Category: Treatment - CBT

Workshop

Workshop 10 - Trauma Informed Guilt Reduction: A Transdiagnostic Cognitive Behavioral Therapy for Posttraumatic Distress

Keywords: Trauma | Transdiagnostic | Veterans
Presentation Type: Workshop
Level of Familiarity: Moderate

Presenter(s)

• 

  Carolyn Allard, Ph.D.

  VA San Diego Healthcare System/UC San Diego

  Nothing to disclose
• 

  Sonya Norman, Ph.D.

  National Center for PTSD; Center of Excellence for Stress and Mental Health and VA San Diego Healthcare
• BD

  Brittany Davis, Ph.D.

  James A. Haley Veteran's Hospital
• CC

  Christy Capone, Ph.D.

  Alpert Medical School, Brown University / Providence VA Medical Center
• KB

  Kendall Browne, Ph.D.

  Center of Excellence in Substance Abuse Treatment and Education

Veterans often report experiencing guilt and shame related to witnessing, failing to prevent, or engaging in acts during combat or deployment that violate values they live by in their civilian lives. Trauma-related guilt plays a key role in the development and maintenance of several forms of posttraumatic psychopathology, including posttraumatic stress disorder (PTSD), depression, substance use disorders (SUD), and suicidal behavior. Therefore, posttraumatic guilt is an ideal target for intervention. Trauma Informed Guilt Reduction (TrIGR) is a 6-session manualized transdiagnostic intervention designed to reduce deployment-related posttraumatic guilt, shame, and distress in veterans based on the work of Kubany and colleagues (1995). TrIGR was designed to help veterans accurately appraise posttraumatic guilt and understand the function guilt has served for them. Posttraumatic guilt is often related to a perceived violation of personal values. Thus, TrIGR includes a focus on re-identifying personal values and setting a plan to re-engage and live according to values in a meaningful way to aid in recovery from posttraumatic distress. A pilot study (Norman et al., 2013) revealed extremely high satisfaction with the intervention, and significant reductions in guilt distress and severity, PTSD, and depression symptoms with medium to large standardized effect sizes. Workshop attendees will learn about the TrIGR model, outcomes to date, and how to implement the treatment. Case examples will be used to illustrate therapeutic techniques throughout the training.



Earn 3 continuing education credits

Learning Objectives:

• Cite research on the role of trauma-related guilt in posttraumatic distress and treatment outcomes.
• Explain the underlying model of Non Adaptive Guilt (NAG) and rationale for Trauma Informed Guilt Reduction (TrIGR), a transdiagnostic intervention to reduce distress from trauma related guilt and shame.
• Implement TrIGR with survivors of combat and Military Sexual Trauma (MST).

Recommended Reading: Norman, S. B., Wilkins, K. C., Myers, U. S., & Allard, C. B. (2013). Trauma informed guilt reduction therapy with combat veterans. Cognitive and Behavioral Practice, 21, 78-88. doi:10.1016/j.cbpra.2013.08.001.
Kubany, E. S., Abueg, F. R., Owens, J. A., Brenna, J. M., Kaplan, A. S., & Watson, S. B. (1995). Initial examination of a multidimensional model of trauma-related guilt: Applications to combat veterans and battered women. Journal of Psychopathology & Behavioral Assessment, 17, 353.
Stapleton, J. A., Taylor, S., & Asmundson, G. J. G. (2006), Effects of three PTSD treatments on anger and guilt: Exposure therapy, eye movement desensitization and reprocessing, and relaxation training. Journal of Traumatic Stress, 19, 19–28. doi:10.1002/jts.20095