Using CPT to Address PTSD: Kelly's Journey

The present session depicted in the video is Kelly’s third CPT session, where the goal is to identify thoughts and feelings through the use of an A-B-C worksheet while discussing “stuck points” and addressing self-blame issues (Resick, Monson, & Chard, 2014). The clinician notices Kelly expressing slight anxiety and engages her in a deep breathing exercise to help her relax. In the first session, the clinician educated Kelly on PTSD and her presenting symptoms; this was then revisited again in the present session (08:16). An “impact statement” was also assigned in the previous session, and Kelly was asked to present this aloud (10:49). The verbalization of the statement in a safe environment helps the client process their thoughts differently

She encourages her to reflect on the feelings of herself, and prompts her to face the belief that she is a bad person by looking at other events where she may have felt similarly (16:38). Kelly then reverts to an earlier traumatic event where her belief first became distorted--watching the death of someone important, this is the identified activating event (17:16); her role as a combat fighter is the behavior that confronts her rationale (17:28); resulting in conflicting feelings of responsibility or have the ability to change the outcome (17:40). Then Kelly is challenged to provide evidence for the punishment (18:16). When she is unable to identify concrete evidence she begins to perceive her thoughts differently

Kelly acknowledges a change in emotion, yet still has a physical response (19:07, 19:30). Socratic questioning is effectively used to process through her thoughts while identifying lingering anger about the present discussion, as well as exploring the direction of her anger (19:50). The clinician challenges her emotional turmoil (20:25). Kelly responds by placing blame onto herself for the sexual assault. With the use of Socratic questioning, Kelly’s words are reiterated for self-reflection (20:49), while linking the direction of anger and blame. A pivotal moment is reached when Kelly acknowledges she is unequipped with how to transition back into civilian life precipitating the onset of potential alcohol abuse and pertinent stressors (21:48). The clinician honed in on key points in Kelly’s statement such as the reintegration into “normal society (22:46),” as well as connecting it back to her presenting symptoms of anxiety. The clinician guides Kelly through critical thinking points, challenging her to think of other occasions where the feelings of guilt have arisen and whether those feelings were valid (24:04). She questions Kelly, “What could you have done? (20:20)” By challenging Kelly’s distortions and processing through them, she realized sometimes things happen outside of her own power, and was validated for her frustration that