American Psychiatric Association (2013) defines PTSD (post-traumatic stress disorder) as a psychiatric disorder that can manifest itself in people that witnessed or experienced a traumatic event. What counts as a traumatic event is often contingent on individual perception. However, some of the most common categories of traumatic events include natural disasters, violent assaults, witnessing a murder, terrorist acts, and war or combat. The term became a household name not earlier than 1980 when it was included in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-lll) published by the American Psychiatric Association. Before that, the disorder was known as “shell shock” during World War I and “combat fatigue” following World War II. The history of studying the phenomenon in psychology and psychiatry is quite young; yet, there have already been developed multiple approaches to tackling the condition.
PTSD is a disorder that worsens a person’s quality of life with effects ranging from mildly disturbing to utterly disruptive and debilitating. American Psychiatric Association (2013) reports that PTSD patients suffer from intense negative thoughts and feelings about the traumatic event long after the situation has ended. It is not uncommon for PTSD patients to relive what happened to them through flashbacks and nightmares (American Psychiatric Association, 2013). They often experience a wide palette of negative emotions such as anger, fear, anxiety, and resentment. PTSD leaves a person detached from reality and estranged from other people, especially if specific events and individuals remind them of the traumatic event.
PTSD patients are difficult to treat because the disorder is largely a physiological response to trauma. In other words, the brain of a person with PTSD differs significantly from that of a healthy person. Since modern medicine has yet to reach yet another frontier and develop a neurological treatment for PTSD, at present, such patients are typically offered medication and therapy – group or individual. Levi et al. (2017) write that group therapy has not yet been recognized as a first-line treatment, even though some evidence suggests that group counseling can be both more efficacious and cost-effective.
Levi et al. (2017) advocate for a psychodynamic approach in the treatment of PTSD. As opposed to cognitive-behavior therapy, psychodynamic therapy focuses not on a person’s behavior but a patient’s unique perspective and mental and emotional interpretation of a problem. The study by Levi et al. (2017) demonstrated the effectiveness of one-year psychodynamic group therapy for veterans with PTSD. The results are suggestive of a tangible reduction in PTSD symptoms; apart from that, participants were reporting better day-to-day functioning and more hope in life.
Cognitive-behavioral therapy (CBT) is also widely used in treating PTSD symptoms. CBT is problem-based, short-term, and goal-oriented: it focuses on the problematic behaviors of an individual that do not allow them to improve their life situation. Haynes et al. (2016) explain that PTSD symptoms are disruptive to a person’s social rhythms: they have the potential of wreaking havoc on his or her circadian patterns. It is not uncommon for PTSD patients to suffer from insomnia or, conversely, increased sleepiness. Dysfunctional sleeping patterns lead to even more mood dysregulation, which locks up a person in a vicious circle. Haynes et al. (2016) studied the effects of Cognitive Behavioral Social Rhythm Therapy (CBSRT) that addresses a lack of daily routine and associated unhealthy behaviors. The study showed that daily routine was instrumental to recovery, and CBSRT proved to be an effective group therapy option.
There is not a single therapy that would work for any PTSD counseling group. Each group consists of individuals with unique needs and preferences that should inform the choice of a psychotherapeutic approach. Regardless of the chosen method, PTSD group therapy helps individuals feel understood as they receive the chance to meet people who have been through similar life events. To make group counseling even better, therapists should pay attention to the ethical consideration of PTSD treatment. American Counseling Association strongly recommends screening prospective group members so that none of them would impede or disrupt the group process. In group therapy, PTSD patients should be protected from physical and emotional trauma. Lastly, therapists need to strongly enforce the standards of confidentiality and communicate them to all participants.
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of mental disorders: Dsm-5. Amer Psychiatric Pub Incorporated.
Haynes, P. L., Kelly, M., Warner, L., Quan, S. F., Krakow, B., & Bootzin, R. R. (2016). Cognitive behavioral social rhythm group therapy for veterans with posttraumatic stress disorder, depression, and sleep disturbance: results from an open trial. Journal of Affective Disorders, 192, 234-243.
Levi, O., Shoval‐Zuckerman, Y., Fruchter, E., Bibi, A., Bar‐Haim, Y., & Wald, I. (2017). Benefits of a psychodynamic group therapy (PGT) model for treating veterans with PTSD. Journal of Clinical Psychology, 73(10), 1247-1258.