mh 5- trauma

Question 1

4 main areas of difficulty after facing trauma

Answer 1

• intrusions
• Avoidance
• hyperarousal
• alteration in mood/ beliefs

Question 2

what % of people that experience traumatic events go on to develop PTSD

Answer 2

25-30%

Question 3

intrusions following trauma

Answer 3

• recurrent, involuntary intrusive memories
• re-living traumatic experience in the here
• distressing dreams
• Experiencing distress when reminded of trauma

Question 4

Avoidance following trauma

Answer 4

avoid:
- circumstances resembling or associated with the stressor
- trauma related thoughts and feelings

Question 5

hyperarousal following traumatic event

Answer 5

difficulty falling or staying asleep
- irritability or outbursts of anger
- difficulty concentration
- hyper vigilance
- Exaggerated startle response

Question 6

Alteration in moods / belief following trauma

Answer 6

• inability to recall key features of event
• change to beleifs and expectations about oneself, the world and others
• Persistent trauma-related emotions (horror, fear etc)

Question 7

what is Complex trauma, extra difficulty

Answer 7

repeated trauma, often across key developmental stages.

difficulties with
- relationships (form + maintain)
- Emotional regulation (Strong emotions, emotionally numb)
- Self Concept (worthless, shame + guilt)

Question 8

NICE guidelines for PTSD

(for adults experiencing PTSD or symptoms longer than 1 month after traumatic event,)
name types of CBT interventions

Answer 8

CBT interventions include:
- cognitive processing theory
- cognitive therapy for PTSD
- narrative exposure therapy
- prolonged exposure therapy

EMDR (eye movement desensitisation reprocessing) for non-combat related trauma only.

Question 9

NICE guidelines for PTSD trauma, advice for all interventions

Answer 9

8-12 sessions. (only accurate for 1 trauma).

• include psychoeducation and strategies for flashbacks etc
• elaboration and processing of trauma memories
• provide help to overcome avoidance
• should acknowledge alcohol and drug abuse

Question 10

first stage of trauma therapy is usually

Answer 10

stabilisation.
get to a nice stable place with new coping strategies.

1. psychoeducation
2. Grounding (to reality, present moment e.g. 54321 technique)
3. Breathing (soothe threat)
4. Mindfulness
5. Trigger discrimination (help break association between trigger and memory

Question 11

Defence cascade (psychoeducation example)

Answer 11

increasing dissociation 1-6

increasing arousal as go thru stages 4 is peak. then decrease arousal.

1. Freeze (brief)
2. flight (for most)
3. Fight
4. Fright
5. Flag
6. Faint (hard to hear…extreme)

Question 12

linen closet metaphpr

Answer 12

expl what Treatment for PTSD involves

idea that we all have that messy cupboard to chuck things in.
Same with traumatic memories, shoved in, can pop out. keeping door closed is hard.

Taking them out, rearranging them, folding them. They won’t now pop out. can still access them.

Question 13

Trauma focused CBT key goals

Answer 13

• Elaborate and integrate traumatic memory
• Evaluate appraisals relating to the trauma memory
• work on coping strategies that may be unhelpful

Question 14

updating trauma memories

Answer 14

identify hotspot in trauma memory.

rate how they feel, pick out worst points. ask what the worst parts are. (not always what u think it would be).

update memory, maybe with the defense cascade.

Question 15

coping strategies

Answer 15

thought supression experiment often used. e.g. not think ab green rabbit.

mindful way of responding to thoughts

Question 16

Narrative Exposure therapy (NET)

procedure

Answer 16

very specific process each week.
1. normalisation and psychoeducation at start.
2. laying out the lifeline. start at birth, lay down items to show hapy and traumatic memories along a rope.
3. Talk thru in very great detail. helps to link into context.
4. Read narrative. at start of session and as a final session.

Question 17

theraputic elements of NET

Answer 17

Chronological reconstruction of memories across lifespan
-prolonged exposure to hotspots
- linking the experience to context
-revisit positive life events to adjust assumptions

Question 18

Evidence for NET

Answer 18

compared NET to interpersonal psychotherapy for Rwandan genocide orphans

6 mnth follow up, 25% NET had PTSD symptoms
but 71% IPT

Question 19

The goals of a trauma-informed approach

Answer 19

To raise awareness among staff about the wide impact of trauma.
* To prevent re-traumatisation of clients.
* To prevent vicarious trauma by supporting staff regularly working with trauma

Question 20

Key principles of trauma informed practice
(from GOV.UK

Answer 20

1. Safety.
2. Trust.
3. Choice.
4. Collaboration.
5. Empowerment.
6. Cultural consideration.

Question 21

Trauma informed care relates to
creating services that aim to

Answer 21

reduce
harm and promote healing.