Ethically Treating PTSD Resulting from Terrorism and other Traumas

Introduction
Welcome to the Home Study Course sponsored by the Healthcare Training Institute. Our primary intent for this Home Study Course is to provide quality education to foster professional growth. The Institute has provided quality education since 1979 to thousands of mental health professionals nationally and in Canada as well. My name is Tracy Catherine Appleton, and I will be the narrator for this tape. We appreciate the fact you have chosen us as a vehicle for you to earn your Continuing Education Credit for purposes of re-licensure. This course was compiled with the assistance of social workers, marriage and family therapists, mental health counselors, and psychologists. We will discuss ethically treating PTSD resulting from terrorism and other traumas. As you will note excerpts from the Code of Ethics for Social Workers, Marriage and Family Therapists, Psychologists, and Counselors is listed in your manual.

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Terrorism by definition is an act that seeks to influence a population significantly larger than the immediate target. Thus, the quality of the public’s understanding and its response to terrorism of all varieties is highly significant. Ultimately, it is public opinion that will help shape the political environment within which government officials must act.

As you are well aware, there is a dearth of articles, books, seminars and the like on Post Traumatic Stress Disorder, commonly referred to as PTSD. The purpose of this home study course is to talk specifically about PTSD resulting from terrorism and similar traumas. It is, of course, hoped that in the future there would be no acts of terrorism. However, as we face the realities of our oftentimes violent society, the violence of terrorist acts has become more and more of a reality.

As you know, a primary ethical mission of the mental health professional is to enhance well-being and help meet the basic needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty.

We have found in treating clients that are either direct victims of terrorism or suffering from secondary traumatic stress disorder, STSD, a question of ethical approaches has become an increasing concern for professionals. For example, you may have a client who does not sympathize with terrorist actions, but sympathizes with their anti-American policy beliefs; or sympathizes with their religious convictions.

At what point are you, as a therapist, bordering on unethical behavior by perhaps even subtly imposing your values and beliefs upon your client? Only you can answer this.
Thus, another purpose of this course is to provide you with perhaps some new perspectives to increase your self-awareness about victims of terrorism regarding such ethical principles as:
• Respect for client self-determination and autonomy
• Respect for the individual’s inherent worth and dignity
• Acceptance
• Individualization of the client as a unique person
• Non-judgmental attitude
• Tolerance for deviance that does not harm others
• Rationality and objectivity
• Empathy, and
• Impartiality among individuals and groups

On this tape we will talk about victims of terrorism experiencing the loss of their feeling of invulnerability, loss of an orderly world, loss of a positive self-image, and loss of trust. We also will discuss the role that prior experience and training make in a predisposition to PTSD. The psychodynamics of hostage victims will include pathological transference and psychological infantilism. The importance of ventilating feelings and realistic guilt will also be discussed along with the psychopathology of being held hostage. PTSD filtering and other ethical issues will also be explored.