Now, in OET, 40% of what you speak are questions. It is like 40% Questions, 40% answers, 20% others. So, you can understand how important questions are. You should ask open ended and closed questions.
Open-ended question give freedom to speak anything but a closed question answers either Yes or No!
- Mr Parker, how do you describe your pain?
- Mr Parker: It is unbearable. (Neither Yes, nor NO)
- Mr Parker, is it a good idea we discus your past surgical history?
What are open ended questions?
|ROLE PLAYER’S CARD
|Patient: You are the father / mother of a 13 year old boy who is being admitted for surgery to remove a mildly grown mass in the colon. He / she is very anxious about the whole procedure due to high sensitive attachment to the son. A nurse is sent to you to talk about the surgery that the child will undergo after two hours.
|CANDIDATE’S CARD – NURSE
|Nurse: You are a head nurse at the Gastroenterology Department. You are talking with the patient’s father.
How Is PTSD Diagnosed?
Mr Joe: Nurse, I know that there are several steps involved in fully diagnosing post-traumatic stress disorder, including a physical and psychological evaluation in addition to meeting the criteria in DSM-5 (the standard for psychiatric diagnosis). Some of the criteria established in the DSM-5 include one or more of the following factors:
Direct experience of a traumatic event
Witnessing trauma to others
Learning someone you love was threatened or affected by a traumatic event
Repeated exposure to graphic details of traumatic events (such as first responders, emergency room staff, soldiers, etc.)
Also, symptoms of PTSD have to affect you longer than one month and interfere with your ability to cope and/or function in normal activities or relationships, for a formal diagnosis to be considered.
How Is PTSD Treated?
The sooner you seek treatment, the faster you can begin to feel relief and not be burdened by the symptoms of your trauma.
Two specific treatments are effective in treating PTSD: medications and psychotherapy. Both can be beneficial on their own, and combining the two types of treatment often is helpful.
Psychotherapy—talk therapy—can take place in one-to-one meetings and/or group meetings. Talk therapy helps people with PTSD in many ways.
Talking about the traumatic memories with a trained therapist can provide the patient with education about their symptoms so they don’t feel so alone and out of control.
Talking can desensitize people to their memories, which gradually allows them to stop avoiding reminders of the trauma. It can help them build skills for re-evaluating the thoughts and feelings that surround the memories. Most importantly, talk therapy can allow people to feel supported and safe.
The most well-studied and effective types of psychotherapy for PTSD are those that are “trauma-focused,” which means that the treatment involves focusing on the specific traumatic event.
There are several types of trauma-focused treatments. Some involve exposure methods, while others involve cognitive restructuring.
Understandably, people with PTSD are often highly reluctant to face the memories they have of the traumatic event. Therefore, they start to avoid any sort of reminders of it. This can lead to their lives becoming very constricted.
For example, if someone was involved in a serious motor vehicle accident on the highway, they may not only start avoiding that specific highway but also start avoiding being in a car or traveling anywhere outside the home. The fear becomes generalized, and their lives become all about avoidance of danger. Nowhere feels safe anymore. They feel haunted by the memories.
Exposure therapy for PTSD is a trauma-focused treatment that involves a trained professional helping a person gradually confront their distressing memories about the traumatic event over time in a safe environment.
The exposure may begin with imagining the traumatic event, talking about it out loud, and writing about it. Then, it may proceed to confronting aspects of the traumatic event in the real world (e.g., having a motor vehicle accident survivor start by just walking out to the car, then sitting in the car; over time, having them take a short drive, etc.).
Over time, with continued exposures, the thoughts and feelings come up and people become sensitized to the fear that accompanies their memories.
Cognitive restructuring for PTSD is a trauma-focused treatment that concentrates on identifying and then re-evaluating thought patterns that underlie the strong negative feelings that are associated with traumatic memories.
After a traumatic event, the survivor may view themselves, other people, and/or the world differently than they did before.
For example, someone who was assaulted by a male stranger while walking through the park may have distorted beliefs as a result. They may believe it was their fault for walking alone or that any man they don’t know is a potential threat. They may come to believe there is no safe place in the world anymore.
Patients and clinician in group therapy
Talk therapy can be useful to patients as one-on-one meetings or group sessions or both
Cognitive restructuring aims to identify the thoughts associated with a traumatic event and then teach people how to challenge the thoughts by asking: Are they accurate, and what are the facts?
Cognitive restructuring works to help people re-evaluate their thinking processes that are associated with the traumatic memories, first, by having the therapist identify and challenge trauma-related thought patterns and then by teaching the person skills to do so themselves.
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR is a trauma-focused psychotherapy approach. It involves recalling a traumatic memory, including the thoughts, feelings, and body sensations that come up while doing so.
In some ways, it is similar to exposure treatment. What makes it different is that while recalling the traumatic memory, people are asked to focus their attention on an external stimulus that invokes side-to-side movements of the eyes. It is thought that the side-to-side eye movements help to facilitate the processing of the belief by activating both brain hemispheres.
The National Center for PTSD provides more in-depth information on trauma-focused treatments.
A Note on Treatment
All treatments for PTSD should be done by a mental health professional who has been trained to deliver the treatment and undergone supervision of cases before doing it on their own. Everyone is different.
While there are three trauma-focused treatments (prolonged exposure, cognitive processing therapy, and EMDR) that have the most research backing them up, studies show that not all patients will respond. If one type of treatment does not work, another may.
Some PTSD specialists believe that these types of short-term, trauma-focused treatments—which can be effective in some people who have survived adult-onset, single-incident traumatic events or combat trauma—may also be effective in people who have sustained prolonged trauma during childhood.
Other PTSD specialists are concerned that trauma-focused treatments may be too overwhelming in these instances. Also, they are concerned that people who have experienced childhood abuse may have considerable difficulty trusting a therapist to take them through treatment.
Instead, they may recommend a phase-oriented treatment that involves the establishment of trust, safety, stabilization, and skills training before trauma-focused work.
Length of Treatment
Trauma-focused psychotherapy treatments typically are provided over a few months. For those who respond, a decrease in the intensity and frequency of PTSD symptoms happens fairly quickly. Some studies have shown that these effects continue to last over time.
Antidepressants can take a month or so to start being effective. Prazosin can be effective almost immediately for the treatment of nightmares.
Family Involvement in Treatment
In addition to a patient receiving medication and/or psychotherapy, it is helpful to have family members involved. Family members should be taught to recognize the symptoms of PTSD so they can understand what is happening to their loved one. They need to know that PTSD is a treatable condition so that they can lend support to relatives by reaching out and providing encouragement.
While there is no one-size-fits-all treatment for those living with PTSD, many treatments have been successful in helping people live with fewer symptoms—allowing them to live healthier, happier lives.
McLean: A Leader in Trauma Disorders Treatment
Let us help you or a loved one. Call us today at 877.964.5565 and we’ll help you find the treatment option that’s right for you.
PTSD and Suicide
Many people who struggle with post-traumatic stress disorder also struggle with suicidal thoughts and/or behaviors.
Although it is not possible to predict suicide with any certainty, our best tool is recognition of the signs that many people exhibit when contemplating suicide. The following three behaviors should prompt you to seek immediate help for yourself or a loved one:
Talking about wanting to die or to kill oneself
Looking for a way to kill oneself, such as searching online or obtaining a gun
Talking about feeling hopeless or having no reason to live
Please seek help immediately if you or someone you love is experiencing suicidal thoughts. If you or someone you know needs help:
Call 911 if you are thinking about harming yourself or someone else
Talk to your doctor about your symptoms and thoughts.
Call a suicide hotline: 1.800.273.TALK (1.800.273.8255)—if you are a veteran, press 1 after calling this number to connect you with the Veterans Crisis Line
Text HELLO to 741-741 for free, 24-hour support from the Crisis Text Line
Outside of the U.S., visit the International Association for Suicide Prevention for a database of resources
Join a support group—it can be beneficial to know that others share similar experiences and understand how you feel
Seek counseling with someone who specializes in post-traumatic stress disorder
Call or connect with a friend or loved one
Contact a spiritual leader
PTSD Can Be Treated—Yes, There’s Hope!
If you are overwhelmed by symptoms or negative thoughts that you suspect are related to PTSD, you should contact your health care team to discuss the possibility of a PTSD diagnosis. You can also contact a local mental health facility, like McLean, to get the help you need. You don’t have to struggle on your own—there is a path to recovery.
If you recognize the symptoms in a friend or loved one, you should always reach out to them and offer support. Whether they accept your help or not, knowing that you’ve offered can be incredibly helpful to those who are affected by mental illness.