How Can Psychiatrists Help Patients Build Resilience After Trauma?

Craig Katz, MD, a clinical professor of psychiatry at the Icahn School of Medicine, emphasized the clinical value of shifting from a risk-focused model of trauma care toward one that also identifies and promotes resilience factors. Early trauma work concentrated on vulnerability, but subsequent research—including studies of soldiers and former prisoners of war—has identified specific resilience-promoting traits and behaviors.¹ Katz noted, "there's a lot of research that has demonstrated what are resilient traits and what are resilience-promoting behaviors." Katz listed several of these factors: facing fear directly, cultivating optimism during difficult periods, engaging spirituality when relevant to the patient, and promoting flexible thinking and adaptability.

Katz argued that stigma remains a substantial barrier to care, with many trauma-exposed patients reluctant to seek mental health treatment; framing interventions around strengths, rather than solely pathology, can lower this barrier. During the COVID-19 pandemic, Katz and colleagues developed resilience plans for patients as a complement to standard treatment plans, emphasizing coping strategies alongside clinical management.

Clinically, Katz described balancing acknowledgment of trauma against the risk of overwhelming the patient with detail. The recommended approach begins with directly asking about trauma exposure, then allowing the patient to set the pace for further disclosure, followed by longer-term planning based on the degree of functional impact. Katz emphasized that traumatic exposures affect individuals differently: the same event—violence or a motor vehicle accident, for example—produces clinically significant psychiatric symptoms in some patients but not others, and clinicians should reserve the term trauma for exposures that actually cause psychiatric morbidity.

Katz cautioned against equating trauma exposure with a diagnosis of post-traumatic stress disorder (PTSD), noting that clinicians sometimes conflate them. "We also don't want to assume just because someone went through a trauma that they are traumatized or that they have PTSD," Katz said. Overpathologizing trauma-exposed individuals who have not developed a clinical disorder can itself carry costs for patients.

Katz cofounded the organization PREACT (Preparedness and Acute Response to Trauma), an organization focused on helping communities prepare in advance for both everyday and mass-casualty trauma rather than reacting only after events occur.²

Dr Katz is a psychiatrist at the Icahn School of Medicine in New York City.

References

1. Southwick SM, Charney DS. Resilience: The Science of Mastering Life's Greatest Challenges. Cambridge University Press; 2018.

2. Reuveni I, Katz CL, Tene O, et al. From 9/11/2001 to October 7, 2023 - the PreAct conference, NYC, June 2025: preparing for mental health response to mass trauma. Psychiatry Res. 2026;355:116855.