Discussion: Posttraumatic Stress Disorder
Chard1
paraphrase.docxTo explain the characteristics of client William that aligns with PTSD criteria, first I would like to discuss some pertinent information about William. William in Thompson
Family Case Study is younger brother of Henry William. He is 38-year-old and was Captain in Armed forces and served in Iraq war. He originally lived in New Jersey but become
homeless and was unable to pay his mortgage. He shifted to his brother’s house and now live with his brother and brother’s wife Rosita. He works in a finance firm, but currently
his job is being jeopardize because of alcohol and PTSD-related concerns. During the interview William mentioned that Henry and Rosita think he was PTSD. He however did not
agree that he has PTSD and did not talk about it.
Now, we understand what PTSD is. PTSD is an acronym for Posttraumatic Stress Disorder (PTSD) and is a chronic psychological disorder that develop after exposure to a
traumatic event (Lancaster, et al., 2016). Bisson et al. (2015) explained in detail the symptoms required for diagnosis of PTSD as per DSM-5 criteria. This criteria and how the
criteria is met by the client is explained in the table below:
|
DSM-5 Criteria |
Client’s Condition |
|
Intrusion Symptoms Recurrent, involuntary and intrusive distressing memories Recurrent distressing dreams Dissociative reaction Intense or prolonged psychological distress to cues Noticeable physiological reaction to cues |
William is an Iraq war veteran. He must have witness trauma, death and injury in the war field. He might have recurrent memories about his past. |
|
Avoidance Avoidance or efforts to avoid distressing thoughts or feelings associated with trauma Avoidance or efforts to avoid external reminders such as activities, objects, people and situation |
William avoided to talk about his PTSD during the interview |
|
Negative alterations in Cognitions and Mood Inability to remember an important aspect Persistent and exaggerated negative beliefs or expectations about oneself Persistent, distorted cognitions about the cause or consequences that lead to self-blame or blame of others Persistent negative emotional state Feelings of detachment or estrangement from others Noticeably diminished interest or participation in important activities
|
These symptoms might be present in William because Henry and Rosita thought he had PTSD. Also, his job was jeopardized because of alcohol and PTSD related concerns. His colleagues and family members might have noticed these symptoms. |
|
Alterations in Arousal and Reactivity Irritable behavior and angry outburst Reckless or self-destructive behavior Problems with sleep and concentration Hypervigilance |
These symptoms might be present in William because Henry and Rosita thought he had PTSD. Also, his job was jeopardized because of alcohol and PTSD related concerns. His colleagues and family members might have noticed these symptoms. |
Explain therapeutic approaches you might use with this client, including psychotropic medications if appropriate.
As per the clinical guidelines, trauma focused psychological therapies are helpful for clients suffering from PTSD (Bisson, et al., 2015). Individual trauma focused CBT and
eye movement desensitization and reprocessing (EMDR) techniques have been found to be equally effective (Bisson, et al., 2013)
Exposure therapy
In this form of therapy, the therapist help patients to confront their traumatic memories through verbal or written narrative. The therapy involve detailed recounting to the
traumatic exposure. The therapist help the client to revisit trauma related situation were are being avoided or feared by the client.
Cognitive therapy
This form of therapy focused on identifying and modifying misinterpretations that cause the patient to overestimate the current threat. The therapist help the patient in
modifying beliefs and how patients interpret their behavior during the trauma.
EMDR
This form of therapy involves the use of bilateral physical stimulation including eye movements, taps or tones to help patient stimulate the patient’s information
processing to help in adapting the events.
I would recommend exposure therapy for the client. This form of therapy help the patient to confront traumatic events in a therapeutic setting with the help of
psychoeducation. The therapy involves repeated imaginal exposure to traumatic memories and discussion with the client to facilities emotional thought process and corrective
learning (Fogger, Moore, & Pickett, 2016).
The National Institute for Health and Care Excellence has recommended drug treatment as second line treatment for PTSD in addition to trauma focused therapy (Bisson,
et al., 2015). In a recent systematic review and meta-analysis, four drugs were found to be effective in reducing the severity of PTSD symptoms. These include paroxetine,
sertraline, fluoxetine and venlafaxine.
Explain expected outcomes for the client based on these therapeutic approaches.
The expected outcome of treatment is that client would have a reduction in symptoms of PTSD. It is expected that his colleagues and family members would start noticing
visible improvement in his symptoms.
References
Bisson, J. I., Cosgrove, S., Lewis, C., & Roberts, N. P. (2015). Post-traumatic stress disorder. BioMedical Journal, 2(1), 351-360.
Bisson, J., Roberts, N., Andrew, M., Cooper, R., & Lewis, C. (2013). Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults (Review). Cochrane Database
Syst Rev, CD00388.
Fogger, S. A., Moore, R., & Pickett, L. (2016). Posttraumatic Stress Disorder and Veterans: Finding Hope and Supporting Healing. The Journal for Nurse Practitioners, 12(9), 598-604.
Lancaster, C., Teeters, J., Gros, D., & Back, S. (2016). Posttraumatic stress disorder: Overview of evidence-based assessment and treatment. Journal of Clinical Medicine, 5(11), 105-
109. doi:10.3390/jcm5110105
