1. Treatment of Clients Experiencing Trauma
A Collaborative Approach to Care
May 5, 2018 * Tex-CHIP Training Series

2. The Treatment of Trauma Symptoms Through Counseling

3. Understanding Provider Role in Treating Trauma
To have an awareness and understanding of trauma
To provide a safe environment
Build rapport
To be warm, empathic, non-judgmental, collaborative and genuine
Gain the cooperation of the client
To work with clients without retraumatizing them.
Establish a common understanding of the client’s traumatic event
(Bicknell-Hentges & Lynch, 2009)

4. Considerations when Interacting with Clients
Clients handle trauma differently
Differing degrees of avoidance
Clients may have a different understanding of why the trauma occurred
Different beliefs about the impact it had on them or others
Not all clients process trauma the same
Written trauma narrative versus no narrative
Don’t underestimate your client’s resiliency
(Resick, Monson & Chard, 2017)

5. Our Treatment Plan Healthcare Domain: Behavioral Health Provider: LPC
Objective:
Provide alleviation of presenting trauma symptoms as indicated by client report of:
(a) Reduction in avoidance behaviors
(b) Identification of stuck points and challenging her beliefs
(c) Decrease in maladaptive thinking
(d) decrease in scores on the PCL-5 and the PHQ-9
Goals:
a)  To drive to work with minimal anxiety or fear provoking symptoms. (In Cognitive Processing Therapy (CPT) the focus is on the trauma event).
b) To focus and concentrate in school. (Goal b) & c) is associated with the trauma and the client’s symptoms should alleviate as the trauma symptoms decrease.)
c)  To feel less irritable and sleep through the night. (CPT protocol does not have specific interventions to address this area)
Interventions:
a) The counselor will also teach the client to identify stuck points, how to challenge beliefs, and how to use self-guided cognitive restructuring to decrease trauma symptoms.
b)  The counselor will also teach the client patterns of problematic thinking to help the client decrease maladaptive thinking.
 c) The counselor will teach the client the ABC worksheet as it relates to her trauma to identify the connection between thoughts, feelings and behaviors.

6. Measuring Outcomes/ Success
Success is a success, no matter how big or small
Always celebrate the little things
Trauma treatment requires the use of trauma instruments
Cognitive Processing Therapy uses PTSD Checklist for DSM-5 (PCL- 5) & Patient Health Questionnaire- 9 (PHQ-9)
Weekly administration to track outcomes
Client’s verbal account of meeting agreed upon objectives & completing homework assignments
(Resick, Monson & Chard, 2017)

7. Communication Needed From Other Providers
If a client is in crisis do not start trauma treatment
Refer client for services based on need
Suicidal ideations or self-harming behaviors
Psychiatric hospitalization or crisis stabilization
Psychiatrist
Medication regiment should continue to avoid sudden changes
Inpatient/Outpatient Substance Abuse Treatment
Detox may be needed
Can participate in treatment but create safety plan
Any other provider working with the client
Legal issues, Medical concerns, Department of Family Protective Services