aps through getting the family involved with therapy), and shows the client how crucial their own coping techniques were in enabling him/her to cope with the traumatic event. The goal of these phases of therapy for PTSD clientele is to have them address what life would be like if a miracle occurred and the traumatic ordeal was over (Meichenbaum 1994). In doing this, the therapist shifts the perspective of the client from victim to survivor. As one of Meichenbaum’s clients stated, “I was victimized, I was in a fight that was not a fair fight. I have reached the stage of survivor and am no longer a slave of victim status. I look back with sadness rather than hate. I look forward with hope rather than despair. I was a victim, I am a survivor” (Meichenbaum, 1994). The shifts in language that the clients use and the metaphors they employ from victim to survivor have important implications for how they appraise traumatic events and how they construct narratives (Meichenbaum, 1994). Termination of therapy involves discussing with the client what the future holds for him/her. During the termination of therapy, the therapist educates the client ways to look out for triggers (i.e., anniversary relapse) and they collaboratively discuss what kind of recovery work needs to be done in terms of relapse prevention, such as having a booster session if the client finds him/herself in a troublesome situation and need assistance. Behavior change occurs through the sequence of intertwined processes involving the interaction of self-instruction, cognitive structures, and behavior and their resultant outcomes. Prior to CBT, a client’s internal dialogue about his/her maladaptive behaviors is likely to be repetitive and unproductive, contributing to a sense of helplessness and despair. The client must attend to his/her maladaptive behaviors and begin to notice opportunities for adaptive behavioral alternatives if he/she is to produce beh...
