Post Traumatic Stress Disorder (PTSD) symptoms

Post Traumatic Stress Disorder (PTSD) symptoms

Colleague 2: Kamran

Jake is a 31-year-old married veteran, he experienced and witnessed a traumatic event on a deployment to Iraq one year ago. Jake is currently taking the medication Paxil for his Post Traumatic Stress Disorder (PTSD) symptoms. He has difficulty sleeping, heart palpitations, and moodiness. He is drinking alcohol heavily to avoid dealing with his feelings which is negatively affecting his marriage, children, and employment (Plummer, Makris & Brockson, 2014).

The evidenced-based intervention that I selected for Jake that I believe would be effective for him was Cognitive Processing Therapy (CPT), This practice will focus on the client’s avoidance of painful memories or reminders that prevents an actual processing of the past traumatic memory. He may be harboring false beliefs about the causes and results of the trauma which are creating strong negative emotions. CPT for PTSD is primarily a cognitive therapy.  The therapy will first focus on distorted beliefs about the trauma he experienced such as denial and self-blame. Then throughout this process, clients are taught to challenge their beliefs and assumptions through Socratic questioning and the use of daily worksheets. Once dysfunctional beliefs are deconstructed, more balanced self-statements are generated and practiced. It may help him to write detailed accounts of the most traumatic incidents during his deployment. The goal in CPT is that clients learn to make sense of their trauma and incorporate this understanding into their beliefs about themselves, others, and the world in a balanced way. Treatment can be delivered in individual or group format conducted by social workers, psychologists, psychiatrists, and other mental health therapists licensed to provide psychotherapy.  (SAMHSA, n.d).

An explanation I would give to the supervisor regarding the implementation of CPT is that I would educate my supervisor that this treatment is not new or experimental and has roots dating back to the 1980’s. and has been confirmed effective by evidence-based research. The other factor to note about the intervention is that first implementation would be simple and straightforward because the intervention could be done by the social worker without having to pay for copyright use or learning specific skills. Treatment consists of typically 12 sessions (range 10-15) conducted once or twice weekly for 60 minutes each (90 minutes in a group setting (SAMHSA, n.d). I would also mention a supporting study using CPT for PTSD was conducted using treatment-seeking veterans with military-related PTSD from Australia who was randomly allocated to receive 12 twice-weekly 60-minute sessions of CPT individually and in a group setting, demonstrated significant improvement scores from baseline to posttreatment (Forbes et al., 2012), (Laureate Education, 2013c).

The two factors that I believe may hinder implementation of CBT in the Jake Levy case is his cooperation and making sure that he attends both the individual and group components of the intervention. I would try to stress the importance of total compliance with the program for it to be effective. Along with that, I would have to be aware of the adverse effects related to CPT which may include mild to moderate increases in PTSD symptoms, anxiety, depression, and distress when the client begins to focus on his trauma. Based on research findings, on average, clients do not report a worsening of symptoms after starting CPT, and any worsening that does occur is generally short-lived (SAMHSA, n.d).

References

Forbes, D., Lloyd, D., Nixon, R. D. V., Elliot, P., Varker, T., Perry, D., Bryant, R. A., & Creamer, M. (2012). A multisite randomized controlled effectiveness trial of cognitive processing therapy for the military-related posttraumatic stress disorder. Journal of Anxiety Disorders, 26, 442–452.

Laureate Education (Producer). (2013c). Levy family episode 2 [Video file]. Retrieved from https://class.waldenu.edu

Plummer S.B,  Makris S.., & Brockson S.M. (2014) Sessions: Case Histories. “The Levy Family”. Laureate International Universities Publishing, Inc.

Substance Abuse and Mental Health Services Administration (n.d.) NREPP: SAMHSA’s registry of evidence-based practices and programs. Retrieved June 5, 2018, from https://www.nrepp.samhsa.gov

 

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