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444 – PTSD Case Study
Using the PACER Method
Counselor Toolbox Podcast Episode 444
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director,
Podcast Host: Counselor Toolbox and Case Management Toolbox
• Review a case study using the transdiagnostic, transtheoretical PACER approach

• As they say on Law and Order…
• The following story is fictional and does not depict any actual person or event.”
• John is 48 years old. When he was 24 his house caught on fire due to faulty Christmas lights which were accidentally left on when the family went to bed. His wife and 2 children died in the fire. He has remarried and had 3 more children (14, 12, 9) since the event and continues to experience PTSD related symptoms. His wife insisted he come to counseling after he was caught having another affair.

• PTSD causes a variety of physical, cognitive, emotional and interpersonal alterations to protect the person from future trauma.
• Until the trauma is integrated the HPA-Axis will often stay activated and have exaggerated responses to reminders of the trauma.
• Persistent activation can lead to sleep deprivation, irritability, anger and hypocortisolism altering the levels of testosterone, thyroid hormones and neurotransmitters.
• Sexual activity and risk taking both increase dopamine
• It is important to explore all behaviors and symptoms through the lens of how they might be a reaction to the trauma, to hypocortisolism or something totally different.