PTSD flashbacks worksheet stimulus discrimination

What is the theory behind this PTSD flashbacks worksheet  stimulus discrimination?

A distinct symptom of PTSD is the re-experience of the traumatic event through intrusive images, nightmares or flashbacks that are a cause of significant distress. This worksheet is based on a clinical intervention used in Cognitive therapy for PTSD (CT-PTSD) called  ‘stimulus dicrimination’. 

It helps clients with PTSD to identify the subtle cues that trigger their intrusive memories that are most often involuntary. The next step is to learn how to distinguish those cues from the memory of the actual traumatic event and the ones that have triggered the memory in the current safe context.

How will the worksheet help?

This worksheet helps clients to focus their attention on the present so that they can differentiate between the trigger cues in the current context and those that were present at the time of the traumatic event. The aim is to help them realise that cues in the present context are safe (NOW) and unrelated to those from the threatening traumatic memory (THEN).

How to use the worksheet?

This worksheet is to be used immediately or shortly after the traumatic memory was triggered. Instruct the client to write down the situation that triggered their memory then move on to highlighting the differences between the THEN and NOW. 

It would also help to instruct clients to use coping strategies such as breathing exercises to control their heightened emotional state following the trigger. 

PTSD flashbacks worksheet stimulus discrimination

What you are experiencing is caused by the remnants of the past. Your past cannot control you. You were in danger THEN but you are safe and sound NOW. Describe the situation that triggered traumatic memory then move on to highlighting the differences between the past and present. Practice breathing exercises before, during and after this worksheet if you feel the need to. 

Describe the situation that triggered the unwanted memory

What are the differences between the situation THEN and your situation NOW?(You could describe the environment, circumstances, time of the day, emotional reactions, physical reactions and bodily sensations, smells, sounds, people etc.) 
THEN (from the traumatic event)NOW (your present experience)


Ehlers A & Clark D. M. (2000) A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319–45

You can download this worksheet here.

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