REFLECTION JOURNAL: MODALITY CHOICE
Key Ideas
Symptoms of Posttraumatic Stress Disorder (PTSD) are common right after traumatic
events, but for most trauma survivors, these symptoms decrease over time through natural
recovery. However, for some people, the PTSD symptoms continue after a 6-month (or more)
delay, become chronic, and interfere with daily functioning. When this happens individuals
should seek help and a more intensive treatment. Prolonged Exposure Therapy (PE) is helpful
with those who have prolonged or delayed responses to traumatic events (Rothaum et al. 2019).
Prolonged Exposure Therapy
PE is a way to help trauma survivors to emotionally process their traumatic experiences.
PE reduces PTSD and other trauma-related problems. According to FOA et al., (2019) the term
“prolonged exposure” comes from the long tradition of exposure therapy for anxiety disorders. In
exposure therapy, people are helped to confront safe but anxiety-arousing situations to decrease
their excessive fear, anxiety, and distress.
Often times clients say that they have tried and failed to face their trauma-related fears
and other negative emotions, or that they did face them, but their distress did not diminish. Some
just cannot picture themselves stopping their avoidance or being strong enough to visualize and
describe traumatic memories. Others think that avoidance is an effective coping technique, and
they need to be encouraged to try another technique (FOA et al., 2019). I find myself trying to
explain to people all the time that some nonchalant characteristics may be a coping skill.
Avoidance
There are two ways that people avoid dealing with trauma reminders. One is trying to
push away memories, thoughts, and feelings about the trauma. Another is escaping or avoiding
situations, places, people, and objects that cause distress and fear because they are similar to the
REFLECTION JOURNAL: MODALITY CHOICE
trauma or are reminders of the trauma. However, while the strategy of avoiding trauma-related
thoughts and situations works in the short run, it actually prolongs the post trauma reactions and
prevents you from getting over your trauma-related difficulties. In a video about PE provided by
this course one of the professors noted that PE is enduring temporary pain for long-term relief
(FOA et al., 2019).
Components of PE
FOA et al., 2019, was insightful in seeing how sessions should be conducted when
administering PE. PE sessions consist of education about trauma, PTSD, and PE including “in
vivo” exposure, “imaginal exposure” and retraining of breathing techniques. In vivo consists of
repeated real-life exposure to situations, people or objects that are objectively safe or low risk.
imaginal exposure is repeated trauma memories or resist visiting and recounting the trauma in
the person's imagination.
I used to believe that implementing these methods could potentially re-traumatize clients.
Yet, research indicates that the more an individual confronts and revisits their trauma, the more
desensitized they become. Regardless of the client or the symptoms they present, I firmly believe
that breathing techniques are always beneficial. Deep breathing not only aids mental wellbeing
but also promotes physical health. I recall a time when I suffered from a migraine, and with some
deep breathing, I noticed it slowly decline.
Technological Advances
What I found interesting and immediately downloaded was the PE Coach that utilizes
technology to keep up with one's PE treatment. PE coach can be used with Android or iPhone
and helps the patient to progress through the whole PE protocol, including presentation of
treatment rationale, support for monitoring the Subjective Unit of Discomfort Scale (SUDS), and
REFLECTION JOURNAL: MODALITY CHOICE
scheduling in vivo and other appointments (Rothaum et al. 2019). This technology is always
useful, and you can go back, to reprocess or rethink every session. It's like an app that I used
called “I am Sober” with my clients presenting eating disorders or addictions. It helped them to
keep track of their relapse and to help them find alternatives, and positive distractions.
Christian World View
According to Tan (2022) basic psychological and spiritual needs include needs for
security (love), significance (meaning/impact), and hope (forgiveness). When someone
experiences a traumatic event, there is a loss of security, significance, and hope. In incorporating
Christian counseling, I am happy to offer God's love, my clients meaning in this world and a
reason to hope.
The Holy Spirit
Christian counseling or psychotherapy can be simply described as counseling conducted
by a Christians who is Christ centered, biblically-based and spirit filled. The Holy Spirit is also
described as the giver of life by the Nicene Creed, supported by Scripture in both the old and
New Testament. His key role in Christian therapy as a counselor as well as the giver of life
means that Christian therapist must acknowledge and depends on the Spirit's presence and
healing power in every counseling situation, with the basic biblical understanding of the work in
the ministry of the holy spirit (Tan, 2022).
I work with clients who are Christians and those who are not. I make it my business not
to be biased and I can apply therapeutic techniques without my Christian beliefs being
incorporated if it's not warranted. However, I often ask my clients if they have a religious
background during our intake and once, I know that they are Christians, I ask them if it's okay to
incorporate Christian counseling. I pride myself in knowing when I'm incorporating Christian
REFLECTION JOURNAL: MODALITY CHOICE
counseling that I have a prayer life and I am keen to allow the Holy Spirit to lead and guide me
in counseling sessions, (even when I'm not administering Christian counseling). When receiving
a breakthrough in counseling that I know the Holy Spirit led me to, I feel so grateful. I often tell
my Christian clients you're blessed to have a person with book knowledge, life experience, a
connection to our Lord and Savior Jesus Christ and His Holy Spirit.
Incorporating Christian Counseling
I am careful to ask if a person is a Christian if they would like to incorporate Christian
counseling. I also try to make it clear that it's okay if they do not. After pastoring for many years,
I know a lot of bitter Christians who have had bad experiences in church and may be triggered by
incorporating Christian counseling. In this understanding some have had traumatic experiences
in their Christian experience. Helping clients heal spiritually, is something that I desire because
I've had my own negative experiences in church. One of my passions is to let people know
leaders in ministry are not God and are prone to make mistakes. However, because leaders make
mistakes, we should not project this on God, or our relationship with Him.
Spiritual Triggers
While the research cited in Sherman et al. (2015) primarily documents positive
relationships between spirituality and indicators of mental health, spirituality is a complex
construct. Some have been found to have negative relationships with various aspects of well-
being. For example, spiritual struggles may have negative effects on mental health, such as anger
or disappointment with one’s Higher Power or community of faith, difficulty resolving
appropriate or inappropriate guilt, and loss of faith (Sherman et al., 2015).
According to Sherman et al. (2015) spiritual struggles may have negative effects on
mental health, such as anger or disappointment with one’s Higher Power or community of faith,
REFLECTION JOURNAL: MODALITY CHOICE
difficulty resolving appropriate or inappropriate guilt, and loss of faith. This construct has been
found to be related to higher levels of PTSD symptoms, poorer quality of life, poorer cognitive
functioning, and poorer physical health. In my experience, this is reason I am careful to ask
clients their wishes (Sherman et al., 2015).
Conclusion
Following a traumatic event, it is not uncommon for individuals to experience symptoms
of PTSD. For some symptoms naturally diminish over time as they embark on their journey of
recovery. Unfortunately, there are some individuals who continue to suffer from persistent PTSD
symptoms even after a delay of six months or more, which can severely disrupt their daily lives.
In such cases, it is crucial for these individuals to seek assistance and opt for a more intensive
treatment approach. One empirically supported treatment is PE, specifically designed to address
the prolonged or delayed responses to traumatic events experienced by individuals.
If it is deemed necessary, it is the responsibility of a Christian counselor, who is
providing guidance to a Christian individual, to assist them in rediscovering a sense of security,
significance, and hope. I am grateful that irrespective of whether my client is a Christian or not, I
rely on the Holy Spirit as my compass in every interaction with each client. With the help of the
client and the Holy Spirit to leave me when a client feels triggered by Christian counseling. I
firmly believe that everything works together for the benefit of those who love God and are
called according to His purpose (Romans 8:28, NIV). Regardless of what unfolds during our
sessions or in my client's life, which often brings fulfillment, I trust that everything is under
God's control and that my path is guided by Him.
REFLECTION JOURNAL: MODALITY CHOICE
References
Foa, E., Hembree, E., Rothbaum, B. O., & Rauch, S. (2019).EProlonged exposure therapy for
PTSD: Emotional processing of traumatic experiences: Therapist guide(2nd ed.).
New York, NY: Oxford University Press.
Rothbaum, B., Foa, E., Hembree, E. & Rauch, S. (2019).EReclaiming your life from a traumatic
experience: A prolonged exposure treatment program(2nd ed.). New York, NY: Oxford
University Press.
Sherman, M. D., Harris, J. I., & Erbes, C. (2015). Clinical approaches to addressing spiritual
struggle in veterans with PTSD.EProfessional Psychology: Research and Practice,E46(4),
203–212. https://doi.org/10.1037/pro0000020E
Tan, S.-Y. (2022).ECounseling and psychotherapy: A Christian perspective. Baker Academic.E
The holy bible: New international version. (2011). Biblica.E
Powered by TCPDF (www.tcpdf.org)
