Crisis Counseling: Acute Stress, Grief, & Trauma CTCO 303 ... · PDF file B. Suicide Risk...

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Transcript of Crisis Counseling: Acute Stress, Grief, & Trauma CTCO 303 ... · PDF file B. Suicide Risk...

  • Crisis Counseling: Acute Stress, Grief, & Trauma 1

    Light University Online

    Crisis Counseling: Acute Stress, Grief, & Trauma

    CTCO 303

    Module 2

  • Crisis Counseling: Acute Stress, Grief, & Trauma 2

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    Module Two

    Table of Contents

    Anxiety and Depression Archibald Hart, Ph.D. ................................................................................................................................................... 3

    Trauma and Attachment Gary Sibcy, Ph.D. ........................................................................................................................................................ 11

    Counseling Strategies Panel Eric Scalise, Ph.D., Jennifer Cisney, M.A., & Kevin Ellers, D.Min. ............................................................. 18

    FOCUSED STRATEGIES

  • Crisis Counseling: Acute Stress, Grief, & Trauma 3

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    Description This lesson focuses on how Post-Traumatic Stress Disorder creates anxiety and depression. Dr. Hart discusses definitions of terms, the prevalence of different types of trauma, risk signs, significant statistics, and prevention and intervention strategies that helpers can utilize. Students will learn the connection between PTSD and anxiety and depression problems, and they will become more educated on how those problems can be prevented and/or treated

    Learning Objectives:

    1. Understand how trauma, stress, and depression/anxiety relate in sufferers of PTSD.

    2. Identify what it is about trauma that puts people at risk for developing

    depression and/or anxiety problems.

    3. Be able to explain prevention and intervention strategies regarding the depression and anxiety components of PTSD.

    ANXIETY AND DEPRESSION

    VIDEO

    Archibald Hart, Ph.D.

  • Crisis Counseling: Acute Stress, Grief, & Trauma 4

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    I. How Do Trauma, Stress, and Depression Relate?

    A. PTSD, depression, and anxiety disorder frequently follow traumatic exposure – both separately and concurrently.

    B. In the immediate aftermath (acute PTSD), they appear to be separate disorders.

    C. In chronic PTSD, they become comorbid. II. Prevalence of Types of Trauma

    A. Assault – 38%

    B. Serious Car Accidents – 28%

    C. Other Accidents or Injury – 14%

    D. Fire, Flood, Earthquakes – 17%

  • Crisis Counseling: Acute Stress, Grief, & Trauma 5

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    E. Life Threatening Illness – 5%

    F. Sudden Death of Friend/Family Member – 60%

    G. Learning About Other’s Trauma – 60%

    H. War - ??? III. Risks of Developing Depression/Anxiety Problems Following PTSD

    A. Traumatic stress is far more powerful and serious than ordinary day-to-day stress.

    B. PTSD sufferers experience twice the risk for major depression and anxiety disorders.

    C. Preexisting depression and traumatic childhood memories are two risk factors that will exacerbate the effects of trauma.

  • Crisis Counseling: Acute Stress, Grief, & Trauma 6

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    IV. Anxiety Orders Triggered by PTSD

    A. Panic Attacks

    B. Agoraphobia

    C. Other Phobias

    D. Obsessive Compulsive Disorder

    E. General Anxiety Disorders

    F. Separation Anxiety V. Depression Disorders Triggered by PTSD

    A. Major Depression

    B. Unstable Mood Disorder

    C. Bipolar Disorder/Manic Episodes

  • Crisis Counseling: Acute Stress, Grief, & Trauma 7

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    VI. Definitions

    A. Endogenous Anxiety or Depression – Anxiety or depression “from within” which is primarily biochemical

    B. Exogenous Anxiety or Depression – Anxiety or depression “from without” which is brought on due to life circumstances

    VII. Neurobiology of Mood Disorders

    A. The Trauma Triangle  Prefrontal Cortex – Orchestrates thoughts and actions with internal goals; takes

    control of emotions  Amygdala – Primary role in the processing and memory of emotional reactions,

    especially fear  Hippocampus – Vital to emotional arousal and the formation of long-term

    memories

    B. Cortisol  One of the stress hormones released by the adrenal system  The surge of cortisol creates the effects in the Trauma Triangle that then leads to

    depression or anxiety

    VIII. Statistics

    A. Major Depression and PTSD occur together early on after the trauma in 30% (PTSD at 1 month)

  • Crisis Counseling: Acute Stress, Grief, & Trauma 8

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    B. 17.5% had PTSD at 4 months

    C. 45% of PTSD patients had comorbid depression at 4 months

    D. When depression and PTSD are comorbid, symptom severity was more severe overall. They interact to increase distress.

    IX. Risk Factors

    A. Risk Factors for Developing Serious Depression and Anxiety Following Trauma  Preexisting morbidity  Lack of social/environmental support  Prolongation of traumatic stress  Lack of coping skills, helplessness  Antisocial or borderline personality traits

    B. Suicide Risk in PTSD-Related Depression  Amongst combat soldiers, suicide rate is the highest it has ever been  Suicide is seen as a coping mechanism  Risk Factors:

    1. Male

    2. alcohol use 3. abuse 4. family history of suicide

  • Crisis Counseling: Acute Stress, Grief, & Trauma 9

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    5. poor social environment 6. history of attempting suicide

     Combat Trauma Risk Factors

    1. multiple wounding 2. extreme guilt reaction 3. loss of close friend 4. sense of hopelessness

    X. Clinical Intervention

    A. Reduce the Cortisol Stress Response

    B. Long-term SSRI’s to Counter Hippocampal Atrophy

    C. Cognitive Behavioral Therapy

    D. Relaxation and Meditation

    E. Targeted Family Interventions

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    Study Questions

    1. Discuss the different types of trauma and their prevalence. Are any of these surprising; if so, which ones?

    2. What are some factors that could worsen trauma within a sufferer of PTSD?

    3. Define “endogenous anxiety or depression” and “exogenous anxiety or depression.” Why is understanding these definitions important when examining people displaying symptoms of PTSD?

    4. Discuss the Trauma Triangle, and the importance of the prefrontal cortex, the amygdala, and the hippocampus.

    5. Discuss the clinical and biblical interventions that were mentioned by Dr. Hart.

  • Crisis Counseling: Acute Stress, Grief, & Trauma 11

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    Description In this lesson, Dr. Sibcy discusses the attachment theory and how it relates to trauma. Attachment is a theory of relationships and emotion, with safety being a key component in understanding problems. Dr. Sibcy teaches students how to apply the attachment theory to trauma situations, and students will learn to better understand the correlation between trauma and how people do relationships.

    Learning Objectives:

    1. Better understand the five components of the attachment system. 2. Be able to explain the four attachment styles that people can have, and

    what each of the styles mean regarding how people act in relationships.

    3. Know how attachment styles relate to trauma, PTSD, as well as understanding the components of effective therapies counselors can utilize.

    TRAUMA AND ATTACHMENT

    VIDEO

    Gary Sibcy, Ph.D.

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    I. What is Attachment?

    A. Attachment is a theory of relationships and emotion, where safety is a key component in understanding problems.

    B. Affect Regulation – how people learn to deal with their deepest ad strongest emotions.

    C. Two sets of beliefs develop from interactions with the attachment figure: beliefs about self and beliefs about others.

    II. Five Components of the Attachment System

    A. A caregiver’s response to a child in distress affects that child’s underlying beliefs about trust.

    B. A caregiver is a “secure base” or “safe haven” for a child.

    C. Secure Base Phenomena – when children feel calm and secure, they feel free to explore the world.

  • Crisis Counseling: Acute Stress, Grief, & Trauma 13

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    D. Separation leads to anxiety and anger.

    E. Loss of attachment figure leads to intense grief and a sense of not wa