with Kate Chard, PhD
Studies suggest that approximately 18% of returning Veterans and 7% of civilians will experience PTSD in their life time. Individuals diagnosed with PTSD often report difficulty experiencing emotions such as love and happiness, instead they may describe feeling numb or angry. Due to the traumatic event circumstances many individuals do not have the opportunity to feel the natural emotions (e.g. fear) associated with the trauma and instead they must process the event later which may lead to a biased recounting of the events, e.g., hindsight bias. Research has shown that individuals with a diagnosis of PTSD commonly report cognitive distortions in the area of shame, blame and/or guilt, which can lead to "manufactured" emotions such as anger, guilt, or helplessness.
Cognitive behavioral therapies, specifically Cognitive Processing Therapy (CPT), have been found to be an effective way to treat the symptoms of PTSD by allowing clients to feel the natural emotions and challenge the problematic thoughts that are leading to their painful emotions. CPT typically consists of three phases with the initial phase focusing on the meaning of the event and the connection between thoughts and feelings. The optional second phase involves a retelling of the traumatic event with a focus on identifying extreme or exaggerated thoughts that developed from the event, e.g. "stuck points." During the third phase the therapist and patient collaboratively examine the individuals stuck points using a series of worksheets designed to provide a more balance view of the event(s). Several randomized controlled trials support the use of CPT for the treatment of PTSD from a variety of traumatic events, including combat, rape, assault and childhood sexual abuse. In addition, CPT is one of two therapies currently being disseminated for use throughout the Department of Veteran's Affairs.
In this presentation, participants will be introduced to several of the basic techniques utilized in CPT, including Socratic Dialogue, A-B-C sheets and Challenging Questions. A live role-play will demonstrate introducing the patient to these techniques and helping him challenge his disruptive cognitions regarding his experiences in Iraq.
Dr. Kathleen M. Chard is the director of the PTSD and Anxiety Disorders Division at the Cincinnati VA Medical Center and associate professor of clinical psychiatry at the University of Cincinnati. As the VA CPT implementation director, Dr. Chard oversees the dissemination of Cognitive Processing Therapy to VA clinicians across the United States. She is the author of the CPT for Sexual Abuse Treatment Manual and is co-author of the Cognitive Processing Therapy: Military Version Manual. She is an active researcher and she has conducted several funded studies on the treatment and etiology of PTSD. Currently Dr. Chard is exploring the efficacy of CPT with veterans with PTSD and comorbid traumatic brain injury.