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PTSD (Post Traumatic Stress Disorder) is a psychiatric disorder that can occur following an experience or witnessing of a life-threatening event such as natural disasters, military combat, or serious accidents. Approximately 8% of Americans will experience PTSD in their lifetime. Learn more about this disorder and how to bring useful information to your massage therapy practice. (Please use Google Chrome when testing. Safari is incompatible with our test site.)
PTSD Course Outline (5 CEUs):
  • Chapter One: What is PTSD?

PTSD is the abbreviation for Post Traumatic Stress Disorder. It is a “a psychiatric disorder that can occur following the experience or witnessing of a life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or physical or sexual assault in adult or childhood.”i About 10 percent of women and 5 percent of men will experience PTSD in their lifetime, with 1 in 30 adults in the United States suffering from the disorder in any given year,ii or 3.6 percent of American adults aged 18 to 54. That is roughly 5.2 million people. About 7-8 percent of Americans will be diagnosed in their lifetime.

  • Chapter Two: What Are the Symptoms of PTSD?

Symptoms of PTSD can occur immediately after trauma, or take months or years to appear. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition(DSM-IV) requires that the symptoms last at least one month after trauma, and that symptoms are associated with “decline in social, occupational, or other important areas of functioning.iii

  • Chapter Three: Diagnosing PTSD

Diagnosing the disorder is difficult because one of the symptoms is avoidance, meaning that the patient is often unwilling to talk about the incident or how it is affecting them. Due to societal pressure that people “deal with” their emotional issues, some doctors or other health professionals might even ignore the signs of PTSD.iv A patient’s symptoms may also be obscured “by depression, substance abuse, or other comorbidities.”v

  • Chapter Four: Etiology of PTSD

Etiology is the study of the causes or origins of PTSD. Aside from the obvious cause of a traumatic event, what makes one person more likely to develop PTSD than another who also suffered from the same trauma? Many researchers believe that a neurobiological predisposition must exist for a person to develop PTSD. “Those likely to develop PTSD tend to have a pre-existing depression or anxiety disorder, or a family history of anxiety and neuroticism.”vi

  • Chapter Five: Traditional Treatment

Treatment of PTSD is highly individualized, depending on the patient’s specific symptoms, trauma, co-disorders, and other needs. Generally speaking, “Treatment options include patient education, social support, and anxiety management through psychotherapy and psychopharmacologic intervention. Patient education and social support are important initial interventions to engage the patient and mitigate the impact of the traumatic event. Local and national support groups may help to de-stigmatize the mental health diagnosis and reaffirm that symptoms of PTSD involve more than just a reaction to stress and require treatment. Support from family and friends encourages understanding and acceptance that may alleviate survivor guilt. However, the mainstay of treatment is psychopharmacologic and psychotherapeutic intervention.”vii

  • Chapter Six: Alternative Therapies

There are a number of alternative therapies currently being researched for treating patients with PTSD. These alternative therapies can help relieve stress and anxiety, and help the patient function in their day to day lives. Treatments range from acupuncture to aqua therapy (including surfing!).viii The use of alternative therapies is actually much higher among soldiers than it is among civilians- 44 percent of active duty service members use some form of complementary or alternative medicine, compared to only 38 percent in the general population.ix

  • Chapter Seven: Massage for PTSD

Massage therapy is an excellent way to help manage the symptoms of PTSD. The overall goal of massage “is to help the client to become safely "embodied within the self." Massage therapists can teach clients safe and effective ways of self-soothing and stress management. People who have been traumatized are no longer at home in their bodies. Talk therapy alone does not always adequately address the fear and mistrust that has been encoded into their bodies.”x

  • Chapter Eight: When Your Client Has a Crisis

A client with PTSD may experience any number of crises during a massage therapy session, including flashbacks and panic attacks. You will need to be prepared to deal with these appropriately.

  • Chapter Nine: Self Care

When dealing with clients who have experience trauma, self-care is essential for a massage therapist. “Without good self-care for the therapist, commitment and compassion weaken, interest wanes, and integrity may be challenged. If the therapist is in an unhealthy frame of mind, a client with PTSD, potentially so attuned to the will and interest of others, will often perceive the shift immediately. Clients may then hide aspects of pain and confusion so as to protect the massage therapist, harkening back perhaps to earlier situations in their lives where their needs may have been distorted or ignored. The massage therapist can then be lulled into a false sense of comfort with the client.”xi




i Nebraska Department of Veterans’ Affairs, “Post Traumatic Stress Disorder,”


ii National Alliance on Mental Illness, “ What is Post Traumatic Stress Disorder (PTSD)?”


iii Ibid.


iv American Family Physician, “Diagnosis and Management of Post Traumatic Stress Disorder,”


v Ibid.


vi Ibid.


vii NAMI


viii American Family Physicians


ix Samueli Institute, “Systematic Review: Acupuncture for Post-Traumatic Stress Disorder,”


x American Massage Therapy Association, “Recovering Body and Soul from Post-Traumatic Stress Disorder,” March 21, 2000,


xi Ibid.



Continuing education units (CEUs) are provided via electronic download in PDF format. Review the course work at your own pace and then take the included test online. You can print your certificate immediately after passing each test! All coursework is NCBTMB approved (NCBTMB # 451897-12). NOTE: Each state has different requirements. Please be sure to check our state requirements page and contact your state to verify your requirements.