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C-PTSD Psycho-ed/Emotion regulation group by Mind Map: C-PTSD Psycho-ed/Emotion regulation group
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C-PTSD Psycho-ed/Emotion regulation group

Prepare Information Meeting

Facilitation Plan

Get refreshments

Sort materials/info to be printed

including practical details leaflet

Decide on dates and duration of course

Points for education programme

Structure of each session

Recap of aims of programme, including ground rules, 5 mins

Recap of last week, including questions etc, 10 mins

Education session, teaching, exercise, 25 mins

break, 10mins

Emotional regulation, recap, teaching, practice, 25 mins

Feedback?, 5 mins

Information Meeting

Preparation, Flip chart, Kate G?, Board pens, Outcome measures, PCL's, Not for info group, Group register, Of all invited, Information leaflets about, PTSD, The psycho-ed group, Refreshments, fruit juice, paper cups, biscuits

Introduction, Suggested Rationale for Group, Something that we will be creating with them, Need some outcome measurement, Before?, Knowledge of PTSD, Has anyone talked to them about it?, Have they been to any courses., PTSD symptoms, HTQ, get from Enfield, PCL?, What would they like to find out about PTSD?, aims of group, aims of information meeting, not a therapy group, Issues of trust, no need to speak if don't want to, respect that, Ground rules based around respect, Will come back to them

Introductions to each other, just going round saying names

Exercise about what they would like to find out about in the meeting today, not Partner work, write down things they would like to find out about, Flip chart, group discussion, for those able to

Break for drink and biscuits

What we are planning to cover in group programme, up on flip chart

Ground rules, write ground rules for group, Rules, Respect for others experience, Don't have to agree, But that is their experience, If not able to come please let us know, Please come on time, Room will be open beforehand, It is disturbing to others if you come in late, And more difficult for you to get the most out of the group as well, on flip chart, Add others suggested

General Learning Points

Use different modalities, talking, showing, doing

Distinguish, Objective, Threat, then!, Subjective, Fear, now!, Coming to terms with what has happened, shame, disbelief, anger, sadness, unfairness, Individual differences

1. What is PTSD? - Overview

Rexperiencing, intrusive, thoughts, memories, images, 'flashbacks', reexperiencing, dreams

Avoidance and Numbing, avoidance of reminders, emotional numbing, dissociation

Hyperarousal, difficulty concentratin, outbursts of anger, sleep disturbance, hypervigilance, exagerated startle resonce

could go through PCL as an introduction to diagnosis, Initial exercise, go through together, people fill out privately, hand in at end, do in 1st session, After discussion, work in 2/3's, put cut out PCL questions onto PTSD dimensions, Materials, cut out questions, A4 sheet with dimensions on

2. PTSD as a disorder of memory

what are memories made of?

What hasn't happened in PTSD

What needs to happen?

memory dysfunction in PTSD, explicit, implicity, disruption of normal memory formation in trauma

3. PTSD as an inappropriate fear response

from 1st group they would like

something on PTSD and how it effects the brain

information about PTSD treatments

Working on now

Physiology - PTSD and the Brain, PTSD as a chronic physical illness, see Allen (2001), Chapter 6, Could go over the neurological foundations of trauma reactions, Amygdala and Hippocampus

information about PTSD treatments

Follow up and feedback session

4. PTSD - Avoidance and Grounding

Avoidance, What do you do to avoid, Pros of avoidance, Cons of avoidance, No chance to process the memory properly

Grounding Techniques, Rachel to prepare

5. Physiology - PTSD and the Brain

6. Information about PTSD treatments

7. Review and feedback session

Background to development of PTSD

Teaching - brief overview, Past experiences, 'stress pile up', Lack of strengthening early experiences, Sensitised nervous system, Trauma with links to earlier traumas, Overwhelming emotional experiences, Unbearably painful emotional states, Incomplete trauma memories, Attempts to emotionally cope, Destructive actions, Aggression, Violence, Aggression, Self destructive actions, Drinking/drugs, Self harm, Isolation, Dissociation, Cutting off from others, Depression

Exercise, re. what would be especially helpful to have later sessions on

Concentrate on particular symptoms in following sessions?

normal course of PTSD

peritraumatic symptoms

acute stress disorder, dissociative, & re-experiencing symptoms, for up to 3 months

PTSD, after 3 months, symptoms tend to subsist if still prominent after 3-4 months, but do continue to decline over time

Sleep disturbance

intrusive aspects, ie. from PTSD symptoms

phobic aspects, eg. anticipatory dread

Responding to PTSD experiences

flashbacks, aborting, grounding techniques, could share experiences, build up list of responses, preventing

? discussion of 'fear of fear' ?

??? Could go through the various symptoms in each session ??

bereavement

hmm... links with, attachment theory, grieving, not directly PTSD, Though obviously often intertwined

Dissociation

See Allen 2001, chapter 7

Also the NET people and their ideas re. Freezing and dissociation

What does treatment involve?

Guilt and shame

Again not PTSD

But often intertwined

And definitely can be a therapy interfering factor

Deborah Lee and others

Post traumatic depression

?? Include this ?

Allen 2001, chapter 9

Developing Treatment Goals

Points for the emotion regulation programme

Adapt attentional training from Wells

Principles of grounding

bringing you back to the hear and now

Grounding techniques

Use of stress balls

Awareness of current situation

Rachel is putting together a list of these

Mindfulness?

Leahy book

And DBT workbook

Self compassion work?

Leahy book

Values work??

Attentional training

Techniques from Wells book

Detached mindfulness

Techniques from Wells book

Monitoring triggers

Setting up personalised responses to difficult emotions

If... then statements

Katherine

Relaxation exercises i.e. progressive muscle relaxation and breathing

Self-Monitoring i.e. keeping a diary of emotions, labelling emotions

Self-Soothing techniques, Exercise re. techniques that work for them

Coping with Flashbacks and dissociation i.e. refocusing attention, finding grounding object, develop grounding phrase or position

The group as experts

What works for them?

There seems to be lots of good stuff in the DBT work book

Acknowledgements

Jon Allen

Ground rules for group

Respect for others in the group

listen to what people are saying

everybody's experience is valid

Commit to coming and on time

Less likely to be helpful otherwise

Respectful to others

Inform if not coming

Put together on flip chart

bring to each meeting

initial contact

phone

those who have not been asked about it

or have been waiting for a long time

go through care co-ordinator

Enfield Tasks

decide on facilitators

Haleh

Oliver

Ed

identify people

invite them

identify time & book room

prepare sessions

do group!!

Info so far

Unified Protocol

Does not see quite right for our client group

also not clear that evidence is for group format delivery

Psycho-ed stuff prepared by Katherine

emotions and PTSD

to delete

Information Meeting

Preparation, Flip chart, Kate G?, Board pens, Outcome measures, PCL's, Not for info group, Group register, Of all invited, Information leaflets about, PTSD, The psycho-ed group, Refreshments, fruit juice, paper cups, biscuits

Introduction, Suggested Rationale for Group, Something that we will be creating with them, Need some outcome measurement, Before?, Knowledge of PTSD, Has anyone talked to them about it?, Have they been to any courses., PTSD symptoms, HTQ, get from Enfield, PCL?, What would they like to find out about PTSD?, aims of group, aims of information meeting, not a therapy group, Issues of trust, no need to speak if don't want to, respect that, Ground rules based around respect, Will. One back to them

Introductions to each other, just saying your name

??fill in outcome form, Might be good in getting them to do something and think about what they might want, But in some ways more relevant when group proper starts

Fill in form re. what you would like to find out about in this meeting?

Ground rules, write ground rules for group on flip chart, with suggestions from group

Exercise about what they would like to find out about in the meeting, not Partner work, write down things they would like to find out about, Flip chart, group discussion, for those able to

What we are planning to cover in group, up on flip chart

Haringey Tasks

decide on facilitators

Katherine

Rachel M

Ed

identify people

invite them

identify time & book room

prepare sessions

do group!!

icon signifies for manual

Collaborative development programme

questionnaire at the end of each session