These techniques are all aimed at challenging the personal, neurological, and emotional triggers that sustain maladaptive thoughts and feelings during natural and therapeutic recovery. These measures are specifically recommended in the Canadian Veterans Administration Department of Defense Clinical Practice Guidelines for PTSD at the highest level. Research into the curvilinear pattern of this therapeutic recovery found considerable evidence showing that CPT and PE increase distress and have higher client dropout rates, and clients completing a standard course of treatment still met the diagnostic criteria for PTSD. Furthermore, comorbidity and heterogeneity are considerable factors in the diagnosis of PTSD when measuring levels of resilience and recovery. For example, PTSD shares diagnostic symptoms with Major Depressive Disorder (MDD), including “sleep apnia, anhedonia, irritability and difficulty sleeping.” Epidemiological data reveals that between 48% and 55% of PTSD sufferers have comorbid MDD, anxiety, and substance abuse …show more content…
These factors are Empirically Supported Principles of Change (ESPs) that have been empirically demonstrated to “contribute to clinical improvement, and can be applied in a flexible manner based on clinician judgment”. Five major ESPs that enhance recovery and resilience post-trauma (in the acute phase) include a sense of safety, calming, a perception of self-efficacy, connectedness, and hope. “A sense of safety and calming” is centred on hyperarousal and panic attacks and reducing heightened resting heartrate; “connectedness” involves using social support as a buffer against protracted stress reactions; “perceptions of self-efficacy” examine the extent to which the client believes they have agency in post-traumatic growth; and “hope” draws the client towards an expectancy of resilience and recovery. Measures in self-efficacy have proven to be pertinent triggers affecting sufferers of PTSD. Positive psychology psychotherapeutic approaches centre around the five major ESPs and have documented support showing their effectiveness in resilience and recovery aspects. Approaches such as Somatic Therapies, Resilience Enhancement, Awareness and Movement (STREAM), Embodied Faith and Spirituality (EFS) studies and the Belief, Affect, Social, Imagination, Cognition and Physical Components (BASIC PH) model have been documented as proven and