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

RECO Health's Delray Beach campus sits twelve minutes north of Highland Beach up A1A, close enough for a Bel Lido Isle or Toscana resident to attend PHP five days a week — or IOP three — without relocating. Trauma care is delivered by clinicians trained to CPT, PE, or EMDR protocol, not by generalists doing "trauma-informed" work, and in-house psychiatry handles SSRI initiation, prazosin titration for nightmares, and comorbid depression on the same treatment team. Stabilization precedes trauma processing by design, not by accident.

Highland Beach runs a narrow oceanfront strip along A1A between Delray and Boca Raton, and RECO Health’s Delray campus sits roughly seven miles north — a twelve-minute drive for residents of Bel Lido Isle, Toscana, Boca Cove, Ocean Cove, or the Penthouse. For clients with post-traumatic stress disorder or complex trauma histories, the clinical density available at RECO — protocol-trained trauma therapists, in-house psychiatry, PHP through IOP levels of care, and adjunctive services including TMS and ketamine — is not something the general behavioral-health offices in Boca replicate. This page describes how PTSD and trauma treatment is structured at RECO, from intake through stabilization to formal exposure or reprocessing work.

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

Every admission to RECO’s trauma track begins with the PCL-5 — the twenty-item self-report scale anchored to the DSM-5-TR PTSD criteria — administered at intake and repeated at defined intervals to track response. The more consequential piece of the assessment, however, is the trauma history interview. Many clients arrive having never disclosed the index event to a treating clinician; a chart that reads “PTSD, chronic” often hides a decade of avoided material that the presenting complaint — insomnia, panic, an alcohol relapse — has been organized around. RECO’s intake protocol paces disclosure so that history can surface without the client dropping out of treatment in week two.

The differential also matters more than the shorthand “PTSD” suggests. Complex PTSD as coded in ICD-11 — with disturbances in self-organization, affect dysregulation, and interpersonal functioning layered on the core PTSD triad — pulls the treatment plan toward phased work with front-loaded stabilization. Classic PTSD from a single-incident trauma often tolerates an earlier move into exposure-based processing. Adjustment disorder with anxiety, which gets mislabeled as PTSD frequently in primary care, calls for a shorter, symptom-focused course. The intake psychiatrist and trauma therapist review the diagnostic formulation jointly before the plan is written, and PHQ-9 and GAD-7 are tracked alongside the PCL-5 because comorbid depression and generalized anxiety are the rule rather than the exception.

Cognitive Processing Therapy, Prolonged Exposure, and EMDR

The three modalities with the strongest randomized-controlled-trial evidence for PTSD are Cognitive Processing Therapy, Prolonged Exposure, and Eye Movement Desensitization and Reprocessing. RECO’s trauma therapists are trained to at least one of the three; most are trained in two, and case assignment is made on presentation rather than on whichever protocol a given clinician happens to prefer. CPT runs twelve manualized sessions organized around identifying “stuck points” — assimilated and over-accommodated beliefs about the trauma — and cognitively restructuring them, with or without written trauma accounts depending on client preference. Prolonged Exposure pairs sustained imaginal exposure to the memory with a hierarchical in-vivo exposure schedule to avoided situations, typically across ten to fifteen sessions.

EMDR uses bilateral stimulation during targeted processing of trauma memories and their associated cognitions, body sensations, and affect. It is often the first choice for clients whose dissociative symptoms make direct narrative exposure destabilizing, and for those who cannot yet articulate the trauma verbally. Strong avoidance patterns — particularly around specific external cues rather than internal experience — often argue for PE. High shame-and-self-blame presentations, common in interpersonal and moral-injury trauma, often argue for CPT. These are clinical heuristics, not rules; the therapist and client formulate the choice together in the first two sessions and revisit it as data accumulates.

Pharmacotherapy for PTSD is adjunctive, not primary

Medication in PTSD is adjunctive to trauma-focused psychotherapy, not a substitute. Sertraline and paroxetine are the only two FDA-approved agents for PTSD, and both produce modest reductions in overall symptom severity — useful, but neither remits the disorder on its own. Venlafaxine has comparable off-label evidence and is a reasonable alternative for clients who have not tolerated an SSRI, and mirtazapine is used selectively for insomnia with appetite or weight considerations.

Prazosin, titrated from 1 mg at bedtime up to 10-15 mg as blood pressure permits, remains the standard pharmacologic intervention for trauma-related nightmares and sleep disruption; baseline and orthostatic vitals are obtained before initiation and at each dose increase. Benzodiazepines are avoided as maintenance pharmacotherapy for PTSD — the evidence base is negative and they interfere with the extinction learning that exposure-based treatments depend on — and are used, if at all, only in narrow acute indications. Second-generation antipsychotics (quetiapine, olanzapine, aripiprazole) are reserved for specific comorbid presentations rather than deployed as reflexive add-ons. For treatment-resistant depression comorbid with PTSD, RECO’s in-house rTMS (3000 pulses per session at 120% of motor threshold) and ketamine services are available on referral from the treating psychiatrist.

Stabilization before trauma processing

Trauma processing conducted before the client has adequate containment retraumatizes. For clients who arrive in acute crisis, in active substance use, or in dissociative overwhelm, the first phase of treatment is skills-based rather than exposure-based. DBT distress-tolerance modules — TIPP, self-soothing, radical acceptance — are taught concurrently with grounding skills, sleep restoration, and medication stabilization. For clients with concurrent substance use disorder, the ASAM Criteria dimensions guide whether medically monitored detox with CIWA-Ar or COWS monitoring is required before residential or PHP-level trauma work can begin.

The failure mode this phase is designed to prevent is the one most commonly seen when clients arrive at RECO having washed out of trauma work elsewhere: an eager clinician moved to imaginal exposure or EMDR reprocessing in week two, the client’s window of tolerance was blown open, and they either dissociated through subsequent sessions or dropped out. RECO treats the transition from Phase 1 (stabilization) to Phase 2 (processing) as a clinical decision with defined criteria — sleep quality, use of distress-tolerance skills under stress, sobriety where applicable, and PCL-5 trajectory — rather than a calendar milestone.

What to expect on your first visit

The first visit is a diagnostic intake and level-of-care determination, not the beginning of trauma work. A master’s-level clinician conducts the biopsychosocial history and administers the PCL-5, PHQ-9, and GAD-7, and — where indicated — screens for dissociation (DES-II) and complex PTSD features. The intake psychiatrist reviews the assessment the same day or the following morning, reconciles current medications, and discusses pharmacotherapy options. Level-of-care recommendation (PHP, IOP, or outpatient trauma therapy) is made against ASAM Criteria and clinical acuity, and the written treatment plan is finalized before the client leaves.

Insurance and admissions from Highland Beach

RECO Health is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and most Blue Cross Blue Shield plans. Admissions runs verification of benefits before the first visit and communicates the specific out-of-pocket exposure — deductible, coinsurance, session limits, and any prior-authorization requirements — in writing rather than as a verbal estimate. From Highland Beach, the standard route is A1A north to Linton Boulevard and west to the Delray campus, twelve minutes in typical conditions, longer through season, when I-95 via Linton or Atlantic Avenue is often faster.

Serving residents of: Bel Lido Isle, Boca Cove, Ocean Cove, Toscana, Penthouse.