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What Keeps Post-Traumatic Stress Disorder (PTSD) Going?

The "What Keeps It Going?" series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concise, they provide an easy way for clients to understand at a glance why their disorders persist, and how they might be interrupted. What Keeps Post-Traumatic Stress Disorder (PTSD) Going? is designed to help clients with PTSD understand more about their condition.

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Notice: The 'Fillable PDF' format has been retired. For resources with form elements, both the 'Professional' and 'Client' versions are now available as fillable PDFs by default.

Professional version

Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.

Client version

Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.

Editable version (PPT)

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Languages this resource is available in

  • Chinese (Simplified)
  • English (GB)
  • English (US)
  • German
  • Hebrew
  • Italian
  • Polish
  • Russian
  • Spanish (International)

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Introduction & Theoretical Background

If you have been through a trauma, it is normal to feel shocked, scared, guilty, ashamed, angry, vulnerable, or numb. With time, most people recover from their experiences, or find a way to live with them, without needing professional help. In spite of this, for many people the effects of trauma last for much longer and may develop into post-traumatic stress disorder (PTSD). Symptoms of PTSD can be split into groups (APA, 2013):

  • Re-experiencing symptoms.
  • Arousal symptoms.
  • Avoidance symptoms.
  • Negative thoughts and mood.

Research studies have shown that Cognitive Behavioural Therapy (CBT) is one of the most effective treatments for panic disorder (Watkins et al, 2018). CBT therapists work a bit like firefighters: while the fire is burning they aren’t very interested in what caused it, but are more focused on what is keeping it going. This is because if they can work out what keeps the problem

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Therapist Guidance

“One interesting way of thinking about PTSD is to look at why, for some people, it does not get better by itself. This handout shows the most common reasons why some people’s PTSD persists. I wonder if we could look at it together and think about whether it describes some of what is happening for you?”

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References And Further Reading

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
  • Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319-345.
  • Watkins, L. E., Sprang, K. R., & Rothbaum, B. (2018).Treating PTSD: a review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258.

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