PTSD and trauma treatment for Delray Beach — CPT, PE, and EMDR to protocol.

RECO Health's PTSD program runs from a campus one block off Atlantic Avenue — walking distance for most of downtown Delray Beach and a short drive from Lake Ida, Tropic Isle, and the Beach District. Trauma work is delivered by clinicians trained to protocol in CPT, Prolonged Exposure, or EMDR, not generalists doing "trauma-informed" talk therapy. Psychiatry is in-house, so prazosin for nightmares, a sertraline trial, or a medication reconciliation happens on the same schedule as your therapy — not weeks later with an outside prescriber.

RECO Health’s main campus sits at 140 NE 4th Avenue, one block off Atlantic and a five-minute walk from the sand. For residents of Pineapple Grove, Lake Ida, Tropic Isle, Osceola Park, and the Beach District, treatment for post-traumatic stress does not require flying to a residential program in another state. It happens in the neighborhoods you already move through, on a schedule that keeps work, family, and recovery from collapsing into each other.

Assessment: the PCL-5 and the trauma history that isn’t in the chart

Every intake begins with the PCL-5 to anchor PTSD severity, plus the PHQ-9 and GAD-7 for the depression and anxiety that almost always ride alongside. Scale scores are useful — they give a defensible baseline and let us track response session by session — but they are not the assessment. The assessment is the trauma history interview, and for most clients that is the first time they have described the index event to a clinician in full.

Our intake protocol is structured around that reality. The first sessions build enough safety, pacing, and psychoeducation about the memory system that the history can surface without the client leaving treatment before therapy has begun. Diagnostic clarity matters here: complex PTSD as defined in ICD-11 — prolonged, repeated interpersonal trauma with disturbances in self-organization — is treated differently than a single-incident PTSD, and both are treated differently than an adjustment disorder with anxious features. Getting that distinction right on the front end shapes the entire treatment plan: the modality, the pace, and whether stabilization work comes first.

Cognitive Processing Therapy, Prolonged Exposure, and EMDR

Trauma treatment at RECO Health is built around the three modalities with the strongest evidence base for PTSD: Cognitive Processing Therapy, Prolonged Exposure, and Eye Movement Desensitization and Reprocessing. Every trauma clinician on staff is trained to protocol in at least one; most are trained in two. The choice is driven by the client’s presentation, not by what the therapist happens to prefer.

CPT is a twelve-session structured protocol that identifies “stuck points” — the assimilated or over-accommodated beliefs the trauma produced (“it was my fault,” “the world is entirely unsafe”) — and uses Socratic dialogue and daily worksheets to restructure them. PE builds an in-vivo avoidance hierarchy and pairs it with repeated, prolonged imaginal exposure to the trauma memory; between-session listening to the recorded narrative is part of the protocol. EMDR uses bilateral stimulation while the client holds a targeted trauma image, cognition, and body sensation in mind, moving through the standard eight-phase sequence toward adaptive resolution.

Presentation guides the choice. Marked dissociative symptoms often favor EMDR or a phased CPT with extended stabilization. Heavy avoidance — the client who has restructured her whole life around not going near a memory or a place — often responds to PE, because the protocol is built to dismantle avoidance directly. Concurrent alcohol or opioid use is not a contraindication once withdrawal is managed, but active use during exposure work suppresses the fear structure and blunts response, which is why substance stabilization and trauma work are sequenced deliberately rather than run in parallel.

Pharmacotherapy for PTSD is adjunctive, not primary

Two medications carry FDA approval for PTSD: sertraline and paroxetine. Both are useful and both are limited — SSRIs reduce hyperarousal and intrusive symptoms in a meaningful minority of patients, but neither remits the disorder on its own. Trauma-focused psychotherapy remains the primary treatment; medication is adjunctive. RECO’s psychiatry team makes that framing explicit at the first medication visit so expectations match the evidence.

Prazosin remains the standard for trauma-related nightmares and sleep disruption, titrated from 1 mg at bedtime up to 10-15 mg with blood pressure monitored at each step. Venlafaxine covers PTSD with prominent comorbid depression; mirtazapine helps when sleep and appetite are the dominant complaints. Off-label adjuncts — low-dose quetiapine, buspirone for daytime anxiety — are used selectively. Benzodiazepines are avoided outside narrow situational indications: they interfere with fear extinction, complicate exposure therapy, and the trial evidence for them in PTSD is negative. Second-generation antipsychotics are reserved for specific residual symptoms, not first-line use.

Stabilization before trauma processing

Trauma processing without stabilization retraumatizes. A client who arrives in acute suicidal crisis, in untreated substance use disorder, or in dissociative overwhelm cannot metabolize a Prolonged Exposure protocol — they will decompensate, drop out, and often leave more symptomatic than when they arrived. The first phase of treatment for those clients is skills-based and non-negotiable.

Practically, that means DBT distress tolerance and emotion regulation modules, grounding practice for dissociation, sleep restoration (often the single highest-yield early intervention), and medication stabilization on the psychiatry side. For clients with co-occurring alcohol or opioid use disorder, that phase also includes buprenorphine or naltrexone induction and CIWA- or COWS-guided withdrawal management before trauma processing begins. The window of tolerance has to be wide enough to hold the material. Rushing to the trauma memory before the containment is built is one of the most common failure modes in PTSD treatment, and it is the failure mode our intake team is watching for.

What to expect on your first visit

The first appointment is a ninety-minute clinical evaluation with a master’s-level trauma therapist and a same-week psychiatric evaluation with a board-certified psychiatrist or psychiatric NP. You will complete the PCL-5, PHQ-9, GAD-7, and — if substance use is part of the picture — a substance use inventory scored against the six ASAM Criteria dimensions. Nothing is asked in the trauma history that you are not ready to answer; the clinician follows the client’s pacing.

You leave the first visit with a working diagnostic impression, a recommended level of care (typically PHP or IOP for trauma work), and an admission date. Most clients from Delray Beach admit within three to seven days of the initial call, with faster turnaround available for anyone in acute distress.

Insurance and admissions from Delray Beach

RECO Health is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS plans, and admissions runs a real-time verification of benefits before your first visit so you know the deductible, copay, and coinsurance in writing rather than as a surprise. Out-of-network plans with mental health benefits are usually workable; a single-case agreement is common when the trauma protocol is the clinical fit. The admissions line runs seven days a week.

Serving residents of: Pineapple Grove, Lake Ida, Tropic Isle, Beach District, Osceola Park.