Post-Traumatic Stress Disorder (PTSD) Assessment and Therapy Techniques

What is post-traumatic stress disorder?

Post-traumatic stress disorder (PTSD) is a mental health condition that develops after a stressful, frightening or life-changing negative experience. This could include witnessing an act of violence, experiencing abuse, the death of a loved one, or living through a disaster or accident.

People who experience a traumatic event may have difficulties coping, and may need a period of time for recovery—that’s completely normal. However, if symptoms worsen or linger for months, that may be a signal it’s PTSD. Sometimes, symptoms don’t even start until years after an event. 

Assessing and diagnosing PTSD can be challenging, as symptoms can vary widely from person to person. However, there are standardized assessments that mental health professionals use to diagnose PTSD. In Canada, mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria to diagnose PTSD. This standardized assessment allows for accurate assessment and diagnosis of PTSD, ensuring that individuals receive the appropriate care and treatment they need.

Key Takeaways

• PTSD is a mental health condition that can develop after someone experiences or witnesses a traumatic event.
• Understanding PTSD and its symptoms is crucial in managing PTSD.
• Mental health professionals in Canada use standardized assessments to diagnose PTSD, ensuring that individuals receive the appropriate care and treatment they need.

Understanding PTSD

Post-traumatic Stress Disorder (PTSD) is a mental health disorder that can develop after experiencing or witnessing a traumatic event. PTSD can affect anyone, regardless of age, gender, or background. In this section, we will explore the symptoms and manifestations of PTSD, its causes and triggers, prevalence in different groups, comorbidity and related disorders, PTSD and the pandemic, and the impact on loved ones.

Symptoms and Manifestations

Symptoms associated with what we now know to be PTSD have been documented throughout history, from ancient Greek battles to Shakespeare to the Civil War. The mental health of veterans after WWI—a condition known as shellshock—pushed PTSD into a modern mental health understanding.

PTSD symptoms can manifest in various ways and can be different for each person. Some common symptoms include numbness, anxiety, flashbacks, nightmares, depression, avoidance, irritability, and dissociation. Intrusive thoughts, memories, and feelings related to the traumatic event can also occur.

Symptoms of PTSD fall into some common categories:

• “Re-experiencing” or intrusive memories: flashbacks, upsetting dreams or nightmares about the event, emotional or physical reactions (triggers) to something that reminds you of the event.
  
  
• Avoidance: avoiding people or places that might remind you of the event, trying to avoid feelings associated with the event. Sometimes this causes people to drastically change their routines, such as avoiding driving altogether after a car accident.
  
  
• Arousal: feeling constantly on edge, being startled easily, irritability that lingers, self-harming or numbing coping choices like drugs or alcohol, difficulty sleeping or concentrating.
  
  
• Cognitive (thinking) and mood changes: distorted or unfair feelings of guilt or blame, negative feelings about yourself or the world, feeling emotionally numb or difficulty feeling joy, feeling detached from family/friends or difficulties maintaining close relationships.

These four symptom areas are defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) that licensed mental health professionals use to diagnose disorders.

Typically, a therapist or medical professional will check if these symptoms are persisting for at least a month. Children may also experience PTSD, and their symptoms could include reenacting the event through play, frightening and disruptive nightmares, being clingy, forgetting developmental skills like toilet training or speaking.

Causes and Triggers

PTSD can be caused by a variety of traumatic events, including death, serious injury, sexual violence, natural disasters, accidents, conflict, childhood trauma, and moral injury. Learning about the traumatic event happening to someone close to you can also trigger PTSD.

Prevalence in Different Groups

PTSD can affect anyone, but some groups are at higher risk, including military personnel and veterans, women, and individuals who have experienced childhood trauma or neglect. According to a study, the prevalence of PTSD among Canadian peacekeepers was 8.2% (Assessment of PTSD in older veterans: The posttraumatic stress disorder checklist: Military version (PCL-M)).

Comorbidity and Related Disorders

PTSD often occurs with other mental health disorders, such as anxiety disorder, depression, and substance use disorder. The impairment caused by PTSD can also lead to difficulties in daily life, including work and relationships. Stigma surrounding mental illness can also make it challenging for individuals to seek help.

Assessment

If you’re experiencing symptoms associated with PTSD, you may seek treatment yourself, or be prescribed medication or therapy (or both) from a medical professional. A therapist will run a screening assessment by asking a series of questions associated with the four symptom groupings listed above, and questions about your personal history. 

If a certain number of these symptoms are met, it may lead to a PTSD diagnosis. Everyone is different and everyone’s experiences are different. If symptoms of PTSD are due to an ongoing trauma, like abuse, there may also be symptoms of depression, anxiety, or other mental health conditions present, which could be diagnosed or addressed in treatment as well. 

Clinical Presentation and Diagnosis

The clinical presentation of PTSD can vary from person to person. Some common symptoms of PTSD include intrusive thoughts, avoidance, negative changes in mood and cognition, and hyperarousal. The diagnosis of PTSD is based on the DSM-5 criteria, which require the presence of specific symptoms for at least one month.

In conclusion, PTSD assessment and diagnosis are crucial for identifying and treating individuals who are experiencing distress due to trauma and stressor-related disorders. If you are experiencing symptoms of PTSD, it is important to seek the support of a healthcare professional who can provide an accurate diagnosis and appropriate treatment.

Treatment

People with PTSD can benefit from a holistic approach to therapy, meaning the therapist will look at the full picture of these symptoms. For example, someone who is experiencing abuse may need tools and resources to remove themselves from that environment before addressing the repercussions of that experience. 

While some patients may be prescribed medication, many patients are treated very effectively with various modalities of psychotherapy, such as cognitive behavioural therapy (CBT). CBT addresses distorted thinking and helps us build healthier connections between our thoughts, emotions and behaviours. 

Some people may benefit from a form of CBT called prolonged exposure (PE). This treatment specifically targets avoidance, guiding patients through confronting the memories and therefore diffusing their fear of them. This helps people learn there is no current danger present.

There are also somatic therapies (body-focused) that have shown promise for treating symptoms of PTSD, such as eye movement desensitization and reprocessing (EMDR). A therapist will guide a patient through recalling the traumatic memory while they move an object in front of their eyes. By following those eye movements while addressing the memory, the brain creates new neurological connections to the memory and we can better cope or process that trauma in the present moment. 

People suffering from PTSD may have thoughts of suicide or death. If you or someone you know may be in danger of self harm or suicide, please get help. Call 911 for emergencies or contact the Canada Suicide Prevention Service hotline at 1-833-456-4566 (24/7) or text 45645 (4pm to 12am ET). 

Support Resources and Programs

There are many support resources and programs available to those with PTSD in Canada. The Canadian Mental Health Association and Veterans Affairs Canada both offer mental health support services, including counseling and education on coping strategies. Crisis hotlines such as the Canada Suicide Prevention Service and Kids Help Phone are available 24/7 for those in need of immediate assistance.

Workplace Accommodations and Policies

Many workplaces have policies and accommodations in place to support employees with mental health conditions such as PTSD. This may include flexible work arrangements, accommodations for triggers or flashbacks, and mental health support services. It is important to familiarize yourself with your workplace's policies and to communicate any needs or concerns with your employer.

Government Initiatives

The Government of Canada has implemented a Federal Framework on Post-traumatic Stress Disorder to help reduce stigma and improve access to treatment and support for those with PTSD. This framework includes initiatives such as increased funding for research and improved access to mental health services for veterans and their families.

New Wave Therapy Approaches - Psychedelic-Assisted Therapy and Virtual Reality Exposure Therapy 

Psychedelic-Assisted Therapy

In recent years, there has been growing interest in the use of psychedelic-assisted therapies for the treatment of mental health disorders such as PTSD. In Canada, there has been a shift towards more trauma-informed care, and psychedelic-assisted therapies have the potential to play a role in this approach.

One example of this is the use of MDMA-assisted therapy for the treatment of PTSD. Health Canada has recently granted permission for a number of clinical trials to take place, with the aim of assessing the safety and efficacy of this treatment. Preliminary results have been promising, with some participants reporting significant reductions in symptoms of PTSD.

However, there are still many questions that need to be answered before psychedelic-assisted therapies can become a mainstream treatment option. For example, it is important to ensure that these therapies are delivered in a safe and controlled environment, and that patients are carefully screened to ensure that they are suitable candidates for treatment.

In addition, there are important policy considerations that need to be taken into account. For example, there is currently a lack of clarity around the legal status of psychedelic substances, which can make it difficult for researchers and clinicians to access these treatments. There is also a need to ensure that these therapies are accessible to all Canadians, including those who may not have the financial resources to pay for private treatment.

Virtual Reality Exposure Therapy  

Virtual Reality Exposure Therapy is a form of exposure therapy that uses VR to help people decrease stress responses to anxiety or fear triggers. Individuals are exposed to their PTSD triggers in a safe environment. VRET can simulate real-life experiences that are difficult to recreate, like military combat or severe motor accidents.

In summary, there are various treatment and management options available for those with PTSD in Canada. It is important to work closely with a healthcare professional to determine the best course of treatment for you and to take advantage of the many support resources and programs available. Additionally, it is important to familiarize yourself with workplace policies and to advocate for yourself when necessary.

Find therapists who specialize in trauma on First Session.

Frequently Asked Questions

What are the available assessments for PTSD diagnosis in Canada?

There are several assessments available for PTSD diagnosis in Canada. The most common ones are the Clinician-Administered PTSD Scale (CAPS), the PTSD Checklist (PCL), and the Structured Clinical Interview for DSM-5 (SCID-5). These assessments are administered by qualified mental health professionals, such as psychologists, psychiatrists, and social workers.

What is the process to get assessed for PTSD in Canada?

To get assessed for PTSD in Canada, you need to first consult with your family doctor or a mental health professional. They will conduct a preliminary assessment and refer you to a specialist if necessary. The specialist will then conduct a comprehensive assessment using one of the available assessments. If you are diagnosed with PTSD, you may be eligible for disability benefits.

What are the criteria for receiving PTSD disability benefits in Canada?

To be eligible for PTSD disability benefits in Canada, you need to have a diagnosed mental health condition that is preventing you from working. You also need to have contributed to the Canada Pension Plan (CPP) for a certain number of years. The amount of benefits you receive will depend on your contributions and the severity of your condition.

What are the statistics on PTSD in Canada?

According to a study published in the Journal of Traumatic Stress, the lifetime prevalence of PTSD in Canada is approximately 9.2%. The study also found that women are more likely to develop PTSD than men, and that the risk of developing PTSD increases with exposure to trauma.

Are there any free PTSD assessment tools available in Canada?

Yes, there are some free PTSD assessment tools available in Canada. For example, the PTSD Coach Canada app provides self-assessment tools and resources for individuals with PTSD. However, it is important to note that these tools should not replace a professional diagnosis and assessment.