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

RECO Health treats PTSD and complex trauma at PHP and IOP with clinicians trained to protocol in Cognitive Processing Therapy, Prolonged Exposure, and EMDR — not generalists doing "trauma-informed" work. Wellington sits 28 miles and 38 minutes east on Southern Boulevard; most residents admitted at PHP level choose a bed in RECO's sober-living network over a daily commute from Olympia, Versailles, or Palm Beach Polo. In-house psychiatry manages sertraline, paroxetine, prazosin, and comorbidity pharmacotherapy on the same treatment team, with rTMS and ketamine available as separate protocols when depression is treatment-resistant.

Wellington sits 28 miles west of Delray Beach — roughly 38 minutes on Southern Boulevard on a normal weekday. The equestrian corridors and gated communities around Palm Beach Polo, Aero Club, Olympia, Versailles, and Wellington View are far enough inland that most residents entering trauma treatment at RECO Health pair PHP and IOP with a bed in the sober-living network rather than a daily commute. For trauma work, that structure matters — continuity across the week is what allows exposure and stabilization to hold.

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

The PCL-5 (PTSD Checklist for DSM-5) is administered at intake and repeated at defined intervals to track symptom response. A total score of 33 or above supports a probable PTSD diagnosis, but the more clinically consequential piece of the intake is the trauma history interview. Many clients arrive with a symptom list — nightmares, hypervigilance, avoidance, emotional numbing, dissociation — and no record of the events driving them. Full trauma disclosure often has not happened at any prior level of care.

RECO’s intake protocol is structured so that safety, pacing, and rapport come before detailed disclosure. The clinician is not trying to extract a narrative on day one. The distinction between complex PTSD (ICD-11), classic PTSD, adjustment disorder, and the dissociative subtype is drawn deliberately, because those diagnoses map to meaningfully different treatment plans. A client with dissociative features and childhood polyvictimization does not receive the same protocol as someone presenting with a discrete adult trauma and intact affect regulation.

Comorbidity screening runs in parallel — PHQ-9 for depression, GAD-7 for anxiety, AUDIT and DAST for substance use, and where indicated the DES-II for dissociative symptoms. ASAM Criteria dimensions guide level-of-care decisions when a substance use disorder is co-occurring.

Cognitive Processing Therapy, Prolonged Exposure, and EMDR

Three trauma-focused psychotherapies carry the strongest evidence base for PTSD: Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), and Eye Movement Desensitization and Reprocessing (EMDR). CPT runs approximately 12 sessions, organized around identifying stuck points — over-accommodated beliefs about safety, trust, power, esteem, and intimacy that formed after the trauma — and restructuring them through Socratic dialogue and structured written work. PE combines imaginal exposure to the trauma memory with an in-vivo hierarchy of avoided situations, typically across 8 to 15 sessions. EMDR uses bilateral stimulation while the client holds targeted trauma material in working memory, delivered through a standard eight-phase protocol.

RECO’s trauma clinicians are trained to protocol in at least one of these; most are certified in two. That distinction matters because “trauma-informed” is not the same as trauma treatment. A generalist who avoids retraumatizing a client is not the same as a clinician who can carry a client through a full CPT or PE course. Modality selection is driven by presentation. Marked dissociative symptoms often favor EMDR or a phased CPT with additional stabilization scaffolding. Strong avoidance with a discrete index trauma often favors PE. Complex PTSD with attachment-based sequelae usually begins with skills work — often in the STAIR framework — before formal exposure begins.

The full continuum of PTSD and trauma treatment at RECO spans PHP, IOP, and outpatient step-down, so modality dose can be sustained across the phase of care that requires it.

Pharmacotherapy for PTSD is adjunctive, not primary

Only two medications carry FDA approval for PTSD: sertraline and paroxetine. Both reduce symptom severity across intrusion, avoidance, and hyperarousal clusters, but neither drives remission on its own. Medication supports the psychotherapy; it does not substitute for it. Where sleep disruption and nightmares dominate the presentation, prazosin is added — typically initiated at 1 mg at bedtime and titrated to 2 to 15 mg with blood pressure monitoring, since orthostatic hypotension is the rate-limiting side effect.

Off-label agents cover common comorbidities. Venlafaxine has independent evidence in PTSD and addresses co-occurring generalized anxiety and depression. Mirtazapine treats insomnia and appetite suppression at low doses. Where depression is prominent and SSRI response is partial, augmentation with aripiprazole or a switch to venlafaxine is considered before further layering. Buspirone may be added for residual anxiety when benzodiazepines are contraindicated.

Benzodiazepines are avoided outside narrow indications. The evidence for chronic benzodiazepine use in PTSD is poor and includes signals for worse trauma-focused therapy outcomes, disinhibition, and dependence — a particular concern in the substance-use comorbid population. Quetiapine and olanzapine are reserved for specific presentations with explicit discussion of metabolic risk. For treatment-resistant depression with prominent PTSD symptoms, RECO’s in-house psychiatry evaluates candidacy for rTMS (3,000 pulses at 120% of motor threshold, standard 36-session course) and ketamine or esketamine as separate protocols — not as PTSD monotherapy.

Stabilization before trauma processing

Trauma processing without stabilization retraumatizes. For a client arriving in acute crisis — active substance use, suicidal ideation with plan, dissociative overwhelm, or unmanaged sleep collapse — the first phase is not exposure. It is skills-based stabilization: DBT distress tolerance and emotion regulation, grounding and orienting practices, sleep architecture repair, medication optimization, and where relevant medically supervised detox using CIWA-Ar for alcohol withdrawal or COWS for opioid withdrawal to guide dosing.

This phased approach follows the consensus trauma treatment framework — safety and stabilization, then trauma processing, then reintegration. Rushing to formal CPT or PE before a client has a functional window of tolerance is one of the most common failure modes in PTSD care and a frequent reason clients arrive at RECO after a prior treatment episode did not hold. Skipping stabilization does not save time; it produces dropout.

For co-occurring substance use disorders, sequencing is coordinated rather than serial. Naltrexone or acamprosate for alcohol use disorder, buprenorphine or extended-release naltrexone for opioid use disorder, and motivational interviewing are integrated with the trauma track. Concurrent treatment of PTSD and SUD outperforms serial treatment in most presentations, and the RECO protocol is built around that evidence.

What Wellington clients can expect at intake

A first appointment at RECO Health is a clinical evaluation, not a sales meeting. A master’s-level clinician conducts the biopsychosocial assessment; a psychiatrist or psychiatric nurse practitioner completes the medication evaluation on the same day or within the first 48 hours for admitted clients. PCL-5, PHQ-9, GAD-7, AUDIT, and DAST are administered at baseline and repeated at defined intervals to track measurable response.

Level of care is determined using ASAM Criteria dimensions for co-occurring presentations and clinical judgment for PTSD-only cases. Partial hospitalization runs six hours a day, five days a week; intensive outpatient runs three hours a day, three to five days a week. Trauma-specific process groups run within both. Individual CPT, PE, or EMDR sessions are scheduled twice weekly during the active trauma-processing phase.

Insurance and admissions from Wellington

RECO Health is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS plans, and works with additional commercial insurers on out-of-network benefits. Verification of benefits is completed before admission; clients receive a written summary of expected copays, deductibles, and any prior authorization requirements before care begins. The utilization review team handles submissions directly with the insurer.

Practical logistics matter. Wellington to Delray Beach is 28 miles and roughly 38 minutes, longer during winter season and afternoon rush on Southern Boulevard. Most Wellington residents admitted at PHP level of care choose to stay in RECO’s sober-living network rather than commute daily from Olympia, Versailles, Aero Club, or Palm Beach Polo. That preserves continuity through trauma processing, when a daily 76-mile round trip would compete directly with the clinical work.

Serving residents of: Olympia, Versailles, Aero Club, Palm Beach Polo, Wellington View.