Many people suffering PTSD or OSI’s (Operational Stress Injuries – psychological injuries sustained while employed as a first responder) also face the added challenge of addiction. What began as an attempt to manage the symptoms of trauma –hyperarousal, difficulties sleeping, flashbacks, hypervigilance and isolation – often becomes an additional problem in its own right. This 9 week program is designed to specifically treat PTSD/OSI and addiction at the same time and designated for military, police, firefighters, EMS, and other first responders.
Our team includes counsellors with extensive trauma therapy training, an occupational therapist, and supporting medical team. Clients are each matched with a primary counsellor, as well as a physician. The specialized nature of the program ensures that much of the programming takes part in small, intimate groups of clients in the same cohort. Clients also have the ability to get consultation from our psychiatrist as needs arise.
The program revolves around the following stages:
Safety, Stabilization and Psychoeducation
Our counsellors and doctors educate clients on the nature of PTSD – how it develops, what the symptoms are, how it affects the body. A thorough understanding of the disorder and why it exists is essential to beginning to learn how to manage it. In addition, addiction education is provided to understand the effects of substances on the brain and body, the multiple causes of addiction, other mental health disorders, risk factors for relapse, and other relevant topics. Staff work with clients to support them to increase their engagement in activities they have withdrawn from that provide enjoyment and a sense of accomplishment, and decrease isolation.
Symptom Management, Trauma Processing and Relapse Prevention
We help clients develop strategies to manage their symptoms, Dialectical Behavioural Therapy (DBT) and Stress Inoculation Therapy (SIT) is used to help clients develop skills to regulate emotions, develop distress tolerance and increase interpersonal effectiveness. This not only reduces the symptoms of PTSD, but also gives the client the tools to do for themselves what they relied on drugs or alcohol for – namely, to regulate intense emotions.
Clients begin to work on in-vivo exposure with our Occupational Therapist. This involves the gradual, guided, and systematic approach to situations and activities that have been avoided due to distress. Clients set their weekly exposure goals with their groups and therapist, and gradually progress through a hierarchy of triggers as progress is made. Clients have opportunities to leave property either alone or in groups to support their in vivo exposure work. In this stage, clients also attend a Cognitive Processing Therapy (CPT) group that focuses on thoughts and feelings related to their trauma. In this group clients identify how the trauma may have impacted how they see themselves and the world, and learn skills to address unhelpful thoughts and feelings. Having the support of others who have are struggling with similar difficulties is an important part of this group.
Simultaneously, clients continue to learn about the impact of their addition, and how this is correlated to PTSD. Clients also attend an intense addiction relapse prevention program to identify their signs of behavioural, mental, and emotional deterioration, and put in place plans to counteract these.
Towards the end of the program, the focus shifts to planning for next steps and discharge. Clients attend sessions to help them identify strategies to maintain their gains when they return home. The team works with clients on developing a solid discharge plan and connects them with ongoing support upon leaving Bellwood.
The program also includes 4 anger management workshops (total of 12 hours). This popular component of the program informs clients about the purposes of anger, its triggers, and its warning signs. Centred around the concept of balance, these sessions invited clients to live a more centred existence and develop healthier, alternate responses to anger.
Facilitated Equine Experiential Learning
In addition to our more traditional approaches, we have introduced Facilitated Equine Experiential Learning (FEEL) into our Addiction & PTSD/OSI Program. FEEL uses horses to teach patients how to reach a specific goal and experience the reward of the journey of personal development. By working in partnership with the horses as teachers and facilitators of change, clients learn to:
- Become aware of subtleties of verbal and non-verbal communication
- Improve attention, mindfulness and focusing abilities
- Become aware of incongruence of intention versus behaviour
- Identify and respect boundaries with ourselves and with others
- Confront insecurities and develop confidence
- Adjust to the relativity of time, expanding the moment
- Cope with stress, grief, and unexpected setbacks.