When Structure Meets Safety in Trauma Therapy with Rachel Grant, MA

There’s a rhythm to the way most of us were trained to begin trauma work.

The clipboard, the intake form, the list of questions designed to give us the “full picture” before we even start to intervene.
And that stuff is super important, the structure matters! Those questions help us understand our clients’ histories, what’s happened to them, and where to start.

But every now and then, a client walks into (or logs onto) that first session, and the structure simply can’t hold them yet. We’re then forced to decide our next step - do we push through so we can check the box on all the documentation requirements or do we pause and pivot to honor their needs for regulation and safety?

That question has been sitting with me since my conversation with Lindsay Boudreau, a trauma therapist, group practice owner, and founder of The Cozy Couch Crew — a community created for therapists living with chronic illness and disability.

To watch the full interview, be sure to head over to our YouTube Channel!.

The Intake Moment I’ll Never Forget

It was early in the pandemic, and I’d just gotten a referral from a colleague who worked with first responders.

The client was a woman who’d been a first responder for years. She has truly been there, done that. She’s a seasoned professional and the kind of person everyone else relied on to hold it together.

When we met over telehealth, she was sitting on her bed, which is common for telehealth, but what stood out immediately was her body.

Arms wrapped tightly around herself, shoulders caved in, eyes darting back and forth between the camera and the corner of the room.

She was trembling.

We started the intake, and within minutes her voice changed — faster, higher, almost breathless.

I could feel her nervous system ramping into hyperarousal right there in front of me.

In that moment, I had a choice. I could keep going to collect the trauma history and fill in the blanks, or I could pause.

So, I stopped. I invited her to look around the room and name five things she could see. Then four things she could touch. Three things she could hear.

We worked through the 5-4-3-2-1 grounding exercise, together and her breathing slowed, her hands loosened, and the shaking subsided.

That is a moment I will never forget because it reminded me that the skill isn’t knowing the form. 

It’s knowing when to put it down.

What Rachel Reminds Us About Being Human

When I sat down with sexual abuse recovery coach Rachel Grant, she put words to something I think most trauma therapists feel but rarely talk about:

Clients don’t just heal because of our methods, they heal because of our presence.

Rachel shared how, early in her career, she was surprised to learn that her clients’ favorite part of working with her wasn’t the curriculum or the tools, it was her realness!

The stories she shared in context, the way she admitted when something had been hard for her too, the moments she laughed or said, “Yeah, I’ve been there.”

As a therapist, I’m very aware of the ethical boundaries around self-disclosure.

But Rachel’s reminder landed: being human isn’t the same as oversharing.

Being human in therapy is about attunement. It’s about letting clients feel your warmth, your authenticity, your humor. All the parts of you that make you safe, not sterile.

In trauma work, our humanity is one of our greatest clinical tools.

Regulation Isn’t Optional — It’s Foundational

When Rachel said that one of her biggest frustrations with therapy is how often clients are asked to tell their trauma story right away, I knew what she meant.

And yes, we need to ask. We need to gather history, understand patterns, and document what’s happened.

The issue isn’t the structure itself, it’s our flexibility within it.

Because assessment isn’t just what our clients say,  it’s what their nervous system tells us.

When the body is trembling, when the breath is shallow, when the gaze turns inward - that’s assessment data too!

It’s information that tells us: “Pause here. Regulate first. The rest will come.”

In that first session with my client, I didn’t abandon the intake. I came back to it once she could breathe again.

And so, regulation isn’t a detour from the work; it’s the first part of the work.

What We Can Learn from Coaches About Permission

Rachel’s approach, as a coach, gives her more space to bring herself into the process, to speak plainly, to model vulnerability, to move flexibly through timing and structure.

And while therapy operates under different ethical guidelines, there’s something we can take from that freedom: permission.

• Permission to pause

• Permission to slow down

• Permission to trust that we don’t have to “get through” the intake form to begin the work

In BRAVE, we talk about how being human isn’t the problem in trauma therapy, it’s the way through it.

What Rachel models is exactly that — a deep trust in relationship, attunement, and pacing. And those are things we can absolutely embody, even within our professional frameworks.

When Structure Meets Safety

There’s a myth that structure and humanity are opposites — that one belongs to the professional, the other to the personal.

But in trauma therapy, they can’t be separated.

Our clients need both: The container of evidence-based care, and the felt sense of safety that only comes from a regulated, attuned therapist.

So, no, we don’t stop collecting information. We don’t stop following our ethical guidelines.
We simply learn when to soften them, moment by moment, in service of what the nervous system actually needs.

Because the truth is: safety starts with us. And we practice it every time we choose connection over completion, presence over protocol, regulation over rush.

Learn More from Rachel Grant

One of the things I appreciate most about Rachel is how she brings both her professional training and lived experience into this work with so much compassion and clarity. She doesn’t just talk about healing, she builds frameworks that help people actually move through it.

If this conversation resonated with you and if you want to understand more about how survivors can go from surviving to truly living, I really encourage you to explore her work.

Rachel is the creator of the Beyond Surviving Program, a step-by-step process she’s been using since 2007 to help survivors of childhood sexual abuse break free from the pain of the past and move forward with their lives.
She’s also the author of Beyond Surviving: The Final Stage in Recovery from Sexual Abuse and an international speaker, podcast host, and Sexual Abuse Recovery Coach.

To learn more, start here:
👉 Discover the 3 Stages of Recovery from Childhood Abuse — This free 9-page guide helps survivors identify where they are in their healing process and what kind of support they might need next.

🌿 More Resources for Healing:
https://www.beyondsurviving.org/resources/

If you’re a trauma therapist, these are powerful tools to share with your clients, especially those doing deep work around shame, safety, and self-trust.

Because, as Rachel reminds us, healing isn’t about fixing what’s broken. It’s about remembering what was never lost.