This worksheet presents a cognitive behavioral model of post-traumatic stress disorder (PTSD) by Ehlers & Clark (2000). This is an incredibly flexible model which identifies three maintenance mechanisms which serve to prolong distress in PTSD:
- Memories having ‘unprocessed’ properties which mean they are more likely to be experienced as involuntarily, intrusive, vivid and experienced as if they were happening in the present
- Beliefs regarding the trauma, the self, others, and the future which can lead to intense emotional reactions
- Coping strategies (e.g. avoidance) which may have maladaptive consequences
Case conceptualizations are best completed with a client rather than presented as a ‘finished article’. When helping a client to conceptualize PTSD stages which it can be helpful to discuss include:
- Discussion of the trauma(s). These can be thought of as ‘facts’ about what the client has experienced
- Discussion of the client’s state of mind at the time of the trauma. E.g. high adrenaline may have led to memories being improperly stored. Dissociation may have been an understandable reaction in the context of the events taking place.
- Discussion of memories in PTSD. Their qualities (often vivid, involuntarily experienced, having ‘nowness’). Their content (e.g. what typical flashbacks are ‘of’).
- Discussion of beliefs in PTSD. These can be peri-traumatic (at the time of the trauma) or post-traumatic.
- Discussion of feelings and emotional states which result from memory re-experiencing or the activation of beliefs.
- Discussion of coping strategies as ways of managing the intense feelings associated with PTSD.
- Discssion of the intended and unintended consequences of the client’s coping strategies.
- Ehlers, A., Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319-345.