PTSD Treatment · Boca Raton · Houston · Austin · Chicago · Denver · Telehealth in 40+ States

Trauma Changes the Brain.
Evidence-Based Treatment Can Change It Back.

The Evidence-Based Treatment Institute provides specialized, evidence-based treatment for PTSD and trauma-related conditions in person in Boca Raton, Houston, and Denver, and via telehealth in Chicago, Austin, and 40+ PSYPACT states. We use Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT): the two treatments with the strongest and most consistent evidence base for PTSD in the world.

We treat PTSD in children, teens, and adults, including when it co-occurs with eating disorders, OCD, and anxiety. Private-pay, boutique practice: your treatment is built around your clinical needs.

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PE & CPT: Gold-Standard Trauma Treatments
Acute & Chronic PTSD
Co-Occurring Conditions Welcome
Children, Teens & Adults
Telehealth in 40+ States
What the Research Shows

Trauma Is Treatable, and the Best Treatments Are Remarkably Effective.

Many people live for years believing trauma is something they simply have to carry. The research tells a different story. Prolonged Exposure and Cognitive Processing Therapy are among the most effective treatments in all of mental health. And for many people, they don't just reduce symptoms, they resolve the diagnosis.

~80%
of patients in a landmark trial no longer met criteria for PTSD after PE or CPT
6 yrs
those gains were largely maintained at long-term follow-up: durable, not temporary
Large
effect sizes for both PE and CPT across decades of randomized trials
First-line
PE and CPT are first-line, gold-standard treatments for PTSD worldwide

Figures reflect findings from the published clinical research literature on PE and CPT for PTSD (randomized controlled trials and meta-analyses), not internal outcome data from the Evidence-Based Treatment Institute. Individual results vary. We share these to convey what well-delivered, evidence-based trauma treatment makes possible, not to promise a specific outcome.

Understanding the Condition

PTSD Is Not a Weakness. It Is a Predictable Brain Response to Unpredictable Events.

PTSD is not about being unable to "move on." It is about a nervous system that learned, correctly and in a moment of genuine threat, that the world is dangerous. Treatment is about updating that learning with new information.

Post-Traumatic Stress Disorder develops when the brain's normal process of integrating and making sense of a threatening experience becomes disrupted. Instead of the memory being stored and filed away like other memories, it remains unprocessed: vivid, intrusive, and chronically activating the same alarm response the original event triggered.

This is not a character flaw. It is not weakness. It is the predictable result of a nervous system doing exactly what it evolved to do, keeping you safe, in a situation where the threat has passed but the brain hasn't received that message yet.

The symptoms of PTSD (intrusive memories, nightmares, hypervigilance, emotional numbing, avoidance of reminders) are not random. They are the brain's attempt to protect you from something it still believes is happening. Effective treatment doesn't ask you to suppress those responses. It helps your brain update its understanding of what is safe and what is past.

Who develops PTSD, and who doesn't:

PTSD is not an inevitable response to trauma. Most people exposed to traumatic events do not develop PTSD. The factors that influence who does are complex: the nature and duration of the trauma, the presence of social support, prior adversity, neurobiological vulnerability, and the availability of early intervention all play a role.

What is clear is that PTSD has no relationship to the magnitude of a person's character, resilience, or strength. Some of the most capable, high-functioning people we work with have PTSD. It develops because of what happened, not because of who they are.

Does This Sound Familiar?

You Might Recognize Yourself in Some of These.

Trauma doesn't always look like flashbacks. It often hides in avoidance, hypervigilance, numbness, and the quiet ways a person reorganizes life around not being reminded. If several of these resonate, what you're describing is treatable.

  • You avoid people, places, conversations, or reminders connected to what happened.
  • Intrusive memories, images, or nightmares arrive uninvited and feel as real as the original event.
  • You're constantly on guard: scanning for danger, startled easily, never quite able to relax.
  • You feel emotionally numb, disconnected, or like you're watching your life from the outside.
  • Sleep, concentration, and mood have changed since the event, and they haven't recovered.
  • You blame yourself for what happened, or your beliefs about safety and trust have shifted.
  • It happened a long time ago, and you've been told, or told yourself, you should be over it by now.
  • The trauma sits alongside an eating disorder, OCD, anxiety, or a perinatal experience.

If you saw yourself above, that recognition is the first step. The next one is a conversation.

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What We Treat

Trauma Takes Many Forms. PTSD Is the Injury That Can Follow.

PTSD has a precise definition: it can follow exposure to actual or threatened death, serious injury, or sexual violence, whether you lived through it, watched it happen, learned it happened to someone you love, or faced it again and again as part of your work. The experiences that lead there are wide-ranging. The condition that can follow is one we treat directly, including when earlier treatment has not brought relief.

Directly Life-Threatening Events

Accidents, assault, sexual violence, disasters, combat

A car crash, a violent or sexual assault, a natural disaster, a combat deployment, a medical emergency where survival was genuinely in question: a moment in which you believed you or someone near you might not make it. By definition, this is the kind of event that can cause PTSD, and it is often highly responsive to a focused course of PE or CPT.

Witnessing Death or Violence

Seeing it happen in front of you

PTSD does not require that the event happened to you. Watching a sudden death, a severe injury, or an act of violence unfold in person can leave the same imprint: the mind holds onto what the eyes could not un-see, and replays it long after the danger has passed.

The Sudden Loss of Someone You Love

Violent or accidental death of a loved one

Learning that a family member or close friend died suddenly, by violence or accident and without warning, is itself a recognized cause of PTSD. You did not have to be in the room. The shock of the news, and everything the mind does with it afterward, can be enough.

Repeated Occupational Exposure

Police, nurses, paramedics, veterans, dispatchers

Some people meet trauma not once but again and again, as part of the job: the police officer walking into one homicide scene after another, the nurse caring for burn victims shift after shift, the paramedic, the ICU clinician, the 911 dispatcher, the service member. Repeated exposure to the aftermath of death and injury is, by definition, a pathway to PTSD, and the culture of "just handle it" too often leaves it untreated.

Medical & Birth Trauma

ICU, emergency surgery, traumatic childbirth, NICU

A frightening ICU stay, an emergency surgery, a life-threatening diagnosis, a traumatic childbirth or NICU experience. Medical events like these routinely produce PTSD that goes unrecognized, because the focus at the time was, understandably, on survival. We see it, and we treat it.

PTSD with Co-Occurring Conditions

ED, OCD, anxiety, or depression alongside PTSD

PTSD frequently travels with eating disorders, OCD, anxiety, and depression. We treat the trauma and the co-occurring condition together, rather than asking you to resolve one before we address the other.

When PTSD Isn't the Only Thing

Trauma Rarely Travels Alone, and We Treat the Full Picture.

PTSD frequently co-occurs with other conditions. In fact, isolated PTSD (without depression, anxiety, OCD, substance use, or an eating disorder alongside it) is clinically less common than PTSD embedded in a more complex presentation. Treating PTSD without addressing what travels with it produces incomplete recovery.

PTSD & Eating Disorders

Trauma is a significant risk factor for eating disorder development and maintenance. For some patients, the eating disorder serves as a coping mechanism for trauma-related distress. We treat both simultaneously using integrated treatment, not sequentially.

PTSD & OCD

Traumatic experiences can trigger OCD symptoms or exacerbate existing OCD. The two conditions require distinct treatments (we do not conflate them), but we address both in a coordinated treatment plan that targets each disorder appropriately.

PTSD & Depression

Major depression is among the most common co-occurring conditions with PTSD. CPT in particular has strong evidence for simultaneous improvement of both PTSD and depressive symptoms, making it a preferred first choice when both are present.

PTSD & Anxiety Disorders

Generalized anxiety, social anxiety, and panic disorder frequently co-occur with PTSD. We develop integrated treatment plans that address the trauma and the anxiety disorder together, rather than treating them as separate and sequential problems.

If you have been told to "stabilize first" and have been stabilizing for years without addressing the trauma, that is a conversation worth having with us.
Our Treatment Approach

Two Treatments. Decades of Evidence. The Best Outcomes in the Field.

We use two treatments for PTSD at the Evidence-Based Treatment Institute: Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT). These are not our preferences or clinical habits; they are the two trauma treatments with the most robust, replicated evidence base in the world. Every major treatment guideline for PTSD, including those from the VA, DoD, APA, and WHO, recommends both as first-line treatments.

We choose between them, or combine elements of both, based on the individual clinical formulation: the nature of the trauma, the patient's symptom profile, their cognitive style, and their goals for treatment. Treatment names mean little until you understand what each one actually targets and why it works. Here is exactly that: what we use, who it's for, and the logic underneath it.

Treatments at a glance

Tap either treatment to jump to its full explanation below.

Prolonged Exposure Therapy (PE)

Adults and adolescents with PTSD from any trauma type. Particularly effective when avoidance is the dominant symptom.

Prolonged Exposure is built on a straightforward but powerful principle: PTSD is maintained by avoidance. Avoiding trauma reminders, avoiding the memory, avoiding feelings associated with the event. All of these provide short-term relief while preventing the brain from learning that the trauma is over and the threat has passed.

PE addresses this through two core components delivered simultaneously:

Imaginal Exposure

The patient revisits the traumatic memory in structured, supported sessions, narrating it in detail, in the present tense, with the clinician present. The reframe at the heart of this is simple but hard-won: the event itself was dangerous, but the memory of it is not. It is horrendous, and it can be terrifying. Yet it can no longer harm you, which is exactly why it is not something you need to keep avoiding. And it is that avoidance, however understandable, that quietly keeps the fear alive. Done correctly, with proper pacing and between-session processing, imaginal exposure lets the memory become just that, a memory, rather than an ongoing threat signal.

In Vivo Exposure

The patient gradually approaches real-world situations, places, or activities that have been avoided because they are associated with the trauma. Using a systematic hierarchy, avoidance is reduced and the nervous system learns that these situations are safe in the present.

PE is delivered over a focused course of weekly sessions, for as long as the work requires. Most patients experience meaningful symptom reduction within the first several sessions of imaginal exposure, not because the work is easy, but because the brain responds quickly when it finally receives accurate information about safety.

Prolonged Exposure does not erase the memory of what happened. It changes the relationship the brain has with that memory: from threat signal to stored experience.

Cognitive Processing Therapy (CPT)

Adults and adolescents with PTSD, particularly when guilt, shame, self-blame, or disrupted beliefs are prominent.

Cognitive Processing Therapy targets the way trauma changes thinking: specifically the "stuck points" that keep the brain from moving through and past the traumatic experience. Stuck points are unhelpful beliefs that developed in response to trauma: "It was my fault." "I should have stopped it." "The world is completely unsafe." "I am permanently broken." "I can never trust anyone again."

These beliefs are not irrational; they were the brain's attempt to make sense of something that made no sense. But they maintain PTSD by keeping the mind continuously engaged with the trauma rather than allowing it to be processed and filed away.

Phase 1: Impact Statement & Education

The patient writes about the meaning the trauma has had for their life and their beliefs. This surfaces the stuck points explicitly and establishes a shared starting point for the cognitive work.

Phase 2: Challenging Stuck Points

Using structured worksheets and guided discovery, the clinician helps the patient examine the evidence for and against their trauma-related beliefs and develop more balanced, accurate ways of understanding what happened. This work spans five key domains: safety, trust, power and control, esteem, and intimacy.

CPT is delivered over a focused course of weekly sessions. It does not require the patient to narrate the trauma in detail during sessions, making it a strong choice when imaginal exposure feels too threatening initially, or when cognitive distortions are particularly prominent.

CPT does not minimize what happened. It restores the patient's ability to hold what happened accurately, without it distorting their entire view of themselves, others, and the future.
View All Treatments We Use
A Common Question

You May Have Heard of EMDR. Here Is Our Honest Clinical Position.

We are asked about EMDR (Eye Movement Desensitization and Reprocessing) constantly, so let us be direct: we don't offer it here, and that is a deliberate clinical decision, not a knock on EMDR. For PTSD, EMDR genuinely works, and we have no quarrel with the clinicians who use it. Our choice to specialize in PE and CPT is about what the evidence says is actually doing the work.

Every major authority that reviews the trauma research (the VA and Department of Defense, the American Psychological Association, the International Society for Traumatic Stress Studies) places Prolonged Exposure and Cognitive Processing Therapy at the front line for PTSD, on the deepest and most consistent evidence base in the field. EMDR appears on those lists too, and it is effective. But here is the part that rarely gets said out loud: when researchers strip EMDR down to isolate its signature ingredient (the eye movements, the bilateral stimulation), that component adds nothing measurable beyond the exposure to the memory that EMDR already contains.

Which means the best evidence on why EMDR works points straight back to the mechanism that drives PE: the structured, repeated, therapeutic confrontation of the trauma memory until it loosens its grip. Picture taking an ibuprofen for a headache while also doing a little dance around the kitchen. The headache lifts, but it is worth being honest about which of the two actually did it. EMDR helps because, underneath the eye movements, it is asking the brain to do the very thing PE asks it to do directly.

So our concern was never EMDR for PTSD: it works, and when it is used for trauma we have no issue with it at all. Our concern is what has happened since: EMDR is now applied, widely and sometimes wildly, to conditions it has no evidence base for (OCD, panic, and more), where the genuinely effective treatment is something else entirely. Too many people reach us after years aimed at the wrong target, sometimes worse for the detour. We specialize in PE and CPT because they are the active ingredient, delivered directly, and because the right treatment for the right condition is the entire point. If EMDR helped you, we are genuinely glad, and we're happy to talk it through at your consultation.
Who Does This Work

Trauma Care From Clinicians Trained in the Treatments That Actually Resolve It.

Trauma treatment here means delivering Prolonged Exposure and Cognitive Processing Therapy with fidelity, not generic "trauma-informed" talk therapy. Our clinicians are trained in these specific, evidence-based treatments and in recognizing how trauma interacts with the eating disorders, OCD, and anxiety we specialize in.

Allie Appenzeller, PsyD

Allie Appenzeller, PsyD

Co-Founder & Director

Co-founder and Director with deep expertise in evidence-based trauma treatment, including Prolonged Exposure and Cognitive Processing Therapy. Particular depth where trauma co-occurs with anxiety, perinatal mental health, and the family system around a traumatized child or adult.

Read Dr. Appenzeller's full bio
Zach Appenzeller, PsyD

Zach Appenzeller, PsyD

Co-Founder & Director

Co-founder and Director, trained in exposure-based and trauma-focused treatment, with particular depth in the complex presentations where trauma is entangled with eating disorders and OCD.

Read Dr. Appenzeller's full bio
Kimberly Osborn, PhD

Kimberly Osborn, PhD

Licensed Psychologist

Trauma-focused treatment with Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) for adolescents and adults, with particular depth where PTSD co-occurs with an eating disorder, OCD, or anxiety. Postdoctoral Fellow with the Eating and Anxiety Treatment (EAT) Lab at the University of Louisville.

Read Dr. Osborn's full bio
Kaitlin Hill, PhD

Kaitlin Hill, PhD

Licensed Psychologist

Trained at Rogers Behavioral Health and the OCD Institute of Texas, with deep experience in exposure-based treatment across every level of care, including the trauma that so often underlies and complicates OCD and eating disorders.

Read Dr. Hill's full bio
Eliza Lanzillo, PhD

Eliza Lanzillo, PhD

Licensed Psychologist

A former NIMH suicide-prevention researcher with deep training in exposure-based treatment, bringing particular expertise where trauma co-occurs with mood, safety concerns, OCD, or eating disorders, and where careful risk formulation matters.

Read Dr. Lanzillo's full bio
Natalia Levy, PhD

Natalia Levy, PhD

Licensed Psychologist

More than three decades of clinical experience across the lifespan, with particular sensitivity to how trauma surfaces over time and interacts with depression, anxiety, and the family relationships that support recovery.

Read Dr. Levy's full bio

Ready to begin? Reach out and a clinician, not a scheduler, gets back to you within one business day.

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Common Questions

Frequently Asked Questions: PTSD Treatment.

No. You don't need to arrive with a confirmed PTSD diagnosis to reach out. What we care about is whether you are experiencing significant distress, disruption, or impairment that appears connected to a traumatic experience. We conduct a thorough diagnostic evaluation as part of the intake process and will give you an honest clinical picture of what we find. Many people who come to us uncertain whether "what happened to them was bad enough" to warrant a PTSD diagnosis have, in fact, been living with significant trauma-related symptoms for years. You deserve to find out.

For PE: yes. Imaginal exposure involves recounting the traumatic memory in detail during sessions, in the present tense, with your clinician present. This is not the same as simply retelling the story. It is a structured, evidence-based process that is prepared for carefully and paced collaboratively. For CPT: the standard delivery involves writing a detailed account of the trauma, which you then read and process with your clinician, but verbal retelling in session is less central than in PE. If talking about the trauma directly feels insurmountable at this stage, CPT may be the more appropriate starting point.

The most common reason trauma therapy fails to produce lasting results is that it used a supportive, non-trauma-focused approach: processing emotions around the trauma without directly addressing the memory or the cognitive distortions maintaining the PTSD. If your prior therapy did not involve structured exposure to the trauma memory or systematic work on trauma-related beliefs, you have not yet received the treatment that PTSD responds to most powerfully. Prior treatment failure does not predict future treatment failure when the approach changes.

Treatment length is individualized. Many people feel meaningful change within a focused course of weekly sessions, but recovery is not run on a stopwatch. Outside of a research trial, people often need longer, and we do the work for as long as it takes to get the job done. We talk through what to expect for your situation at your initial consultation.

The concern about re-traumatization is understandable, and clinically important. The research on PE and CPT is unambiguous: these treatments do not re-traumatize. The mechanism is the opposite: they allow the brain to complete the processing the trauma interrupted. The temporary increase in distress that some patients experience early in treatment is not re-traumatization. It is the expected, temporary result of confronting avoided material, and it is a predictor of subsequent improvement, not of harm.

Yes. We treat PTSD and trauma-related conditions in adolescents using adapted versions of PE and CPT that are developmentally appropriate. For younger patients, parent involvement is an important part of treatment: parents are coached on how to support their child's recovery and how to avoid inadvertently reinforcing avoidance.

That is a real and legitimate place to be, and we take it seriously. Some patients arrive at our practice needing a period of stabilization before trauma-focused work is appropriate. We do not push patients into trauma processing before they are ready. We also do not let "not ready yet" become a permanent holding pattern that never resolves. We discuss what readiness actually looks like for you, and we work toward it with honesty and genuine respect for where you are.

Selected References

  1. Foa EB, Hembree EA, Rothbaum BO. Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences: Therapist Guide. Oxford University Press, 2007.
  2. Resick PA, Monson CM, Chard KM. Cognitive Processing Therapy for PTSD: A Comprehensive Manual. Guilford Press, 2017.
  3. Resick PA, Nishith P, Weaver TL, Astin MC, Feuer CA. A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology, 2002.
  4. Resick PA, Williams LF, Suvak MK, Monson CM, Gradus JL. Long-term outcomes of cognitive-behavioral treatments for posttraumatic stress disorder among female rape survivors. Journal of Consulting and Clinical Psychology, 2012.
You Don't Have to Keep Carrying This

Trauma Treatment That Works Is Available. Right Now, Wherever You Are.

What happened to you was real. The impact it's had on your life is real. And the treatment that can actually address it (not manage it indefinitely, but address it) is available right now.

PE and CPT have helped hundreds of thousands of people reclaim their lives from PTSD. Not because the work is easy. Because it works.

Fill out our brief new patient inquiry form. We will be in touch within one business day, with no pressure, no rush, and no expectation beyond a conversation about whether we're the right fit for what you're facing.

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Call us: (954) 247-1114  ·  hello@EBTInstitute.com
Questions first? Read our FAQ What does "evidence-based" actually mean? Trauma alongside an eating disorder? Eating Disorders Program Trauma alongside OCD? OCD Treatment Trauma alongside anxiety? Anxiety Treatment Birth trauma or perinatal PTSD? Women's & Perinatal Health Considering fees? Fees & Insurance
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