Passing your National Licensing Exam
Getting licensed can open up incredible opportunities, but the exam can seem daunting. Our podcasts make passing more achievable and even fun. Dr Hutchinson and Stacy’s energy and passion for this content will get you motivated and confident.
We break things down in understandable ways - no stuffiness or complexity and focus on the critical parts you need so your valuable study time counts. You’ll come away feeling like, “I can do this!” Whether it’s nailing down diagnoses, theoretical approaches, or applying ethics in challenging situations, we help you get into a licensed mindset. Knowledge domains we cover in these podcasts include:
Professional Practice and Ethics
Intake, Assessment, & Diagnosis
Areas of Clinical Focus
Treatment Planning
Counseling Skills and Interventions
Core Counseling Attributes
And, of course, the DSM-5-TR.
If you listen, you might surprise yourself at how much you absorb and enjoy it along the way. Take that first step – you’ll gain confidence and valuable skills and feel confident getting ready for your licensing exam!
Passing your National Licensing Exam
Demystifying Disorders: PTSD
Ever wondered why not everyone who faces trauma ends up with PTSD? Join us as we unravel this complex disorder. You'll gain a clear understanding of PTSD's diagnostic criteria as outlined in the DSM-5-TR, exploring the crucial differences between PTSD and acute stress disorder, particularly the significance of symptom duration. We shatter prevalent myths, such as the notion that PTSD solely affects veterans or inevitably results in violence, emphasizing that the disorder arises from a wide range of traumatic experiences and affects individuals uniquely.
Linton also highlights the importance of diagnostic specifiers, which offer essential nuances that can shape effective treatment plans. We explore how factors like social support and resilience can prevent acute stress from evolving into PTSD. Furthermore, the episode delves into adjustment disorder, examining its development due to identifiable stressors. This episode promises a comprehensive exploration of PTSD and adjustment disorder, aiming to expand your understanding and dismantle common misconceptions.
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Let's start with PTSD, or post-traumatic stress disorder. According to the DSM-5-TR, the diagnostic criteria for PTSD include exposure to actual or threatened death, serious injury or sexual violence. The exposure can happen directly, by witnessing the event, or indirectly, like learning about a traumatic event occurring to a close friend or family member.
Speaker 2:And therein lies our first myth to debunk that everyone who experiences trauma develops PTSD. Exposure to a traumatic event is just part of the criteria needed to diagnose PTSD. And what are the other criteria for PTSD? Linton.
Speaker 1:Well, after the trauma, the person experiences a variety of symptoms that are grouped into four main clusters One, intrusion symptoms, two, avoidance. Three, negative changes in thinking and mood and four, changes in arousal and reactivity.
Speaker 2:So let me give some examples of these. Intrusive symptoms include distressing memories, dreams and flashbacks. Avoidant symptoms involve behaviors like not wanting to be around people or places that remind them of the traumatic event. Cognitive and mood changes include negative beliefs, feelings of guilt, shame, anger and withdrawal from others. And destructive symptoms could include things like angry outbursts, stress systems or physical reactions to reminders of the trauma. This could include things like angry outbursts, hypervigilance and trouble concentrating Got it.
Speaker 1:The symptomology for PTSD is almost the same as acute stress disorder. There's a difference in the total number of symptoms required for each diagnosis. Acute stress requires nine symptoms from a long list of symptoms, while PTSD requires at least six symptoms, with a certain number of symptoms coming from specific categories. However, the most significant difference between the two disorders, which you must remember for the exam, is duration, or how long the symptoms last. With acute stress disorder, the symptoms last between three days and one month.
Speaker 2:So what happens if you're working with a client in New Zealand who has just been through an earthquake and has been diagnosed with acute stress disorder, and their symptoms go on for longer than one month?
Speaker 1:Then you're looking at potentially changing the diagnosis to PTSD. Now you've got me curious about something. Yes Say, you've got a client who is diagnosed with acute stress disorder. Do they always go on to develop PTSD?
Speaker 2:No, Some cases of acute stress disorder will resolve in the first month. There are several reasons for this. Early clinical intervention after a trauma can help prevent acute stress reactions from developing into PTSD. Also, resilience factors like social support, healthy coping strategies and a positive outlook can help some clients recover from acute trauma without chronic impairment. Plus, the traumatic event itself matters. Sexual trauma, for example, has a higher risk of PTSD versus physical trauma sustained from a car accident or an earthquake. The severity and nature of the trauma affect the probability of developing PTSD.
Speaker 1:Thanks for explaining that. Now, there are a lot of misconceptions about PTSD. One of those is that PTSD always develops immediately. But in reality, while symptoms usually begin within the first three months following the trauma, it could take several more months or even years before the full criteria for PTSD are met. There's even a specifier for that in the diagnosis PTSD with delayed expression. This is noted when full diagnostic criteria are not met until at least six months following the traumatic event. That's not the most common course, but it's still possible.
Speaker 2:There are those diagnostic specifiers that you love so much. Are they really that important for test takers to know about?
Speaker 1:Yes, this is not the time to start skimping in your studies. You need to have a good foundational knowledge of diagnostic criteria and familiarize yourself with the different specifiers used to provide extra clinical details about the client's presentation. Certain specifiers, like those for severity, may indicate the need for more aggressive treatment. Specifiers noting remission suggest treatment has been effective so far. Specifiers allow clinicians to provide more nuance and detail in the diagnosis, which can help guide treatment planning. I've got more reasons if you want them.
Speaker 2:Okay, okay, I get the picture Back to PTSD. Some people think it only affects veterans, but the truth is it can develop following any traumatic event like sexual assault, robbery, accidents or earthquakes in New Zealand.
Speaker 1:Right. Another misconception is that people with PTSD are prone to violence. Most people with PTSD are not violent. Irritability can be a symptom, but PTSD treatment actually aids by improving emotional regulation.
Speaker 2:Good point. Let's move on to adjustment disorder. This diagnosis requires the development of emotional or behavioral symptoms in response to an identifiable stressor.
Speaker 1:Yes, the distress must occur within three months of the onset of the stressor. What do we mean by stressor? Well, common stressors include divorce, job loss and a new life phase. Now, one thing that we hear a lot of confusion about is the duration requirements to diagnose adjustment disorder. Can you explain that, eric?
Speaker 2:So one of the big misconceptions is that adjustment disorder can only last six months. This is incorrect. If you learn this, please, please, please, listen closely. The duration of an adjustment disorder can vary. There's an acute form and a chronic form, and to explain this, I'm going to take it from the top. Adjustment disorder is diagnosed when emotional or behavioral symptoms develop in response to an identifiable stressor. The symptoms must develop within three months of the stressor's onset. Once the stressor or its consequences are gone, the symptoms cannot persist for more than six months.
Speaker 1:Now. Can you give us a recap of this?
Speaker 2:Sure. Adjustment disorder is diagnosed when emotional or behavioral symptoms develop in response to an identifiable stressor. The symptoms must develop within three months of the stressor's onset. Once the stressor or its consequences are gone, the symptoms cannot persist for more than six months. If the symptoms resolve in six months after the stressor or its consequences terminate, you will use the specifier acute. If the symptoms persist for six months or longer in response to a chronic stressor or a stressor that has persistent consequences, then you can tack on a persistent chronic specifier to the adjustment disorder diagnosis Make sense.
Speaker 1:Well, let's move along to the critical difference between adjustment disorder, acute stress disorder and PTSD. A key difference is that with adjustment disorder, the stressor does not have to be traumatic. Any significant life stressor can lead to adjustment difficulties. The main diagnostic criteria for PTSD are exposure to actual or threatened death, serious injury or sexual violence, losing a job and financial housing struggles, while very stressful, does not meet the threshold for a traumatic event that could cause PTSD. Adjustment disorder is commonly diagnosed when someone has difficulty coping with unemployment. Ptsd would only be considered if the job loss itself was traumatically experienced.
Speaker 2:Right and although you can diagnose adjustment disorder for someone who has experienced a trauma and is having subsequent issues related to the trauma, you have to consider their entire clinical presentation. For example, are they having flashbacks? Are they easily startled? Are they unable to experience positive emotions? If so, then you might consider acute stress disorder or PTSD as you make your diagnosis. Here are the characteristics of adjustment disorder.
Speaker 2:One adjustment disorder develops within three months of an identifiable stressor. Two common stressors include divorce, job loss and illness. 3. Common symptoms include depression, anxiety and or conduct problems. 4. If the symptoms resolve in less than six months, it's an acute form. 5. If the symptoms become chronic and last longer than six months, it's a persistent form. And here are the characteristics of acute stress disorder. Acute stress disorder can occur after exposure to actual or threatened death, serious injury or sexual violence, to symptoms last three days to one month after the trauma. Three acute stress disorder may predict the development of PTSD, for the client experiences intrusion symptoms, negative mood, disassociative symptoms, avoidance symptoms and arousal symptoms. And finally, the characteristics of PTSD. Ptsd can occur after exposure to actual or threatened death, serious injury or sexual violence. Symptoms are very similar to acute stress disorder. Symptoms must last more than one month.
Speaker 1:Well said. Thank you all for tuning in today. We hope we've helped to demystify the trauma and stressor-related disorders for you and until the next podcast remember it's in there.
