Post traumatic stress disorder, or PTSD, is a psychiatric disorder that develops in some people after experiencing a trauma. Those with PTSD typically display symptoms such as hypervigilance, anxiety, flashbacks and nightmares. Because of their past trauma, individuals with PTSD feel their life is threatened even in non-threatening situations, and they may react with anger even when it seems unwarranted. As with all symptoms of PTSD, the presence and frequency of anger will significantly vary depending on the individual. It can be especially difficult to interact with people who have PTSD if you are a physical therapist because many patients with PTSD have boundary issues.
Research
To successfully interact with patients that have PTSD, you should understand the mental illness. Some patients with PTSD may seem irrational and angry and easily frustrated. Your patient may demonstrate physical symptoms as a result of the illness, such as stomach problems, headaches, general pains and muscle tension. He will be more likely to trust you if you demonstrate knowledge of the mental illness. Displaying compassion and empathy to his illness will also help.
Demeanor
Your patient will likely trust you if you display a calm and caring demeanor. PTSD is classified as an anxiety disorder and your patient may have high levels of anxiety. You will help her relax if you are calm and speak evenly. It can be difficult to do this when your patient is likely restless and irritable. When interacting with a person that has PTSD, try to model calm behavior, such as remaining composed, to help reassure your patient.
Explanation
Many people with PTSD have been violated in some way. Your patient may be jumpy and uncomfortable with being touched. It can make your job as a physical therapist much more difficult. Explain everything you are going to do to your patient before doing it. Make sure you get his permission before touching him. Encourage your patient to speak up if anything is making him uncomfortable. You will also want to have an assistant in the room with you, especially if your patient has had any history of sexual assault.
Considerations
Some people with PTSD, especially if untreated, can become irritated or even violent for no clear reason. If you suspect your patient is having a bad day or seems to be off of her medications, you should reschedule the appointment. Ask your patient before beginning a session how she is feeling to gauge her symptoms. People with PTSD will sometimes be depressed and can have suicidal or homicidal thoughts. Keep your patient's treating therapist or psychiatrist's contact information available and notify the treatment team in case you notice any sudden changes in mental health.
