Cognitive Therapy for Post Traumatic Stress Disorder

Prof. Anke Ehlers

Wednesday, 8 December 2021

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Introduction

Cognitive therapy is rooted in the idea that clients' symptoms, emotions, and behaviour are understandable, arising from perceptions they hold of themselves and the world and what they make of these perceptions. CT-PTSD is a trauma-focused cognitive behaviour therapy (TF-CBT), recommended by the National Institute for Health and Care Excellence (NICE) as a treatment for PTSD (NICE, 2018) and international treatment guidelines (APA, 2017; ISTSS, 2019). A key part of this treatment to change the meanings of the worst moments of trauma in memory and work on triggers of reexperiencing. Delivering trauma-focused cognitive behavioural therapy to patients with PTSD during the COVID-19 pandemic poses challenges. The therapist cannot meet with the patient in person to guide them through trauma-focused work and other treatment components, and patients are restricted in carrying out treatment-related activities and behavioural experiments that involve contact with other people.


The event will be equivalent to 5.1/4hrs of CPD.

Content

This workshop builds on Ehlers and Clark’s (2000) cognitive model of PTSD. This model suggests that people with PTSD perceive a serious current threat that has two sources; excessively negative appraisals (personal meanings) of the trauma and/or its sequelae; characteristics of trauma memories that lead to re-experiencing the symptoms. The problem is maintained by cognitive strategies (such as thought suppression, rumination, safety-seeking behaviours) that are intended to reduce the sense of current threat, but actually maintain the problem by preventing change in the appraisals and trauma memory. The workshop will describe how to deliver core interventions of CT-PTSD remotely, including updating memories, trigger discrimination and behavioural experiments, and present video illustrations.

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 ways of accessing and changing threatening meanings of trauma in PTSD
3. Identify ways of integrating changed meanings into trauma memories.
4. Identify ways of changing responses to triggers of reexperiencing.
5. Identify ways of adapting procedures to working remotely.

Training Modalities

This workshop will include didactic teaching and videos with some experiential elements and Q&A.

Key References

Ehlers, A. & Clark, D.M. (2000). A cognitive model of posttraumatic stress disorder, Behaviour Research and Therapy, 38 319-345.
Ehlers, A., & Wild, J. (2020). Cognitive therapy for PTSD. In L. F. Bufka, C. V. Wright, & R. W. Halfond (Eds.), Casebook to the APA Clinical Practice Guideline for the treatment of PTSD (p.91-121). American Psychological Association. https://doi.org/10.1037/0000196-005
Murray, H., Wild, J., Warnock-Parkes, E., Kerr, A., Thew, G., Grey, N., Clark, D.M. & Ehlers, A. (2020). Cognitive therapy for PTSD following critical illness and intensive care unit admission. The Cognitive Behaviour Therapist, DOI: https://doi.org/10.1017/S1754470X2000015X
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

Anke Ehlers if Professor of Experimental Psychopathology and Wellcome Trust Principal Research Fellow at the University of Oxford. Professor Ehlers is Co-Director of the Oxford Centre for Anxiety Disorders and Trauma and an NIHR Senior Investigator.
The cognitive therapy programme for PTSD developed by her group has been shown to be highly acceptable to patients and very effective. It has been successfully disseminated to provide effective treatment services for victims of the bombings in Omagh and London, and to National Health Service clinics.
Current research projects investigate whether the treatment can be delivered more efficiently, and what the mechanisms of treatment are. Experimental studies investigate mechanisms of intrusive memories after trauma.
Professor Ehlers is also a Fellow of the British Academy, The Academy of Medical Sciences, the Association for Psychological Science, and an elected Member of German National Academy of Scientists Leopoldina and the Academia Europaea.

Who should attend

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