28 Simple PTSD Techniques for Immigration Evaluations – Part I

two women talking

National PTSD Awareness Day was celebrated a couple of days ago on June 27th, and I wanted to finish the month by focussing on healing for our clients who have experienced trauma.

Many of our clients have experienced trauma, and if we are seeing them only for a couple of sessions to conduct an evaluation, we may not be able to do the more in-depth clinical work needed.

However, there are still many things we can do to help!

Immigration Evaluations Might be Their First Time

It will be the first time for many clients to meet a mental health clinician. Thus, it is an excellent opportunity to set the tone and expectation for their future interactions with therapists.

It’s helpful to explore the stigmas about mental health and help debunk some myths about getting care and help. Here is a short video about breaking the mental health stigma, specifically for the Latinx population.

Another thing to consider is that even if you are only seeing a client for an evaluation, you can still provide crucial psychosocial education about the symptoms they are experiencing.

I like to give clients simple booklets on a variety of topics. You can obtain them for free (in English and Spanish) here.

Finally, if a client becomes overwhelmed during the evaluation, I like to use a straightforward grounding technique. I also like to teach clients this one technique so that they can use it at home. Of course, be sure to use your best clinical judgment about using this or any grounding technique with a client.

5-4-3-2-1 Grounding technique

Ask the client to sit comfortably, take a deep breath, and then tell you:

  • 5 – Describe five things you can see in the room (“picture hanging on the wall,” “spot on the ceiling,” or “a red car outside”)
  • 4 – Name 4 things you can feel (“my feet against the floor” or “the cushion I am leaning against”)
  • 3 – Listen for three sounds you can hear now (“traffic outside,” “clock ticking”) and have the client say them out loud to you
  • 2 – Say two things you can smell (“the scent of my shampoo”). If the client can’t smell anything, have them name their two favorite smells.
  • 1 – Tell me one thing you can taste – What does the inside of your mouth taste like? (“toothpaste from brushing my teeth” or “the coffee I had this morning”) if the client can’t taste anything, have them share with you their favorite taste.

28 Simple Techniques Based on Senses

I want to share some techniques to help our clients who have experienced trauma. These are by no means the in-depth type of work that needs to happen to help our clients heal from trauma – there is certainly no substitution for excellent psychotherapy with a trauma-informed clinician.

However, these techniques are quick and straightforward and, if appropriate, can be done during an evaluation to help calm a client experiencing distress.

Also, You can quickly share them with a client as a simple way for them to regulate their feelings when they are on their own.

I’ll be sharing with you a total of 28 techniques (one for each day of the month), and I’ll group them according to the sense that they focus on (sight, smell, touch, etc.).

As always, please use your best clinical judgment when using these tips and techniques and always seek additional supervision if needed.

Movement

To start, we’ll be exploring the world of movement. Although not technically one of the five senses, techniques that focus on action can be incredibly soothing for clients that feel antsy, fidgety, or restless.

#1 – Slow stretches with simple yoga or tai chi moves

It can also be as simple as a stretch or just standing tall and loosening your knees, letting them unlock. My favorite yoga instructor, online Yoga with Adrienne, has many free videos, including this 5-minute stress fix. She even has a video for “Yoga for PTSD” if someone is interested in a more extended sequence. As always, you want to be mindful of a client’s physical condition.

#2 – Rocking or pacing 

It is not a significant movement but can be very soothing. Think of a middle school slow dance and slowly shift your weight from one foot to another.

# 3 – Slow breathing

There are lots of deep breathing techniques out there, but sometimes simpler is better. For example, you can help a client by instructing them to breathe in for the count of two, hold it for two, and then breathe out for two counts.  

#4 – Artwork

The healing benefits of art therapy are far too many to list here, but for a simple technique, you can ask the client to draw or doodle while paying close attention to the medium they are using, whether it’s a crayon or charcoal.

#5 – Detailed work

This one might be best for the client to try while at home. Intrusive thoughts and memories can be very disruptive and distressing.

Clients can refocus their minds on something that requires them to focus detailed attention on something else, such as completing a jigsaw puzzle, applying intricate makeup, or assembling a model plane.  

Sight

Now, let’s start looking at the world of sight (ha! see what I did there?!)

In all seriousness, we rely on our sight probably more than any of our other senses, so it makes sense to tap into this sense next.

#6 – Motion toys

Watching these in motion can be soothing, and you might already have some of these in your office. My favorites include Newton’s cradle, sand hourglasses of different sizes, and liquid bubble toys.

#7 – Looking at a particular photo

You can help a client find or take a photo that invokes only good memories or thoughts. Then, they can save it on their phone or print it out to carry with them. However, I advise clients against using this photo as a screensaver because they want to reserve the photo when they feel upset. They can then look at the photo and relive the positive memory. But, if they are seeing it all the time will dilute the effect.

#8 – Get lost in a book

Sometimes getting lost in another world can be a welcome respite from what your client is experiencing in their mind. You can help them come up with titles that won’t be upsetting or triggering ahead of time.

#9 – Watch an uplifting show or movie

Like reading a book, an uplifting, positive, or funny show or movie can help distract clients from their intrusive thoughts. You can brainstorm with the client to see what shows they find uplifting and help them make a list ahead of time. Remind them only to watch things they know are helpful to them avoid any unexpected scenes that could be triggering.

#10 – Look at soothing GIFs

I love GIFs! I think they can be funny, witty, and calming. The repetitive nature of some GIFs can have a soothing effect on your client. My favorites are this one and these, and there’s even a set for Disney fans. You can help your client come up with a list of what they find soothing.

We are reaching to the end of this first part one where we reviewed the first 11 PTSD techniques, where we covered the 5-4-3-2-1 Grounding technique, as well as movement and the sense of sight.

Remember that when it comes to Immigration Evaluations, we can use all the senses to cause a connection with a client.

In the second part I will speak about PTSD techniques based in hearing, smell, taste and touch.

Cecilia Racine: Immigration Evaluation Therapist

I’m Cecilia Racine, and I teach therapists how to help immigrants through my online courses. As a bilingual immigrant myself, I know the unique perspective that these clients are experiencing. I’ve conducted over 500 evaluations and work with dozens of lawyers in various states. Immigrants are my passion, I believe they add to the fabric of our country.

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