Cognitive therapy for post-traumatic stress disorder following critical illness and intensive care unit admission - Volume 13

Resources for cognitive therapy for PTSD, social anxiety disorder and panic disorder.

Abstract. Behavioural experiments are an integral component of cognitive therapy (CT) for posttraumatic stress disorder (PTSD), but they can be overlooked due to practical constraints and therapist...

Traumatic Bereavement (NHS England Webinar, 19 May 2020) Please submit any feedback you have below. Please note that we do not record any identifiable information from your feedback, so it is fully…

Workshop Video This video is a recording of a full day workshop on Cognitive Therapy for Panic Disorder (CT-Panic) that David Clark presented to IAPT high intensity therapists in training. The ther…

Remote Delivery Guides Many therapists are likely to be working from home and delivering treatment remotely during the COVID-19 pandemic. Below we provide guidance in how to remotely deliver the NI…

Cognitive therapy for moral injury in post-traumatic stress disorder - Volume 14

Remote Delivery Guides Many therapists are likely to be working from home and delivering treatment remotely during the COVID-19 pandemic. Below we provide guidance in how to remotely deliver the NI…

Survivor guilt: a cognitive approach - Volume 14

During a pregnancy, the health and wellbeing of the mother and unborn child are of paramount importance, so it makes sense that therapists often worry about using trauma-focused treatments. Undenia...

In DSM-5, criterion A of the PTSD diagnostic criteria specifies what kinds of events constitute a traumatic stressor. This is because PTSD has historically been conceived of as a condition that only...

Cognitive therapy for moral injury in post-traumatic stress disorder - Volume 14

By including indirect, work-related, exposure to trauma (criterion A4) in the PTSD diagnosis, DSM5 formalised what many already knew - that psychological therapists working with very traumatised...

We all differ in how we express emotion, often influenced by our upbringing and culture. In therapy, the way in which our client expresses their emotions is perhaps less important than whether they...

Nightmares and flashbacks are often two of the easiest to spot symptoms of PTSD. However, in DSM-5, to meet criterion B (the re-experiencing cluster), someone only needs one of the possible symptoms,...

The therapist who suggested this FAQ told us how thoughts like “I’m a loser/weak for needing these techniques” were preventing their client from using grounding strategies or stimulus discrimination....

For this week's blog, we have something different. Michael Davitt, who has lived experience of childhood trauma, answered our questions about what what it is like going through therapy and gives us...

Having a conversation in imagery with a person who has died is a useful technique for addressing some loss-related appraisals and dealing with head-heart lag. For example, if someone feels guilty...

Cognitive therapy for post-traumatic stress disorder following critical illness and intensive care unit admission - Volume 13

PTSD can arise after the experience of, and treatment for, critical illness – a timely issue given the current COVID-19 pandemic. Treatment in ICU is particularly high risk for PTSD, with approxima...

The client in question has religious beliefs which value forgiveness and has been advised by a faith leader that she should try to forgive her ex-husband who abused her over many years. However, she...

Gaps in trauma memories are quite common and can occur for several reasons. There may be an obvious reason, for example if your client lost consciousness during the trauma or they were drugged. In...

As ever, when we update hotspots in a trauma memory, our focus is on what they mean to the client, and our updates follow that. Meanings are always highly individual, so we don’t make assumptions...

Trauma-related guilt is often linked to beliefs about perceived responsibility (‘because I did this, the trauma happened’) or foreseeability (‘I should have known it was going to happen’). Often...

Memories formed very early in life are often unclear or fragmentary, not least because our autobiographical memory system is still developing at that time. Under the age of two years, most events are...

Strongly associated with the emotion of shame is the belief that others will judge us negatively, leading to a natural desire to hide what we are ashamed of from others. In therapy, this means that...

In short – sometimes! It really depends on whether an individual client is dissociating when they access the trauma memory. If they have a full immersive flashback, or detach and can no longer...

Survivor guilt is a commonly used term, but little research has addressed its prevalence in clinical samples. A UK traumatic stress clinic sample was systematically assessed for survivor guilt over...

Usually with trigger discrimination, we are helping our clients to focus on the differences between ‘then’ (the trauma) and ‘now’ (the trigger) and we deliberately introduce triggers during therapy...

The COVID pandemic led many of us to start offering PTSD therapy online from our homes. For many of us, this arrangement has continued at least some of the time, as it can be more convenient for both...

Our thinking on this topic, and that of the OxCADAT team run by Anke Ehlers and David Clark, has evolved over the years. Imaginal reliving was probably our usual preferred option as it had an...

Usually, moral injury is defined as the profound psychological distress that can arise after perpetrating, failing to prevent, or witnessing events that transgress an person’s moral or ethical code...

Therapist are people, not robots. Especially when working with PTSD, we hear some very distressing things and it is a normal, human reaction to feel upset at times. Furthermore, our clients do not...

Imaginal reliving is often a bit simpler than written narratives when we are working via an interpreter. Here, we set up reliving in the same way as usual i.e. asking the client to speak in the first...