People who are the most likely to be traumatized and to develop PTSD are often the least likely to receive treatment. For example, individuals with serious mental illness, substance abuse, or a history of poverty; adolescents; ethnic minorities; and survivors of disasters or mass violence are all more vulnerable to traumatization than those in the general population. This book describes a flexible, low-stress, manualized program for treating PTSD in these individuals, who often have limited social support and resources and face multiple life challenges.

The program emphasizes the use of cognitive restructuring to help clients recognize, challenge, and change negative and unhelpful thoughts and feelings related to their past traumatic experiences. The program is brief—just 12–16 sessions—and focuses on building lasting skills that can be applied to treating the aftereffects of past traumas, lessening the impact of ongoing stressors, and helping clients to more effectively manage their lives. The program is solidly based on research and clinical practice, with modifications to accommodate the unique challenges of special populations. In contrast to exposure-based treatments for PTSD, this treatment is designed to minimize stress and to help participants increase social supports during and following treatment.

This accessible volume includes everything needed to implement the program, including session-by-session instructions, sample dialogues to demonstrate techniques, and user-friendly handouts and worksheets that can be photocopied and used in sessions. It will be useful to social workers, primary care providers, mental health counselors, clinical psychologists, addiction treatment providers, psychiatrists, and other helping professionals who interact with special populations and trauma victims.

Table of Contents

—Mardi Horowitz


—Kim T. Mueser, Stanley D. Rosenberg, and Harriet J. Rosenberg

I. Background and Assessment

  1. Trauma and Posttraumatic Stress Disorders in Vulnerable Populations
    —Kim T. Mueser, Stanley D. Rosenberg, and Harriet J. Rosenberg
  2. Assessment of Trauma and Posttraumatic Disorders
    —Kim T. Mueser, Stanley D. Rosenberg, and Harriet J. Rosenberg
  3. An Overview of the Cognitive Restructuring for Posttraumatic Stress Disorder Program
    —Kim T. Mueser, Stanley D. Rosenberg, and Harriet J. Rosenberg

II. Treatment

  1. Beginning Treatment: Engagement, Orientation, Crisis Planning, and Breathing Retraining
    —Kim T. Mueser, Stanley D. Rosenberg, and Harriet J. Rosenberg
  2. Psychoeducation About Posttraumatic Reactions
    —Kim T. Mueser, Stanley D. Rosenberg, and Harriet J. Rosenberg
  3. Cognitive Restructuring I: The Common Styles of Thinking
    —Kim T. Mueser, Stanley D. Rosenberg, and Harriet J. Rosenberg
  4. Cognitive Restructuring II: The 5 Steps of CR
    —Kim T. Mueser, Stanley D. Rosenberg, and Harriet J. Rosenberg
  5. Cognitive Restructuring III: Solutions to Common Problems
    —Kim T. Mueser, Stanley D. Rosenberg, and Harriet J. Rosenberg
  6. Generalization Training and Termination
    —Kim T. Mueser, Stanley D. Rosenberg, and Harriet J. Rosenberg

III. Special Populations

  1. Psychosis
    —Rachael A. Fite
  2. Borderline Personality Disorder
    —Elisa E. Bolton and Kim T. Mueser
  3. Co-Occurring Posttraumatic Stress Disorder and Substance Use Disorder in Addiction Treatment Settings
    —Mark P. McGovern, Arthur I. Alterman, Keith M. Drake, and Amanda P. Dauten
  4. Adolescents
    —Harriet J. Rosenberg and M. Kay Jankowski
  5. Disaster, Terrorism, and Other Mass Violence
    —Jessica L. Hamblen, Fran H. Norris, and Kim T. Mueser
  6. Minority and Refugee Clients
    —Lisa R. Fortuna
  7. Treatment in Primary Care Settings
    —Annabel Prins, Delia Cimpean, and Paula P. Schnurr




About the Authors

Author Bios

Kim T. Mueser, PhD, received a doctorate in clinical psychology from the University of Illinois at Chicago. He is currently on the faculty of Dartmouth Medical School, Hanover, New Hampshire, where he is a professor in the Departments of Psychiatry and of Community and Family Medicine. Dr. Mueser's clinical and research interests focus on the treatment of posttraumatic stress disorder in vulnerable populations and in psychiatric rehabilitation for persons with severe mental illness. He has given numerous workshops on his work, both nationally and internationally, and has coauthored more than 10 books and more than 300 journal articles and book chapters. He has received a number of awards, including the Armin Leob Research Award and the Emily Mumford Medal for Distinguished Contributions to Social Science in Medicine.

Stanley D. Rosenberg, PhD, is a professor of psychiatry and community and family medicine at Dartmouth Medical School, Hanover, New Hampshire, and director of the Dartmouth Trauma Interventions Research Center. He directs the New Hampshire Project for Adolescent Trauma Treatment (National Child Traumatic Stress Network) and has served as a consultant for multiple state mental health authorities, federal agencies, health provider organizations, and Fortune 500 corporations. He has also has served as a reviewer for the National Institutes of Health, National Institute of Drug Addiction, National Cancer Institute, and multiple professional journals. He is currently on the editorial board of the Journal of Traumatic Stress and has authored several books and more than150 journal articles and book chapters.

Harriet J. Rosenberg, MA, received a bachelor of science degree from Cornell University, Ithaca, New York, and a master of arts degree from Columbia University, New York, New York. She is an instructor in psychiatry at Dartmouth Medical School, Hanover, New Hampshire. As a research scientist at the Dartmouth Trauma Interventions Research Center, she has been a coinvestigator on numerous sponsored research projects involving the study of people with posttraumatic disorder (PTSD), including individuals with severe mental illness, medical populations such as people with seizure disorders and prostate cancer, children and adolescents with trauma and PTSD, and veterans. Ms. Rosenberg has specialized in the clinical assessment of psychiatric disorders, particularly the assessment of PTSD in special and multiply diagnosed populations. She has authored and coauthored numerous articles and book chapters on trauma and posttraumatic disorders.