Working with Differential Diagnoses and PTSD

Published by ninakeeler on

PTSD is not the only disorder that may be triggered by a traumatic event.  Other diagnoses such as depression, anxiety, adjustment disorders, psychosis-related disorders, personality disorders, and dissociative disorders could also come into play.  Being able to navigate through the multitude of possibilities is a part of doing good trauma treatment.

I like to tell my clients I have a number of hypothesis in my back pocket and as we continue to work together, and I get to know them and their story I am narrowing those hypothesis down.  This works well when there is no outside time factor such as insurance demanding a diagnosis after the intake session.   In these situations, I try to take what I know and give the best diagnosis at the time, knowing that in some cases it may change as time passes and more information is revealed.

Below are three things I discuss in this week’s vlog.

1.Be willing to update your diagnosis as times past. 

2. Understand that a trauma survivor might not be forthcoming with assessment information in the beginning. 

3. Be open to the idea of comorbid diagnoses.

Taking your time and being open to continual updates to the diagnosis as the client’s treatment unfolds is one way to ensure the client is being given the best trauma treatment possible.  Trauma is complex and how it shows up in a person’s system and day to day to experiences can be complex.  Giving yourself space and time to really understand the client and their symptoms ensure you provide the most accurate diagnosis and best possible care.

Categories: Training


Mara · May 17, 2019 at 10:19 am

I’m wondering how insurance companies typically respond when you update/change a diagnosis.
Tips for navigating that?

    ninakeeler · May 18, 2019 at 7:50 am

    Mara, I have never gotten push back. I usually do it at my treatment plan review which is every three months. I kind of feel as if that makes sense for a dx update. Hope that helps.

Mara · May 18, 2019 at 12:53 pm

Yes, thank you! That makes sense. It’s good to know insurance companies don’t give you any trouble.

    ninakeeler · May 22, 2019 at 1:17 pm

    No problem. Yeah…fingers crossed not yet at least!

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