The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition or (DSM-5) states that PTSD is caused by ‘Exposure to actual or threatened death, serious injury, or sexual violence …’.  The DSM-5 then describes in great detail how a person can be exposed to these traumatic circumstances along with symptoms and behaviours that commonly occur with such an exposure.  These exposures described in the DSM-5 include:

Directly experiencing the traumatic event.

Witnessing, in person, the event(s) as it occurred to others.

Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.

Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (ie: first responders collecting human remains, police officers repeatedly exposed to details of child abuse).

Post-traumatic stress disorder (PTSD) is a mental illness. A mental illness that we at OSI-CAN prefer to think of as an Operational Stress Injury or Occupational Stress Injury that one can recover from rather than to refer to it as a Disorder.  PTSD or an OSI involves exposure to trauma involving death or the threat of death, serious injury, or sexual violence.

Some jobs or occupations put people in dangerous and traumatic situations. Military personnel, first responders (police, firefighters, and paramedics), doctors, and nurses experience higher rates of PTSD than other professions.

Something is traumatic when it is very frightening, overwhelming and causes a lot of distress. Trauma is often unexpected, and many people say that they felt powerless to stop or change the event. Traumatic events may include crimes, natural disasters, accidents, war or conflict, or other threats to life. It could be an event or situation that you experience yourself or something that happens to others, including loved ones.

PTSD or an OSI causes intrusive symptoms such as re-experiencing the traumatic event. Many people have vivid nightmares, flashbacks, or thoughts of the event that seem to come from nowhere. They often avoid places, people, conversations, or even things that remind them of the event—for example, someone who was hurt in a car crash might avoid driving.

PTSD or an OSI can make people feel very nervous or ‘on edge’. Many feel startled very easily, have a hard time concentrating, feel irritable, or have problems sleeping well. They may often feel like something terrible is about to happen, even when they are safe. Some people feel very numb and detached. They may feel like things around them aren’t real, feel disconnected from their body or thoughts, or have a hard time feeling emotions.  People also experience a change in their thoughts and mood related to the traumatic event. For some people, alcohol or drugs can be a way to cope with PTSD or an OSI.

While most people experience trauma at some point in their life, not all traumatic experiences lead to PTSD. We aren’t sure why trauma causes PTSD or an OSI in some people but not others, but it’s likely linked to many different factors. This includes the length of time the trauma lasted, the number of other traumatic experiences in a person’s life, their reaction to the event, and the kind of support they received after the event. Trauma is not always a single event in the past. Some trauma, particularly repeated acts like abuse or trauma during wartime, can impact a person’s life far beyond the symptoms of PTSD. Some use other terms like ‘complex PTSD’ to describe these experiences

The people who are licensed to diagnose are psychiatrists and registered psychologists who have the designation APE behind their name. An Authorized Practice Endorsement (APE) is required to communicate a psychological diagnosis in Saskatchewan.

No, most people who suffer from symptoms related to one or more traumatic events will not meet the full diagnostic criteria of PTSD. That does not mean that they are not in need of counseling therapy. 

Many professionals are trained and qualified to provide professional psycho-therapeutic services. These people are clinical counselors, social workers, psychologists, and psychiatrists. Not all these people are trained and experienced in working with people with psychological injury. 

A psychiatrist is a medical doctor who did additional studies on a doctoral level in psychiatry. Psychiatrists are the only Mental Health specialists who can prescribe medication and they are trained and licensed in providing a formal diagnosis. Not all psychiatrists do offer psychotherapy. 

A registered psychologist is a person who has a background in psychology on a master’s or doctoral (PhD. or PsyD.) level. Psychologists work in a variety of different organizations and not all of them are specialized and trained in offering psychotherapy. Not all psychologists are licensed to diagnose mental health disorders. 

A clinical counselor may have a background in psychology, counseling, or social work. Clinical counselors are trained on diploma level, Bachelor’s level (BA), but many have a master’s degree (MA or M.Sc.) and there are also clinical counselors with a Ph.D. (Doctor of Philosophy). Counselors offer counseling therapy (psychotherapy). This is their main area of expertise. 

Social workers either have a bachelor’s (BSW) or master’s (MSW) degree in social work and some social workers also have a doctoral degree (PhD). Social workers, like psychologists, can be employed in many different settings and may have different roles. One of them can be offering counseling therapy. 

There is none. Some mental health professionals prefer the word therapy over counseling. In the past, the word therapy was used for the more “serious” mental health disorders. More recently the term counseling therapy is used to avoid confusion. 

Despite what has been published and repeated by many people in the field of mental health, there is no one treatment for trauma that is better than the others. Research conducted over the last 30 years consistently demonstrates that the approaches used in treating people with trauma symptoms share core active ingredients. These most important components of successful therapy are feeling respected, feeling safe, and working with someone who listens and who works on clients’ priorities. Secondly, what is important is helping clients with tools and techniques to self regulate and providing information on trauma, and how it affects the brain, sleep, concentration, and daily functioning. Even non-specific therapy approaches have been found to be equally effective to special trauma approaches. Psycho-dynamic, person-centered Therapy, Cognitive Therapy, Cognitive Behaviour Therapy, Narrative Therapy, Dialectical Behaviour Therapy, etc. have been found equally effective in working with trauma compared to exposure-based therapies, cognitive processing therapy, and others. Additional therapies are Hypnosis, Meditation and EMDR.

The more current approach in determining helpful service providers is focusing on competency. A competent Mental Health professional offering counseling therapy is trained in the area they provide a service in. This means that most of the professionals that may be a good fit are trained in trauma, grief, depression, anxiety, addiction, and other areas of mental health. Most of the specialized training is obtained through professional development courses after graduation. However, the best predictor of a good therapy outcome is the therapy relationship and the therapist’s ability to adapt psychotherapy to the preferences of the client. This means that the best therapy is individualized to the needs of the client. There is no one approach that fits all, and manualized approaches are not sufficient. Evidence-Based Practice (EBP) is exactly that “the integration of the best available research with clinical expertise in the context of patient characteristics” (American Psychological Association, 2006). 

When looking for a good psychotherapist, you can go on the Internet and type in some referral sources such as Psychology Today. What you can do is look for people who list trauma as an area they are trained in. Most private practitioners have a website. Look up more information and if you have questions that are not answered on their website, feel free to send an email. Ask them how long their waitlist is, ask them the fee for service, and if not stated on the website ask them about insurance and benefits. A good therapist will have no issues with answering questions. One core component of ethical health service provision is “informed consent”. This means that clients have the right to ask questions and to feel confident about the choices they make regarding their health. After all, the service is for you and the quality of the therapeutic relationship is a core ingredient of successful therapy. Relationship building starts right there, finding a person whom you feel comfortable with, and who is open to listening to your feedback. 

Five provinces in Canada have regulated the counseling profession. These provinces are Ontario, Quebec, Nova Scotia, New Brunswick, and Alberta. Saskatchewan and Manitoba, as well as British Columbia, are working on regulation. Insurers, third party payers, and companies often stipulate conditions to ensure the quality of services. This means that in the absence of regulation, formal relevant education, years of experience, and membership in a professional organization can be included as requirements for hiring, referral, and inclusion in the list of approved providers.

Peer support, as well as many other activities, are extremely helpful. Relationships with others are healing. Finding support within your own family and from others is crucial. Many people suffering from symptoms of trauma feel isolated. In addition to having support and feeling connected to others, any type of physical activity and relaxation is healthy, including yoga, meditation, equine therapy, walking in nature, and being involved in art, craft, and music. 

OSI-CAN has a number of ways to donate funds.  On the top of the page is a ‘DONATE’ button that allows you to donate to OSI-CAN electronically through the CanadaHelps.Org website service.  Cheques can be sent to the Canadian Mental Health Association Saskatchewan Division (CMHA Sk Div.) with OSI-CAN written into the ‘Memo’ section of the cheque which will earmark the funds for OSI-CAN’s program.  Our mailing address is 2702 – 12th Ave., Regina, SK. S4T 1J2