What is PTSD?
PTSD
▪ a psychiatric disorder that can occur following
the experience or witnessing a life-threatening
events such as a military combat, natural
disasters, terrorist incidents, serious accidents,
or physical or sexual assault in adult or
childhood
▪ symptoms may include nightmares, flashbacks
and severe anxiety
Chronic PTSD
▪ A complex Post Traumatic Stress Disorder
▪ is a condition that results from chronic or long
term exposure to emotional trauma over which
a victim has little or no control and from which
there is little or no hope to escape such as in
cases of: domestic emotional, physical or
sexual abuse
Who can experience PTSD?
▪ person exposed to the traumatic incident as the
victim
▪ as a witness to the traumatic event
▪ family of the victim
▪ earlier life-threatening event or trauma like
being abused as a child
▪ policemen, firemen, military personnel
▪ those who pick up the pieces following the
incident
Examples of traumatic events
▪ military combat
▪ violent personal assault (sexual assault,
physical, robbery)
▪ being kidnapped
▪ being taken as hostage
▪ terrorist attack
▪ torture
▪ vehicular accident
▪ natural or manmade disasters
▪ diagnosed with life-threatening disease
Posttraumatic Stress Disorder
PTSD can occur at any age including childhood.
Estimates are that up to 60% of people at risk,
such as combat veterans and victims of violence
and natural disasters, develop PTSD.
Complete recovery occurs within 3 months for
about 50% of people.
(American Psychiatric Association [APA], 2000).
Posttraumatic Stress Disorder
The severity and duration of the trauma and the
proximity of the person to the event are the most
important factors affecting the likelihood of
developing PTSD
(American Psychiatric Association [APA], 2000).
What are the symptoms of PTSD?
▪ symptoms can begin right after a traumatic
event
▪ diagnosed after the symptoms last for at least
one month
▪ three types of symptoms:
1. re-experiencing symptoms
2. avoidance and numbing symptoms
3. arousal symptoms
Re-experiencing symptoms
▪ reliving the traumatic event
▪ “flashback”
▪ sometimes the memories feel so real
▪ may cause intense feelings of fear, helpless-
ness, and horror similar to the feelings when
the event took place
▪ recurrent dreams of the event
▪ intense psychological distress
▪ sudden acting or feeling the traumatic event
▪ at least one of these
Avoidance and numbing
▪ are efforts people make to avoid traumatic
event
▪ avoid talking about the incident
▪ avoid going near to the place
▪ avoid the sights, smells, sounds
▪ avoid the news
▪ feelings of detachment or estrangement from
others
▪ at least three of these
Arousal symptoms
▪ people feel constantly alert after the traumatic
incident
▪ increased emotional arousal
▪ it can cause difficulty of sleeping, outburst of
anger or irritability, and difficulty concentrating
▪ exaggerated startled response
▪ hypervigilance – paranoia
▪ at least two of these
Other problems:
▪ depression
▪ anxiety
▪ substance abuse
Treatment of PTSD
▪ talking with the therapist help the person with
PTSD get better
▪ there are good treatments available for PTSD
▪ Debriefing
Psychological debriefing
▪ is a procedure of providing emotional and
psychological support immediately
following a traumatic event. The goal is to
prevent PTSD.
Phases of Stress Debriefing
Phase 1 – Introduction
▪ team members introduce themselves and
describe the process
▪ present guidelines for conduct of the process
▪ motivate participants to participate actively but
voluntary
▪ information discussed in the session is
confidential
Phase 2 – Facts
▪ brief overviews of the facts are requested
▪ this phase helps participants to begin talking
▪ “Can you give our team a brief overview of
what had happened from your point of view?”
▪ answer is optional
Phase 3 – Thoughts
▪ it is easier to talk about one's thought than to
focus immediately to the painful aspect of the
event
▪ what was your first thought?
▪ answer is optional
Phase 4 – Reactions
▪ the heart of the debriefing process
▪ what is the very worst thing about this event
for you personally?
▪ support team listen carefully and encourages
team members to add something if they wish
▪ anger, frustrations, sadness, loss, confusion
and other emotions may emerge
Phase 5 -Symptoms
▪ how this tragic incident shown up in your life?
▪ what cognitive, physical, emotional or
behavioral symptoms have you been dealing
with since the incident?
▪ signs and symptoms will be used by the
support team for the teaching phase
Phase 6 – Teaching
▪ provide explanation of the participants
reactions
and provide stress management information
▪ other topics are addressed during this phase
Phase 7 – Re-Entry
▪ participants may ask questions or make final
statements
▪ team summarizes what has been discussed
▪ final explanation, information, action directives,
guidance, and thought are presented to the
group
Cognitive behavioral therapy (CBT)
▪ one type of counseling
▪ the therapist helps the person understand and
change how the person thinks about the
trauma and its aftermath
▪ the goal is for the victim to understand how
certain thoughts about the trauma cause stress
and make the symptoms worse
▪ learn to identify thoughts that may cause to
fear or upset
▪ learn to cope anger, fear, guilt, etc
Adaptive Disclosure
- is a specialized CBT approach developed by the
military to offer an intense, specific, short-term
therapy for active-duty military personnel
- Incorporates exposure therapy and empty chair
technique- well tolerated and effective in
reducing PTSD symptoms and promoting post
trauma growth
Adaptive Disclosure
- Incorporates exposure therapy and empty chair
technique in which the participants says
whatever he needs to say to anyone- alive or
dead
- Despite the short 6-session format, this
approach is well tolerated and effective in
reducing PTSD symptoms and promoting post
trauma growth
EXPOSURE THERAPY
• is a treatment approach designed to combat the
avoidance behavior that occurs with PTSD, help
the client face troubling thoughts and feelings ,
and regain of control over his thoughts and
feelings
EXPOSURE THERAPY
• the client confronts the feared emotions,
situations and thoughts associated with the
trauma rather than attempting to avoid them.
(example returning to the place one was
assaulted, or may use imagined confrontation-
placing one’s self mentally in the traumatic
situation
Exposure therapy
▪ the goal is to have less fear about the
memories
▪ by talking about the trauma repeatedly with the
therapist, a person learns to control of the
thoughts and feeling related to the trauma
Group therapy
Family therapy
Medications:
▪ Selective serotonin reuptake inhibitors (SSRIs)
▪ these are types antidepressants
▪ citalopram (Celexa)
fluoxetine (Prozac)
paroxetine (Paxil)
sertraline (Zoloft)
▪ these raise the level of serotonin in the brain
▪ helps a victim less sad and worried
▪ some are helpful, others are very effective
PTSD- TREATMENT
MEDICATIONS
- SSRIs antidepressants
- SNRI Venlafaxine
- SGA Risperidone
A combination of medications and CBT is more
effective than either one alone
THANK YOU
