Is Jacinta in “treatment” or is she in “trauma milieu”? Reading her case, it just didn’t sound like that she was in actual treatment. She is forced into a program syllabus and is highly symptomatic. I cannot hear Jacinta at all. She is being judged a lot. There is no mention of any of her strengths. Is she ready for IOP group? Did she complete a “group readiness” intervention. Anyway . . . I would probably start out with the grounding strategies.
Is it believed that Susto can be reversed in the course of healing? I might take one or two symptoms and ask her to monitor it to see if she can notice improvement. Maybe have her use a fitbit to monitor her sleeping patterns—assuming that she is interested in tracking sleep. Of course there’s a risk that her symptom could become worse before better. So I would want to make really sure that she chooses what she would like to track.
I probably would not actually “refer” her only because that verb seems a little bit “directive”. I would help her to self-refer to a program that she chooses. I would make sure that we reviewed all of the options available and support whatever direction she takes. I also think that Jacinta really needs a skillful individual counselor with whom she forges a strong and lasting therapeutic alliance. I would also coach her on how to find a support group. It would be hard for me to refer her to a manualized treatment group (e.g. DBT) because she already has little control over herself. I would want her to be in treatment that allows her to be whoever she needs to be for that session—as far from judgement as possible.
My big take-away is remembering that humans are very complex and no two people are alike. We must use the trauma informed strategies to learn how to really get to know our clients as best as we can. The theories and content of this course gave me some new tools that I hope will let me better describe the very wide bandwidth of my clients experiences.