Complex PTSD and Childhood Trauma Therapy Online
Some trauma isn’t a single event. It’s years of abuse, neglect, violence at home, or relationships where you never felt safe. When trauma is repeated and inescapable, especially in childhood, it can shape how you see yourself, handle emotions, and let others close. This is often called complex posttraumatic stress disorder (complex PTSD or CPTSD), and recovery is possible at any age. Our clinicians offer evidence-based therapy for complex trauma by secure video in 44 states, and we’re in-network with many major insurers.
What Is Complex PTSD?
The World Health Organization’s International Classification of Diseases, 11th Revision (ICD-11), recognizes complex PTSD as a diagnosis. It includes the core symptoms of PTSD:
- Re-experiencing, such as intrusive memories, flashbacks, or nightmares
- Avoidance of reminders of the trauma
- A persistent sense of threat, such as hypervigilance or being easily startled
Complex PTSD also includes three additional areas, sometimes called “disturbances in self-organization”:
- Difficulty regulating emotions, such as intense reactions or numbness
- A negative self-concept, such as deep shame or feeling permanently damaged
- Relationship difficulties, such as trouble trusting or feeling close
The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) does not list complex PTSD separately; many of these symptoms fall under PTSD there.
PTSD vs. Complex PTSD
| PTSD | Complex PTSD | |
|---|---|---|
| Typical cause | Often a single event or a limited period | Repeated or prolonged trauma, often in childhood or close relationships |
| Core symptoms | Re-experiencing, avoidance, and sense of threat | The same, plus problems with emotions, self-worth, and relationships |
| Recognized in | DSM-5-TR and ICD-11 | ICD-11 |
Signs You May Be Living with Complex Trauma
- You feel “on guard” most of the time, even when you’re safe
- Shame or self-criticism feels like part of who you are
- Emotions feel too big, or you feel nothing at all
- Relationships feel confusing, unsafe, or hard to keep
- You notice gaps in memory or feel detached from yourself at times
- Ordinary stress sends you into panic, shutdown, or anger
How We Treat Complex PTSD
The same trauma-focused therapies that work for PTSD also help many people with complex trauma histories, and the U.S. Department of Veterans Affairs and Department of Defense (VA/DoD) Clinical Practice Guideline for PTSD (2023) recommends them as first-line treatments. Many people also benefit from building coping skills first. Treatment usually includes three parts:
1. Safety and stabilization. Skills for managing intense emotions, grounding during flashbacks or dissociation, and getting through hard days, often drawing on Dialectical Behavior Therapy (DBT) and Acceptance and Commitment Therapy (ACT).
2. Processing the trauma. When you’re ready, we use a trauma-focused treatment to reduce the power of traumatic memories and the beliefs attached to them:
- Cognitive Processing Therapy (CPT) helps you identify and change “stuck” beliefs, such as self-blame and shame.
- Prolonged Exposure (PE) helps you safely face memories and situations you’ve been avoiding.
- Eye Movement Desensitization and Reprocessing (EMDR) helps you reprocess memories without describing them in detail.
3. Rebuilding your life. As symptoms ease, therapy focuses on self-worth, relationships, and boundaries.
Treatment isn’t always a straight line, and you won’t be pushed before you’re ready. Learn more about our trauma-focused treatment and trauma and PTSD therapy.
Healing Childhood Trauma as an Adult
Many adults don’t connect present-day struggles with childhood until something brings it to the surface, such as becoming a parent, a breakup, or a loss. It’s never too late. Therapy can help you understand how the past shaped your patterns, process the memories that still hurt, and treat yourself with more compassion. You may also find our article on how childhood trauma affects adulthood helpful.
Can Complex PTSD Be Treated Online?
Yes. Research shows trauma-focused therapies by video work about as well as in-person care for many people, and your own space can make it easier to feel safe. Before trauma processing begins, your clinician will set up a safety plan, including what to do if the connection drops. Learn how our teletherapy works.
What to Look for in a Complex Trauma Therapist
Look for a licensed clinician trained in CPT, PE, or EMDR who also understands emotion regulation and pacing. It’s fine to ask how they approach complex trauma and how they’ll help you feel safe.
Insurance Coverage
Trauma therapy is billed as standard outpatient psychotherapy, so most plans with mental health benefits cover it. We’re in-network with Aetna, Optum and UnitedHealthcare, Oscar (through the UnitedHealthcare network), Blue Cross Blue Shield, Ambetter (in Washington only), and others. Depending on the clinician and state, some of our clinicians also accept Anthem.
We do not accept Medicare or Medicare Advantage plans.
Where We Offer Care
Psychological Healing has 40 clinicians, offering in-person sessions in 20 states and video sessions in 44 states. See our pages for California, Texas, Florida, and New York, among others.
Frequently Asked Questions
How long does complex PTSD treatment take? Usually longer than single-event PTSD, often several months to a year or more, though many people notice changes well before treatment ends.
Do I have to relive everything to heal? No. You’ll build coping skills first, and trauma processing is paced so it stays manageable. Some approaches, such as EMDR and CPT without a written account, don’t require you to describe every detail.
What is the best therapy for complex PTSD? Trauma-focused therapies such as CPT, PE, and EMDR have the strongest evidence, and DBT or ACT skills can help with emotion regulation. Your clinician will recommend a plan based on your needs.
Is complex PTSD therapy covered by insurance? Usually, yes, as outpatient psychotherapy. We’ll verify your benefits before you start.
If you are in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911.
Clinically reviewed by Karan Singh, Ph.D.
Last reviewed October 16, 2026