Treating Trauma, PTSD and Traumatic Brain Injury
Clinical Update August 2014
By Zur Institute
View a complete list of Clinical Updates.
Traumatic disorders have sometimes become fuzzy, catch-all diagnoses, and this severely affects treatment. Trauma, Post-Traumatic Stress Disorder, Traumatic Brain Injury (TBI), and bereavement all require different treatments, both psychotherapeutically and psychopharmacologically. Additionally, when depression and anxiety are co-morbid with any of these--which is often the case--the best treatment decisions are more difficult to make. The increasing awareness and diagnosis of traumatic brain injury (TBI), heightened and informed by the recent wars in Afghanistan and Iraq, and the growing awareness of head injuries in both school and professional sports has made the treatment picture even more complex and confusing. Not only does choosing the wrong treatment result in ineffective therapy, but in some cases the wrong treatment can exacerbate the primary disorder. This is especially true with PTSD and TBI: standard treatments for one condition can make the other worse.
Effective treatments for each of these conditions exist; it is essential for clinicians to have the correct diagnosis, choose the right treatments and to be informed about the various available psychotherapy treatments and medications. The competent clinician who treats a traumatized client needs to have a general perspective on how trauma undermines clients' normative assumptions about how the world and their own life operate in order to help clients re-establish a coherent perspective. It is also important to take into account the cultural perspective of traumatized clients.