Factors that may have maintained Saiku’s PTSD symptoms:

• Avoidance: Saiku avoided anything that reminded him of the trauma, including talking about it, thinking about it, and going to places where it happened. Avoidance can help to reduce anxiety in the short term, but it can also prevent healing and lead to the persistence of PTSD symptoms.
• Negative cognitions: Saiku had negative cognitions about himself, others, and the world as a result of the trauma. For example, he believed that he was worthless, that other people were dangerous, and that the world was a scary place. These negative cognitions can maintain PTSD symptoms by making it difficult for Saiku to feel safe and secure.
• Hyperarousal: Saiku was hyperaroused, which means that he was constantly on edge and easily startled. This is a common symptom of PTSD that can make it difficult to relax and sleep.

How trauma and subsequent symptoms impacted Saiku’s beliefs about himself, other people, and the world in general:

The trauma that Saiku experienced had a significant impact on his beliefs about himself, other people, and the world in general. As a result of the trauma, Saiku developed negative cognitions, such as the belief that he was worthless and that the world was a scary place. These negative cognitions can lead to a variety of problems, such as depression, anxiety, and social withdrawal.

TF-CBT strategies used by Dr. Hong to support Saiku’s recovery:

Dr. Hong used a variety of TF-CBT strategies to support Saiku’s recovery. Some of these strategies include:

• Psychoeducation: Dr. Hong educated Saiku about PTSD and its symptoms. This helped Saiku to understand his own experiences and to develop coping mechanisms.
• Exposure: Dr. Hong helped Saiku to gradually expose himself to the things that he was avoiding. This exposure was done in a safe and controlled environment, and it was always at Saiku’s own pace.
• Cognitive processing: Dr. Hong helped Saiku to identify and challenge his negative cognitions. This helped Saiku to develop more realistic and positive beliefs about himself, others, and the world.
• Trauma narrative: Dr. Hong helped Saiku to develop a coherent narrative of his trauma experience. This helped Saiku to process his trauma and to integrate it into his life story.

How Dr. Hong made Saiku comfortable in the process of facing his fears:

Dr. Hong made Saiku comfortable in the process of facing his fears by:

• Building rapport: Dr. Hong established a strong rapport with Saiku. This helped Saiku to feel safe and trusted.
• Providing support: Dr. Hong provided Saiku with support and encouragement throughout the treatment process.
• Going at Saiku’s pace: Dr. Hong respected Saiku’s pace and allowed him to take breaks as needed.
• Using coping skills: Dr. Hong taught Saiku coping skills to help him manage his anxiety and distress during exposure exercises.

Overall, Dr. Hong used a variety of TF-CBT strategies to support Saiku’s recovery from PTSD. He also made Saiku comfortable in the process of facing his fears by building rapport, providing support, going at Saiku’s pace, and using coping skills.