with Claudia Zafert, PhD & Jason DeViva, PhD
Cognitive-Behavioral Therapy (CBT) is widely recognized as an effective treatment for posttraumatic stress disorder (PTSD). Yet clinicians often encounter challenges when implementing CBT for PTSD patients with multiple problems. As a result, sometherapists question the clinical utility of CBT and are reluctant to use it for many of their PTSD patients. The goal of this institute is to enhance comfort and confidence in flexibly applying evidenced based methods for treatment of PTSD in clinical practice with complicated patients. Participants will learn the latest findings, case conceptualization methods, and clinical tools that willhelp them implement CBT and optimize clinical outcomes.Participants will learn how to use a case formulation approach to conceptualize the array of difficulties faced by patients with complicated posttraumatic presentations and to develop a treatment plan tailored for each patient’s problems drawing from available evidence-based strategies. We will discuss the challenges of designing treatment to address multiple problems, including whether to deliver treatments simultaneously or sequentially, using assessment data to guide treatment decisions at various stages, and revising the case formulation when treatment does not proceed according to plan.
The approach to clinical decision-making is systematic yet respectful of both the individuality of the patient and the creativity of the clinician. We will cover the fundamentals of cognitive-behavioral assessment and treatment, including the “whats,” “whys,” and “how-tos” of core CBT components. For example, clinicians will learn how to use exposure principals to guide decision making in treatment, prepare patients for exposure, select useful and appropriate stimuli for exposure, construct useful hierarchies, implement exposure, titrate anxiety, facilitate engagement and habituation, target hot spots, and integrate imaginal and in vivo exposure. We will demonstrate how to weave together therapy methods and adapt them for patients with varying trauma histories, comorbidity, and complicating life circumstances. We will guide participants through the therapy process with complex cases and offer troubleshooting suggestions and clinical tools. Case examples and sample dialogues will illustrate ways to overcome frequently encountered hurdles. We also will help therapists examine their own ambivalence about therapy procedures and prepare them to conduct treatment that is both compassionate and effective. Finally, we will discuss terminating treatment or transitioning from PTSD treatment to other goals, including determining and prioritizing treatment needs, planning for generalization and maintenance, tapering medications, and ending treatment.