Episode 244 - Dr. Julian Ford: New Perspectives on Complex Posttraumatic Stress Disorder (PTSD) and Its Treatment

Monday, July 30, 2018, 7:54:14 AM

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In this episode, our guest Dr. Julian Ford describes assessment with trauma survivors and evidence-based treatment options for PTSD. He discusses strategies that can be incorporated by clinicians at critical turning points in therapy, matching treatment modalities with clients and personal styles, and mitigating secondary PTSD.

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Average Rating: 4.8 stars (5 listener reviews )

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Average Rating: 4stars  differences between dsm v and previous editions, Friday, January 31, 2020

By Dean :

I believe that Dr. Ford did a nice job of delineating some of the major changes that differentiate the DSM V from previous editions of the DSM. He made a good point regarding how clinicians may conceptualize trauma and stress differently as these terms are frequently used interchangeably and the diagnosis of complex Post-traumatic-stress-disorder (PTSD) may be ambiguous at times. Dr. Ford also made some of the important changes made between the DSM V and previous versions of the DSM more transparent such as the fact that post-traumatic stress is much more common than previously thought, and that women are much more likely then men to meet diagnostic criteria for complex PTSD as a result of women having a much higher probability of having been sexually abused as children and experiencing higher incidence of interpersonal relationship violence. Other significant changes in the DSM V include that PTSD is no longer classified as an anxiety disorder but rather is considered a trauma and stress related condition. Another paradigm shift is that in previous editions of the DSM, in order to meet diagnostic criteria for PTSD, one was expected to experience fear, helplessness or horror that was related to the trauma. Clinicians who frequently work with trauma survivors argue that the conditions are not always met. Dr. Ford expounded the example of a child who had been sexually abused as a child and whose abuser who practiced what is referred to as grooming behaviors with a child in an attempt to make the child feel special in some way by showering them with gifts may cause a child to not experience fear, helplessness, or horror but this is not to say that the trauma will be any less distressing despite the absence of this criteria. I have to say that I really enjoyed this podcast and Dr. Ford is very knowledgeable regarding changes to the DSM V.

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Average Rating: 5stars  review, Sunday, February 10, 2019

By Anon :

As a novice clinician, I found Dr. Ford’s interview on complex PTSD and assessment of trauma survivors illuminating, informative and inspiring. It was helpful to have an overview of the diagnosis of PTSD and how the criteria morphed from the DSM-IV to DSM-V. It seems that the change in criterion has revealed the severity and chronicity of PTSD. Dr. Ford was fantastic at providing an overview of evidence-based practice for the treatment of PTSD. I especially appreciated his discussion matching the use of the appropriate evidenced-based practice. Dr. Ford recognized that clinicians may have a personal style and therefore predilection for a specific approach. However, he does make an important note “one size fits all” approach to trauma therapy is not advantageous in the treatment of trauma survivors. In fact, he states that clinicians should be client-centered and allow the client’s needs to be a guiding force for choosing the appropriate practice strategy. Dr. Ford also discusses the importance of ensuring a holding space for clients as they process difficult feelings. I appreciate that Dr. Ford humanizes the internal response of clinicians. There is a perception that a clinician is unflappable and that only new social workers have a visceral response when rendering services. It was helpful to hear that even tenured clinicians become flustered but recognition of this allows one to regroup so that so that he/she can continue to be present for the client. Finally, Dr. Ford discusses strategies for mitigating secondary trauma which he believes is unavoidable. I appreciate his suggestion about the importance of self-care and consulting with colleagues to examine one’s reactions.

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Average Rating: 5stars  enlightening exploration of ptsd, Wednesday, February 06, 2019

By Kandis LeBaron :

Dr. Ford presents an explicit exploration of Post Traumatic Stress Disorder (PTSD). The narrator begins by bringing forth the history as PTSD first entered into the DSM IV then leads into the updates in the DSM V as more information of the diagnosis was revealed. Not only does the podcast cover the foundation information of PTSD but it probes into groundbreaking new perspectives in the assessing and treatment process. As Dr. Ford transitioned into the different treatment modalities, it became clear the importance of clinicians continuously searching out treatment options as well as how research brings forth progression and new modalities. This concept of continuously fine-tuning therapeutic treatment is especially important when hearing Dr. Ford explain there is no medication remedy possible at this point, and most likely will never be an option. The podcast reviewed areas of PTSD but then dove deeper, deciphering the difference and similarities of an adult to children’s PTSD. As a child welfare worker, the information regarding the new research in children’s PTSD was fascinating and exciting. The perspective in the podcast covered the effects PTSD has on the clients and the struggles faced by a therapist in treatment. I especially liked his thoughts regarding the therapist-client relationship during treatment and the uniqueness of PTSD treatment, are moments that it is appropriate as a clinician to offer no therapeutic technique and instead, be a calming source with the client and offer support. Looking forward to hearing more from Dr. Ford.

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Average Rating: 5stars  misperceptions of ptsd, Saturday, February 02, 2019

By Anonymous :

As a first year MSW student, I found this podcast very informative. I have heard of the effectiveness of CPT and CBT in relation to PTSD, however I had no idea there were so many other methodologies to treating PTSD. I was particularly impressed with the fact that Dr. Jones stresses that treatment for Trauma should be based on each individual client’s experience and which approach will work best with that particular client. This is one of the reasons I agree that there should be a diagnosis of Developmental Trauma Disorder separate from a PTSD diagnosis. Although the diagnosis is not the important factor, I think that PTSD has become somewhat “loaded” with a preconceived notion that there was a specific event (related to combat or rape) and the diagnosis is almost portrayed as a “badge of honor” in the media in that it conveys a harrowing life event. I believe that this glorification can lead to many Trauma patients feeling that their experience is not qualified as PTSD or a belief that they have not “earned” that diagnosis. I am glad that Dr. Jones and Mickey Sperlich have discussed this fact in the podcast and I think that we need to be having more of a national discussion about this reality. If a person experiencing lifelong trauma symptoms is not aware that what they experience is indeed a form of PTSD, they may not be informed enough to choose a clinician that can recognize their specific treatment needs. I think that a separate diagnosis might help speed this knowledge along by specifying the distinction between lifelong trauma and acute traumatic experiences.

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Average Rating: 5stars  ptsd symptoms, assessment, and treatment can be complex in multiple ways, Thursday, January 31, 2019

By Meschelle Linjean :

Having the background information precede the interview was very helpful in contextualizing the discussion. I appreciated Dr. Sperlich’s overview of changes in the DSM regarding PTSD and in the conceptualization of PTSD in general, as well as the difficulties in PTSD diagnosis when there are comorbidities, avoidance, or self-medicating. I am not convinced that the dissociative and preschool subtypes of PTSD in the DSM-V adequately replace the concept of DESNOS and believe that the concept of Developmental Trauma Disorder should become a recognized diagnosis because of the reasons Dr. Ford addressed, with children being misdiagnosed with ODD or ADHD (and then receiving inappropriate or even harmful treatment). I think the enduring repercussions of developmental trauma often go unrecognized or misdiagnosed in adults as well, leading to inappropriate treatment and development trauma should be considered no matter the client’s age. The distinction Dr. Ford made between trauma processing and trauma memory processing was new to me, and something I will now explore further. It seems that trauma processing, and therapies such as Emotion-focused trauma therapy and STAIR, which focus on how a person reacts to their world and others as a result of their traumatic experiences is every bit as important as trauma memory processing. The discussion made me wonder if trauma processing alone, without trauma memory processing, would be effective for clients who are not haunted by traumatic memories but have developed a survival-orientation and poor interpersonal skills as a result of trauma. The discussion on critical turning points, which might involve suicidal ideation or self-harm and be shocking or distressing for the clinician, was very important. Stepping back to regroup and consider what the client is trying to make sense of or achieve, while assuring him or her of your continued presence, can allow a breakthrough for client understanding of what they’re capable of.

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