Identify and challenge stuck points — the unhelpful beliefs about the trauma and its aftermath that maintain PTSD symptoms.
Stuck points are beliefs that developed from or were reinforced by the trauma — about safety, trust, power/control, esteem, and intimacy. They often take the form of overgeneralised conclusions (e.g. "The world is completely dangerous," "I can never trust anyone"). This worksheet helps you identify a stuck point, examine the evidence, and develop a more balanced perspective.
Use during the cognitive restructuring phase of CT-PTSD to identify and update the negative appraisals of the trauma and its aftermath that maintain PTSD symptoms. Target appraisals identified during formulation and reliving work.
Explain that trauma often leads to understandable but inaccurate conclusions about ourselves, others, or the world. The worksheet helps examine these conclusions with the same curiosity and evidence-based approach used throughout therapy.
For clients with deeply held guilt or shame appraisals, begin with less emotionally charged appraisals to build the skill before tackling core beliefs. For clients who intellectually restructure but retain the emotional conviction, combine with reliving-based updating at the hotspot where the appraisal was encoded.
Avoid purely cognitive restructuring for appraisals rooted in pre-trauma schema without addressing the developmental context. Do not use in a way that implies the client's emotional response to the trauma is 'wrong' — validate the emotion while examining the appraisal driving it.
The most common trauma appraisals fall into categories: self-blame, permanent change, inability to cope, and the world as completely dangerous. Identify which category applies and tailor the Socratic questioning accordingly. The goal is a more balanced and contextualised appraisal, not a positive one.
Suitable for clients working with ptsd, stuck points, trauma appraisal, cpt, cbt, cognitive restructuring, safety, trust. This tool can be used as a standalone worksheet or as part of a structured homework plan.
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Practise and record the use of grounding techniques when experiencing flashbacks, dissociation, or overwhelming emotions.
Explore how the traumatic event has affected your beliefs about yourself, others, and the world.
Write a structured impact statement exploring how the trauma has affected your beliefs about safety, trust, power, esteem, and intimacy.
Prepare for a visit to the trauma site, record predictions, and process the experience afterwards to update the trauma memory.