Therapy Exercises
20 Mar 2025
17
23 Post Traumatic Growth Worksheets for Therapy (+PDF)
20 Nov 2019 by Jo Nash, Ph.D.
Scientifically reviewed by Tiffany Sauber Millacci, Ph.D.
Key Insights
13 minute read
Post-traumatic growth involves positive psychological change following
adversity, fostering resilience & a renewed sense of purpose.
Worksheets & exercises facilitate reflection & help individuals identify
personal strengths, encouraging growth from challenging experiences.
Guided activities support healing by promoting self-awareness, gratitude
& setting meaningful goals.
Post traumatic growthWe’ve all heard the saying ‘what does not kill you
makes you stronger.’
Post Traumatic Growth, or PTG, explains how trauma survivors can not
only heal from their trauma, but can actually learn from the experience to
become more resilient individuals.
In the mid-1990s, psychologists Richard Tedeschi and Lawrence Calhoun
(Tedeschi & Calhoun, 1996) discovered that the severe psychological
struggle that follows major life crises can result in positive growth and
deepening resilience afterward.
While our other PTG article defines Post-Traumatic Growth with detail on
the concept itself and the science behind it, this article provides you with
practical tools to apply PTG with your clients or students.
Before you continue, we thought you might like to download our three
Resilience Exercises for free. These engaging, science-based exercises will
help you cope with difficult circumstances and give you the tools to
improve the resilience of your clients, students, or employees.
This Article Contains
A Look at Trauma Therapy Techniques
Post Traumatic Growth Worksheet
6 PTSD Worksheets (PDF)
3 Common Therapy Techniques for Trauma
16 PDF Trauma Worksheets
Activities for Trauma Therapy
PositivePsychology.com Resources
A Take-Home Message
References
A Look at Trauma Therapy Techniques
There are many trauma therapy techniques mentioned in this article. In
this section, we will explore how some of these techniques can be applied
to promote post-traumatic growth (PTG) using the model developed by
Stephanie D. Nelson, a Behavioral Science Officer from the United States
Army.
In 2011, Nelson developed a posttraumatic growth path (PTGP) for
veterans suffering from post-traumatic stress disorder (PTSD; Nelson,
2011). This pathway can also work with other types of trauma survivors.
The program comprises four stages for those struggling with PTSD
symptoms (Nelson, 2011):
Deal,
Feel,
Heal, and
Seal.
Evidence shows the techniques applied during each stage are beneficial
for relieving specific PTSD symptoms in all types of trauma survivors and
promoting post-traumatic growth (Ogilvie & Carson, 2021).
1. Deal – Writing a Trauma Narrative
This stage consists of writing a trauma narrative by focusing on the facts
surrounding the incident(s), including the who, what, where, and when.
Next, the client describes the thoughts and feelings that arose during the
experience to create a comprehensive narrative.
Finally, the client is asked to write a paragraph reflecting on how they feel
now, what they have learned, and if they have grown from the experience.
Trauma survivors should complete this exercise with a therapist or
counselor for support with any distressing feelings and sensations that
may arise such as flashbacks, anxiety, or panic.
Once the trauma narrative is completed, the client proceeds to step 2.
2. Feel – Imaginal Exposure
The next step involves experiencing the feelings aroused by reading the
trauma narrative aloud using imaginal exposure.
Exposure therapies work by exposing then desensitizing clients to any
uncomfortable, distressing, and frightening feelings associated with the
original trauma (Van Der Kolk, 2014).
Imaginal exposure entails revisiting the experience in the mind’s eye
using the vivid sensory capacity of the imagination. Imaginary exposure to
traumatic experiences using a trauma narrative, helps clients fully process
their feelings with the support of a counselor or therapist.
This technique reconnects the client to their original emotional responses
to the trauma which otherwise can become displaced onto other
associated stimuli called ‘triggers’. Often, trauma survivors avoid
emotional triggers which can lead to a narrowing of life experience and a
lower quality of life.
For example, physical contact with their partner or spouse may trigger a
rape survivor who withdraw or even freeze upon physical contact. This can
destroy a survivor’s capacity for intimate relationships.
Imaginal exposure allows a client to process any repressed feelings safely,
and overcome avoidance.
3. Heal – Channeling PTG
Stage three helps the client reintegrate their feelings and thoughts about
the original trauma to facilitate opportunities for learning and growth. The
healing stage involves three phases.
Freedom of choice
During this phase, the therapist explains that while the client did not
choose their traumatic experience, they can choose how to go forward.
The narrative therapy technique of “rewriting the ending” can help the
client create their own path.
Finding meaning
The client is encouraged to find meaning in their experience in whatever
way is appropriate and workable for them.
The hero archetype
Finally, the therapist guides the client through the transformative journey
of the Hero archetype by re-telling their story in the context of the client’s
spiritual and cultural values to make the experience more meaningful. The
client may also benefit from hearing stories where the hero experiences a
significant trauma and becomes a much stronger person as a result.
Once these three techniques have been explored, the therapist can teach
the client PTG channeling which involves redirecting their emotional
energy away from avoiding triggers into productive, goal-oriented
behavior. The therapist may assign the client homework exercises to help
shift them from survival toward post-traumatic growth.
4. Seal – The mind as a filing cabinet
The last step of the post-traumatic growth path involves reorganizing the
traumatic memory using the “mind as a filing cabinet” metaphor. This
likens the memory of the traumatic experience to disorganized
information scattered throughout the filing system of the mind.
Rather than the files being neatly ordered, numerous folders contain
fragments of information that are confusing and disorientating.
The ‘sealing’ step reorganizes memories as files and stores them away
safely. Files can be consulted in the future, but are no longer anything
more than one of the many files that are stored in the cabinet of the mind.
The client may need to repeat this process of reorganizing further
memories over the course of therapy.
For a moving true-life account of how traumatic childhood experiences
can lead to post-traumatic growth and a rounded, fulfilling life, check out
this TEDx talk by Martha Londagin below.
Adverse childhood experience can be connectors to joy
Adverse Childhood Experiences Can Be Connectors to Joy | Martha
Londagin | TEDxDicksonStreet
Post Traumatic Growth Worksheet
Here at PositivePsychology.com, we have several free worksheets that
help clients deal with trauma.
However, we selected one as the ultimate post traumatic growth
worksheet.
The worksheet start by identifying what is distressful, and causes
avoidance.
Avoidance is a strategy trauma survivors often use to eliminate triggers
and other associations with the original traumatic event. The problem with
avoidance is that it constrains life by restricting options and prevents
learning and growth.
The consequences of avoidance are an intensification of fear and
restrictions that undermine quality of life.
It is possible to overcome avoidance through gradual exposure until
desensitized to the triggering stimuli. Although this process is
uncomfortable, it results in an increased sense of safety, widens options,
and leads to a more fulfilling life (Collier, 2016).
The post-traumatic growth worksheet then assists with selecting and
implementing healthier coping mechanisms than avoidance.
You can access the Conquering Avoidant Tendencies worksheet via the
link.
6 PTSD Worksheets (PDF)
Post Traumatic Growth in PracticeThe following six worksheets can support
your clients in managing their PTSD symptoms during their post-traumatic
growth journey.
The worksheets include identifying triggers, self-regulating emotions,
grounding, decatastrophizing, and taking steps towards gratitude for the
things they still enjoy and that support them as they heal.
1. What are your unique triggers?
Identifying triggers is an essential coping skill that can help a client
manage their symptoms during their recovery. If a client is aware of their
triggers this also helps in overcoming avoidance (Van Der Kolk, 2014).
Look at our What Are Your Unique Triggers? Worksheet for guidance.
2. Letter of self-compassion
Cultivating self-compassion is crucial when recovering from a traumatic
experience (Collier, 2016). All too often we expect way too much of
ourselves and don’t give ourselves enough time and space to heal. Try our
Letter of Self-compassion worksheet and read it aloud whenever the inner
critic looms.
3. Skills for self-regulating emotions
An ability to self-regulate our emotions is an essential life skill in any
context but this can be especially challenging after a traumatic
experience when our emotions can become unpredictable or even numb
(Van Der Kolk, 2014).
Try our Skills for Self-Regulating Emotions worksheet to help clients self-
soothe.
4. Catastrophizing and decatastrophizing
Catastrophizing entails imagining the worst-case scenario every time we
face a problem. It is rooted in a limbic brain response designed to protect
us from danger, but following trauma, it can be a symptom of
hypervigilance (Van Der Kolk, 2014).
Try our Decatastrophizing worksheet for practical support.
5. Countdown to calmness
Grounding ourselves is essential when feeling disconnected from our body
or environment, or after catastrophizing (Van Der Kolk, 2014).
Try our Countdown to Calmness worksheet which uses radical acceptance
to ground you by focusing on your five senses.
6. It could be worse
Despair and anger are natural responses to a traumatic experience that
can rob our lives of meaning (Collier, 2016).
Try our It Could be Worse worksheet to help your client take small steps
toward gratitude for the little things that they can still appreciate while
they heal, such as a nourishing meal, a walk in nature, or a chat with a
relative or friend. This will help to dissolve despair and anger over time.
3 resilience exercises
Download 3 Free Resilience Exercises (PDF)
These detailed, science-based exercises will equip you or your clients to
recover from personal challenges and turn setbacks into opportunities for
growth.
3 Common Therapy Techniques for Trauma
Although there are various therapies that can be used for trauma therapy,
including EMDR, the following are commonly known therapy types used.
Narrative Therapy
Narrative therapy was developed in the 1980s by Michael White and David
Epston (White & Epston, 1990). We explained above how writing a trauma
narrative can be used to process and integrate traumatic experiences.
White and Epston believed that separating a person from their
problematic behavior was crucial for therapeutic success (White, 2011).
Narrative therapy achieves this by helping clients externalize their
experience in writing.
White and Epston (1990) formulated their model using three key
principles:
Narrative therapy is respectful.
Narrative therapy is non-judgmental.
Narrative therapy views the client as the expert on their problems.
Narrative therapy equips clients with story-telling skills to help separate
their sense of personal identity from their trauma. When the client stops
seeing their trauma as an integral part of their identity, resolving to learn
and grow from the experience becomes easier (Van Der Kolk, 2014).
Art Therapy
Art therapy is a therapeutic practice that uses visual arts techniques to
facilitate the therapeutic process and can be especially helpful given that
many aspects of traumatic experiences are difficult to express in words
(Malchiodi, 2020).
A client doesn’t need any artistic skills to take part in this type of therapy.
Rather, the art therapist encourages the client to tap into their creative
process to explore and express emotions and develop greater self-
awareness. This can help with processing buried conflicts and unresolved
trauma.
For a more detailed account of this approach to trauma therapy, we
recommend these art therapy, and expressive arts therapies articles.
Play Therapy
Play therapy is typically used to facilitate psychotherapy with children but
can also be used with adults. Play therapy requires movement which can
help address unresolved trauma that is difficult to express in words,
especially for children (Allen & Hoskowitz, 2017).
Play therapy incorporates many techniques such as sand and water play,
role play, and the use of representational toys like dolls, trucks, and guns
to create play that expresses the client’s traumatic experience. This helps
the client externalize their trauma similar to narrative therapy and art
therapy, making the experience easier to process (Allen & Hoskowitz,
2017).
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16 PDF Trauma Worksheets
We have sixteen further worksheets that can help process trauma.
We have grouped them into 5 themes for your convenience.
1. Strengths
Identifying a client’s strengths and previous experiences of overcoming
difficulties helps with recovery from a traumatic experience. These two
worksheets help clients identify their character strengths and recognize
their capacity for post-traumatic growth.
Exploring Character Strengths
Exploring Past Resilience
2. Exposure
Post traumatic stress disorder post traumatic growthExposure is an
evidence-based approach to overcoming triggers and avoidance. These
three worksheets can help guide clients through different types of
exposure.
For physiological symptoms of trauma try our Interoceptive Exposure
worksheet,
For traumatic memories try our Imagery Based Exposure worksheet
For feared objects and situations try our Graded Exposure worksheet.
3. Anxiety
Fear and anxiety are common responses to trauma which can lead to
dysfunctional thinking. These four worksheets are designed to help clients
cope with the anxiety that often arises during and after trauma, and
support them in moving on to post-traumatic growth.
Challenging Catastrophic Thinking Worksheet
Replacing ‘What if’ Statements
Dysfunctional Thought Record
FLARE for Anxiety and Fear
4. Grounding
Feeling far away or unreal is common following a traumatic experience.
This is because of the dissociation and depersonalization that can occur as
the body struggles to process sensory overload.
These three worksheets are designed to ground clients in the present
moment using breathwork and radical acceptance.
Yogic Breathing
Anchor Breathing
Focus on the Present for Radical Acceptance
5. Growth
Finally, these four worksheets have been designed using evidence-based
interventions that promote post-traumatic growth.
Eye Movement Desensitization and Reprocessing (EMDR) involves
coupling negative cognition with a chosen target image, selecting a
positive replacement cognition, then reprocessing traumatic memories
into more adaptive thoughts.
Download our EMDR Worksheet to find out more.
Meanwhile, our Imaginal Exposure worksheet uses the Subjective Units of
Distress Scale (SUDS) to quantify the disturbance a client feels when
revisiting their traumatic experience during therapy. It is especially useful
for those who misuse substances to self-soothe.
Your clients can also try this Goal Planning and Achievement Tracker
worksheet to monitor their progress during their post-traumatic growth
journey.
Finally, our Growing Stronger From Trauma worksheet helps clients identify
what they’ve learned from a traumatic experience, and appreciate the
strengths they have developed as a result. This exercise helps clients
cultivate a more balanced perspective on previous trauma and identify
ways to manage future challenges.
Activities for Trauma Therapy
The following activities aim at improving the reintegration of the mind,
heart, and body connection that is often fragmented by a traumatic
experience.
1. Psychoeducation
Psychoeducation is an important intervention to help trauma survivors
understand they are experiencing a normal response to an abnormal
experience. (Whitworth, 2016).
Our article on psychoeducation interventions explains more.
2. Self-soothing
Equipping a client with self-soothing skills will help support their recovery
between sessions (Dreisoerner et al., 2021).
Look at our article 4 Best Self-Soothing Techniques & Strategies for Adults
for more resources.
3. Expressive arts
Expressive arts activities can help to process blocked emotional responses
to trauma through painting, drawing, clay modeling, photography, music,
and movement (Malchiodi, 2020).
Check out our article Expressive Arts Therapy: 15 Creative Activities and
Techniques for more resources.
4. Mindfulness
Mindful movement can support grounding when clients feel scattered or
fragmented (Teut et al., 2013). Take a look at our articles on Mindful Yoga
and Mindful Walking for further guidance.
5. Nature therapy
Ecotherapy interventions are deeply grounding for trauma survivors
(Atkins & Snyder, 2017). Activities include forest bathing (Mao et al.,
2012), walking in nature, or just gazing at the ocean (Cracknell, 2019).
Check out our article on the Positive Effects of Nature for activity ideas.
17 Tools To Build Resilience and Coping Skills
Empower others with the skills to manage and learn from inevitable life
challenges using these 17 Resilience & Coping Exercises [PDF], so you can
increase their ability to thrive.
Created by Experts. 100% Science-based.
PositivePsychology.com Resources
Besides all the resources we’ve included above, consider our 6-module,
science-based Realizing Resilience Masterclass©. It includes all the
resources you’ll need to deliver high-quality resilience training and more.
We have other useful related articles with linked resources including:
7+ Trauma-Focused Cognitive-Behavioral Therapy Worksheets. Trauma-
focused CBT comes highly recommended by the APA as a trauma
treatment with a firm evidence base.
What is Post-Traumatic Growth? (+ Inventory & Scale) examines the
science behind PGT in detail.
PTSD Treatments: How to Help Clients Process Trauma includes
psychoeducation tips and resources for working with children and groups.
If you’re looking for more science-based ways to help others overcome
adversity, this collection contains 17 Resilience & Coping Exercises. Use
them to help others recover from personal challenges and turn setbacks
into opportunities for growth.
A Take-Home Message
We hope you find the resources in this article useful. Nobody wants to
suffer, but we will inevitably face adverse experiences, whether it’s
through loss and grief, sudden illness or injury, a natural calamity, or
witnessing violence and extreme suffering in others.
If you struggle with trauma and its aftermath, remember that you have
overcome obstacles in the past, and that you can draw on those
experiences to cultivate the skills you need to process your experience,
and become a wiser, more compassionate, and more resilient person as a
result.
Finally, if you would like further inspiration about the potential for growth
after trauma check out this short and powerful TED Talk by trauma
survivor Charles Hunt. You won’t regret it!
What trauma taught me about resilience – Charles Hunt
What Trauma Taught Me About Resilience | Charles Hunt | TEDxCharlotte
We hope you enjoyed reading this article. Don’t forget to download our
three Resilience Exercises for free.
References
Allen, B. & Hoskowitz, N. A. (2017). Structured trauma-focused CBT and
unstructured play/experiential techniques in the treatment of sexually
abused children: A field study with practicing clinicians. Child
Maltreatment 22(2), 112-120. https://doi.org/10.1177/1077559516681866
Atkins, S., & Snyder, M. (2017). Nature-based expressive arts therapy:
Integrating the expressive arts and ecotherapy. Jessica Kingsley
Publishers.
Collier, L. (2016). Growth after trauma. Monitor on Psychology, 47(10).
Cracknell, D. (2019). By the sea: The therapeutic benefits of being in, on,
and by the water. Aster.
Dreisoerner, A., Junker, N. M., Schlotz, W., Heimrich, J., Bloemeke, S.,
Ditzen, B., & van Dick, R. (2021). Self-soothing touch and being hugged
reduce cortisol responses to stress: A randomized controlled trial on
stress, physical touch, and social identity. Comprehensive
Psychoneuroendocrinology, 8.
https://doi.org/10.1016/j.cpnec.2021.100091
Malchiodi, C. A. (2020). Trauma and expressive arts therapy: Brain, body,
and imagination in the healing process. Guilford Press.
Mao, G. X., Lan, X. G., Cao, Y. B., Chen, Z. M., He, Z. H., Lv, Y. D., Wang, Y.
Z., Hu, X. L., Wang, G. F., & Yan, J. (2012). Effects of short-term forest
bathing on human health in a broad-leaved evergreen forest in Zhejiang
Province, China. Biomedical Environmental Science. 25(3), 317-24.
https://doi.org/10.3967/0895-3988.2012.03.010
Nelson, S. D. (2011). The posttraumatic growth path: An emerging model
for prevention and treatment of trauma-related behavioral health
conditions. Journal of Psychotherapy Integration 21, 1-42.
https://doi.org/10.1037/a0022908
Ogilvie, L. & Carson, J. (2021) Trauma, stages of change and post-
traumatic growth in addiction: A new synthesis. Journal of Substance Use,
27 (2), 122-127. https://doi.org/10.1080/14659891.2021.1905093
Tedeschi, R. G. & Calhoun L. G. (1996). The Posttraumatic Growth
Inventory: measuring the positive legacy of trauma. Journal of Traumatic
Stress. 9(3), 455-71. https://doi.org/10.1007/BF02103658
Teut, M., Roesner, E. J., Ortiz, M., Reese, F., Binting, S., Roll, S., …
Brinkhaus, B. (2013). Mindful walking in psychologically distressed
individuals: A randomized controlled trial. Evidence-Based Complementary
and Alternative Medicine, 1–7. https://doi.org/10.1155/2013/489856
Van Der Kolk, B. (2014). The body keeps the score. Penguin.
Whitworth, J. D. (2016). The role of psychoeducation in trauma recovery:
Recommendations for content and delivery. Journal of Evidence-Informed
Social Work, 13(5), 442-51.
https://doi.org/10.1080/23761407.2016.1166852
White, M. & Epston, D. (1990). Narrative means to therapeutic ends. W. W.
Norton & Company.
White, M. (2011). Narrative practice: Continuing the conversations (D.
Denborough, Ed.), W.W. Norton.
