When Rebecca Rampe, Psy.D., associate professor in the UAB Department of Psychiatry and Behavioral Neurobiology, began working with patients affected by childhood abuse, neglect and traumatic loss, she noticed many struggled to find treatment approaches that fully addressed the lasting impact of those experiences. That observation ultimately led to the creation of the Developmental Trauma and Traumatic Grief Clinic.
Rampe founded the clinic to address gaps in care for individuals experiencing developmental trauma, traumatic grief, and attachment-related challenges. She found that many patients needed support beyond traditional psychotherapy approaches, including help developing emotional awareness, self-compassion, emotional regulation and a stronger sense of self.
"With early life trauma comes a significant amount of grief and loss for what could have been or who a person could have been if they had different caregivers with better skills," Rampe said. "We often work with parents with the goal of changing intergenerational patterns for their children and families."
The clinic also serves patients experiencing traumatic grief, including parents who have lost a child and others coping with sudden or life-altering loss. Rampe said these experiences often bring new awareness to unresolved childhood trauma and highlight the need for specialized support.
To address these complex needs, the clinic uses a three-phase treatment model. The first phase focuses on psychoeducation and skill-building, while the second incorporates reprocessing experiences and reframing their meaning. The third phase emphasizes integrating new insights into daily life and helping patients move forward. Rather than following a strictly linear path, treatment is tailored to each patient's needs.
Since its launch, the clinic has expanded beyond traditional psychotherapy services delivered through telehealth. It now includes two specialized service lines: esketamine-assisted psychotherapy through the Mindfulness, Meaning, and Self-Compassion program and a maternal mental health psychotherapy service for perinatal and postpartum patients seeking to break cycles of intergenerational trauma. The maternal mental health service is offered in partnership with the Perinatal Psychiatry Clinic led by Calley Johnston, M.D., assistant professor in the Department of Psychiatry and Behavioral Neurobiology and director of the Perinatal Psychiatry Clinic.
Rampe said quality improvement data has shown encouraging outcomes for patients participating in the clinic's developmental trauma and maternal mental health programs. Patients reported increased trust in others, decreased anxiety in relationships, improved emotional awareness, and greater ability to regulate distress through attention to bodily sensations. Additional findings showed improvements in self-kindness, mindfulness, and overall well-being.
The clinic also serves as an important training environment for psychology trainees. According to Rampe, trainees complete extensive psychotherapy training before entering the clinic and receive an additional 25 to 30 hours of specialized training focused on developmental trauma and traumatic grief.
"My trainees provide the bulk of patient care in the clinic," Rampe said. "Offering training to the next generation of therapists within this approach prepares them for tailoring treatment to meet realistic needs of patients with early life trauma, giving patients more voice and choice."
Looking ahead, Rampe hopes to extend the clinic's reach beyond traditional therapy settings and continue bringing trauma-informed practices to broader audiences across UAB and the community. One example is the clinic's Compassion and Trauma Responsive Practices training program, which shares many of the principles used in patient care with faculty, staff, and community members.
"I hope we continue to have the opportunity to bring what we are learning within the clinic to others who may not directly be served by us," Rampe said.