ACT for PTSD: Special Topics and Tips for Working With Trauma Survivors

Sonja-Batten

Booz Allen
Department of Veterans Affairs
Yale University
University of Nevada, Reno

Key Points

  1. The goal of exposure exercises isn’t to reduce the arousal or reactivity to these trauma reminders but to increase psychological flexibility instead.
  2. Some trauma survivors may have difficulty contacting an independent sense of self that guides their choices.
  3. Shame and guilt are common emotional reactions that often co-occur with a trauma history.
  4. Assess for suicidal thoughts and behaviors with all of your trauma clients.
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Transcript

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So now, some take-home messages from this module. Acceptance and commitment therapy regularly uses some components that are very similar across presenting problems. However, in a handful of areas, it is very important that the therapist has thought through how to approach a number of more complex issues as they apply specifically to trauma survivors.

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Experienced trauma therapists, or anxiety disorder therapists in general, will likely already have experience with a highly effective component of trauma-focused therapy, which is exposure treatment. In exposure, the client is repeatedly in contact with thoughts, feelings, bodily sensations, and memories related to the traumatic event, and this work can be very intense and evocative.

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Although exposure treatment is usually thought of as part of traditional cognitive behavioral therapy, in vivo interoceptive and imaginal exposure can be a core part of ACT treatment for some trauma clients, too. However, in ACT, the goal of exposure exercises is not to reduce the arousal or reactivity to these trauma reminders but instead, to help the client practice and maintain increased psychological flexibility in the presence of trauma cues.

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