PTSD can, however, be difficult to tease out of a shrubbery of other diagnoses. If someone presents, for instance, with a substance abuse issue with PTSD and let’s say, panic disorder. One might initially diagnose that person with the substance abuse issue, generalized anxiety disorder, and panic disorder. It won’t become evident until later, if the client continues to return to sessions and participate thoroughly, that PTSD is evident and can then be treated accordingly in a different fashion.
PTSD should always be at the top of the pyramid when discussing these issues, substance use must ALWAYS BE ADDRESSED, but the client will not get sober until the PTSD symptoms begin to be treated, but that’s just my experience. You also need to make the DISCLAIMER to your patients: “It will get harder before it gets easier”. During the hardest work, clients may stop treatment, increase substance use, and, possibly even attempt suicide. Be aware of these possibilities and be prepared that increased flashbacks will likely take place as well.
Here are some other references to navigate working with client’s with PTSD: (Disclaimer: I am in no way affiliated with any recommended sources and am receiving no funding from them or acting on their behalf.) Substance Abuse and Mental Health Services Administration has a listed 24/7 365 days a year helpline: 1-800-662-HELP(4357). https://www.samhsa.gov/find-help/national-helpline
Text HOME to 741741 and you will reach the Crisis Prevention Line where you can text with someone rather than talk, which is sometimes preferred. You can visit them here:https://www.crisistextline.org/ . Know that taking these steps can save your client’s (or your) life.
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