Week 8: Chapter 4: Cognitive Behavioural Therapies for Posttraumatic Stress Disorder - Ehlers & White

Question 1

What is In Vivo Exposure?

Answer 1

directly facing a feared object, situation or activity in real life → for example, someone with social anxiety might be instructed to give a speech in front of an audience

Question 2

Imaginal Exposure

Answer 2

vividly imagining the feared object, situation or activity → for example, someone with Posttraumatic Stress Disorder might be asked to recall and describe their trauma(s)

Question 3

Avoidance Behaviour

Answer 3

any behaviour people use to escape or distract themselves from di cult thoughts, feelings, and situations

Question 4

Several theorists pointed out that conditioning alone is insu cient in explaining all the symptoms of PTSD, including features of re-experiencing symptoms that are central to the disorder. Name three others.

Answer 4

a) Features of trauma memories
b) Negative meanings of the trauma (interpreta-tions, appraisals, beliefs)
c) Avoidance

Question 5

Emotional Processing Theory (EPT)

Answer 5

Emotional processing is the ability of people to process stress and other extreme events and move past them.
Emotional Processing Theory (EPT) is used as an organisational framework → highlights activating and changing pathological trauma-related responses and increasing adaptive responses across cognitive, emotional, behavioural, and physiological domains

Question 6

What is prolonged Exposure?

Answer 6

a psychotherapy for PTSD → it is one specific type of Cognitive Behavioural Therapy: PE teaches you to gradually approach trauma-related memories, feelings, and situations that you have been avoiding since your trauma

Question 7

What is Psychoeducation (PE) ?

Answer 7

interventie met systematische, gestructureerde en didactische kennisoverdracht voor een ziekte en de behandeling ervan, waarbij emotionele en motiverende aspecten worden geïntegreerd om patiënten in staat te stellen met de ziekte om te gaan en de therapietrouw en effectiviteit te verbeteren

Question 8

Exposure

Answer 8

technique used by therapists to help people overcome fears and anxieties by breaking the pattern of fear and avoidance → works by exposing someone to a stimulus that causes fear

Question 9

What are two other treatments of PTSD?

Answer 9

Dealing with a range of emotions
Emotion regulation

Question 10

What is Dealing with a Range of Emotions treatment in PTSD?

Answer 10

early PTSD theories and treatments emphasised the role of fear in PTSD → however, guilt, shame, anger, grief, or sadness are also common and addressed

Question 11

What is emotion regulation?

Answer 11

trauma-focused treatments improve emotion regulation and coping skills → some programs include skills training designed to help clients tolerate the exposure, such as breathing training in PE or relaxation in BEP

Question 12

What is cognitive therapy?

Answer 12

helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more e ffective way (think of CBT)

Question 13

Cognitive therapy model for PTST has thee treatment goals, what are they?

Answer 13

1. 1. Modify excessively negative appraisals (meanings) of the trauma and its consequences
2. Herbeleving verminderen door traumaherinneringen uit te werken en triggers te onderscheiden
3. Verminder gedrag en cognitieve strategieën die het gevoel van huidige dreiging behouden

Question 14

What are the core aspects of treatment in CT-PTSD ?

Answer 14

Individualised care formulation
Reclaiming your life assignments
Changing problematic appraisals
Updating trauma memories
Discrimination training with re-experiencing A site visit (complete memory updating) Dropping unhelpful behaviours & processes Blueprint (summarising what was learned)

Question 15

What is the format of CT PTSD?

Answer 15

→ usually delivered in up to 12
who re-experience a small number of traumas, more
traumas & complex presentations

Question 16

Why should therapists allow 90 minutes for sessions that involve work on trauma memories?

Answer 16

So that the client has time to refocus on the present before they leave.

Question 17

CT-PTSD uses a special procedure to shift problematic meanings of the trauma. What is thta called?

Answer 17

Updating trauma memories

Question 18

What thee steps does the updating trauma memories involve?

Answer 18

1. Identifying Threatening Personal Meanings → imaginal reliving & narrative writing both have strengths in working with trauma memories, and the relative weight given to each in CT-PTSD depends on client’s level of engagement with trauma memory and length of event
2. Identifying Updating Information → identify information that provides evidence against the problematic meanings (i.e., updating information): can be something the client is already aware of but has not yet linked to the meaning of this par-ticular moment in memory, or it may be something the client remembers during imaginal reliving or narrative writing
3. Active Incorporation of the Updating Information into the Hot Spots → once the therapist and client have worked together to identify updating infor-mation that the client finds compelling, it is actively incorporated into the rele-vant hotspot → this can be done as soon as the updating information has been identified for that particular hotspot