Applications of Cognitive Processing Therapy to Post-Injury PTSD: A Case Study

Abstract

Approximately one in three traumatically injured patients will go on to experience post-injury posttraumatic stress disorder (PTSD) and/or depression within a year of injury. In many cases, the nature of a traumatic injury itself constitutes a traumatic event. Traumatic injuries are often followed by subsequent potentially traumatic medical events (i.e., medical trauma) that may characterize post-injury recovery. Adequately addressing the complex biopsychosocial needs of traumatically injured patients in a traditional mental health setting can be challenging. The goal of this case study is to provide mental health professionals additional guidance to meet the needs of traumatically injured patients, including strategies to concurrently treat trauma-related symptoms and aspects of physical recovery that can elicit trauma cues. Specifically, this case study provides guidance to clinicians on the conceptualization and treatment of post-injury PTSD, with a specific focus on medical traumatic stress reactions (i.e., distress related to hospitalization, recovery, and adjustment to injury/disability). To demonstrate clinical considerations and applications of Cognitive Processing Therapy to post-injury PTSD, we focus on the experiences and treatment considerations of a fictional patient who represents an amalgamation of patients the authors have encountered in their clinical practice. Future directions for clinical practice and research to address medical traumatic stress are also discussed.