Complex Trauma Certification Training: A Strength-Based Approach for Treating Complex PTSD

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Planning Committee Disclosure - No relevant relationships

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners.  For speaker disclosures, please see the faculty biography.

Handouts

Faculty

Arielle Schwartz, PhD, CCTP-II, E-RYT, EMDR-C Related seminars and products

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Arielle Schwartz, PhD, CCTP-II, E-RYT, EMDR-C, is a licensed clinical psychologist, certified complex trauma professional, EMDR Consultant, and Kripalu yoga teacher. She is an internationally sought-out speaker, leading voice in the field of trauma recovery, and the author of eight books including The Complex PTSD Workbook, EMDR Therapy and Somatic Psychology, The Post-Traumatic Growth Guidebook, and Applied Polyvagal Theory in Yoga.

As the founder of the Center for Resilience Informed Therapy, her work is rooted in the positive psychology movement, which is focused on enhancing resources and fostering growth. She offers an integrative, mind-body approach to therapy that includes relational therapy, somatic psychology, EMDR therapy, parts work therapy, and therapeutic yoga for trauma. Praised by Dr. Stephen Porges, Arielle specializes in applying his polyvagal theory, which focuses on addressing imbalances within the autonomic nervous system that underlie most mental and physical health conditions. Her work can be found at the Shift Network, Sounds True, Psychotherapy Networker, Embody Lab, Art of Living, Omega Institute, and more.

Speaker Disclosures:
Financial: Dr. Arielle Schwartz maintains a private practice and is a trainer with Advanced EMDR Therapy Trainings. She receives royalties as a published author and receives compensation as an international presenter and a yoga instructor. Dr. Schwartz is a paid consultant for Evergreen Certifications. She receives speaking honorarium, recording, and book royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Arielle Schwartz is a member of the American Psychological Association and the Yoga Alliance.

Additional Info

Access never expires for this product.

For a more detailed outline that includes times or durations of time, if needed, please contact cepesi@pesi.com.

Objectives

1. Distinguish key contributing factors to the development of Complex PTSD as it relates to client case conceptualization. 
2. Analyze the impact of Complex PTSD on the cognitive, emotional, and physical health of the client.
3. Determine how to assess clients for Complex PTSD symptoms within other diagnoses, including personality disorders, mood disorders, anxiety disorders, and dissociative disorders.
4. Incorporate into clinical treatment practical mind-body therapy tools to help clients feel resourced and prepared for trauma processing.
5. Articulate the six stages of trauma responses within the neurobiology of Complex PTSD as it relates to clinical treatment.
6. Utilize assessment tools to properly assess for Complex PTSD to better inform treatment planning.
7. Analyze implicit memory foundations of preverbal and nonverbal memories.
8. Breakdown how mutual regulation within the therapeutic relationship teaches clients self-regulation strategies that help them develop new interpersonal strengths that help with the treatment process.
9. Analyze parts work from Structural Dissociation, Internal Family Systems, and Gestalt perspectives.
10. Evaluate the basic principles of a unified approach to somatic psychology.
11. Implement mindfulness-based techniques into trauma treatment.
12. Integrate interventions for the treatment of Complex PTSD drawn from CBT, DBT, EMDR Therapy, Parts Work Therapy, Somatic Psychology, and mind-body therapies.
13. Determine how the neuroscience of interpersonal neurobiology provides insight into the psychobiological changes possible within trauma treatment. 
14. Analyze how working within the “Window of Tolerance” can help reduce the likelihood of re-traumatization.
15. Assess how “top-down” and “bottom-up” interventions can speed up or slow down the pacing of trauma treatment.
16. Differentiate past experience from present moment experience as it relates to the treatment of trauma.
17. Employ resilience as a strength-based approach that fosters growth and integration of a positive sense of self-identity in clients.
18. Evaluate the role of neuroplasticity in treating trauma.
19. Determine resilience and protective factors to aid against the development of PTSD.
20. Demonstrate effective strategies for working with clients' preverbal memories.
21. Utilize relational interventions for shame.
22. Utilize EFT, Havening Technique, and other “neuromodulation” strategies for trauma recovery.
23. Apply techniques of focusing and resourcing to prepare clients for trauma reprocessing.
24. Analyze somatic cues to determine level of internal trauma processing. 
25. Employ coregulation to reduce level of client distress.
26. Adapt standard trauma therapy to the increased demands of complex PTSD.

Outline

Post-Traumatic Stress Disorder vs. Complex PTSD: Understand the Difference

• Acute traumatic stress, PTSD, Complex PTSD
• Diagnostic clarification, differential diagnosis and co-morbidities
• Key contributing factors of Complex PTSD
• The common symptoms of Complex PTSD

The Neurobiology of PTSD: Beyond Fight and Flight

• Polyvagal Theory
• Stages of trauma response
• Trauma specific psychopharmacology
• Heart Rate Variability and the Social Nervous System
• Interpersonal Neurobiology
• Psychobiological regulation
• Rupture and repair
• Implications of childhood neglect or abuse
• Neuroplasticity and Complex PTSD

Psychological and Physiological Repercussions of Complex PTSD: A Deeper Understanding for Accurate Assessment

• Intrusive symptoms and anxiety
• Emotional dysregulation: Outbursts of anger and debilitating shame
• Avoidance symptoms and phobic reactions to traumatic material
• Interpersonal problems and difficulty being close to others
• Dissociation and dysregulation
• Cognitive distortions and compromised meaning making
• Physical health problems, ACE factors and painful somatization
• Preverbal and nonverbal memories
• Disturbing somatic sensations
• Depressive symptoms
• Learned helplessness and shame

Therapeutic Interventions for Complex PTSD: Summary of Effective Therapies

• Psychodynamic and Relational Therapy
• Psychobiological perspectives: Polyvagal Theory
• Cognitive Behavioral Therapy (CBT)
• Dialectical Behavioral Therapy (DBT)
• EMDR Therapy
• Somatic Psychology
• Parts Work Therapy: Work with Ego States
• Complementary and Alternative Medicine (CAM):
  mindfulness, yoga, and integrative healthcare

Integrative Treatment for Complex PTSD: Putting it All Together for an Effective Treatment Plan

• A Biopsychosocial Approach: Partner with clients to build a health care team
• Goal of treatment: Memory retrieval vs. trauma recovery
• History taking: Identify chronic, repeated, and/or developmental trauma events
• Cultural factors and Complex PTSD
• Recognize attachment injuries
• Identify parts, ego states and defenses
• Assess for dissociation (“fragmentation”)
• Clinical Vignette #1
• Mutual regulation and relational repair in therapy
• Prepare for trauma processing: Develop resources and stability
• Working with parts of self
• Work through traumatic memories: EMDR and Somatic Psychology
• Clinical Vignette #2
• Grief work in Complex PTSD
• Integrate and Instill positive change

Experiential Interventions: Mind-Body Practices for Clients with Complex PTSD

• Conscious breathing for self-regulation
• Grounding and sensory awareness
• Containment: Reclaim choice and control
• Build imaginal allies
• Cultivate mindfulness, acceptance, and self-compassion
• Somatic interventions: Titration, sequencing, and somatic re-patterning
• Bilateral stimulation and dual attention in EMDR Therapy
• Potential risks and limitations of mind-body therapies

Special Considerations in Complex Trauma Treatment

• Working with Preverbal and Nonverbal Memories
• Working with transgenerational trauma
• Somatization, Chronic Pain and illness
• Gate Control Theory
• Mindfulness, Yoga, and Compassion Based Interventions
• Clinical Vignette #3

Fostering Resilience: For Post-Traumatic Growth and Healing

• Learn the 6 Pillars of Resilience
• Trauma recovery and the bell curve
• Resilience as a process and an outcome
• Help clients move from learned helplessness to learned optimism
• Post-Traumatic Growth: Help clients reach their potential

Vicarious Trauma: Improve Client Outcomes Through Effective Self-Care

• Identify resources that improve your clinical skills
• In-session self-care to improve focus on the client and therapeutic process
• Burnout prevention techniques

Clinical Vignette – Wendy

• 56 year old woman with Hx of Bipolar Disorder, PTSD, DDNOS and Borderline traits

Trauma history of neglect, grandmother suicide, father inappropriate sexually

• Addressing internalized negative aspects of parents
• Goals of therapy

Integrative Approach to Trauma Reprocessing

• Focusing and resourcing
• Touchstone target
• Negative and positive cognitions
• Emotions and body sensations

Deepening the work

• Parts work, pendulating between distress and resource, and somatic interventions

Top down and bottom up

• Cognitive reappraisal, somatic interventions, and parts work

Somatic repatterning and reprocessing

• Parts work, cognitive reappraisal

Integration:  A path to self-regulation

• Parts work, somatic integration, and cognitive reappraisal

Target Audience

• Counselors
• Social Workers
• Psychologists
• Physicians
• Case Managers
• Psychotherapists
• Addiction Counselors
• Marriage and Family Therapists
• Nurses
• Other Mental Health Professionals