Should Only Licensed Professionals Work with Trauma Survivors?

Do you need a professional degree or license to work with survivors of trauma? This is a question that I’ve grappled with as a coach and someone who has worked with survivors of domestic violence and sexual assault for over 10 years. I’ve recently been challenged by licensed social workers and therapists who insist that coaches should not delve too deeply into our clients’ past and that case managers need degrees to provide services.

The problem with this argument is that our ancestors have worked with survivors of trauma for thousands of years, long before the study of counseling and psychology was even invented. We’re not talking about medically diagnosing someone or giving them pills. Simply put, we’re talking about support.

But when we say that we can’t support trauma survivors unless we have a MSW, MFT, PsyD, etc., what we’re really upholding is a western and white centered way of thinking. This professionalization and establishment of what the best practices should be is oppressive because at the same time, we are downplaying the role that cultural healing and treatment have in communities of color. And this is potentially dangerous in communities where mental health is heavily stigmatized – where the idea of talk therapy is not widely accepted because it means we’re airing out our dirty laundry for the world to see.

One of the main ways we treat mental health in the U.S. is by asking someone to see a therapist and/or take medication. But finding the right therapist – someone who truly understands you – is like finding a needle in a haystack. Not only do you have to jive with that person, but you also have to trust the type of treatment they’re using. There can be trauma in the actual process of finding a therapist because you’re often repeating your story over and over again.

I recently had a long discussion with my psychologist about psychiatric service animals. She’s highly educated, has developed a deep expertise in the field of clinical depression, and has years of experience. But she does not believe that service dogs or emotional support animals can support individuals with psychiatric disabilities. In disagreeing with her and rattling off the multitude of psychiatric service dog tasks (such as getting someone out of bed and prompting them to take their medication), I was once again reminded that I’m functioning in a very mainstream system.

Animal assisted therapy, sound healing, shamans, meditation, acupuncture, and Chinese herbs are just some of the many ways that communities have supported trauma survivors for centuries. And although we’re beginning to see that some licensed professionals are adopting more holistic treatments, it’s not being embraced fast enough. And survivors are being left behind as a result.

When I worked in domestic violence programming, a lot of our immigrant Asian and Pacific Islander survivors who had mental health issues refused to see a therapist. And even if they wanted to, the multicultural cities of Washington, D.C. and San Francisco didn’t have therapists who could speak their native language. Our organization offered different ways of support and healing such as art therapy, storytelling, and culturally specific services through case managers who understood the survivor’s language and culture (unlicensed but whom we trained). Diversity, equity, and inclusion are hot topics right now. Everyone seems to want to jump onto the bandwagon to do this work. But doing so means we have to be humble and open to alternative practices. After all, shouldn’t we be supporting trauma survivors in a way that best fits their needs?



Jessica Litrauma, survivors