To address these challenges and assist our clients in their recovery process, not only do we need in-depth familiarity with diagnostic tools, but we may also need to customise our approach – such that clinically tested therapeutic techniques are applied for managing trauma symptoms, nightmares, dissociation and shame. Specifically, we need therapeutic tools drawn from sensorimotor and body-focussed methodologies which can be adjunct to our primary models. This practical and clinically oriented workshop led by Christiane Sanderson – one of UK’s leading experts on PTSD and complex PTSD – is aimed at equipping us with these much-needed therapeutic tools and skills.

The workshop begins by discussing the latest diagnostic criteria for PTSD as they are presented in the new DSM V and ICD-11; including the recently added subtype: PTSD with Prominent Dissociative Symptoms and its linkage to dissociative disorders and childhood abuse. The workshop highlights how these revised diagnostic criteria present a more inclusive and comprehensive formulation of PTSD that accounts for prolonged and repeated exposure to interpersonal trauma. Over the course of two days, the workshop discusses and explains the essential therapeutic techniques, which encompass both psychological and somatic symptoms and allow us, as trauma-wise practitioners to create a customised recovery toolkit for our clients.

Drawing on her extensive clinical experience and using case vignettes for practical demonstration, Christiane outlines the process by which psychotherapeutically trained practitioners can assess and prepare traumatised clients for the ‘journey of therapy’ whilst bearing in mind their need for emotional regulation and a sense of security.

The workshop’s focus in Part 1 is to evaluate the clinical challenges inherent to therapeutic work with PTSD and C-PTSD, including the need to view PTSD on a spectrum. Specifically, we look at:

• The advantages of reformulating PTSD as Post Traumatic Injuryrather than a disorder, to better reflect the fact that most reactions and symptoms are normal responses to trauma
• Comorbidity and misdiagnosis when looking at the linkages between C-PTSD and personality disorders, including BPD, dissociative disorders, Somatic Symptoms and Related Disorders
• Practitioner familiarisation with a range of assessment scales including ICD-11 Trauma Questionnaire; Traumatic Events Checklist (TEC) (Nijenhuis et al 2001); Trauma Symptom Inventory; Dissociative Experiences Scale (DESII); the Somatoform Dissociation Questionnaire (SDQ20) (Nijenhuis et al 1996) and the Somatic Symptom Severity Scale(PHQ-15)
• Predictors of PTSD including peri-traumatic dissociation, age at time of trauma and ability to process traumatic events
• Clinical challenges such as sub-syndromal PTSD and comorbidity with substance misuse, self-harm and depression

The day will offer us an opportunity to develop our own trauma-case formulation through a number of case studies.

Building on the theoretical formulation and clinical challenges introduced in Part 1, the emphasis in Part 2 will be on how trauma informed practice acts as a scaffold for the primary model used by practitioners to aid their work; when working with complex trauma, PTSD and C-PTSD. We will examine the importance of titrating exposure to trauma work by employing a three phased model which ensures stabilisation before processing traumatic experiences and moving towards integration. The use of psychoeducation, grounding skills, and affect regulation to widen the Window of Tolerance – so as to facilitate somatic safety and distress tolerance when processing traumatic experiences will be explored. We will also specifically look at clinically tested, effective therapeutic techniques for managing trauma symptoms, flashbacks, intrusive memories, nightmares, dissociation and shame. Specifically, we look at:

• Both top-down and bottom-up processing skills and sensorimotor techniques, considering how we can make trauma safe adjustments to body focused techniques such as breathing, mindfulness and body scans
• Grounding skills using sensory stimuli; and the phased implementation of Stabilisation, Processing and Integration
• Body focused techniques, somatic safety and the management of trauma symptoms for both PTSD and C-PTSD
• How the therapeutic relationship can facilitate post traumatic growth by facilitating the client’s reconnection with self and others

Through a range of experiential exercises participants will have the opportunity to familiarise themselves with psychoeducation skills, grounding skills, and sensorimotor techniques, and practice how to apply these. In addition, they will able to explore how to create a customised recovery toolkit not only for their clients but also for themselves as part of their own self-care.