COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

COSIG Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006
A New Diagnosis:
Complex Posttraumatic Stress
Disorder (Herman, 1992)
Complex Posttraumatic Stress
Disorder (Cont’d) (Herman, 1992)
• Alterations in perception of
perpetrator
(preoccupation with perpetrator,
acceptance of beliefs of perpetrator, etc.)
• Alterations in relations with others
(isolation, distrust, searching for rescuer,
failures at self-protection, etc.)
• Somatization (unexplained or
exacerbated physical complaints)
• Alterations in system of meaning
(sense of hopelessness and despair, etc)
A history of subjection to totalitarian
control over a prolonged period ( e.g.
survivors of childhood sexual abuse)
• Alterations in affect or impulse
regulation (chronic suicidal ideation, selfinjury,
explosive anger, etc.)
• Alterations in consciousness or
attention (dissociative episodes, reliving
trauma, depersonalization, etc.)
• Alterations in self-perception (selfblame;
sense of helplessness, etc.)
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Multi-Dimensional
Biopsychosocial Assessment
• Mental Health
• Substance Use
• Psychosocial
• Medical
• Developmental
Examples Of Assessment
Domains (APA, 2001)
• Presence of risk-taking & impulsive
behaviors
• Mood disturbance and reactivity
• Risk of suicide
• Risk of violence to persons or property
• Substance abuse
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Assessment Domains (cont’d)
(APA, 2001)
• Ability to care for self or others (e.g.
children, aging parent)
• Achievements, skills
• Financial resources
• Psychosocial stressors and supports
• Motivation and readiness for treatment
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Engagement
Start where the person is, including
developmentally
Balance client-centered expectations,
goals regarding behavioral change with
therapist goals of balancing safety issues
and placing responsibility on the individual
Maintain a dialectical abstinence approach
Complete and total emphasis on abstinence
on one hand with on other hand a planned
approach for lapses that mitigates harm and
increases resumption of abstinence
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