The Advocate Magazine 2022 Issue 3 | Page 22

Using Evidence-Based Practices to Treat Veterans With PTSD
continued from page 21
focus on the autobiographic memory component , but that each component is interconnected .
We discuss the relationship between PTSD and our thoughts and emotions . To describe this relationship , I may share a personal example and self-disclose my own automatic thoughts that arise after an event . For example , I may share my automatic thoughts when I get cut off while driving on the highway ; this is certainly not a frequent experience , but one that can raise this Jersey girl ’ s blood pressure and lead to frustration . description together , and I remind them that I am not asking for the description of what happened , but rather what they are telling themselves about the cause of the event . These beliefs impact the way they view themselves , others , and the world around them .
Together , we identify the beliefs they cultivated about the traumatic event they experienced and its outcomes , including the assimilated and over-accommodated stuck points . For example , an assimilated belief about a traumatic event might be , “ If I had just gone home earlier , I wouldn ’ t have been assaulted .” An example of an over-accommodated belief about the world as a result of an event would be , “ No one can be trusted .”
Phase III — Processing the trauma : Next , we transition to the formal processing of the traumatic event using the impact statement . The impact statement — the first homework assignment of treatment — serves to reveal what automatic thoughts ( known as “ stuck points ” in CPT — see page 21 ) the participant may have in connection to the traumatic event . We read the assignment
A Plug for Evidence-Based Practice
The Suicide and Trauma Reduction Initiative ( STRIVE ) program at The Ohio State University College of Medicine offers intensive PTSD treatment using CPT with military personnel and veterans . We used evidence-based practices ( EBPs ) to continue effectiveness research of such treatments among different conditions and populations , such as through telehealth , with people with disabilities , and with an adjunctive suicide-specific intervention .
I perceive the use of EBPs as fundamental to the promotion of client welfare . The American Mental Health Counseling Association ’ s Code of Ethics , www . amhca . org / ethics , implores us to treat clients with dignity , consideration , and respect at all times ( I . B . 7 ). I discuss the use of evidence-based practices with my clients , even those outside of the context of clinical research , as part of the informed consent process . Clients are aware of their options for treatment and the implications of certain interventions before we begin . At STRIVE , we ensure that clients in the context of clinical research understand what their participation in the program encompasses , and how this may not mirror typical outpatient counseling services .
I recommend the National Center for PTSD ( www . ptsd . va . gov ) as a resource when considering what treatments are implicated for PTSD symptom reduction . The Center also features a decision aid for individuals , family members , loved ones , or providers who are looking to discern what treatment is most appropriate ( www . ptsd . va . gov / apps / decisionaid / index . aspx ).
STRIVE has several clinical trials in which we are continuously enrolling participants with PTSD , as well as those with experience of suicidal thoughts and behaviors . Most of these trials are available to individuals across the country through telehealth . For more information , visit the STRIVE program at www . STRIVE2Be . org .
My clients write their stuck points in their Stuck Point Log , a living document that contains their beliefs about the traumatic event , which we will reference during each session of treatment . These stuck points live in a large workbook that was specially constructed for STRIVE . The hefty workbook includes ample copies of the worksheets that correspond to treatments and handouts , such as :
• ABC Worksheets ( worksheets that examine an Activating event , the corresponding Belief or stuck point , and the Consequence or emotion associated with the beliefs ),
• Challenging Questions Worksheets ,
• Patterns of Problematic Thinking Worksheet , and
• The Challenging Beliefs Worksheets , or CBW .
All of these worksheets are in the public domain and available in : “ Cognitive Processing Therapy : Veteran / Military Version : Therapist and Patient Materials Manual ,” produced in 2014 , by the U . S . Department of Veterans Affairs , bit . ly / 3gItseN .
Participants can also use the worksheets to target other automatic thoughts that aren ' t necessarily related to the traumatic event . As one of my colleagues says , “ I personally love that the skills clients learn in CPT can be applied to other situations outside of their trauma history , and can likely help with comorbid symptoms , too .”
I remind participants that they will take with them the skills they learn
continued on page 23
22 The Advocate Magazine 2022 , Issue # 3 American Mental Health Counselors Association ( AMHCA ) www . amhca . org