Psychosocial Factors Affecting Post-Burn Rehabilitation: Post-Traumatic Stress Disorder

HOW TO ADDRESS PSYCHOSOCIAL FACTORS AFFECTING BURN REHABILITATION

Tips for Therapists to Help Patients Deal with Post-Traumatic Stress Disorder (PTSD)

HOW CAN THERAPISTS ADDRESS THE IMPACT OF PTSD ON REHABILITATION?

When it comes to addressing the challenges posed by PTSD in clinical practice, therapists can play an important role

STEP 1: IDENTIFY SIGNS

Although the therapist cannot make a diagnosis, he can still be on the lookout for these signs during rehabilitation that may point to possible a PTSD issue:

Patient looks lethargic and apathic, complains of being tired, sometimes comes late or sleeps during rehabilitation

Patient does not want to do rehabilitation alone, seems insecure and unable to stay alone or do anything without being accompanied by his caregiver.

Patient shows signs of regressive behaviors, overreliance of patient on caregiver even when he is fully capable of doing those things himself

Patient shows low levels of motivation and participation in rehabilitation, defeatist attitude.

Remember!

Sleep disturbances may be caused by nightmares or poor sleep quality due to PTSD, but pain and itch from scars can also keep patients up at night and significantly affect their sleep quality

STEP 2: GUIDE PATIENT TOWARDS PSYCHOLOGICAL HELP

If PTSD is suspected

Refer the patient to appropriate psychological assistance, such as social workers, psychologists, or psychiatrists, who can provide psychological assessments and necessary treatment

Help the patient overcome the stigma associated with mental health and emphasize that seeking professional help is a normal response to trauma

HOW CAN THERAPISTS ADDRESS THE IMPACT OF PTSD ON REHABILITATION?

STEP 3: INCORPORATE EMPATHIC STRATEGIES IN THE REHABILITATION PROCESS

To help the patient cope and eventually overcome PTSD, as well as reduce the negative impact this condition has on rehabilitation, the therapists can:

Help the patient establish and maintain a healthier, more stable daily routine

Reestablish a sense of security, calm, competence, connection, and hope during rehabilitation (See next section for more details)

STEP 4: EDUCATE AND INVOLVE THE CAREGIVER

The patient needs to be understood and supported on all fronts. This includes his main caregiver(s). The therapist can:

Help the caregiver(s) understand what is PTSD and what is the impact of PTSD on the patient.

Teach the caregiver(s) about the above-mentioned empathic strategies and methods

WHAT EMPATHIC STRATEGIES CAN BE USED TO REDUCE THE IMPACT OF PTSD ON REHABILITATION?

When it comes to addressing the challenges posed by PTSD in clinical practice, therapists have several strategies at their disposal to help patients develop coping mechanisms and enhance their sense of security, calm, competence, connection, and hope.

SENSE OF SECURITY

Provide detailed explanations before starting exercises, to help the patient know what to expect and be psychologically prepared for any physical discomfort.

Establish a specific time and place for rehabilitation sessions to allow the patient to predict and mentally prepare for the activities.

Adjust intensity of exercises based on the patient’s reaction to pain

Carefully choose words and gestures to create an atmosphere of safety and reassurance

SENSE OF CALM

Encourage the patient to maintain regular routines for meals and resting hours

Incorporate light activities like chit-chat or listening to music during rehabilitation

Combine relaxation techniques or fun activities with rehabilitation exercises (ex: arts and crafts projects).

SENSE OF COMPETENCE

Set achievable goals and design daily missions based on the patient’s abilities

Give verbal encouragements and point out to the patient his progress (compare progress made with a week/a month ago, specific things the patient is now able to do).

Relate rehabilitation to activities of daily living (ex: eating, showering) to set concrete and meaningful goals.

Give sense of control by asking the patient to keep time during the rehabilitation session or allowing the patient to decide the order of rehabilitation exercises

WHAT EMPATHIC STRATEGIES CAN BE USED TO REDUCE THE IMPACT OF PTSD ON REHABILITATION?

SENSE OF CONNECTION

Facilitate interaction with peers

Encourage conversations about the patient's interests beyond rehabilitation

Organize group activities or social outings to alleviate sense of isolation

SENSE OF HOPE

Discuss the patient's future goals and aspirations (about family, work or personal interests), and incorporate them into the rehabilitation plan.

Highlight progress made by the patient so far

Introduce burn survivors who have overcome similar challenges, to instill hope and confidence in the patient's journey towards recovery.