Traumatic Incident Reduction Therapy (TIR) For Substance Abuse

Last Edited: December 29, 2023
Reisto Belovich
Clinically Reviewed
Edward Jamison, MS, CAP, ICADC, LADC
All of the information on this page has been reviewed and certified by an addiction professional.

Treatment with Traumatic Incident Reduction (TIR)

Some rehab facilities utilize the proven method of Traumatic Incident Reduction or TIR. This type of treatment is used on people 12 years old or older, to desensitize their emotional reaction to a traumatic incident that is stored in their memory. Traumatic incidents are described as natural disasters, war, interpersonal violence, child abuse, neglect, or the unexpected death of a loved one. The practicing professional will help guide the patient through the recollection of the event in their own minds multiple times, in increments of about two hours at a time, about two days a week. Generally, this therapy will allow the patient to overcome their emotional reaction to the memory of the incident while watching the incident in their memory on loop. This therapy is considered complete when the patient can speak about and remember the incident with little emotion triggered with it. While this therapy primarily addresses issues of trauma, it can utilized to treat issues of trauma that directly contribute to substance abuse, aiding in the recovery process.

Components of The Traumatic Incident Reduction Therapy

TIR practitioners go through a rigorous training program specifically for TIR before treating patients. This type of therapy is effective and is used by practitioners all over the country and in several countries around the world.

Most sessions have a duration of approximately 90 to 120 minutes. Depending on the state of the client, the problem may be resolved within one session. The qualified mental health practitioners begin by acquiring accurate knowledge of both the traumatic event (or events), as well as examining the physical and mental symptoms displayed by the client. The client is then asked to identify the most significant item regarding the event, or even a negative feeling that is induced by the event. Next, the client is asked to examine the incident itself, and analyze time frames, mental connection to the event, as well as a verbal report of the event. At the conclusion of the sessions, the client should be able to describe the event itself in relatively extensive detail, while still maintaining a healthy emotional state, level of calmness, and an ability to face the event without any cognitive distortions or unhealthy coping mechanisms (such as repression, splitting or projection).

Ultimately this therapy allows the clients mind to restructure their emotional response when recalling their traumatic memory. Instead of the negative reactions they once had, they vaguely have any emotion at all upon recall of the incident. This therapy is parallel to the approach that teaches the patient new habits in place of the old ones in regards to substance abuse.

Philosophical Principles of Traumatic Incident Reduction Therapy

Much of Gerbode’s philosophical outlooks were derived from the works of Sigmund Freud, Ivan Pavlov, and Carl Rogers. Much of Freud’s and Pavlov’s work is manifested in remnant elements of techniques like “Flooding and Implosion” (revisiting certain events under careful supervision), “Gradual Dosing” (To assist in desensitizing the client), “Repetitive Review” (to help establish more long-lasting alleviation) and numerous other elements. Much of Carl Roger’s work comes in the form of the therapeutic process being solely focused on the client’s view of the situation, and being sensitive to his/her needs above all else.

Since its inception in 1986, TIR has been subjected to controlled outcome studies that have demonstrated its effectiveness. Based on that research and based on the straightforward and duplicatable methodology of TIR, the U.S government Substance Abuse and Mental Health Services Administration have deemed TIR an “evidence-based intervention”. TIR is used successfully and extensively in the United States, Canada, and many European countries and Africa, where it is equally effective when applied in a variety of cultural settings.“ – Dr. Frank Gerbode


Dr. Frank Gerbode
Dr. Frank Gerbode graduated from Stanford University with Honors, and later pursued graduate school at Cambridge for philosophy. During the 1970s, Gerbode acquired his medical degree from Yale University, and completed a psychiatry residency at Stanford’s Medical Center. In addition, Gerbode is credited with several papers and academic journal articles in subjects of neuropharmacology, neurochemistry, and Ration-Emotive Cognitive Therapy (or REBT). He is creditted with numerous breakthroughs in the field of meta-psychology, which later proved to have uses in treating reactions to traumatic events.