What you'll learn
- Advanced trauma treatment, Trauma informed care
Requirements
- This is a discussion of the elements of trauma informed care and supporting materials on the nature of how trauma/adversity can impact life and health throughout the lifespan.
Description
Presenter: Dr. J. Eric Gentry, Ph.D., LMHC, D.A.A.E.T.S.
While the focus of the CCTS-I was to acquire the basic skills for treating post traumatic stress, the focus of the Complex PTSD training is acquiring skills for effectively treating those challenging clients with complex post traumatic stress, or C-PTSD. C-PTSD can present with a myriad of difficult symptoms including intense abreactions/flashbacks; severe “depression-like” shutdown and avoidance; dissociation; relational difficulties and challenges; chronic emotional and somatic dysregulation; chronic pain; and psychotic symptoms. This course provides comprehensive presentation of clinical skills for screening/assessing, stabilizing, skills-building, and treating complex post traumatic stress in all its challenging presentations. Focusing upon working in a tri-phasic model, the participant will learn how to titrate treatment to minimize discomfort and crises while, at once, accelerating treatment gains in early, mid and latter stages of treatment. The course provides a balance of current evidence/science-based interventions and protocols paired with experiential practice wisdom from clinicians who have successfully worked with population for decades. Participants completing this course will discover a newfound sense of competency and excitement for working with these clients who, in the past, have baffled even seasoned clinicians.
Learning Objectives
1. Articulate the differences between simple and complex PTSD (C-PTSD) and identify the distinct challenges for diagnosis, treatment planning, stabilization and treatment of C-PTSD.
2. Understand the neurobiology of C-PTSD and how chronic exposure to threatening environments can produce the spectrum of symptoms of C-PTSD
3. Appreciate the role that attachment trauma and Adverse Childhood Experiences (ACEs) play in risk for and creation of C-PTSD; and how successfully addressing attachment issues can accelerate treatment for C-PTSD.
4. Articulate the causes of attachment trauma (e.g., relational threat/anxious attachment; avoidant attachment; disorganized attachment) and how these adaptations are easily misunderstood as personality disorders.
5. Articulate the importance of neuroplasticity/pruning and understanding neuronal sequencing (i.e., “neural networks”) in treating C-PTSD and all post traumatic conditions.
6. Understand the important role that conditioned threat response and subsequent ANS dysregulation play in generating and sustaining the symptoms of all post traumatic conditions including C-PTSD.
7. Expanded knowledge of the science and applicability of Porges’ Polyvagal Theory to treatment with C-PTSD; specifically the importance of developing and utilizing healthy attachment relationships to augment treatment.
8. Articulate and explain how dissociation symptoms (e.g., numbing; derealization; depersonalization; hearing “voices”; fractured multiple ego-states; dissociative identity) are adaptations to recurring (usually developmental) trauma.
9. Identify evidence-based pharmacological interventions for stabilization and treatment for clients with C-PTSD.
10. Apply Herman’s Tri-Phasic Model to conceptualization, titration and delivery of treatment for C- PTSD.
11. Identify specific assessment and treatment tasks for each of the three phases of the Tri-Phasic Model.
12. Understand symptoms of C-PTSD as adaptations to ongoing developmental trauma that can include extreme symptoms including self-injury; suicide; dissociation; numbing; addiction (process and substance); eating disordered behavior; chronic & intractable depression; hyper/hypo sexuality; and rage.
13. Articulate the role of crucial non-specific factors of positive expectancy and therapeutic relationship using Feedback Informed Therapy (FIT) as central focus of treatment with C-PTSD.
14. Learn and appreciate the pivotal role of psychoeducation in treating C-PTSD to help survivors to begin to honor their survival, ameliorate shame and move towards self-compassion.
15. Learn and implement the four “common factors/active ingredients” shared by all effective trauma therapies for clients with C-PTSD.
16. Appreciate the ubiquitous role of reciprocal inhibition embedded in all evidence-based trauma therapies
Skills
Preparation/Assessment/Treatment Planning/Relationship-Building
1. Master self-regulation of ANS dysregulation (i.e., anxiety) for clinician resilience and optimization of treatment delivery.
2. Become intentional with maximizing positive expectancy as crucial early treatment intervention for engagement and ongoing intervention to enhance outcomes.
3. Informed Consent for C-PTSD
4. Develop understanding and usage of various assessment tools
5. First-session Interventions to enhance safety, stabilization, positive expectancy and therapeutic relationship
6. Skilled implementation of Feedback Informed Therapy using Miller’s Session Rating Scale
Stage I: Safety & Stabilization
1. Enhance case-management skills to facilitate and co-author safety planning interventions with clients in current danger.
2. Practice psychoeducational skills to help C-PTSD clients discern difference between real vs. perceived threat then coaching skills to avoid “real” danger and confront perceived threats with self-regulation (i.e, in vivo exposure).
3. Develop mastery of psychoeducation/cognitive restructuring skills for reframing symptoms from shame and affliction to “over”-adaptation.
4. Develop mastery for teaching and coaching self-regulation skills for clients to down-regulate negative arousal, achieve stability and begin in vivo exposure in early treatment.
5. Gain generic stabilization skills for all C-PTSD clients
Stage II: Remembrance & Mourning/Trauma Resolution
1. Master skills for Direct Therapeutic Exposure using reciprocal inhibition with in vivo exposure as primary means for resolving symptoms in Criteria B (Intrusion), Criterion C (Avoidance), Criterion D (Negative Alterations of Cognition &Mood) & Criterion E (Arousal & Reactivity) of PTSD.
2. Discover CBT skills to lessen avoidance, arousal, shame, dysphoria, reactivity, and distorted thinking symptoms.
3. Compare evidence-based/evidence-informed treatments currently utilized to address symptoms of C-PTSD
Stage III: Reconnection
1. Identification of specific treatment goals and empirical markers for objectives in this final stage of treatment. This stage requires a new and additional treatment plan.
2. Skills for implementing psychoeducational techniques to help client understand and engage the intention of moving from survival to intentional and deliberate lifestyle.
3. Skills for identifying both cognitive and behavioral impediments to transitioning to optimal lifestyle for C-PTSD survivors.
4. Building and enhancing post traumatic resilience
5. Engaging and optimizing post traumatic growth
6. Implementing Forward-Facing Trauma Therapy as reconnection, resilience and moral healing strategy.
This course is not available for NBCC credit.
Who this course is for:
- Mental health, teachers, probation, courts, child-protective agencies, foster parents, clergy
Course content
- 00:53Welcome
- 00:41Module 1: Introduction to Advanced Training for Trauma Treatment of Complex PTSD
- Preview51:58
- 10 questionsModule 1: Introduction to Advanced Training for Trauma Treatment of Complex PTSD
- 00:41Module 2: Foundation and Knowledge
- 01:00:13Module 2: Foundation and Knowledge
- 10 questionsModule 2: Foundation and Knowledge
- 00:40Module 3: Symptoms of C-PTSD
- 01:00:12Module 3: Symptoms of C-PTSD
- 10 questionsModule 3: Symptoms of C-PTSD
- 00:39Module 4: Neurobiology of C-PTSD
- 01:00:27Module 4: Neurobiology of C-PTSD
- 10 questionsModule 4: Neurobiology of C-PTSD
- 00:34Module 5: Stress Response and Stages of Traumatic Response
- Preview53:31
- 10 questionsModule 5: Stress Response and Stages of Traumatic Response
- 00:40Module 6: Deliberate Practice
- 01:00:19Module 6: Deliberate Practice
- 10 questionsModule 6: Deliberate Practice
- 00:36Module 7: Self-Regulation and Co-Regulation
- 52:46Module 7: Self-Regulation and Co-Regulation
- 10 questionsModule 7: Self-Regulation and Co-Regulation
- 00:40Module 8: Introduction to Active Ingredients
- 01:00:11Module 8: Introduction to Active Ingredients
- 10 questionsModule 8: Introduction to Active Ingredients
- 00:48Module 9: Empowerment and Resilience Treatment Structure – Stage I: Preparation
- 01:00:08Module 9: Empowerment and Resilience Treatment Structure – Stage I: Preparation
- 10 questionsModule 9: Empowerment and Resilience Treatment Structure – Stage I: Preparation
- 00:38Module 10: Empowerment and Resilience Treatment Structure – Stage II: Psychoeduc
- 01:00:04Module 10: Empowerment and Resilience Treatment Structure – Stage II: Psychoeduc
- 10 questionsModule 10: Empowerment and Resilience Treatment Structure – Stage II: Psychoeduc
- 00:34Module 11: Graphic Timeline
- 40:06Module 11: Graphic Timeline
- 5 questionsModule 11: Graphic Timeline
- 00:37Module 12: Skills Development - Relaxation
- 01:00:46Module 12: Skills Development - Relaxation
- 10 questionsModule 12: Skills Development - Relaxation
- 00:44Module 13: Skills Development - Grounding
- 01:00:15Module 13: Skills Development - Grounding
- 10 questionsModule 13: Skills Development - Grounding
- 00:38Module 14. Skills Development Conclusion and Regression
- 01:08:23Module 14. Skills Development Conclusion and Regression
- 10 questionsModule 14. Skills Development Conclusion and Regression
- 00:53Module 15: Forward Facing Trauma Therapy (FFTT)
- 01:00:16Module 15: Forward Facing Trauma Therapy (FFTT)
- 10 questionsModule 15: Forward Facing Trauma Therapy (FFTT)
- 00:43Module 16: Therapist Driven Treatments
- 01:04:19Module 16: Therapist Driven Treatments
- 10 questionsModule 16: Therapist Driven Treatments
- 01:01Bonus lecture: Congratulations on the successful completion of the training!
Instructor
Dr. Robert Rhoton, CEO of Arizona Trauma Institute and President at the Trauma Institute International possesses a rich history of experience in the mental health field. Dr. Rhoton has supervised multiple outpatient clinics, juvenile justice programs, and intensive outpatient substance abuse programs for adolescents, day treatment programs for youth and children, adult offender programs and child and family therapeutic services. Additionally, Dr. Rhoton has advanced training in child and adolescent trauma treatment, family therapy, and family trauma. Dr. Rhoton served as president of the Arizona Trauma Therapy Network from 2010 through 2012. Dr. Rhoton was a Professor at Ottawa University in the Behavioral Sciences and Counseling Department whose primary interests were training counselors to work with traumagenic family dynamics, child and family trauma, and non-egoic models of treatment. Dr. Rhoton is a Diplomate of the American Academy of Experts in Traumatic Stress and collaborates and consults with numerous Arizona agencies fine tuning their understanding of trauma and the impact of developmental trauma on the individual and family. Dr. Rhoton has served on the Arizona Department of Health Services Trauma Informed Care (TIC) task force, currently is on a SAMHSA Technical Assistance committee working with trauma and education. Dr. Rhoton also works with Arizona State Epidemiologists around the identifying of concrete markers and the predictive nature of public health impact of early developmental trauma on Arizona children.
Dr. Rhoton's most recent publication can be found in the July 2017 Journal of Counseling and Development titled; Trauma Competency: An Active Ingredients Approach to Treating Posttraumatic Stress Disorder.