/Therapist
Erin Eckman
Clinical Social Work/Therapist, MSW , LSW
Verified Verified
Imperial, PA 15126
Are you dealing with anxiety, depression, and ADHD symptoms that are exacerbated by external life circumstances? Do you want to understand your emotions and learn how to cope with them? My ideal client is seeking support and wants to begin the journey of improving their mental health. The client may have short-term or long-term goals but needs support to achieve them. The client might also want to improve their self-esteem through therapeutic work. Working with a strengths-based, trauma-informed, person-centered eclectic approach can help clients feel supported, develop coping skills, and improve self-esteem.
Are you dealing with anxiety, depression, and ADHD symptoms that are exacerbated by external life circumstances? Do you want to understand your emotions and learn how to cope with them? My ideal client is seeking support and wants to begin the journey of improving their mental health. The client may have short-term or long-term goals but needs support to achieve them. The client might also want to improve their self-esteem through therapeutic work. Working with a strengths-based, trauma-informed, person-centered eclectic approach can help clients feel supported, develop coping skills, and improve self-esteem.
(412) 991-1706 View (412) 991-1706
Photo of Sheray Anthony, LPC, Licensed Professional Counselor
Sheray Anthony
Licensed Professional Counselor, LPC
Verified Verified
Imperial, PA 15126
I enjoy working with young adults going through transitions and adjustment issues. These young adults may struggle with moving forward due to unresolved childhood trauma, or an individual may struggle to establish better boundaries within their interpersonal/intimate relationships, or even an individual struggling to meet their goals due to a substance use disorder they are facing. I enjoy working with these individuals, especially if they have moderate-high motivation, but I am also willing to assist patients in the population who are struggling with motivation altogether.
I enjoy working with young adults going through transitions and adjustment issues. These young adults may struggle with moving forward due to unresolved childhood trauma, or an individual may struggle to establish better boundaries within their interpersonal/intimate relationships, or even an individual struggling to meet their goals due to a substance use disorder they are facing. I enjoy working with these individuals, especially if they have moderate-high motivation, but I am also willing to assist patients in the population who are struggling with motivation altogether.
(412) 998-7508 View (412) 998-7508
Photo of Courtney Pursell, LPC, NCC, C-DBT, CCTP, Licensed Professional Counselor
Courtney Pursell
Licensed Professional Counselor, LPC, NCC, C-DBT, CCTP
Verified Verified
Imperial, PA 15126
My approach combines Dialectical Behavioral Therapy (DBT) and psychoeducation to help you develop practical skills for emotional regulation and trauma recovery.
Struggling with overwhelming emotions or constant anxiety? Are you finding it hard to break free from negative thinking patterns & triggers? I’m here to help. As a Licensed Professional Counselor and Certified Clinical Trauma Professional, I specialize in treating Anxiety, Depression, Bipolar Disorder, and Borderline Personality Disorder. My goal is to support you in managing your thoughts & feelings, reducing distress, and achieving a sense of inner calm and happiness. I understand that navigating life’s challenges can feel daunting, especially if you’re unsure where to start.
My approach combines Dialectical Behavioral Therapy (DBT) and psychoeducation to help you develop practical skills for emotional regulation and trauma recovery.
Struggling with overwhelming emotions or constant anxiety? Are you finding it hard to break free from negative thinking patterns & triggers? I’m here to help. As a Licensed Professional Counselor and Certified Clinical Trauma Professional, I specialize in treating Anxiety, Depression, Bipolar Disorder, and Borderline Personality Disorder. My goal is to support you in managing your thoughts & feelings, reducing distress, and achieving a sense of inner calm and happiness. I understand that navigating life’s challenges can feel daunting, especially if you’re unsure where to start.
(412) 900-2026 View (412) 900-2026
Photo of Elijah Jackson, LCSW, Clinical Social Work/Therapist
Elijah Jackson
Clinical Social Work/Therapist, LCSW
Verified Verified
Imperial, PA 15126
Are you trying to learn more about yourself and how you can best navigate your world? Are you exploring all parts of your identity and what makes you "you"? I have focused primarily on identity-related challenges, including Gender/Sexuality exploration, Race/Ethnic identity concerns, Religious/Cultural trauma, and Sex/Intimacy issues. I also have experience helping clients navigate issues related to depression, anxiety, and ADHD/Neurodivergent disorders. I'm here to be a collaborative and warm therapist who isn't going to throw a therapy book at them but instead wants someone who sees them as human beings walking through life.
Are you trying to learn more about yourself and how you can best navigate your world? Are you exploring all parts of your identity and what makes you "you"? I have focused primarily on identity-related challenges, including Gender/Sexuality exploration, Race/Ethnic identity concerns, Religious/Cultural trauma, and Sex/Intimacy issues. I also have experience helping clients navigate issues related to depression, anxiety, and ADHD/Neurodivergent disorders. I'm here to be a collaborative and warm therapist who isn't going to throw a therapy book at them but instead wants someone who sees them as human beings walking through life.
(412) 301-9936 View (412) 301-9936
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Trauma and PTSD Therapists

When should I seek treatment for trauma?

Not everyone who undergoes trauma needs therapy to heal, but many do. If, after experiencing a traumatic event, you find yourself struggling with symptoms such as nightmares, dissociation, irritability, or emotional numbness—especially if these symptoms last more than a month and are severe enough to interfere with your daily functioning—you may benefit from seeking out therapy with a trauma-informed provider.

How long does trauma therapy take?

Different types of therapy for trauma unfold on different timelines. Prolonged exposure therapy and cognitive processing therapy, for example, each take about three months, while trauma-informed CBT may last anywhere from 8 to 25 sessions. Other approaches, especially those that are less structured or that incorporate elements from multiple modalities, may be more open-ended, though many patients report feeling better within the first few months of treatment.

What happens if trauma is left untreated?

Unaddressed trauma can have serious—even devastating—effects on relationships, career, and day-to-day functioning. Post-Traumatic Stress Disorder (PTSD) can lead people to distrust or lash out at others, making it difficult to maintain intimate relationships; it can also trigger symptoms such as flashbacks or hyperreactivity that can interfere with a person’s ability to function effectively, personally and/or professionally. Some sufferers turn to drugs to find relief. Symptoms may lessen on their own with time, but there is no guarantee that PTSD will resolve on its own.

Can PTSD come back after treatment?

It is possible for PTSD symptoms to recur months or years after successful treatment. This is because, like most mental health disorders, it is not possible to “cure” PTSD, and stressful life events may cause symptoms to recur in even the most resilient individuals. There is no shame in re-experiencing PTSD symptoms nor in returning to therapy when such relapses occur; indeed, many forms of trauma therapy explicitly encourage periodic “maintenance sessions” to reinforce coping skills and ensure that symptoms stay manageable.