Clien Intervention: A Case Study

This presentation is on the article titled, “Recovery Ranch”, by Tim Smith. This recovery facility caters to those with a number of ailments, including PTSD. This facility located in Nunnelly, TN offers a continuum of addiction treatment services. This outdoor facility allows the clients to participate in an array of recreational and leisure activities. Some treatments of PTSD are cognitive behavioral therapy and cognitive processing therapy. The ranch can be quite costly. Recovery ranch uses the social behaviors of the clients in order for their healing process to begin. This topic was chosen because the clients are able to partake in many nature activities and the participants are able to cope better with people that they can relate to. It

Client continues to deny any mental health issues, but on 4/11/2016, she met with Dr. Shuster and an initial psychiatric evaluation was completed and the client was diagnosed with Axis 1: PTSD (Post traumatic stress disorder) F43.10 (Primary), rule out symptoms off. She was refer to participate in individual mental health treatment. Client reported she went for mental health assessment at Woodhull Hospital client need to submit medical documents.

In the case of Conrad Jarrett I would envision utilizing two frontline treatment options in order to reduce the client’s symptoms of Posttraumatic Stress Disorder (PTSD). Bryant (2008) designed a treatment protocol that combines the use of cognitive restructuring and exposure therapy. Utilizing both of these therapies within structured individual sessions would allow a reduction in negative cognitions (e.g., feelings of guilt and shame) should these feelings intensify during exposure. My concern stems from the patient’s previous attempt at suicide and my desire to provide Conrad with some tools to combat his negative thoughts increasing the likelihood that he will remain unharmed and in therapy through the duration of treatment.

Mr. Adams has no prior history with the VA. It is apparent he has been thinking about seeking help but fears being seen as “weak” by his father, a retired Marine Master Sergeant, and brothers if he was to come to the VA for what he describes as, “head problems.” He reports having chronic headaches, infrequent rapid heartbeats, shortness of breath, and hearing loss. He initially reports feeling, “alright.” Mr. Adams has two older brothers who are Marines. His oldest brother, Jonathan (33), was physically injured in the war. His other brother, Jeremy (29), is preparing to begin his second deployment. Before his deployment tours, Mr. Adams described himself as “very social.” After returning home from his first deployment he stated that he “felt different.” Currently, Mr. Adams reports rarely wanting to socialize with anyone, including friends and family. Mr. Adams tells the worker he feels anxious and nervous, even in small groups. He also reports he and Melissa frequently fight about whether or not to spend time with their family and friends. He reports feeling like he has to make a “threat assessment” of his physical environment, even though he knows he is in a safe area.

The client is a twenty-year-old Caucasian female, presenting for medical care one month after a serious automobile accident. She appeared well groomed with good eye contact. The client presented with a euthymic mood as evidenced by her calm voice, friendly nature, and straight posture. The client displayed coherent speech and a logical thought process. The client was oriented to people, the date, and the location. The client was screened for Post Traumatic Stress Disorder (PTSD) due to the severity of the automobile accident. The PTSD CheckList – Civilian Version (PCL-C) was conducted in a private office, which allowed for a quiet atmosphere.

This treatment approach is based on cognitive and learning theories, tackling-misleading beliefs related to the traumatic events of acknowledgments related to the abuse and provides a supportive environment of which individuals are encouraged to talk about their traumatic experience. A numerous amount of research has been carried out to investigate into how effective CBT really can be for PTSD. (Resick et al, 2002) carried out an investigation comparing CBT with strong cognitive restructuring focus and CBT with a strong exposure focus and to a waiting-list control of rape survivors. Prior to this experiment approximately 80% of patients who completed either form of CBT no longer met the criteria for PTSD. Once this investigation was complete a follow up treatment took place of which it was noted 2% of the waiting list group had lost the PTSD diagnoses. Only a year after this investigation Bryant, Moulds, Guthrie, Dang & Nixon, (2003) restructured the experiment comparing exposure alone, exposure plus cognitive restructuring, and supportive counselling in civilians with PTSD resulting from various traumatic events. At this particular follow up 65-80% of participants who either completed either form of CBT were now clear of PTSD diagnosis, compared to less than 40% of those who completed supportive counselling.

My role as the clinician is quite important. The primary task is to engage the client in identifying cognitive errors, refuting them, and replacing them with more adaptive thoughts. A sound therapeutic relationship is necessary for effective therapy, but not the focus of the therapy. Many forms of other counseling believe that the main reason people get better in therapy is because of the positive relationship between the therapist and client. Cognitive-behavioral therapists believe it is important to have a good, trusting relationship, but I know that is not nearly enough. We believe that the clients change because they learn how to think differently and they act on that learning. Therefore, CBT tries and focuses on teaching rational self-counseling skills. CBT is the teamwork that exists between the therapist and the client. This form of therapy is used to seek ways of learning what their clients want out of life and then helping their clients achieve those goals. The therapist's role is to listen, teach, and encourage, while the client's roles is to express concerns, learn, and implement that learning (Pucci1).

During the first session clinicians educate participants on chronic pain and PTSD. In this first session participants are asked to generate three reasonable goals they desire to achieve through therapy. Weekly goal completion is examined before each session occurs. The second session is where clinicians guide participants in making sense of the chronic pain and PTSD they have endured. The third session allows participants to discuss their thoughts and feelings towards their understanding of chronic pain and PTSD. The fourth session clinicians employ cognitive reconstructing by identifying negative thoughts and giving participants the opportunity to change these thoughts into positive ones. The fifth session involves participants learning diaphragmatic breathing and progressive muscle relaxation. The sixth session, clinicians discuss avoidance and implement interoceptive exposure. The seventh session involves participants finding pleasant activities to enjoy. The eighth session is dedicated to education on sleep hygiene. The ninth session works with veterans safety and trust issues. The tenth session is where veterans learn about their own power, control, and anger. The eleventh session works on veteran’s esteem and intimacy. The final session is reserved for relapse prevention and planning for the future. Clinicians administered a pre and post treatment assessments as follows: The Clinician Administered PTSD Scale (CAPS), PTSD Checklist

It is also estimated that approximately twenty percent of these people progress and develop PTSD. One out of every nine women are diagnosed with PTSD which makes them about twice as likely as men to suffer the effects. Prior to PTSD being a clinically diagnosed disorder, our military personnel returning from various wars throughout history were said to be suffering from “shell shock”. Soldiers experiencing this displayed behavior related to having difficulty adjusting the life after combat. The first-time PTSD was identified as a disorder was the result of the Vietnam War. Our soldiers were finally diagnosed correctly and the term Post Traumatic Stress Disorder was first spoken. Currently, mental health providers such as psychiatrists and psychologists can attempt to understand people’s response to these traumatic events and help them recover from the impact of the trauma. Although the disorder must be diagnosed by a mental health professional, symptoms of PTSD are clearly defined. To be diagnosed with PTSD, you must have been in a situation in which placed you at risk for death, serious injury, or sexual violation. Traumatic, life-threatening events leading to PTSD must have been witnessed or experienced in person, and not through media, pictures, television or

The main problem discovered is military members are experiencing psychological problems from stressors due to deployments and not seeking help for their discomforts. Many of the military members returning

I was among three therapists sent to New Hope Corps transitional home for quarterly face-to-face contact with client. Client has been at the transitional home for three months and all reports are that he is doing well. I met with transition home counselor at the home prior to meeting with client. The transitional home counselor reported that the client had made much progress in his therapy group this quarter. She had reported at previous meeting that client had not wanted to share any of his issues with the group and just sat there until the time was up in group and then left with no remarks. During this quarter, he has begun to open up about his feelings regarding his birth father and his anger toward him. He has talked about his drug use. The transition home counselor began meeting with him individually two months ago and that one-on-one counseling has given him the encouragement to share with the group. The transition home counselor warned me that client would want to discuss his desire to return home as soon as possible. I met with client alone to discuss his progress over the last quarter. He reported that he is feeling good about

The dynamics of the client-therapist relationship in cognitive therapy is a collaborative effort. Cognitive therapists elicit patient’s goals at the beginning of treatment. They explain their treatment plan and interventions to help patients understand how they will be able to reach their goals and feel better. At every session, they elicit and help patients solve problems that are of greatest distress. They do so through a structure that seeks to maximize efficiency, learning, and therapeutic change (Robert & Watkins, 2009). Important parts of each session include checking the client’s mood, a connection between sessions, setting an agenda, discussing specific problems and teaching skills in the context of solving these problems, setting of self-help assignments, summary, and feedback (Robert & Watkins, 2009). The status that CBT has with insurers and funding agencies is a result of concrete and measurable goals, goal-focused processes and clear outcomes-based evaluations/results. Therapy is typically conducted in an outpatient setting by trained therapist in cognitive behavioral techniques. Treatment is relatively short in comparison to some other forms of psychotherapy, usually lasting no longer than 16 weeks.

Cognitive Behavioural Therapy – is concerned with helping people form realistic expectations and challenging negative assumptions that have been accepted too readily. Work is given to service users so they can test elements of this intervention themselves between sessions, practice their skills and test out conclusions in their real life situations. This model of intervention is also mixed with client centred counselling, which operates on the thinking that people tend to move towards healing on their own especially if the counsellor;

I chose this topic because I have always been interested in PSTD and what causes PTSD, and how to reduce or cure PTSD. I often feel touched or sad for people who have PTSD and I know some people who have PTSD. For people with PTSD, they often get flashbacks of the trauma incident and then they get angry or scared. I want to help them and hand them my support as I learn how to help them. I have family members who have PTSD and PTSD has definitely impacted/affected their lives. Unfortunately, it should not change their lives, but they do. I would like to help them to change their perspective of how they could live through their PTSD and how they can overcome the fear. I know that it would not be easy to move on with their trauma and it takes a lot of time to put it aside. Some people with PTSD never got therapy sessions to help how to overcome or handle their trauma. Often, the people with PTSD would reject therapy because they do not want someone to know their story or feeling uncomfortable. I would like to learn more about the topic and maybe become a clinical psychologist in one day. I like to help and support people to recover from their issues. I believe that clinical or counseling psychology is a right place to go and ask for support to recover. This is one of the reasons why I would like to focus on the topic.

Approximately twenty-five to thirty percent of those who have experienced a traumatic event will proceed to develop post-traumatic stress disorder (Fry, 2016). Those who have experienced a traumatic event and developed PTSD continue reliving it to an extent in which it interferes with their lives. The symptoms of the disorder affect the person’s life by interfering with daily activities and personal relationships with friends and family. There is