P5#1
TaniAlexis
P51.docx4 hours ago
Week 5- Main discussion
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NURS 6640: Psychotherapy With Individuals
Initial post
In this case study, the client is William Thompson who is aged 38. He was a captain in the Iraq war and he is a veteran. He is also a lawyer and he specialized in finance law. However, even with his achievements in regard to his career, he became homeless and started living with his brother together with his wife. The concerns in this case are PTSD and alcohol and this cost him his job. When the finances stopped coming in, he was not able to pay for his mortgage. This is a typical case that happens to many army veterans. Being in war where very many traumatic events occur could lead to the development of post-traumatic stress disorder. Veterans see their friends die. They see other human beings getting injured very seriously and they have in some cases have to kill other human beings or be killed. When fighting, they are always in constant fear of losing their lives and every minute bomb goes off or a bullet is fired in their direction mean that it is their lives at stake. It is because of this that many war veterans end up suffering from PTSD. In the last few years, many war veterans have been seeking help and presenting with PTSD and this has grown to be a major public health concern (Reisman, 2016).
The Thompson family seems to agree that William has PTSD after coming back from the war. PTSD is diagnosed after a number of symptoms are presented. The Diagnostic Statistical Manual has criteria that has to be looked into in order to make sure that the patient is actually suffering from PTSD. In the case of William, it is clear that he must have experienced more than one traumatic event during the war. Many soldiers died in the Iraq war. He has psychological distress from the events, he avoids stimuli that resemble events in the war like loud noises, he has distorted cognition and has been having problems when it comes to the expression of emotions that are not negative. He is increasingly becoming irritable with those around him and lacks concentration. In fact, he cannot concentrate even in his jo and this contributed to him being homeless. His recklessness and self-destructive behavior have led him to start drinking irresponsibly and this also affected his job. According to the DSM-5, there is need to specify if the PTSD presents with depersonalization or derealization (APA, 2013). In the case of William, he has been the outside observer and even pointing out that the rest are falsely saying that he has a problem with PTSD. Therefore, his PTSD has the subtype of depersonalization.
According to available guidelines through an integrated recommendation by APA and Veterans Health Administration and Department of Defense, treating PTSD should make use of cognitive processing therapy, prolonged exposure as well as trauma focused cognitive behavioral therapy. These treatment options have been established as being effective mostly because they address disturbances related to memories, thoughts as well as feelings that are associated with the traumatic events (Watkins, Sprang & Rothbaum, 2018). In a very recent systematic review, the effectiveness of intranasal oxytocin was investigated in patients with PTSD. The study showed that this agent modulates emotional and cognitive activities and also rewards brain areas in patents with PTSD. It was concluded that it is an effective agent when used with psychotherapy (Giovanna et al., 2020). This is the approach that should be used in this patient. It is expected that after using these interventions, the patient shall have reduced symptoms, both cognitive and emotional. He shall start functioning normally and shall not continue to engage in destructive behavior such as drinking as a way of coping.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub
Giovanna, G., Damiani, S., Fusar-Poli, L., Rocchetti, M., Brondino, N., de Cagna, F., ... & Politi, P. (2020). Intranasal oxytocin as a potential therapeutic strategy in post-traumatic stress disorder: A systematic review. Psychoneuroendocrinology, 115, 104605
Reisman, M. (2016). PTSD treatment for veterans: What’s working, what’s new, and what’s next. Pharmacy and Therapeutics, 41(10), 623
Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in behavioral neuroscience, 12, 258
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