TPC-Journal-V4-Issue2

The Professional Counselor \Volume 4, Issue 2 116 (Peterson et al., 2011).The Emotion Regulation Questionnaire (ERQ) assesses differences between expressive suppression and cognitive reappraisal during treatment intake and discharge (Boden et al., 2013). The ERQ as- sessment assists the counselor in targeting and reducing maladaptive regulation strategies within the context of PTSD treatment in order to help the veteran develop alternative coping skills (Boden et al., 2013). The Quick Test for PTSD (Q-PTSD) is useful for identifying individuals with a true disability (Morel, 2008). Q-PTSD is a time-efficient method of detecting malingering in veterans applying for disability; it may be used by the coun- selor as an initial assessment of the disorder (Morel, 2008). Other useful instruments can be incorporated into a treatment plan, such as a strengths-based assessment, depression inventory, substance abuse assessment, and insomnia inventory. Seligman (2011) also recommends the Post-Traumatic Growth Inventory (PTGI) for use with veterans. The 21-item PTGI “measures the extent to which survivors of traumatic events perceive personal benefits, including changes in perceptions of self, rela- tionships with others, and philosophy of life accruing with their attempt to cope with trauma and its aftermath” (Tedeschi & Calhoun, 1996, p. 458). Seligman (2011) suggests that trauma often sets the stage for growth; a counselor may use the PTGI to facilitate veterans’ understanding of the conditions under which growth can hap- pen. Making a diagnosis of PTSD requires assessing symptoms and also gathering data from multiple assess- ments, a structured interview, and other knowledge of the client in order to make an evaluative judgment that leads to the development of a sound treatment plan (Ottati & Ferraro, 2009). PTSD Treatment Cognitive behavioral therapy (CBT) is unanimously endorsed as the best-practice treatment for PTSD by the VA and the Department of Defense (DOD; U.S. VA & U.S. DOD, 2010), the International Society for Traumatic Stress Studies (Foa, Keane, & Friedman, 2000), and the American Psychiatric Association (Ursano et al., 2010) . Tramontin (2010) specifically states that the VA supports Prolonged Exposure (PE) therapy and Cognitive Pro- cessing Therapy (CPT). In CPT and CBT, counselors challenge clients’ automatic thoughts connected with trauma. Through the use of written narratives in CPT, counselors target issues of safety, trust, power, control and self-esteem. Counselors also work with veterans to identify and label feelings as they work through impasses in their stories (Moran, Schmidt, & Burker, 2013). Exposure therapy is an evidence-based practice for many types of trauma includ- ing PTSD. According to Rauch, Eftekhari, and Ruzek (2012), PE therapy reduces PTSD symptoms and aids in treating comorbid issues. Rauch et al. (2012) explain that PE therapy consists of four components: psychoedu- cation, in vivo exposure, imaginal exposure, and emotional processing. Psychoeducation can help those suf- fering from trauma to understand their PTSD (Rauch et al., 2012). In vivo exposure consists of literally con- fronting the variables associated with the trauma (i.e., people, places and things; Rauch et al., 2012). Imaginal exposure involves reliving the memories associated with the trauma and engaging the accompanying emotions (Rauch et al., 2012). Emotional processing involves the counselor posing open-ended questions to the client in order to elicit both the emotions the client felt associated with the trauma and present emotions (Rauch et al., 2012). Virtual reality exposure. In recent years, a new development of a virtual reality exposure therapy has sur- faced. Albert “Skip” Rizzo developed a program titled “Virtual Iraq,” a virtual reality simulation designed to as- sist in the treatment of PTSD (Virtually Better, Inc., 2013). Rizzo developed the program after stumbling upon a video game called “Full Spectrum Warrior” that was originally created to train military service men and women.