Maggie Mu-Tzu NIU, Counseling Psychologist
Sunshine Social Welfare Foundation
Burn injuries are a traumatic experience that can have a lasting impact on an individual's mental health. After such a life-threatening experience, it is common for patients to experience psychological sequelae, which will not only affect the patient’s daily routine, but will also have a serious impact on their rehabilitation progress. In this article, we examine the impact of Post-Traumatic Stress Disorder (PTSD) on burn rehabilitation, what are the signs that therapists need to pay attention to, and what can the therapist do to support the patient in his physical and mental recovery.
What is PTSD?
PTSD is a mental health condition that can develop in individuals who have experienced (or witnessed) a traumatic event, such as burns. People with PTSD often experience symptoms that persist long after the traumatic event has occurred. These symptoms can be categorized into four main clusters:
Intrusive thoughts or memories of the traumatic event: These can manifest as distressing nightmares or flashbacks, where individuals relive the traumatic event.
Avoidance of triggers or reminders associated with the trauma: This may include avoiding certain places, people, or activities that remind them of the trauma.
Negative changes in thinking and mood: This can take the form of feelings of guilt, shame, or a distorted sense of blame for the event.
Heightened arousal or reactivity: This can take the form of increased irritability, hypervigilance, difficulty concentrating, or an exaggerated startle response.
These reactions may lead to more severe emotional ups and downs, impaired daily routines, and even social isolation. Not every burn patient will develop PTSD, and for the patients who do, the severity and duration can vary. If these symptoms persist for more than a month, it is likely that the individual is suffering from PTSD, and the patient should seek professional help from a mental health expert, such as a psychiatrist or psychologist, who can provide an accurate diagnosis and appropriate treatment.
What is the treatment for PTSD?
Psychological treatment for PTSD typically involves a combination of medication and psychotherapy, such as individual therapy, group therapy, family therapy, or community therapy. Sleeping pills or mood-stabilizing medication may be prescribed by a psychiatrist, but with close monitoring, patients should not be concerned about addiction. Psychotherapy sessions with a psychologist can help patients learn coping mechanisms and increase their sense of control and security.
What is the impact of PTSD on burn rehabilitation?
In clinical practice, therapists often come across patients who exhibit symptoms of lethargy, apathy, and excessive tiredness. These patients may struggle with sleep disturbances due to PTSD, experiencing difficulties falling asleep and frequent nightmares. As a result, they may try to compensate for the lack of sleep by napping during the day, leading to an irregular routine that further affects their energy levels and motivation. Consequently, patients may arrive late for rehabilitation sessions, doze off during training sessions or seem to be involved only half-heartedly in their exercises.
Another significant challenge therapists face is patients who prefer to skip rehabilitation rather than participate in activities independently. This behavior stems from a deep-seated sense of insecurity and vulnerability when left alone. Patients with PTSD often feel unsafe without the presence of a caregiver or family member, rendering them unable to perform tasks on their own. This reliance on others not only hampers their progress in rehabilitation but also intensifies their feelings of powerlessness and loss of control.
Patients may exhibit regressive behaviors, convinced of their inability to accomplish even simple tasks. This pessimistic mindset arises from the trauma they have experienced, leading them to perceive the future as uncontrollable and hopeless. Consequently, patients may display resistance or avoidance when it comes to participating in their own rehabilitation.
When confronted with these behaviors, the therapists must understand that they are not expressions of the patient’s personality or character, like laziness on the part of the patient. Instead, it is because PTSD is standing in the way of physical recovery.
How can the therapist help burn patients suffering from PTSD?
Although the actual treatment of PTSD is provided by mental health professionals such a psychiatrists or counseling psychologists, therapists can also contribute to supporting the patient’s mental health recovery and reduce the disruptive impact of PTSD on rehabilitation.
1. Facilitate referral to mental health professional
PTSD is a serious condition that requires professional treatment and should not be ignored. Because of their frequent interaction with patients, therapists are often in a good position to observe and identify potential symptoms of PTSD, and the first thing therapists can do is help refer patients to appropriate mental health professionals. However, patients may be reluctant to seek treatment due to the stigma associated with mental health, therefore the therapist can help patients to understand that seeking professional help is not a sign of weakness, but rather a necessary step in the recovery process.
2. Develop and incorporate empathic strategies to the process of rehabilitation
Therapists must approach such situations with empathy, patience, and a deep understanding of PTSD, recognizing that the patient's behavior is rooted in their trauma and that they have the potential to overcome it with time and support. Therapists can play a vital role in helping patients regain a sense of control, security, calmness, competence, connection, and hope by incorporating simple yet effective empathic strategies in their work with the patient. By providing detailed explanations before rehabilitation exercises, therapists prepare patients psychologically and establish a sense of safety. Encouraging patients to maintain a normal routine, engaging in relaxing activities during sessions, and recognizing their progress helps instill a sense of calm and competence. Furthermore, therapists can facilitate social interaction by discussing the patient's interests, organizing group exercises, and arranging social participation outings. By incorporating patients' future goals into their rehabilitation plans and fostering hope, therapists can motivate patients and increase their compliance with the treatment process.
3. Don’t forget to involve the caregiver!
The role of caregivers is also crucial in supporting the patient during the rehabilitation process. A therapist can engage caregivers to help them understand the impact of PTSD on the patient and teach them methods to support their recovery. By working together, patients can overcome the effects of PTSD and make significant progress in their rehabilitation plans.
Conclusion
Rehabilitation can be difficult for burn injury patients with PTSD, but with the right support and guidance, it can be successful. The therapist can first become aware of PTSD and recognize potential symptoms. The therapist can also work with the patient to help them understand the impact of PTSD on their recovery and guide the patient toward appropriate mental health resources. In the process of rehabilitation, the therapist can incorporate empathic strategies to help the patient regain a sense of control, security, calmness, competence, connection, and hope. Caregivers can also be engaged to provide support and understanding to the patient. With the right support and guidance, patients can overcome their challenges and make progress in their rehabilitation journey.
Read online tips to help burn patients with Post-Traumatic Stress Disorder (PTSD):
To learn more about how burn rehabilitation can be affected by psychological factors and what therapists can do to help their patients, check out our online training Psychosocial Factors Affecting Burn Rehabilitation.