Professional version
Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.
Cognitive Behavioral Model Of Post Traumatic Stress Disorder (PTSD: Ehlers & Clark, 2000)
A licensed copy of Ehlers and Clark (2000) cognitive behavioral model of post-traumatic stress disorder (PTSD).
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Overview
This professional handout describes the cognitive-behavioral model of PTSD by Ehlers and Clark (2000). The model serves as a comprehensive framework for understanding how PTSD is maintained through problematic memory processes, negative appraisals, and maladaptive coping strategies. It outlines how products of the traumatic event, such as intrusive memories and appraisals of the experiences, result in a heightened experience of current threat, and directs therapists towards effective avenues for intervention.
Why Use This Resource?
The Ehlers and Clark model (2000) is a cornerstone for treating PTSD, providing insights into the psychological processes that maintain the disorder. This handout aids clinicians in:
- Understanding the cognitive processing during trauma that influences PTSD development.
- Identifying the nature of trauma memory and its sensory qualities.
- Analyzing negative appraisals and their role in maintaining a sense of threat.
- Addressing coping strategies that may hinder recovery.
- Understanding how these elements fit together resulting in the maintenance of PTSD.
Key Benefits
Comprehensive
Offers a detailed theoretical grounding for understanding PTSD.
Practical
Provides actionable guidance for therapy, including interventions in CT-PTSD.
Development
Facilitates development of treatment plans by detailing memory, appraisal, and coping strategies.
Awareness
Enhances awareness of factors influencing PTSD, such as prior experiences and beliefs.
Who is this for?
Post-Traumatic Stress Disorder (PTSD)
Developing and refining interventions for clients with this diagnosis.
Complex Post-Traumatic Stress Disorder (C-PTSD)
Working with complex trauma, emotional dysregulation, and interpersonal difficulties rooted in prolonged exposure to traumatic experiences.
Acute Stress Disorder
Early intervention in clients exposed to trauma.
Depersonalization / Derealization Disorder (DPDR)
Addressing dissociative symptoms and the impact of trauma on self-experience and reality perception.
Integrating it into your practice
01
Assess
Evaluate your client's experience of trauma, their memories, and their cognitive processing during trauma.
02
Identify
Highlight maladaptive appraisals and coping strategies.
03
Modify
Work on evaluating and altering negative appraisals of self, others, and the world.
04
Reclaim
Help clients re-engage with previously avoided activities and situations.
Theoretical Background & Therapist Guidance
Ehlers and Clark's model (2000) conceptualizes PTSD as a sense of current threat, maintained by memory characteristics, negative appraisals, and ineffective coping behaviors. Trauma memories are experienced as involuntarily vivid with sensory characteristics resulting in charactersitic re-experiencing symptoms. Negative appraisals, both of the trauma and subsequent symptoms, contribute significantly to perceived ongoing danger and emotional distress. Coping strategies, often intended to mitigate threat perceptions, such as avoidance and thought suppression, can hinder recovery by preventing trauma processing and maintaining negative appraisals. Ehlers and Clark's insight is that effective treatment should thus focus on memory elaboration, appraisal modification, and strategic behavior change to break the cycle of perceived threat.
What's inside
- A licensed diagram illustrating the Ehlers and Clark cognitive model of PTSD.
- Detailed explanation of Ehlers and Clark's cognitive model of PTSD (2000).
- Guidance for therapists detailing how to assess a client's experience of PTSD using the model as a framework.
FAQs
The model uniquely focuses on the interaction of memory processing, appraisal, and behaviors as maintaining PTSD.
It informs the case conceptualization processes and guides subsequent aspects of effective treatment for PTSD.
Begin with small, manageable tasks to gradually reduce avoidance and introduce positive coping strategies.
Collaborate with clients to test and modify appraisals through evidence-based practices, such as cognitive restructuring.
How This Resource Improves Clinical Outcomes
Utilizing this resource helps in:
- Enhancing client and therapist understanding of PTSD maintenance factors.
- Guiding meaningful engagement with trauma-focused therapies.
- Encouraging lasting change through updating of trauma memories and updating of trauma-related appraisals.
- Increasing client engagement by targeting personalized therapy goals.
Clinicians benefit from a structured framework for assessing and treating PTSD and related symptoms.
Clinicians Who Use This Resource Also Use
References And Further Reading
- American Psychological Association. (2017). Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. Retrieved from http://www.apa.org/ptsd-guideline/ptsd.pdf
- Brewin, C. R. (2014). Episodic memory, perceptual memory, and their interaction: Foundations for a theory of posttraumatic stress disorder. Psychological Bulletin, 140(1), 69.
- Brewin, C. R. (2015). Re-experiencing traumatic events in PTSD: New avenues in research on intrusive memories and flashbacks. European journal of Psychotraumatology, 6(1), 27180.
- Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour research and therapy, 38(4), 319-345.
- Ehlers, A., Clark, D. M., Dunmore, E., Jaycox, L., Meadows, E., & Foa, E. B. (1998). Predicting response to exposure treatment in PTSD: The role of mental defeat and alienation. Journal of Traumatic Stress: Official Publication of The International Society for Traumatic Stress Studies, 11(3), 457-471.
- International Society of Traumatic Stress Studies. (2019). Posttraumatic stress disorder prevention and treatment guidelines. Retrieved from http://www.istss.org/getattachment/Treating-Trauma/New-ISTSS-Prevention-and-Treatment-Guidelines/ISTSS_PreventionTreatmentGuidelines_FNL.pdf.aspx
- Kilpatrick, D. G., Resnick, H. S., Milanak, M. E., Miller, M. W., Keyes, K. M., & Friedman, M. J. (2013). National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria. Journal of traumatic stress, 26(5), 537-547.
- National Institute of Health and Clinical Excellence (2018). Posttraumatic stress disorder. Retrieved from www.nice.org.uk/guidance/ng116
- Santiago, P. N., Ursano, R. J., Gray, C. L., Pynoos, R. S., Spiegel, D., Lewis-Fernandez, R., & Fullerton, C. S. (2013). A systematic review of PTSD prevalence and trajectories in DSM-5 defined trauma exposed populations: Intentional and non-intentional traumatic events. PloS one, 8(4), e59236. doi: 10.1371/journal.pone.0059236
- Schauer, M., & Elbert, T. (2015). Dissociation following traumatic stress. Zeitschrift für Psychologie/Journal of Psychology, 218(2)
DOI:10.1027/0044-3409/a000018 - Wild, J., Warnock-Parkes, E., Murray, H., Kerr, A., Thew, G., Grey, N., & Ehlers, A. (2020). Treating posttraumatic stress disorder remotely with cognitive therapy for PTSD. European journal of psychotraumatology, 11(1), 1785818.
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