PTSD Awareness Presentation March 2018

PTSD Awareness Presentation March 2018

Tips and Information Thank you for choosing to share these slides. We ask that you recognize the National Center for PTSD as the source and keep the NCPTSD template intact during your presentation. This presentation may be used in whole or in part. Much of the content is taken from our PTSD 101: PTSD Overview course. You are welcome to use screen shots of other NCPTSD materials to amend the slides as long as you credit the National Center for PTSD as the source. Notes are included for most slides. Additional comments in bold offer suggestions for amending or adding content. VETERANS HEALTH ADMINISTRATION Additional Content

You might consider adding NCPTSD multimedia content to the PPT. Download AboutFace Interview Highlights: compilation of Veteran responses to key questions about symptoms and treatment experiences Download Whiteboard Videos: series of animated whiteboard videos on PTSD and effective treatments. There are 8 videos for the public and 1 for providers Healthcare providers who treat Veterans can ask for advice about their presentation from the PTSD Consultation Program at [email protected] Inquiries from other users of this slide deck should be directed to [email protected] VETERANS HEALTH ADMINISTRATION Posttraumatic Stress Disorder:

Overview, Treatment, and Resources [Insert Presenter Information] January 2019 Overview What is traumatic stress?

How common are trauma and PTSD? What are the symptoms of PTSD? Why do some people develop PTSD and others do not?

What problems co-occur with PTSD? How is PTSD treated? Trauma-focused psychotherapy Medications National Center for PTSD Resources for Trauma Survivors & Clinicians VETERANS HEALTH ADMINISTRATION

What is traumatic stress? Daily hassles Can include Car breaking down Paying bills VETERANS HEALTH ADMINISTRATION Major life events Can include Losing a job

Divorce Buying a new home Getting married Serious traumatic events Can include War zone exposure Physical or sexual assault Serious accidents Child sexual or

physical abuse Natural disasters Torture Trauma exposure is common. VETERANS HEALTH ADMINISTRATION What happens after trauma? VETERANS HEALTH ADMINISTRATION How common is PTSD?

VETERANS HEALTH ADMINISTRATION Criterion A: Traumatic Event Directly experiencing a traumatic event Witnessing, in person, an event that happened to someone else Learning about the violent or unexpected death of a friend of family member Experiencing repeated or extreme exposure to aversive details of traumatic events VETERANS HEALTH ADMINISTRATION

Symptom Clusters VETERANS HEALTH ADMINISTRATION Symptom Clusters (II) Intrusion (or re-experiencing, flashbacks) Recurrent distressing dreams or memories of the event; acting/feeling as if the event is happening again Avoidance Avoiding memories, thoughts, feelings, people, places or activities that are reminders of the event

VETERANS HEALTH ADMINISTRATION Symptom Clusters (III) Negative alterations in cognitions and mood Diminished interest in activities, feeling detached, inability to feel positive emotions, negative emotions, distorted blame of self or others Alterations in arousal and reactivity Irritable behavior, outbursts of anger, reckless or self destructive behavior, problems concentrating, hypervigilance, exaggerated startle, sleep disturbance VETERANS HEALTH ADMINISTRATION

Most people do not develop PTSD following trauma. 12% 10% Men Women Overall 8% 6% 4%

2% 0% Lifetime PTSD Current PTSD US General population estimates from the National Comorbidity Survey - Replication VETERANS HEALTH ADMINISTRATION PTSD is a common consequence of war. About 15% of returning Post-9/11 (OEF/OIF) Veterans have PTSD.

Depression Anxiety PTSD Any of 3 30% 25% 20% 15% 10%

5% 0% Hoge, et al., 2004 VETERANS HEALTH ADMINISTRATION Mental Health Problem Why do some people get PTSD while others do not? VETERANS HEALTH ADMINISTRATION Personal Factors

VETERANS HEALTH ADMINISTRATION Characteristics of the Traumatic Event VETERANS HEALTH ADMINISTRATION The Recovery Environment VETERANS HEALTH ADMINISTRATION PTSD often co-occurs with other problems.

VETERANS HEALTH ADMINISTRATION Other Co-occurring Problems VETERANS HEALTH ADMINISTRATION Trauma-focused psychotherapy is the best treatment. VETERANS HEALTH ADMINISTRATION What is trauma-focused psychotherapy? Trauma-focused

psychotherapy is any therapy that uses cognitive, emotional, or behavioral techniques to facilitate processing a traumatic experience and in which trauma focus is a central component of the therapy. VETERANS HEALTH ADMINISTRATION Trauma-focused Psychotherapies Prolonged Exposure (PE): In PE you confront situations you

have been avoiding until distress decreases. Cognitive Processing Therapy (CPT): In CPT you examine and challenge thoughts about the trauma until you can change the way you feel. Eye Movement Desensitization and Reprocessing (EMDR): EMDR helps you process and make sense of your trauma while paying attention to a back-and-forth movement or sound (like a finger moving side to side, a light, or a tone). VETERANS HEALTH ADMINISTRATION Trauma-focused Psychotherapies (II) Brief Eclectic Psychotherapy (BEP): You will practice relaxation skills, recall details of the traumatic memory, reframe negative thoughts about the trauma, write a letter about

the traumatic event, and hold a farewell ritual to leave trauma in the past. Narrative Exposure Therapy (NET): You will talk through stressful life events in order (from birth to the present day) and put them together into a narrative. NET was developed for people who have experienced trauma from ongoing war, conflict and organized violence. Written Narrative Exposure: This therapy involves writing about the trauma during sessions. Your therapist gives instructions on the writing assignment, allows you to complete the writing alone, and then returns at the end of the session to briefly discuss any reactions to the writing assignment. Specific cognitive behavioral therapies for PTSD: There are a limited number of psychotherapies shown to work for PTSD in which the therapist helps you learn how to change unhelpful behaviors or thoughts. VETERANS HEALTH ADMINISTRATION

Trauma-focused psychotherapy works. VETERANS HEALTH ADMINISTRATION Evidence-based Pharmacological Treatments First line medications Selective Serotonin Reuptake Inhibitors (SSRIs) paroxetine (Paxil) sertraline (Zoloft) fluoxetine (Prozac)

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) venlafaxine (Effexor) VETERANS HEALTH ADMINISTRATION Benzodiazepines can be dangerous. Warning: Benzodiazepines (e.g., Xanax, Valium, Klonopin) Limited efficacy Increased safety concerns Even more risk for older people Confusion, awkwardness, falls Not recommended for PTSD

VETERANS HEALTH ADMINISTRATION NCPTSD Target Audiences Veterans, trauma survivors, family members Increase awareness of PTSD and engagement in PTSD treatment Optimize Veterans personal support systems (family,

friends) VETERANS HEALTH ADMINISTRATION Professionals Promote the implementation of evidence-based care for Veterans and other trauma survivors Resources and Tools for Professionals VETERANS HEALTH ADMINISTRATION

About the Consultants Experienced senior psychologists, psychiatrists, social workers, pharmacists, and other health professionals who treat Veterans with PTSD Available to consult on everything from your toughest cases to general PTSD questions Ask about:

Evidence-based treatment Medications Clinical management Resources Assessment Referrals Collaborating with VA on Veterans care

Developing a PTSD treatment program Available Resources - www.ptsd.va.gov/ consult PTSD-related publications Free continuing education Videos, educational handouts, and manuals PTSD and trauma assessment and screening tools Mobile apps, and more

WWW.PTSD.VA.G OV PTSD Consultation Program Lecture Series Monthly one-hour webinar for providers Free continuing education credits Register and sign up for notifications at https://www.ptsd.va.gov/consult PAST TOPICS HAVE INCLUDED

PTSD and Women's Mental Health Suzanne Pineles, PhD Assessing and Managing Violence Risk in Veterans with PTSD Eric Elbogen, PhD Recent Research and New Strategies for Suicide Prevention Mark Reger, PhD and Caitlin Thompson, PhD

The Revised Clinical Practice Guideline for PTSD: Recommendations for Medications Matt Friedman, MD, PhD VETERANS HEALTH ADMINISTRATION Continuing Education Courses NCPTSD offers well over 50 hours of web-based co

urses for professionals . All courses are free. Most offer continuing education for multiple disciplines. Available to Anyone

For VA Staff VETERANS HEALTH ADMINISTRATION Trauma and PTSD: Stay Up-To-Date NCPTSD works to bring the most current research on trauma and PTSD to professionals.

All our publications are available through free e-subscriptions. VETERANS HEALTH ADMINISTRATION PTSD Awareness in Health Care Settings VETERANS HEALTH ADMINISTRATION

PTSD Awareness in Healthcare S ettings is a 15-minute video that shares the stories of three Veterans being seen at VA for PTSD care. Models strategies to improve interactions in health care settings with Veterans who have PTSD and trauma histories.

A Facilitators Guide is also available for those offering a training to medical staff. Toolkits Easy-to-access handouts and other resources Provider Self-Care Toolkit Clergy Toolkit Police Officer Toolkit: PTSD and

Military Veterans VA Campus Toolkit Community Provider Toolkit Veterans Employment Toolkit VETERANS HEALTH ADMINISTRATION PTSD Assessment NCPTSD provides information on a variety of measures assessing

trauma and PTSD. We also offer online courses on conducting assessments. Most NCPTSD-authored measures are available for direct download on

our website. Others are available by request. VETERANS HEALTH ADMINISTRATION Manuals and Guidelines The NCPTSD website offers manuals and guidelines to help health care providers and clinicians employ best practices for trauma-related conditions and PTSD.

VETERANS HEALTH ADMINISTRATION PTSDpubs PTSDpubs is a free electronic index to the worldwide literature on trauma and PTSD. Currently, PILOTS has more than 61,000 citations. Millions of searches are run each year. VETERANS HEALTH ADMINISTRATION

Resources and Tools for Veterans, the General Public, Family & Friends VETERANS HEALTH ADMINISTRATION Understanding PTSD series Coming soon: Understanding PTSD and Aging in English and Spanish VETERANS HEALTH ADMINISTRATION PTSD Treatment Decision Aid VETERANS HEALTH ADMINISTRATION

Animated Whiteboard Videos NCPTSD created a series of whiteboard videos, including one for professionals about PTSD and effective treatment s . Short (~3 minute), engaging videos that are easily shared via email or Facebook.

VETERANS HEALTH ADMINISTRATION AboutFace VETERANS HEALTH ADMINISTRATION Learn about PTSD treatment from people who have been there. Browse videos or search by era, service branch and more.

Mobile Apps VETERANS HEALTH ADMINISTRATION Apps are focused on PTSD, related health problems (e.g., insomnia, alcohol use, etc.), or general well-being.

There are apps for patients, providers, and for use with patient-provider dyads. Online Self-help Tools VetChange helps users set goals and work at their own pace to cut down on their drinking and deal with stress symptoms. VETERANS HEALTH ADMINISTRATION

PTSD Coach Online offers a suite of 17 tools to help manage symptoms like sadness and anxiety. Printable Materials to Share VETERANS HEALTH ADMINISTRATION Thank you! [Insert Contact Information] Visit the National Center for PTSD at: https://www.ptsd.va.gov

VETERANS HEALTH ADMINISTRATION

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