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PTSD+Plus is a 12 week outpatient treatment program that meets for six hours per week (2 half-days). The half-days are planned for an afternoon followed by the following morning. This allows those from the Lower Mainland and the Central and North Island to attend with the need for only one night's hotel accommodation. The program was designed for those who have post-traumatic stress disorder (PTSD) due to combat/work-related trauma.

Recent research has determined that "exposure therapy", a specialized form of cognitive-behaviour therapy that includes adjusting harmful cognitions (thoughts) is the only form of therapy that is known to deal effectively with PTSD. PTSD+Plus has drawn extensively on this well researched cognitive/behavioural therapeutic approach, while at the same time recognizing the significant somatic component of PTSD. Thus, it incorporates motivational interviewing, solution-focused counseling approaches, exposure therapy, psycho-education, and empathic supportive counseling.

Goals of therapy include reducing PTSD symptoms, enhancing clients’ understanding of the relationship between PTSD and other disorders, and encouraging behavioural change so that clients are able to lead more adaptive and personally fulfilling lifestyles.

There are three phases of treatment. The first phase consists of assisting clients to explore more adaptive ways to cope with re-experiencing, avoidance, and hyperarousal symptoms without self-medicating with alcohol, other drugs, or other dysfunctional coping processes. This phase of treatment focuses on immediate symptom management and skills training.

The second phase of PTSD+Plus involves trauma processing, including identifying “hot cognitions” associated with each individual client’s trauma story. During this phase of treatment, clients examine how childhood experiences, underlying beliefs, family values, and military and/or police service expectations may have influenced their personal trauma responses.

An important and third component of the PTSD+Plus program is “Family Days”, when family members are given the opportunity to attend and learn more about PTSD and the other co-occurring disorders.

This group program integrates guidelines set out in other established group treatment programs for PTSD, including the New Directions and Transcend Programs developed at the Cleveland Veterans Administration Medical Center.

In summary, treatment includes the following three components: 1.An educational component whose goal is to help participants understand PTSD and its effects on their feelings, ways of thinking, and behaviour; 2.A skill building component aimed at helping participants learn new ways of managing their emotions, address avoidance, and improve relationships; and, 3.A psychotherapy component that allows participants to process traumatic memories (the exposure component), with the goal of helping them make meaning of and integrate their experiences and move forward.

The general criteria for successful outcomes of the program are those outlined in the Transcend Program, as listed below:

  • Reduction in the frequency of memories, nightmares, and flashbacks as well as in the intensity of distress/anxiety associated with re-experiencing of traumatic events;
  • Reduction in avoidance symptoms, with increased ability to remember traumatic events with appropriately intense feelings, rather than with detachment;
  • Ability to identify and endure emotional and physical arousal states without resorting to avoidance, isolation, numbing, or acting out behaviours;
  • Decreased tendency to distance and detach from others; •Increased trust, and a greater capacity to seek and provide emotional support;
  • Integration of the trauma in a way that allows for replacing guilt, shame, and a damaged sense of self with a renewed sense of meaning, purpose, and internal control.

PTSD+Plus Program