Do I Need Trauma Therapy?

Asking this question does not mean something is wrong with you, and it does not mean the answer is yes. Official sources are clear that many people who live through a frightening or dangerous event get better with time.

This article sets out what those sources say about recovering without treatment, the signs that an assessment is worthwhile, and what a screening tool can and cannot tell you. It cannot assess you. In the VA's words, "Only a mental health provider can diagnose PTSD."

Do most people recover without therapy?

Yes, according to the VA's National Center for PTSD. Its page on common reactions says, "Most people will recover from trauma naturally," and it describes stress reactions after trauma as "normal and not weakness." Its overview of PTSD adds, "Most people start to feel better after a few weeks."

The National Institute of Mental Health (NIMH) says much the same about the reactions that follow a traumatic event: "Most people will recover from these symptoms, and their reactions will lessen over time." What is common in the early weeks is covered in after a traumatic event.

What happens when PTSD goes untreated?

For people who do develop PTSD, the picture is mixed. A 2014 meta-analysis pooled 42 observational studies with 81,642 participants and looked at people who had PTSD and received no specific treatment. The studies followed people for 40 months on average. Across them, an average of 44.0% no longer met criteria for PTSD at follow-up. The spread between studies was very wide, from 8% to 89%. Where the first assessment took place within five months of the trauma, the remission rate was 51.7%. Where it took place later, it was 36.9%. No longer meeting criteria is not the same as being free of symptoms.

A 2018 analysis of the World Health Organization's World Mental Health surveys, which are international, asked 1,575 people who had ever had PTSD to look back. By their recollection, 20%, 27% and 50% of cases recovered within 3, 6 and 24 months, and 77% within 10 years.

An older U.S. survey points the other way. The 1995 National Comorbidity Survey, which used the diagnostic criteria of its time and relied on people's recall of how long their symptoms lasted, found that "more than one third of people with an index episode of PTSD fail to recover even after many years."

Taken together, these studies suggest that many people with PTSD improve without specific treatment and that a substantial minority stay unwell for years. None of them can tell one person which group they will be in.

When do official sources say to get assessed?

The VA gives three signs. It says to talk to a doctor or mental health care provider, such as a psychiatrist, psychologist, counselor or social worker, if your symptoms:

• Last longer than a month
• Are very upsetting
• Disrupt your daily life

NIMH puts it this way: "It is important to seek professional help if symptoms do not improve over time or begin to interfere with daily life." The symptom groups clinicians look for are described in PTSD symptoms.

An assessment mostly involves answering questions about your thoughts, feelings and behaviors, the VA says. It adds: "You will be in control of how much information you share about any traumas you experienced."

Some situations should not wait for an appointment. If you are having thoughts of suicide, call or text 988, or call 911 in an emergency.

What can a PTSD screening questionnaire tell you?

A screen can show whether a fuller assessment is worthwhile. It cannot show whether you have PTSD. The one the VA uses is the PC-PTSD-5, which it describes as "a 5-item screen that was designed to identify individuals with probable PTSD in primary care settings." The 2023 guideline from the Departments of Veterans Affairs and Defense (VA/DoD) suggests it as a screening tool, with its "Weak for" rating.

The VA is careful about what a result means. Writing for clinicians, it says "those screening positive require further assessment, preferably with a structured interview." Where to set the cut point is a clinician's judgment, and the VA notes that a cut point that worked for men produced many false negatives for women. The screen was first tested in a convenience sample of 398 veterans, most of them men in their 60s. On its public pages the VA says a positive result "does not always mean you have PTSD" and that "A screen only helps a provider understand if you should be assessed further."

This article does not reproduce the questions or give a score to count. If you come across the screen, treat any result as something to bring to a clinician, not as an answer.

Is it too late if the trauma happened years ago?

No, according to the VA. Its page on reasons to get treatment says, "Treatment can help even if your trauma happened years ago." It also says that symptoms "may get worse" and that dealing with them now "might help stop symptoms from getting worse in the future." Note the hedges. The VA says "may" and "might," not "will."

Timing can be confusing in the other direction too. The VA notes: "PTSD symptoms usually start soon after the traumatic event, but they may not appear until months or years later. They also may come and go over many years."

What kind of help is there?

If you decide to look for help, the type of therapy is worth understanding. For PTSD, U.S. guidelines most strongly recommend specific trauma-focused psychotherapies. The VA/DoD guideline recommends cognitive processing therapy, eye movement desensitization and reprocessing (EMDR) and prolonged exposure. Psychodynamic therapy has been studied much less for PTSD. That guideline lists it under insufficient evidence to recommend for or against, and the American Psychological Association's 2025 guideline found too little qualifying research to make a recommendation about psychodynamic approaches. Insufficient evidence means too little good research. It is not proof that a therapy fails, and it is not an endorsement. Types of trauma therapy and what the research says compares them.

Dr. Rabin's trauma therapy is psychodynamic, attachment-based, trauma-informed and mindfulness-based, guided by safety, pacing and the therapeutic relationship. The work moves at your pace, and you decide what is discussed and when.

This guide makes no claim about whether she offers any of the named trauma-focused treatments. You can ask on a free consultation of about 15 minutes, requested through the contact page, whether she offers them or would refer you. Fees are set out on the fees and insurance page.

Keep reading

• Types of Trauma Therapy and What the Research Says
• Do You Have to Talk About What Happened in Trauma Therapy?
• How to Choose a Trauma Therapist
• All trauma guides

Sources

• VA National Center for PTSD, Common Reactions After Trauma (last updated September 25, 2026)
• VA National Center for PTSD, PTSD Basics (page header: Last Updated October 2026)
• National Institute of Mental Health, Coping With Traumatic Events (last reviewed May 2024)
• Morina N, Wicherts JM, Lobbrecht J et al., Remission from post-traumatic stress disorder in adults: a systematic review and meta-analysis of long term outcome studies. Clin Psychol Rev (2014)
• Rosellini AJ, Liu H, Petukhova MV et al., Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys. Psychol Med (2018)
• Kessler RC, Sonnega A, Bromet E et al., Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry (1995)
• VA National Center for PTSD, Do I Have PTSD? (last updated September 25, 2026)
• VA National Center for PTSD, How Is PTSD Assessed? (last updated September 25, 2026)
• VA National Center for PTSD, Why get PTSD treatment? (last updated September 25, 2026)
• U.S. Department of Veterans Affairs and Department of Defense, VA/DoD Clinical Practice Guideline for Management of Posttraumatic Stress Disorder and Acute Stress Disorder (June 2023)
• American Psychological Association, Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults (2025)
• VA National Center for PTSD, Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) (last updated September 16, 2026)
• Prins A, Bovin MJ, Smolenski DJ et al., The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5): Development and Evaluation Within a Veteran Primary Care Sample. J Gen Intern Med (2016)

Last reviewed October 2026. This guide is general information, not medical advice or a diagnosis. If you are in crisis or thinking about harming yourself, call or text 988, or call 911 in an emergency.