Transcript CJ440 Case Management

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Overview for this evening Seminar!
Anxiety Disorders (PTSD) and Acute Stress
Treatment planning for PTSD
Therapy methods for PTSD and Acute Stress
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PTSD (Posttraumatic Stress Disorder and
Acute Stress Disorder)
PTSD is one of several anxiety disorders.
For general purposes, the others are as
follows:
Phobias (including Agoraphobia, Specific
Phobia, and Social Phobia)
Panic Disorder
Obsessive-Compulsive Disorder
Generalized Anxiety Disorder
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PTSD and Acute Stress disorder
Both PTSD and Acute Stress disorder involve a
reaction to an extreme stressor that has
caused or threatened death or severe injury.
Extreme stressors include rape, combat,
automobile accidents, and natural disasters,
among others.
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A person’s contact with the stressor may
involve direct experience, observation (as
with a firefighter or the witness to an
accident) or vicarious experience (as when a
friend, family member, or close associated
experiences the stressor).
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DSM-IV includes the following criteria as
relevant to the diagnosis of these disorders:
Great fear and helplessness in response to
the traumatic event.
Persistent reexperiencing of the event (for
example, through dreams, distressing
recollections, or intense distress on exposure
to reminders of the event)
Loss of general responsiveness,
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And, at least three indications of avoiding
reminders of the trauma (for example
detached from others, believing that one’s
life is foreshortened, and dissociating from or
being unable to recall major aspects of the
traumatic experience).
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At least two persistent symptoms of arousal
and anxiety (such as sleep disturbances,
anger or startle responses, and difficulty
concentrating) that are apparently due to the
stressor and are severe enough to cause
significant distress or impairment.
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The primary differences between PTSD and
Acute Stress Disorder?
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There are two primary differences
First, is the time of onset and second would
be the duration.
Acute Stress Disorder begins within four
weeks of exposure to a traumatic stressor
and lasts at least two days but no longer than
four week; it sometimes develops into PTSD.
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PTSD is describe Acute if it lasts for less than
three months and is Chronic if the symptoms
last longer.
The disorder is termed PTSD with delayed
onset if the symptoms begin more than six
months after exposure to the stressor.
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What are some possible Intervention
Strategies when treating PTSD?
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Treatment and Acute Disorder and PTSD
should begin as soon as after the trauma, and
preventive treatment is recommended even
before symptoms.
However this does not always happen?
With military, law enforcement and or any
other similar field why would treatment be
delayed or what would be some reasons for
people not seeking treatment immediately.
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Group and individual counseling are
treatment methods.
One group intervention (CISD) or Critical
Incident Stress Debriefing is use to provide
early help for people who have undergone
traumas.
CISD should be provided within 24-72 hours
after the event, and is also used for people
have experienced airplane crash, act of
terrorism, natural disaster, as well as officers
of the law, firefighters, military and EMS, etc.
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With Groups ideally 8-12 people, ongoing
sessions and the emphasis is on caring, peer
support, hope and empowerment of the
participants.
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Stages of the Group process:
1. Introductions, information about the
process, guidelines for the group.
2. Exploration of facts and information
related to the trauma.
3. Discussion of thoughts about the event.
Continue on next Slide!
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4. Exploration of emotions and reactions.
5. Exploration of symptoms of distress.
6. Teaching about reactions to trauma and
risk factors.
7. Reinforcement of coping skills,
management of life and encouragement of
reentry and closure.
Additional treatment skills, will continue on
the next slide.
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Other treatment skills are:
CBT or Cognitive-behavioral interventions in
accordance to research seems best for the
treatment of PTSD and Acute Stress Disorder
and exposure to the memory of the trauma is
an important element of treatment.
CPT or Cognitive processing therapy which is
twelve-session structured model in which
exposure is combined with cognitive
restructuring to change people’s disrupted
cognitions.
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CPT or Cognitive processing therapy which is
twelve-session structured model in which
exposure is combined with cognitive
restructuring to change people’s disrupted
cognitions.
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AMT or Anxiety Management Training,
typically pairs prolonged activation of
traumatic memories with techniques (such as
relaxation, cognitive restructuring and
biofeedback) designed to modify these
memories and the associated fears.
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SIT-Stress inoculation training includes
education and training in six coping skills
(muscle relaxation, thought stopping, breath
control, guided self-dialogue, cover modeling
and role playing)
And there are others treatment methods, at
this point I will stop there.
Questions for the class
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What are some possible long-term effects of
PTSD?
See you next week for Seminar #4!
Remember No seminar in Unit#5 and Unit#10!