CBT for Post-Traumatic Stress Disorder

Dr Jennifer Wild

Thursday, 12 January 2023

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Introduction

Cognitive therapy is rooted in the idea that whilst people may face gritty times, it is the meaning they make of them that matters. A patient’s symptoms, emotions, and behaviours are seen as inextricably linked to their thinking. Cognitive therapists extend curiosity and compassion to elicit then better understand thoughts and processes that may be maintaining distress and this understanding or formulation is integral to guiding treatment. CT-PTSD is based on a robust cognitive model that identifies three core processes that keep the disorder going (Ehlers & Clark, 2000). The treatment aims to modify these processes through intervention that targets trauma memories, triggers, unhelpful behaviours and thoughts. Updating painful meanings linked to the trauma memory with information and often images that address relevant cognitive themes is a key part of the treatment. Cognitive themes typically relate to anger, shame, guilt, betrayal, overgeneralised danger, loss or permanent change. CT-PTSD is recommended by the National Institute for Health and Care Excellence (NICE) and numerous international guidelines as a first line treatment for the disorder. The treatment leads to high rates of recovery, is often described as life-changing, can be delivered in about 10 to 12 sessions and easily adapted for remote delivery during pandemic-working.


The event will be equivalent to 5.1/2hrs of CPD.

Content

This workshop builds on Ehlers and Clark’s (2000) cognitive model of PTSD. The workshop will demonstrate how to deliver core interventions of CT-PTSD face-to-face and remotely, including how to update memories, carry out trigger discrimination and design highly effective behavioural experiments. A focus will be included on how to transform challenging cognitive themes, such as loss and permanent change, which arise after the death of a loved one or permanent injury. We will also discover how to work with trauma that the patient is likely to experience again, such as in the context of healthcare, emergency or military work.

Learning Objectives


By the end of the session, attendees will be able to:
1. Use the Ehlers and Clark cognitive model to understand PTSD and develop an individual formulation for patients.
2. Identify core cognitive themes and ways of working with them
3. Describe ways of integrating updated meanings into trauma memories
4. Describe steps in transforming images of loss and permanent change
5. Identify ways of changing responses to triggers of reexperiencing
6. Identify ways of adapting procedures to working remotely

Training Modalities

The presenter will use a range of teaching methods: slides, videos and experiential exercises.

Key References

Wild, J., Warnock-Parkes, E., Murray, H., Kerr, A., Thew, G., Grey, N., Clark, D.M. & Ehlers, A. (2020). Treating posttraumatic stress disorder remotely with Cognitive Therapy for PTSD. European Journal of Psychotraumatology, 11:1, 1785818 doi: 10.1080/20008198.2020.1785818

About the presenter

Dr Jennifer Wild is a consultant clinical psychologist, associate professor and NIHR Oxford Health BRC Senior Research Fellow at the University of Oxford. Her area of expertise is in developing and evaluating evidence-based interventions to treat and prevent PTSD. With her team, she developed and evaluated internet-delivered cognitive training in resilience (iCT-R), which targets risk factors for PTSD and depression in emergency workers. This intervention is being adapted for evaluation in Singapore and Australia, and disseminated to emergency services across England by the mental health charity, Mind. Dr Wild has developed a brief evidence-based intervention to support hospital and paramedic employees (SHAPE) during and after COVID (www.shaperecovery.com). She has worked in an advisory role to the Cabinet Office on best practice for developing preventative interventions for emergency responders. She has over 70 publications, including book chapters, and a recently published popular science book on resilience, Be Extraordinary: 7 Key Skills to Transform Your Life from Ordinary to Extraordinary. Dr Wild regularly appears in the media giving evidence-based advice for trauma-related mental health problems.

Who should attend

CBT practitioners who treat people with PTSD including IAPT High Intensity Therapists.