This in the tenth in a series of blog posts about Cognitive Behavioural Therapy for a range of issues. This blog will focus on CBT for post-traumatic stress disorder.
1. What is post-traumatic stress disorder (PTSD)?
PTSD is the presence of one or more of the following, following the experiencing of actual or threatened injury, death or sexual violence; frequent, intrusive distressing memories of the event, dissociative re-experiencing of the event, frequent distressing dreams regarding the event, physiological reactions to cues which mirror elements of the experienced trauma, or intense psychological distress in response to reminders of the traumatic event.
Following this, the individual is likely to avoid distressing memories, thoughts of feelings associated with the event and attempt to avoid any associated reminders of the event (e.g. places, activities, situations, people, objects, sensory stimuli).
Changes in cognition or mood consisting of two or more of the following; inability to recall significant aspects of the trauma, strong negative beliefs about self, others and the world, distorted beliefs about the cause or consequence of the trauma that result in the individual blaming themselves, frequent negative affect, experience of being detached from others, decreased interested in previously enjoyed activities or persistent inability to experiencing positive emotions.
Changes in arousal are also present, such as outbursts of anger, engagement in risky behaviours, concentration difficulties, hyper vigilance, and disruptions to sleep.
The duration of these experiences will be more than 1 month to meet the specific diagnostic criteria, and must result in clinically significant distress or impairment to social, occupational or other areas of functioning.
2. Predisposing factors
There are some factors that may make some individuals more likely than others to experience post-traumatic stress following a traumatic incident. Predisposing factors may include: early exposure to traumatic experiences, experiences of anxiety prior to age 6, childhood adversity such as familial separation or socioeconomic difficulties, lower education status.
3. Precipitating factors
Precipitating factors include the ‘severity’ of the trauma (e.g. increased violence, more than one trauma experienced), perception of threat to life, sustaining injuries during the trauma, trauma perpetrated by a known individual, the experience of dissociation during the event.
4. Perpetuating factors
Perpetuating factors include repeated exposure to stimuli associated with the trauma, other trauma-related losses, such as financial loss or social isolation following the trauma, unhelpful coping strategies, negative appraisals.
5. Protective factors
Protective factors include examples such as: positive social support, stable and reliable relationships, healthy coping strategies, financial stability and educational attainment. Being high in emotional expressiveness and higher rates of self-compassion have also been highlighted as protective factors.
6. What is Trauma-focused cognitive behavioural therapy (TF-CBT)?
Trauma-focused CBT is a form of cognitive behavioural therapy (CBT) specifically designed for PTSD. NICE recommends that clients attend between 8–12 weekly sessions with the same therapist. See our page on trauma for more information about this talking therapy.
7. How does CBT work for other mental health conditions?
To find out more about how Cognitive Behavioural Therapy work for other specific mental health conditions such as low mood & depression or anxiety disorders please read our series of blog posts on this topic:
- A Guide to Cognitive Behavioural Therapy
- Cognitive Behavioural Therapy for Anxiety Disorders
- Cognitive Behavioural Therapy for Bipolar Disorder
- Cognitive Behavioural Therapy for Depression
- Cognitive Behavioural Therapy for Health Anxiety
- Cognitive Behavioural Therapy for Social Anxiety
- Cognitive Behavioural Therapy for Panic Disorder
- Cognitive Behavioural Therapy for Obsessive Compulsive Disorder
- Cognitive Behavioural Therapy for Separation Anxiety
- Cognitive Behavioural Therapy for Specific Phobia