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Learning Center Experience
By Dr. Alyssa Gilston, Faculty for the College of Social and Behavioral Sciences
I recently participated in training on posttraumatic stress
disorder (PTSD). One of the major factors that jumped out at me from the beginning
was that unlike so many other clinical disorders, PTSD has a known etiology,
meaning that we know where and how it likely developed. Regardless of which
orientation we follow, as clinicians we spend a great deal of time creating
case conceptualizations to gain a better understanding of our client and
develop the most effective treatment plan. The onset of PTSD is linked to a
traumatic event, whether it is an accident, some type of abuse, a natural
disaster, or, for so many of our service men and women who served on active
duty, as a result of combat. Something traumatic has had a huge influence on
the client’s life in a very dramatic and negative fashion. We know that the occurrence
of traumatic events is common in our world—even the observance of some of the
most recent events, like the bombing at the Boston marathon, could evoke a
traumatic reaction in people. It made me wonder if knowing how the disorder
developed in the first place increases our ability to treat and assist the
individual with PTSD.
When we are working with a client with PTSD, we need to be
cognizant of many factors. First, we of course need to have an awareness of the
event that occurred that caused the PTSD. The person can re-experience the
traumatic event in so many ways, including nightmares or flashbacks, or through
association with people, places, sights, and even certain smells. By keeping
this in our conscious thought process, we can most certainly gain a better understanding
of our client and help him or her to deal with the stressful physiological and
emotional reactions. Without understanding a particular stimuli that a client
is attempting to avoid, we could easily incorrectly diagnose our client, and in
turn, create an ineffective treatment plan.
We also need to remember that if a client has PTSD, it is
very likely that he or she will have other disorders as well, including
substance disorders, mood disorders, and other anxiety disorders. Assessing for
any type of comorbidity is essential. There are often deficits in functioning
in a variety of areas such as in academic, occupational, marital, and social
functioning. Understanding that PTSD does have an impact on all of these areas
and providing the client with psychoeducation about this relationship can also
be quite effective.
On a personal note, I
have been working as a mentor with our returning female veterans. Almost all of
them carry a diagnosis of PTSD and are involved in cognitive behavioral
therapy along with psychopharmacological treatments to address
their symptoms. Support is so incredibly important and by empathizing and
offering my assistance, I am able to assist these women with creating goals
beyond treatment. I encourage them to create SMART goals—goals that are Specific,
Measurable, Attainable, Realistic/Relevant, and Timely. I find my clients to be
incredibly brave, strong, and resilient, and they seem to have great peace in
knowing that I have an understanding of where their reactions and symptoms
originated. A major advantage to the clinician is that we have an understanding
about how PTSD developed so we have some extra tools in our clinician’s toolbox
to assist us with treating
and working with our clients.
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