Recognizing PTSD (ICD-11): PDF Worksheet, Tools and Exercises

Patients presenting with PTSD rarely arrive with the label. They come in describing fragmented sleep, a body that will not settle, and a vague sense they are "not handling it well." Getting from that presentation to a shared clinical picture, quickly and without pathologising, is exactly what this fiche PDF is designed to support.

Why PTSD Is Hard to Explain at Intake

The diagnostic criteria are deceptively clear on paper, but in session the concept fragments. Patients hear "trauma" and immediately discount their own event ("It wasn't that bad"). They confuse re-experiencing with ordinary sad memory. They read avoidance as sensible caution rather than a maintenance cycle. And the sense of current threat, expressed as hypervigilance and irritability rather than fear, almost never maps onto what they expect "PTSD" to look like.

A verbal explanation alone rarely holds. You can spend ten minutes describing the three-pillar structure, and the patient nods while privately wondering whether their own reactions qualify. The absence of a shared visual reference means each term has to be re-anchored at every subsequent session. The fiche solves this directly: it gives the patient something to look at while you speak, and something to take home as a reference point.

What the Fiche Contains, and Why the Visual Layout Matters

The resource is built around six panels, each addressing a distinct clinical need.

• Panel 1 presents the three-pillar diagram: Re-experiencing / Avoidance / Current threat, shown as simultaneous co-occurring dimensions, not a checklist. The visual immediately communicates that all three must be present together, which is the piece most patients miss.
• Panel 2 draws a direct, side-by-side contrast between ordinary remembering and genuine re-experiencing: "Body: calm, in your chair. Time: past tense" versus "Body: reacting now. Time: present tense." This distinction is where most psychoeducation stalls at the oral level; the parallel layout resolves the confusion in one glance.
• Panel 3 lists precipitating events broadly, anchored around the phrase "what matters is the experience of overwhelming threat or horror, not the label", directly countering the "soldiers only" myth before it surfaces.
• Panel 4 covers differential diagnosis: acute stress reaction, Complex PTSD, depression, panic disorder, and adjustment difficulties. This panel supports the early formulation conversation without requiring the clinician to narrate each distinction from scratch.
• Panel 5 addresses five named myths ("You must remember the whole event," "Avoidance is good coping"), framed as corrections the patient can re-read independently. It pairs naturally with tools for examining avoidance cycles and understanding how trauma memories form.
• Panel 6 explains why naming the diagnosis matters and names the evidence-based approaches: trauma-focused CBT, prolonged exposure, and EMDR.

> Key takeaway: This fiche is a visual support that facilitates the explanation of PTSD in session, not a self-administered questionnaire. You use it to anchor your psychoeducation, the patient leaves with a concrete reference.

When and How to Introduce It in Practice

The fiche fits naturally in a second or third session, once the anamnèse has surfaced the traumatic context and a basic alliance is established. Introducing it earlier risks feeling diagnostic before the patient is ready; waiting too long means the absence of a shared framework slows everything else.

A useful framing: "I'd like to show you something that maps what you've been describing, not to put a label on it, but so we have the same picture in mind when we talk." This positions the fiche PDF as a shared clinical vocabulary, not a verdict.

When debriefing, panel 2 (re-experiencing versus remembering) tends to produce the strongest reaction, patients frequently pause here and revise their self-assessment upward. Panel 5 is useful for patients who have spent months or years self-dismissing. For complex or prolonged trauma presentations, the fiche opens the conversation toward Complex PTSD and the additional self-organization difficulties that structure differentiates.

For patients whose trauma occurred in medical contexts, it pairs usefully with resources addressing critical illness and PTSD. Clinicians building toward an exposure-based protocol will find it a clean conceptual precursor to graded exposure hierarchy work, and understanding the fight-flight-freeze response complements panel 3's somatic content directly. Once the diagnostic picture is shared, PTSD-specific tools for memory and narrative work and the Ehlers and Clark cognitive model become the natural next steps. For clinicians using EMDR, negative and positive cognitions work follows logically once the pillar structure is understood.

The fiche does not replace clinical formulation, but it shortens the time from first disclosure to shared understanding, which is where psychoeducation earns its place in trauma work.

Sources

• World Health Organization (WHO) (2022). 6B40 Post traumatic stress disorder. World Health Organization.
• Brewin, C. R. (2020). Complex post-traumatic stress disorder: a new diagnosis in ICD-11. BJPsych Advances, 26(3), 145-152.
• Cloitre, M., Garvert, D. W., Brewin, C. R., Bryant, R. A., & Maercker, A. (2020). ICD-11 complex post-traumatic stress disorder: simplifying diagnosis in trauma populations. The British Journal of Psychiatry, 216(3), 129-131.