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Online Therapy in New Jersey

Mind by Design Counseling

Knowing the Differences Between
for optimal treatment

Trauma presents differently in each individual however, differentiating between PTSD and C-PTSD is important when finding the right treatment for your needs. When people think of trauma, there is  they are likely to think of post-traumatic stress disorder (PTSD) or “Acute Stress Disorder”. However, interest in Complex-PTSD (C-PTSD) has been on the rise, and it’s important to know the difference between PTSD and C-PTSD.While PTSD and C-PTSD share some symptoms in common, both diagnoses have distinct differences that require different treatment approaches. In this blog, we will explore the differences between PTSD and C-PTSD, their symptoms, and treatment approaches.

Types of Trauma

Trauma is defined by the person who is experiencing the stressful event. Therefore, two people may share an experience, yet only one of them may perceive it as traumatic.  Hence why, when assessing an individual for PTSD or CPTSD, we must understand how the stressor impacted the person’s functioning.

Some examples of traumatic events that can cause PTSD include natural disasters, combat, sexual assault, or witness to accidents, violence or other stressful events.. C-PTSD, on the other hand, typically results from long-term abuse or neglect, such as childhood abuse, domestic violence, or living in a war zone.

What Are the Differences Between PTSD and C-PTSD ?

PTSD is a disorder that is caused by exposure to real or perceived danger, threat or stress. Symptoms of PTSD last for more than 4 weeks and occur after a threatening event occurs. PTSD is more likely to result when trauma occurs as a single incident or within a brief period of time.

On the other hand, C-PTSD is a form of PTSD that develops after a person experiences prolonged or repeated trauma. While PTSD is typically associated with a single traumatic event, C-PTSD is associated with ongoing or repeated trauma.

trauma-informed care at mind by design trauma informed therapy nj therapy for ptsd and c-ptsd

Additional Symptoms of C-PTSD

C-PTSD also includes additional symptoms such as:

  • Challenges with emotion regulation
  • Negative self-image
  • Issues with interpersonal relationships
  • Symptoms are often more complicated and persistent, and may require a longer period of treatment.

Type & Duration of Symptoms

While PTSD and C-PTSD share some symptoms, these diagnoses differ in their type of symptoms and the duration of symptoms. PTSD symptoms usually appear soon after the traumatic event and can last for weeks, months, or even years. Unlike PTSD, C-PTSD symptoms may take years to fully present, and the course of development of these symptoms may change (i.e., avoidance, interpersonal challenges, etc). People with C-PTSD may experience ongoing symptoms of PTSD, such as:

  • flashbacks
  • nightmares
  • avoidant behaviors
  • difficulty regulating emotions
  • dissociation
  • relationship difficulties.

 Because C-PTSD is correlated with longer exposures to trauma, many individuals with C-PTSD experience symptoms post-stress that were once “adaptive”, survival behaviors but are now interfering with their lives.

Common Symptoms of PTSD and C-PTSD :

The overlap of symptoms of PTSD and C-PTSD can cause confusion for clients and even some providers. It’s importnat to note that there are some shared symptoms of PTSD and C-PTSD which may include: 

  1. Intrusive memories, including flashbacks and nightmares
  2. Avoidance of reminders related to the traumatic event
  3. Changes in mood and thought patterns
  4. Arousal symptoms like hypervigilance, difficulty concentrating, and insomnia

Characteristics of C-PTSD

In addition to PTSD symptoms, C-PTSD is often characterized by three main symptoms:

  • Emotional dysregulation
  • Negative self-perception
  • Difficulty forming relationships.

Emotional dysregulation refers to difficulty regulating emotions, which can lead to mood swings, explosive anger, or emotional numbness.
Negative self-perception refers to feeling shame, guilt, or worthlessness, often as a result of the trauma.
Difficulty forming relationships can manifest as mistrust, fear of intimacy, or difficulty expressing emotions.

Characteristics of PTSD

PTSD is often characterized by four main symptoms: 

  • Re-experiencing,
  • Avoidance
  • Hyperarousal,
  • Negative changes in mood or cognition.

Re-experiencing refers to flashbacks, nightmares, or intrusive memories of the traumatic event.
Avoidance behavior refers to efforts to avoid thoughts, feelings, or reminders of the traumatic event.
Hyperarousal refers to an exaggerated startle response, irritability, or difficulty sleeping.
Negative changes in mood or cognition refer to feelings of guilt, shame, or detachment from others.

How Does Treatment Differ between PTSD and C-PTSD ?

Treatment for PTSD and C-PTSD are similar and typically include a combination of medication and psychotherapy. The most common therapeutic approaches for trauma related disorders are:

  • Cognitive processing therapy 
  • Prolonged Exposure Therapy 
  • Trauma Focused CBT

In addition to this, CPTSD treatment may include supportive modalities such as:

  • Skills Training in Affective and Interpersonal Regulation (STAIR)
  • Somatic Experience Therapies
  •  Eye Movement Desensitization and Reprocessing (EMDR)

Because C-PTSD is often the result of prolonged or repeated trauma, it may require additional therapy, or therapy that offers more flexibility and focus on relationships, emotional regulation and communication skills.

Although medication can be helpful in reducing the intensity of symptoms, it should be used in conjunction with therapy to address the root cause of the trauma. Also, it is important that you work with a qualified therapist when undergoing trauma-therapy to ensure that re-traumatization does not occur.

Is it possible for
PTSD to develop into C-PTSD?

Individuals may feel that their symptoms of trauma intensify, and that this prolonged struggle may add to the risk of developing CPTSD. Furthermore, maladaptive coping skills, re-triggering events or people, and vulnerability to additional trauma may exist. Therefore, it is important that an individual who has PTSD or CPTSD be provided with services that look at the person as a whole, and ensure that safety and comfort are established in their surroundings and in their relationships.

Moreover, what may initially appear as PTSD stemming from a single traumatic incident or short-term trauma may later be recognized as a result of a series of traumatic events over time. This accumulation of trauma can result in more complex and severe symptoms that are better characterized as C-PTSD.

"Trauma Response" Triggers

Symptoms of trauma may disappear or decrease for a large portion of time, though may resurface if triggered by changes in the environment or life circumstances. This includes changes  in relationships, careers, living environment, or lifestyle. 

This experience is sometimes referred to as a “trauma response” in which an individual responds to changes with a “fight, flight, or freeze” response, even if the situation does not warrant an intense response. This cycle can continue to perpetuate, leading to more difficulties.

Tips for Finding a Therapist for
PTSD or C-PTSD Treatment

As soon as you notice symptoms of PTSD or C-PTSD, it’s crucial to seek help from a mental health professional trained in trauma-informed care. These therapists follow specific guidelines that ensure a safe, welcoming office space and offer choices about the type of treatment you prefer. They focus on collaborating with you and earning your trust. Moreover, they empower you to gradually develop coping skills and learn how to manage triggers.

Final Thoughts on differentiating between PTSD and C-PTSD

Understanding the distinctions between PTSD and C-PTSD can help you find the right treatment approach and therapist for you. Equally important, finding an experienced trauma-informed therapist can provide you with the support you need. You are entitled to a safe, confidential and supportive environment.

Professional treatment for both PTSD and C-PTSD t is available to help you cope with the aftermath of trauma. Taking the initiative to seek help and actively participate in treatment is the first step.

Reach out, help is here.

FAQ's about therapy at Mind by Design Counseling

How do I get started as a new client?

New Clients can reach out to us directly via call, text or email here:






What is your cancellation policy?

We ask that clients provide at least 24 hours notice in the event that they need to cancel to avoid the 50% cancellation fee. we understand that life happens and do our best to be flexible & reschedule.

Does my insurance cover my visits?

We provide”Courtesy Billing” for clients who are using the Out-of-network insurance benefits.

Our Insurance Page shares a small blurb about Why We Left Insurance Panels

Do you offer traditional talk therapy?

of course! though we have some unconventional therapy approaches, we are rooted in evidenced based practices. Talk therapy is a major player in the therapy room! See What we Treat and Integrative Services for more information

Is Online Therapy As Effective As In-Person Therapy?

Online therapy is essentially face-to-face counseling, just conducted remotely. Studies show that teletherapy is as effective as traditional counseling. Professional organizations and state governments recognize its benefits and have set regulations for it. However, like any therapy, its success in achieving your goals isn’t guaranteed. It’s important to discuss with your therapist whether teletherapy is working for you.

Can I Change Therapists If I'm Not Happy?

Yes, you can switch therapists to another provider within the practice, or we can provide you a referral if preferred. We want to ensure that your time and effort are well spent, and that you are getting the relief you need, that’s why we work collaboratively with each other in the practice, as well as outside therapists who we know and trust.

How Do I Know If Therapy Is Helping?

You should feel like you’re making progress. Signs it’s working include:

Feeling comfortable talking to your therapist
Your therapist respects boundaries
You’re moving towards your goals
You feel listened to
You’re doing better in life
Your self-esteem is getting better

Is Online Therapy Easy to Use for Non-Tech-Savvy People?

Yes, it’s pretty simple to access sessions. You’ll need basic internet skills, such as opening and visiting the patient link sent to you via email. It’s similar to video chatting like Facetime or Zoom. We can also walk you through it on the phone the first time to ensure a strong connection

What Questions Should I Ask My New Therapist?

Feel free to ask anything. Some good questions are:

  • How often will we meet?
  • What do you specialize in?
  • What experience do you have with my issue?
  • What outcomes can I expect?
  • How will I know I’m progressing?
  • How long do you usually work with clients?
  • How will we set my treatment goals?

How Should I Prepare for My First Session?

Showing up is all that you need to do! But if you really want to get the most out of session, it could help to take some time to think about what you want from therapy. It helps to write down your goals, questions you have or things that you feel are important to share. 

What is the difference between associate therapists & fully licensed therapists?

Our Qualifications:

Our founder, Rebecca Sidoti, is a highly qualified, state-licensed therapist and supervisor with extensive training in anxiety related disorders and innovative treatment such as Ketamine Therapy. Mind by Design Counseling adheres to standards set by the our governing counseling boards.

To see each providers credentials, training and licenses, visit our “Meet the Therapists” Page to learn more.


  • LAC/LSW are therapists who may practice clinical work under the supervision of a fully licensed therapist.
  • LPC/LCSW are therapists who have completed the necessary clinical hours post-graduation under supervision and can practice clinical work independently.

What Geographic Areas Are Served?

Currently, we serve clients in New Jersey and are expanding to other states as telehealth laws evolve. While telehealth offers the convenience of attending sessions from anywhere, state laws require clients to be in-state during their session.

Is Virtual Counseling Suitable for Everyone?

Online therapy might not be as effective for individuals with chronic suicidal thoughts, severe trauma, significant mental health history, or those recently in intensive care. Such cases often benefit more from traditional, in-person counseling. We’ll help you decide if our online services are right for you during your intake and evaluation.

What Equipment is Needed for Online Therapy?

To join a session, log in using the credentials we provide. No downloads are needed. Our platform, compatible with both individual and group sessions, requires:
A computer or mobile device with a webcam and internet access.
We’ll help you test your setup before your first appointment to ensure a reliable connection. iOS users should use the Safari browser for mobile and tablet sessions.

What Questions Will Therapists Ask Me?

It depends on your goals. Expect questions about your thoughts, feelings, relationships, work, school, and health. They’ll ask to understand your therapy goals.

How Do You Keep Client Information Secure?

Security and Confidentiality of Sessions:
Your privacy is crucial to us. We use TherapyNotes, a HIPAA-compliant platform, ensuring secure and confidential teletherapy sessions. This platform’s security features include encrypted video connections, secure data transfers, and encrypted databases, ensuring your information is safe at all times.

What is VRT used for?

we use VRT to support Exposure Therapy, a long standing traditional therapy modality to treat phobias, anxiety and stress. we send a headset directly to your home so you can access VRT from anywhere.

VRT not only helps with exposure therapy for phobias, but is great for ADHD, mindfulness, PTSD and social anxiety.