Strategies for dealing with people with PTSD?

[Wahine]

I work as a PT and I have had several patients with significant PTSD where it seriously impacts their function on a day to day basis. One of my clients went off this morning in the clinic and while I understand that they do not have control of their reactions much of the time, this individual was verbally aggressive/inappropriate with my support staff and I'm afraid that if this behaviour continues, my staff will end up with PTSD. OK, I'm not serious but I do need to do something about this.

Does anybody have any resources they can share about dealing effectively with individuals with PTSD? I'm all ears. Article links would be great, books, whatever.

TIA for any information you can share.

[Crankin]

PM me and I will get back to you when I get home.

[Biciclista]

whether or not they have PTSD the behavior is not acceptable and they need to know that; and you need to set limits. (like you have to leave if you do that again)

[Wahine]

Agreed Biciclista. I'm just thinking that even with setting boundries, there may be strategies that I can employ to help things go more smoothly. I want to help this person with their PT related issues and while I need to address the issue, I want to do it as sensitively as possible while getting the job done. I don't think setting boundries with this individual should be done in the same manner as I would with, let's say my SO or mother or a friend. Or even another patient that didn't constantly feel threatened and easily angered.

[Bethany1]

While I don't have experience with PTSD, I do deal with being bipolar and it is very hard to control your reactions. It doesn't excuse the behavior, but be aware that it's hard to stop once a person gets going. While it doesn't look like it, the person is trying. It's hard being in emotional or physical pain 100% of time trying to pretend you are fine and it's easy to blow up on people trying to help.

Sometimes anger is a silent plea for help that the person can't express like normal people can.

Before you work with the person again, pull the person aside privately, sit down and explain the rules and what you expect from this person and make an agreement that both of you can keep and understand. Sometimes the "unwritten" rules aren't clear to those who struggle emotionally. Make it clear that you want to work with this person but you can't if the behavior continues as it's not safe for you and everyone else.

[Wahine]

Solobiker, thank you. I've been thinking of actually writing something up with this patient. It's nice to have confirmation that this is expected practice in settings where you have to deal with behaioural stuff.

Bethany, thank you for sharing. It means a lot to me. The issues you brought up are why I want to do this properly. I realize that this person has trouble coping and I don't want this to be just another incident where they feel attacked or threatened.

[solobiker]

whether or not they have PTSD the behavior is not acceptable and they need to know that; and you need to set limits. (like you have to leave if you do that again)

+1 I work as an OT and have run into issues like you explained. We have had to sit these individuals down and explain to them the expectations/ proper behavior in a public setting.

The setting I work in is different then yours...I work in a short term rehab unit where the people "live" there for a few weeks up to several months. We have had to write up contracts with some of these individuals that they will behave in a respectful manner. We always have them involved in the content of the contract so they have some of the control and input. This also gives them a voice to express concerns to us about situations that may exacerbate their symptoms.


Good luck and I hope you find something that helps.

[mmouwse]

Good Morning,
PTSD can be physically induced as well as emtionally/mentally. In either case, the patient is truely incapable of controlling the reaction as they no longer have normal physiological brain function.
Please treat these patients with extreme care, compassion, understanding and acceptance. Writing them up, threatening them with removal, or expecting them to behave differently is not realistic to their condition and will actually harm them, making their PTSD worse.
Please contact PTSD and Brain Injury Expert Professionals to learn how to deal with these patients without causing harm to them or yourselves. With training, staff can learn appropriate, effective skills to cope with the patients behavior and staffs reactions/feelings.
It is incumbant upon you, as the caregiver, to understand the patient and meet their needs. It is not the patient's responsibility nor within their capacity to teach you, explain to you, understand themselves, or immediately alter or contain their behavior.
As difficult as it may be for you to understand this or accept this, they truly cannot control their behavior much. Kindness and understanding in dealing with them will be most effective in calming them.
If you google "brain injury" or "PTSD" you will find informative resources.