Post-Traumatic Stress Disorder (PTSD)

Brief Introduction

This document is provided as a guide for choosing a psychologist for the treatment of Post-Traumatic Stress Disorder (PTSD).  It is not meant to be a guide for treatment.  The information here is not meant to replace an evaluation by a qualified practitioner.  For information on PTSD, visit the National Institute of Mental Health.

Post-Traumatic Stress Disorder (PTSD) may develop after a person experiences a traumatic situation such as war, sexual assault, child sexual molestation, physical attack, or a severe accident.  In adults, symptoms may include intrusive thoughts, images, dreams, or flashbacks of the event.   In children, symptoms may include frightening dreams and reenactments of the event.  Children may also develop enuresis (bed-wetting) or encopresis.  There may also be symptoms such as changes in sleeping patterns, outbursts of anger, or irritability.  These symptoms may last for months or years depending on many factors such as predisposing conditions, social supports, and other existing stressors.

Therapist Qualifications

It is common for psychologists who work with PTSD patients to have specific training in PTSD.  While not a requirement, it is best to seek a psychologist who has this specialized training.  A trained therapist can recognize the dependence of treatment on the specific nature of the symptoms.  It is common for therapists who are unfamiliar with PTSD to misdiagnose the patient’s symptoms or to mistakenly attribute them to another diagnosis.  For example, PTSD is often confused with Psychotic Disorder, Major Depression, Generalized Anxiety Disorder, or Depersonalization Disorder.  In children, it may also be confused with Attention-Deficit/Hyperactivity Disorder, Conduct Disorder, or Oppositional Defiant Disorder.  A therapist experienced with PTSD would recognize the full range of PTSD symptoms and would be less likely to fall into these traps.

It is important to note that in recent years, specialized PTSD related jobs have appeared in which “training” is offered in a specific cause of PTSD, such as car accidents.  The nature of the training at these jobs is very specific and does not qualify the recipient as being trained in PTSD.

What to Expect From Testing

Psychologists use a battery of general psychological tests in conjunction with PTSD-specific tests to help create a complete profile of a patient.  While this is useful in creating an effective treatment plan, many patients will find they are not ready to be tested.  However, it is important to note that in combat-related and forensic (legal) cases, testing is required.

Therapeutic Focus

One of the most important things in working with PTSD is to have a creative and flexible therapist who is able to find different approaches to the specific difficulties of each individual patient.  Just as each trauma is different, each person has a different constellation of symptoms.  Different symptoms combined with the patient’s age and predisposing factors will involve a different therapeutic focus.  For example, in children treatment may be more behaviorally focused than in adults.  For adults with combat-related PTSD, treatment may involve dealing with issues such as coping with flashbacks and survivor guilt.  For children with sexual-abuse-related PTSD, treatment may focus initially on behaviors with consideration of issues related to depression and social and school functioning.

What to Expect From Sessions 

Therapy may differ in not only the therapist’s approach but in the type of session held.  Individual sessions are important, but sometimes they are not sufficient on their own.  Since PTSD and its symptoms are difficult for others to understand, it is often important for family members to attend family sessions.  Sometimes additional marital sessions are held for adults.  Specific group sessions may be helpful to allow adults with PTSD to share their experiences.  A qualified therapist would be able to discuss these options and to find the best possible arrangement of sessions.