Global Treatment Issues for PTSD

Abstract

Before choosing any of the specific PTSD treatments (detailed in Chaps. 10.1007/978-3-319-15066-6_4 and 10.1007/978-3-319-15066-6_5), there are a number of general questions to consider. These include timing and priority issues related to treatment (e.g., psychiatric emergency, co-occurring substance use, and situational factors). Other therapeutic considerations include combining different approaches, how to treat PTSD when a comorbid disorder is also present, and the best strategies for very complicated patients. When developing a treatment plan, a major question is whether psychotherapy should focus on the details of the traumatic event itself (e.g., trauma-focused therapy), whether it should focus on here-and-now present-centered issues, or whether it should be primarily supportive in nature. Finally, major personal issues for clinicians treating PTSD are discussed such as therapeutic neutrality, advocacy, secondary traumatization, countertransference, and clinician self-care.