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Treatment
Because transgenerational trauma is a form of indirect traumatic exposure, it often goes unrecognized or is misdiagnosed by clinicians. Moreover, there is a general lack of trauma therapy specialists in the US, which significantly affects treatment accessibility. A lack of treatment accessibility can have several consequences such as health, behavioral, and social issues that may persist across an individual’s lifespan.

The experience of traumatic stress can modify cognitive, behavioral, and physiological functions, which can increase susceptibility to both mental and physical health issues. Because transgenerational trauma is a form of traumatic stress, it can increase risk for developing psychological disorders such as post-traumatic stress disorder, major depressive disorder, generalized anxiety disorder, schizophrenia, autism spectrum disorder, and substance use disorders.

Several therapy modalities have been found to be effective in treating various trauma and stress disorders, such as cognitive behavioral therapy (CBT), cognitive processing therapy (CPT), prolonged exposure (PE), compassion focused therapy (CFT), dialectical behavior therapy (DBT), and narrative therapy. Each of these therapies share similar components that are useful in addressing trauma, such as psychoeducation, emotion regulation and processing, cognitive processing and reconstruction, and trauma processing. Given that transgenerational trauma is a unique form of traumatic exposure, such therapy modalities can be effective in reducing its negative long-term effects. However, there are specific components of transgenerational trauma that must be addressed directly despite the modality of therapy chosen. Because the attachment relationship between parent or caregiver and child is a dominant mechanism through which transgenerational trauma is transmitted, treatment should focus on the importance familial and interpersonal patterns relative to the client, and utilize attachment-focused interventions.

Effective treatment for those experiencing transgenerational trauma also focuses on exploring, developing, and maintaining protective factors that can reduce the negative impact of transgenerational trauma. Some protective factors include fostering secure attachment between parent and child, as well as having access to several sources of support (i.e., family, peers, community). One treatment model that places focus on the parent-child relationship is the Intergenerational Trauma Treatment Model (ITTM). The model incorporates several features from existing empirically-supported methods of treatment, such as trauma exposure, cognitive processing and reframing, stress management, and parent education. ITTM gives specific attention to the intergenerational nature of traumatic experiences and targets the parent’s or caregiver’s ability to respond to a child’s traumatic experiences. Fostering secure attachment and a supportive home environment can mitigate the potential negative impact of transgenerational trauma.

Other less conventional modalities of therapy have also been found useful in addressing the negative impact of transgenerational trauma. Music therapy has been found to be an effective form of treatment for those who have witnessed or experienced a traumatic event. For example, music therapy has been successfully implemented with military personnel, traumatized refugees, and Holocaust survivors. Specifically, analytic music therapy (AMT) was found to be effective in facilitating a degree of healing through self-exploration that mitigates the negative impact of transgenerational trauma. Movement and dance therapy was also found to be effective in reducing trauma held within the body and its subsequent negative effects. Specifically, this therapy modality allows the therapist to directly decipher specific movement patterns and determine how to challenge any identified negative cognitive patterns. For example, experiences of trauma may be reflected in the particular movements of a client. Within these movement patterns, the therapist can interpret a client’s means of emotional coping and work towards cultivating better emotion regulation through creative expression.

Outside the treatment modalities described, several tools and techniques were also found to be helpful in bringing awareness to the effects of transgenerational trauma, as well as decreasing its psychological impact. For example, the Transgenerational Script Questionnaire (TSQ) has been used to compliment psychotherapy sessions as a means of helping to develop consciousness of both the internal and external family system. The TSQ targets transgenerational scripts, which are unconscious systemic patterns that persist in families and groups, and are perpetuated through emotions, beliefs, and behaviors. These scripts are then used to explore a client’s implicit and explicit perceptions about their family dynamic and system. In using the TSQ, the clinician can guide the client to separate their ancestors’ experiences from their own. In more complex cases of intergenerational trauma, the Transgenerational Trauma and Resilience Genogram (TTRG) can help guide clinicians to better understand and assess the impact of such trauma. The TTRG targets the various components that contribute to the maintenance of transgenerational trauma by implementing an ecosystemic view of trauma, as well as attention to specific sociopolitical concerns. The TTRG maps out the family unit, marking those who have experienced trauma and their experience, as well as relationships between individuals, and patterns of functioning. This process allows for clinicians to better assess the origins and maintaining factors of an individual’s experience of transgenerational trauma, which ultimately contributes to a more comprehensive conceptualization of treatment.

In conceptualizing treatment for individuals experiencing transgenerational trauma, it is critical to take into account the ways in which various cultural factors impact how different treatments may be received or perceived. Although the mechanisms through which transgenerational trauma are consistent across cultures, there are variations in the degree of salience regarding sociocultural factors that may exacerbate the effects of transgenerational trauma in different marginalized communities. Additionally, therapists must incorporate a culturally responsive perspective to whichever modality of therapy they chose to implement. It is imperative for therapists to focus on establishing a concrete basis of trust and safety within the therapeutic relationship, as several minoritized groups who suffer from transgenerational trauma may have developed significant mistrust within interpersonal interactions, as well as mistrust of larger organizations or institutions.