Post-Traumatic Stress Disorder (PTSD)

PTSD and Trauma

Diagnosis for PTSD:

Criteria includes the following factors (after experiencing a trauma directly or indirectly):

Re-experiencing Repeated, intrusive, and unwanted memories, nightmares, flashbacks
AvoidancePersistently staying clear of trauma memories and reminders – people, places, sights, smells, sounds, music
Changes in thinking or emotionsOverly negative beliefs about self, others, world, exaggerated blame of self or others, difficulty experiencing positive mood, isolating
Changes in arousal or reactivityOverly alert, easily startled, on guard, difficulty concentrating or sleeping, irritability or aggression, risky behavior
Associated concerns: anxiety, mood problems, addictions. The criteria above is for six years and older – there is a subtype for preschool aged PTSD diagnosis

Treatment for PTSD Symptoms:

Prolonged Exposure (PE) is a leading evidence based therapy to treat trauma.  

DBT-PE is adapted from PE and used to treat trauma in combination with suicidal/self-harming symptoms, multiple diagnoses, and specifically while a person is in DBT.

It is helpful to seek treatment when: the symptoms have lasted for more than a month.

PE / DBT-PE can be completed in: 12 sessions on average.  Outcomes are most effective when participating in all the procedures of DBT-PE (in vivo and imaginal exposures and processing).

Other treatments for PTSD:  EMDR, Cognitive Processing Therapy, Behavior Activation has some evidence of change in PTSD


How does Exposure Therapy Work for PTSD?:

Rumi Trama Quote 1 | Wise Mind Counseling

How does PTSD develop?: To understand how exposure therapy works, it’s important to understand PTSD and what causes and maintains the diagnosis. Avoiding people, places, memories, thoughts, and feelings are all reasonable responses to a painful event, a trauma.  These patterns of avoidance are not effective long term solutions and are at the root of the disorder. 

What are the patterns of avoidance in PTSD?: People with PTSD can develop a lifestyle of avoidance, but there are two specific types of avoidance that occur after a trauma.  One type is avoiding things in the environment related to the trauma (people, places).  The other type is avoiding the trauma story (memories, feelings, thoughts).  

How does DBT-PE help?: It is designed to support clients in approaching trauma reminders that have been avoided, that are creating misery in life, and the person wants to stop avoiding. Exposure therapy allows people to experience the trauma reminders, emotions and thoughts in order to learn how to effectively cope with them. 

After exposure practices, the therapist and client explore what was learned. The goal of this processing is to gain new learning different from trauma beliefs that developed and are interfering in life, to reduce anxiety, and to build mastery over emotions. 

Treating PTSD wtih DBT-PE by Kim Marohl

DBT-PE Trained at Wise Mind Counseling:

Kim has advanced training in DBT-PE from the creator of the treatment, Dr. Melanie Harned. Kim also participates in ongoing training and consultations to increase competency and provide the most effective trauma treatment. 


Resources for PTSD and Trauma:

Why Start Trauma Therapy Today: 
Trauma CTA Image | Wise Mind Counseling
  • 30% of individuals with PTSD attempt suicide. 
  • Untreated trauma further increases the risk of life threatening concerns.  Adding the DBT PE protocol to DBT is likely to decrease the risk of suicidal and self-injurious behaviors. 
  • DBT-PE is a very safe therapy and has been proven to be effective at reducing emotional distress.
  • American Psychological Association says “untreated PTSD from any trauma is unlikely to disappear and can contribute to chronic pain, depression, drug and alcohol abuse and sleep problems that impede a person’s ability to work and interact with others.
  • Treatment can help prevent other trauma symptoms, including pandemic PTSD. 
  • Among those that have completed DBT-PE, recovery rates were 60-100% across people with multiple diagnoses and problems.
  • Data shows that people prefer DBT-PE versus DBT or PE alone.