Treatment of Posttraumatic Stress Disorder in Serious Mental Illness The Cognitive Restructuring Program

This book is a practical guide to the evidence-based cognitive restructuring (CR) for PTSD treatment, which has been specifically designed to meet the unique needs of people with serious mental illness. 

Posttraumatic stress disorder (PTSD) is one of the most common disorders in persons with serious mental illness (SMI), leading to more severe psychiatric symptoms, greater impairment in psychosocial functioning, poorer physical health, and higher use of acute care services. Yet despite major advances in the treatment of PTSD in the general population, for many years PTSD has remained under-diagnosed and under-addressed among SMI sufferers, and treatments have been relatively neglected in this population.

The cognitive restructuring (CR) for PTSD program described in this book offers clinicians tools for screening, detecting, and treating PTSD in their clients with SMI, in hopes of addressing the great burden of trauma on their lives. Chapters summarize contemporary research and theory regarding the interaction between PTSD and serious mental illness, and provide nuts and bolts strategies for implementing the cognitive restructuring program, with treatment implications for various sub-populations and different kinds of mental illness including schizophrenia, psychosis, and borderline personality disorder.

The book's appendix includes educational handouts and worksheets for delivering the CR for PTSD program and tracking clients’ progress throughout. This book also features valuable online resources, including the educational handouts and worksheets translated into Spanish to facilitate using this intervention with Spanish-speaking individuals with SMI, an underserved population with very high rates of trauma and PTSD. A supplemental chapter and practical manual that outline a three-session intervention for PTSD which can be implemented in settings or situations where use of the full CR for PTSD program may not be appropriate are also included online.

Kim T. Mueser, PhD, is a professor in the Department of Occupational Therapy and Psychological and Brain Sciences at Boston University. He has published over 400 peer-reviewed articles, 10 book chapters, and 15 books primarily on psychosocial treatments for serious mental illness (SMI), and has given numerous conference presentations, workshops, and invited lectures in the U.S. and abroad. Dr. Mueser began adapting empirically supported treatment methods for PTSD in the general population to the SMI population in the late 1990s, which resulted in the first standardization and feasibility testing of the CBT for PTSD program in the early 2000s.

Jennifer D. Gottlieb, PhD, is a diplomate in the Academy of Cognitive Therapy, whose research and clinical work is dedicated to the development and implementation of effective psychotherapeutic interventions for persons with severe psychiatric conditions and other members of vulnerable populations. She serves as vice-president (and is a founding member) of the North American CBT for Psychosis Network (nACBTpN) and is on the psychiatry faculty at Cambridge Health Alliance and Harvard Medical. In addition to numerous publications and presentations related to cognitive-behavioral and other psychosocial interventions for psychosis and SMI, Dr. Gottlieb has been involved with these particular PTSD interventions for 15 years, both as a co-investigator and as a program development consultant. She has provided workshop training, clinical supervision, and treatment fidelity measurement to hundreds of clinicians and has worked with multiple mental health agencies to implement and sustain this intervention, nationally, and internationally.

Foreword
Preface
Part I: Background, and Overview of Trauma and PTSD in Serious Mental Illness
Chapter 1. Trauma and PTSD in Serious Mental Illness
Chapter 2. Treatment of PTSD in People with Serious Mental Illness: The Cognitive Restructuring Program 
Chapter 3. Understanding and Assessing Trauma and PTSD
Part II: The Cognitive Restructuring for PTSD Program
Chapter 4. Logistics of Implementing the CR for PTSD Program
Chapter 5. Beginning Treatment, Engagement, Orientation, Wellness Planning, and Breathing Retraining
Chapter 6. Psychoeducation and Goal-Setting
Chapter 7. Cognitive Restructuring I: The Thought-Feeling Model and Common Styles of Thinking
Chapter 8. Cognitive Restructuring II: The 5 Steps of Cognitive Restructuring and Action Plans
Chapter 9. Cognitive Restructuring III: Working with Trauma-Related Thoughts, Core Beliefs, and Persistent PTSD Symptoms
Chapter 10. Solutions to Common Challenges
Chapter 11. Skill Generalization and Termination
Part III: Special Clinical Challenges and Populations
Chapter 12. Working with People with Psychosis
Chapter 13. Working with People with Borderline Personality Disorder
Part IV: Conclusions
Chapter 14: The Role of the CR for PTSD Program in a Comprehensive System of Mental Health Care
References
Appendix: Tools, Handouts, and Worksheets