PTSD

PTSD WorkshopPTSD Workshop

Presented by: Dawn-Elise Snipes Ph.D., LMHC, Presented by: Dawn-Elise Snipes Ph.D., LMHC, CRC, NCCCRC, NCC

WHO WHO

People's Basic NeedsPeople's Basic Needs

• Biological (Food, Water, Warmth)Biological (Food, Water, Warmth)• SafetySafety• Love and belongingLove and belonging• EsteemEsteem

* Discussion Forum ** Discussion Forum *

• Think of a client you have worked Think of a client you have worked with who did not have their basic with who did not have their basic needs met. How did they present? needs met. How did they present? How did they respond to treatment? How did they respond to treatment? What services can you refer this What services can you refer this client to?client to?

• Please take a moment to share your Please take a moment to share your responses in the discussion forum. responses in the discussion forum.

• Thank you.Thank you.

Types of Post Traumatic Types of Post Traumatic Stress DisorderStress Disorder• CombatCombat• Rape TraumaRape Trauma

– VictimVictim– Parent of VictimParent of Victim

• Gradual OnsetGradual Onset– DefinitionDefinition– Law Enforcement, Nurses, Psychologists, Law Enforcement, Nurses, Psychologists,

Fire/EMSFire/EMS• Domestic ViolenceDomestic Violence• Other Trauma. . .(Discussion)Other Trauma. . .(Discussion)

Diagnosis/DefinitionDiagnosis/Definition

• Exposure Exposure • Actual or threatened death; serious injury; Actual or threatened death; serious injury;

witnessing suchwitnessing such• Response involves intense fear, helplessness, or Response involves intense fear, helplessness, or

horror horror • Persistent reexperiencing of the traumatic event Persistent reexperiencing of the traumatic event • Avoidance of stimuli associated with the traumaAvoidance of stimuli associated with the trauma• Numbing of general responsivenessNumbing of general responsiveness• HypervigilenceHypervigilence• IrritabilityIrritability• Clinically significant distress for more than 1 month Clinically significant distress for more than 1 month

Complications/Impact of Complications/Impact of PTSDPTSD• EmotionalEmotional• MentalMental• PhysicalPhysical• SocialSocial• SpiritualSpiritual• EnvironmentalEnvironmental• Occupational/FinancialOccupational/Financial

* Discussion Forum ** Discussion Forum *

• Think of a client you have worked Think of a client you have worked with who’s spirituality was deeply with who’s spirituality was deeply affected as a complication from the affected as a complication from the impact of PTSD. How did this affect impact of PTSD. How did this affect their life as a whole? How did this their life as a whole? How did this affect you? affect you?

• Please take a moment to share your Please take a moment to share your responses in the discussion forum.responses in the discussion forum.

• Thank you.Thank you.

WHAT / WHYWHAT / WHY

DiscussionDiscussion

Most concerning of all people with PTSD Most concerning of all people with PTSD are PEOPLE who continue to are PEOPLE who continue to

experience experience a loss of basic needs.a loss of basic needs.

Anger and FearAnger and Fear

• Fear as Anger/Fight or FlightFear as Anger/Fight or Flight• Six basic fearsSix basic fears

– DeathDeath– IsolationIsolation– RejectionRejection– Loss of ControlLoss of Control– FailureFailure– The UnknownThe Unknown

InitiationInitiation

• Discriminitive StimuliDiscriminitive Stimuli– TriggersTriggers– Person/Place SignificancePerson/Place Significance

• Why here, Why now, Why not?Why here, Why now, Why not?– Reward vs. PunishmentReward vs. Punishment– AmbivalenceAmbivalence

WHENWHEN

ActivityActivity

• When would someone with PTSD be When would someone with PTSD be motivated to take hostages?motivated to take hostages?

• When would someone with PTSD be When would someone with PTSD be motivated to commit suicide?motivated to commit suicide?

* Discussion Forum ** Discussion Forum *

• Think of a client you have worked with Think of a client you have worked with who was suicidal as a complication of who was suicidal as a complication of PTSD. How did this affect you? What PTSD. How did this affect you? What were your interventions? Have you since were your interventions? Have you since discovered further interventions you could discovered further interventions you could implement in a future, similar implement in a future, similar circumstance?circumstance?

• Please take a moment to share your Please take a moment to share your responses in the discussion forum. responses in the discussion forum.

• Thank you.Thank you.

INTERVENTIONSINTERVENTIONS

RapportRapport

• Rapport=TrustRapport=Trust– Why would this person NOT trust you?Why would this person NOT trust you?

•Crime victims and trustCrime victims and trust•The addicted family and trustThe addicted family and trust•Domestic violence and trustDomestic violence and trust

Rapport: CommunicationRapport: Communication• Characteristics of effective Characteristics of effective

communicationcommunication• Top communication blockersTop communication blockers

TransferenceTransference

• DefinitionDefinition• OptionsOptions

– Building a positive bridgeBuilding a positive bridge– Rewriting the storyRewriting the story

Counter-TransferenceCounter-Transference

• ““I'm rubber and you're glue”I'm rubber and you're glue”

PTSD TriagePTSD Triage

• SimilaritySimilarity• ProximityProximity• 6-month stressors6-month stressors• History of mental health issuesHistory of mental health issues• Social supportSocial support

Don't Fix ItDon't Fix It

• Characteristics of the Hostage Characteristics of the Hostage Taker/Suicidal PersonTaker/Suicidal Person– HopelessHopeless– HelplessHelpless– Feel unheard/ignoredFeel unheard/ignored

• New RolesNew Roles– Scientist/AnthropologistScientist/Anthropologist– Parent (A good one)Parent (A good one)– MinisterMinister

Brief InterventionsBrief Interventions

• Miracle QuestionMiracle Question

LinkingLinking

• Information and ReferralInformation and Referral• Receiving facilitiesReceiving facilities• Victim advocatesVictim advocates• Department of Children and FamiliesDepartment of Children and Families• VA HospitalVA Hospital• DetoxificationDetoxification• Crisis TeamsCrisis Teams• Domestic violence sheltersDomestic violence shelters

SummarySummary