● Suicidal thoughts and feelings : Sometimes depression can lead to thoughts of suicide. If you or someone you know is having suicidal thoughts following a traumatic event, it is very important to consult a professional immediately and get help. ● Substance abuse : People with PTSD may, understandably, turn to alcohol or drugs—legal or illegal—to try to deaden their pain. However, inappropriate substance use greatly aggravates the symptoms and makes successful treatment difficult. Alcohol and drugs will make a bad situation much worse. ● Feelings of alienation and isolation : People with PTSD need support, but they often feel very alone and isolated by their experience and find it very difficult to reach out to others for help. They find it hard to believe that other people will be able to understand what they have gone through. They may also find it difficult to function socially. Relationships with partners, friends and family are difficult after a severe trauma. ● Anger and irritability : Anger and irritability are common reactions among trauma survivors. If you have been assaulted, anger is a natural and justified reaction. However, extreme anger can interfere with recovery and make it hard for a person to get along with others at home, at work, and in treatment. A survivor may express disproportionate anger about a minor issue—this can turn out to be displaced anger about the trauma. ● Severe impairment in daily functioning : Some people with PTSD have very severe problems functioning in simple day-to-day life. A person may lose their ability to do ordinary tasks that were formerly easy and may be unable to fulfill their previous obligations. ● Uncontrolled crying : Sometimes people cry a lot for a long period of time. The pure thought of the event, or any “triggers,” produces a deep grief that expresses itself through intense crying and even screaming. If your patient experiences any of the symptoms mentioned, they should be encouraged to consult a mental health professional or healthcare provider who is licensed and trained to diagnose PTSD. He or she can also inform you about strategies to address your symptoms. Having knowledge of these signs and symptoms can help you address anything that may arise during a treatment session, while then being able to take the proper course of action to best meet the client’s needs. If a patient begins to cry and becomes emotional during a treatment, you can stop whatever interventions you are performing but maintain a physical connection with the client. A hand of their back or maintaining pressure can assure the client that you are there, and they are safe to feel their emotions. You can verbally ask if they would like to continue the session or offer them a tissue. Sometimes, patients can benefit from a few minutes alone in the room if they would like. Verbally assure them that they are in a safe space to cry, and that it is perfectly normal for emotions to come out in a treatment. If someone begins to have disassociation or a flash back, it is important that you stop physical touch and any interventions immediately. Give the person space and try Flashbacks and dissociation While more uncommon, flashbacks and dissociation are one of the more severe symptoms that can occur during a treatment, and therapists should be prepared to handle these situations appropriately. Given the sometimes violent history of their trauma, it is understandable that even subtle things—an odor, a photo, or a touch—can trigger explosive emotional releases in individuals (e.g., combat veterans), leading to possible rage or violence toward an inappropriate
to connect with them verbally. Ask the client what they are seeing and reassure them of where they are and that they are safe. Dealing with someone who is having a flashback and bringing them out of it requires extensive psychotherapy training and is generally outside our scope of practice for rehabilitation professionals. However, if this occurs during a therapy session, make sure to give the patient space and assure them they are safe. Ensure you can alert a coworker or trusted person in case of a violent outburst, which is a possibility if the patient is not present or aware of their surroundings. During the flashback you may also: ● Remind the client who he or she is and where both of you are at the moment. ● Have the client open his or her eyes and describe what he or she sees. ● Have the client shift to a different position (sitting instead of lying down). ● Remind him or her that this is a memory, but is not actually occurring, and that it will pass momentarily. After the flashback, offer water, sit, and give the client time to talk about what happened if they need to. Refer them to a psychotherapist if they are not already seeing them and ask permission to make future treatment plans in accordance with their recommendations. You can help a patient avoid a flashback or disassociation by: ● Using the client’s name. ● Helping them to stay connected by asking, for example, “Are you able to hear me? Is this okay?” ● Engaging the client in what is being done in each part of the process (e.g., what you are doing and why), rather than in talk that distracts from what you are doing. Other considerations you can take with intake or treatment of a client with PTSD can include: ● Involve the survivor in the plan of care and review treatment approaches before initiating. This will help open a line of communication with the client and provide the therapist with an understanding of any possible triggers. ● Provide a checklist that helps patients identify which concerns they have about the encounter (e.g., discomfort with certain procedures, boundary issues and others). ● Ask patients for ideas to make the procedure more comfortable (e.g., specific signals to stop or have a time out). ● Start with a straightforward procedure with patients, especially those who are hesitant to participate in therapies due to their diagnosis. ● Let the patient know that they can stop the procedure or exam at any time if they find it too uncomfortable, which shows that you will respect the client’s wishes and limitations. ● Adjust the set-up of treatment to enable the patient to be in a favorable position (i.e., sitting vs. laying). This may help them feel more empowered and enables visual contact to be maintained. target. Powerful outbursts during a session can be very uncomfortable, distressing, and even dangerous for the client and the practitioner. Flashbacks can cause patients to feel flooded by horrifying images or terrifying feelings. They may dissociate, removing them mentally from the current time and place. They may curl up in a ball, scream, tremble, or become violent.
Page 3
Book Code: MLA1225
EliteLearning.com/Massage-Therapists
Powered by FlippingBook