On this occasion, we have the collaboration of our former student Elena Rodríguez Calero, who provides us with an overview of post-traumatic stress disorder from a professional point of view. If you want to share your knowledge and experiences in the field of clinical psychology, contact us.
We leave you with Elena’s professional experience.
Post-Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is classified in the DSM-5 in the group of Anxiety Disorders. It appears as a response to a traumatic (highly stressful) situation, resulting in an inability to function in various areas of life after exposure to this traumatic event.
We could say that we are dealing with risk groups when the profiles are people affected by war (whether combatants, military personnel, or civilians), victims of sexual or physical abuse, people who have witnessed an event that puts their own or others’ lives at risk (attacks or accidents, for example, plane, train…), attacks, people involved in a natural disaster, etc.
The importance of establishing an adequate diagnosis (PTSD)
For the establishment of a diagnosis, the presence of specific symptoms in response to the traumatic event is necessary. Examples of these include:
– Persistent re-experiencing.
– Avoiding stimuli associated with the trauma.
– Increased arousal, as well as social, occupational, or other significant impairment in the individual’s daily activity.
All these alterations and symptoms must last for more than one month.
In this case, the approach will be from Cognitive Behavioral Therapy, applied by a specialized psychologist. This type of therapy will help us modify thoughts, emotions, and behaviors linked to PTSD, thus facilitating the management of panic, anger, and anxiety.
Creating therapeutic alliances between psychologist and doctor
It is very important to highlight that, in certain cases, for an effective therapeutic intervention, a combination between the psychologist and the doctor is necessary, as the patient may need both psychotherapy and pharmacological prescription.
Regarding a therapeutic plan for PTSD, we can establish certain techniques that we will normally use in various patients with this pathology. It is important to emphasize the great importance of establishing an adequate therapeutic alliance, as this enables and facilitates the application of rehabilitation techniques. This should begin to be forged from the first consultation.
After collecting information and once the diagnosis has been established, the first thing we must do with the patient is psychoeducation regarding the pathology and the therapy to be followed. Among other functions, the reduction of uncertainty will result in a decrease in anxiety about the unpredictability of the treatment and the lack of knowledge about the pathology.
Another task to perform with the patient is breathing training. In this case, we will use diaphragmatic breathing, which will be of great help in reducing physiological arousal and therefore in coping with anxiety.
Environment and routines, key in post-traumatic stress disorder
We must also highlight how essential it is for this disorder to have an emotional support network, as well as the emotional expression the patient has within that network: family, friends, acquaintances… even co-workers.
In addition to the aforementioned, another technique used in PTSD is usually behavioral activation, since when the patient comes to consultation, they have often stopped performing activities, such as going out with friends, reading… neglecting their physical and psychosocial appearance. The goal is for them to progressively recover those activities that help them immerse themselves back into daily life.
In these cases, cognitive restructuring is quite common, as its objective is to reduce emotional distress by identifying, evaluating, and modifying dysfunctional beliefs, as well as helping the patient to generate new, more realistic beliefs about their coping capacity and the situation, related to the traumatic event.
The exposure technique in this type of patient is elemental: it will help us reduce avoidance behaviors (previously detected) and also help the patient understand that stimuli, places, activities… etc. are not objectively dangerous in the present. With this technique, we aim to facilitate “reprocessing,” which will reduce a wide range of negative emotions related to PTSD.
Adapting the combination of techniques for each patient
Generally, the techniques cited so far are usually the most common in patients with post-traumatic stress disorder (PTSD), but we must emphasize that a specific therapy will be adapted to each patient. Even when using specific techniques, in a given case, it may be useful to apply them in one way, and in another patient, we will have to carry it out differently for it to work. Also, it should be noted that in addition to these, depending on what is valued and evaluated by the clinical psychologist, we will use more new techniques, for example, social skills training.
Finally, I would like to point out that on this same website you can find my thesis where a complete clinical case is developed, with a deeper and broader development; it is titled “Post-traumatic stress disorder from a clinical case” or more on the personal blog