The treatment of posttraumatic stress disorder (PTSD) through cognitive and Exposure therapies is one of the most effective ways to treat and help patients cope with past traumas. Cognitive behavioral therapy (CBT) consists of the therapist first putting the patient into a very calm state through breathing and relaxation exercises. They then challenge the negative thoughts and ideas about past events. Specifically, trying to “decatastrophize his/her interpretations of intrusive recollections” (Paunovic, & Ost, 2001). This involves challenging faulty thinking and thoughts connected with a certain catastrophic event. This learned uncoupling of negative thoughts attached to those events is the core to cognitive therapy. Exposure therapy …show more content…
The therapist can then help the patient challenge and reconfigure their fear attachment to the event. CBT and Exposure use similar strategies to recall memories. Imaginal Exposure is the most common way for patients to evoke avoidance of trauma related emotions, thoughts, and memories (Wortmann, et al., 2014). As well as “In vivo exposures target behavioral avoidance of people, places, and situations that serve as reminders of the trauma.” (Wortmann, et al., 2014). Patients can then in a safe setting review and interpret these events without the connection of fear and anxiety. Eventually this habituates the connection of fear and anxiety to these events. With a new learned emotional connection to these past events patients see large drop in depression and anxiety. The two studies done by Marks, et al. and Paunovic, N., & Öst, L., attempted to see if there is was significant difference between these two approaches. One study tested refugees, and the other were outpatients referred by Professionals (Marks, et al., 1998). However both use the same method of choosing participants and testing. All participants were diagnosed using the CAPS-IV. “The CAPS-IV assesses the frequency and intensity of the 17 symptoms of PTSD outlined in the DSM-IV (each scored 0–4) . . . an Anxiety Scale (14 items, 0–4 scale) and the Hamilton (HDS; 1960) Depression Scale (25 items, 1–5 scale) were administered.” (Paunovic, & Ost, 2001). A self-survey was given during the screening
Foa and her colleagues (2011) created prolonged Exposure (PE) for clients trying to overcome with PTSD that is based on the emotional processing therapy (Foa, 2011). PE treatment plan includes collecting of information associated to both the traumatic experience and the trauma survivor's responses to it, the teaching of breathing retraining techniques, education, the re-experiencing of the trauma in imagination, and in vivo exposure (Foa, 2011). When compared with CPT, PE is a 10-session treatment (60-90 minutes) that is centered on both in-vivo and imaginal exposure to the trauma memory and ensuing adaptation. PE reports that repetitive stimulation of the trauma memory allows the clients to integrate new, counteractive information about themself and their world. Additionally, homework assignments in PE allow the client to face safe situations, which were formerly resolute to be threatening based upon inaccurate post-traumatic beliefs (Foa,
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.
Stein, Dan J., Seedat, Soraya, Iversen, Amy, and Wesley, Simona, (2007), Post-traumatic stress disorder: medicine and politics, 369: 139 44
The symptoms that are being treated through this individualized treatment plan related to post traumatic stress disorder are: dissociative reactions, irritable and aggressive behavior, concentration problems, and trauma-related external reminders. The first goal is in place to assist Precious in learning to eliminate intrusive memories, a “notable feature of memory in PTSD is the reliving experiences or “flashbacks” to the trauma” (Berwin, 2003, p. 340), and addressing causes of these memories through the intervention of prolonged exposure. In addition, the second goal that is being implemented, preventing and addressing distortions, is being addressed through prolonged exposure. This technique is “a general treatment strategy for reducing anxiety that involves confronting situations, activities, thoughts, and memories that are feared and avoided even though they are not inherently harmful.” (Foa, 1998, p. 65). The flashbacks and distortions that Precious experiences are being addressed through prolonged exposure, due the fact that it
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.
According to Tuerk, Yoder, Ruggiero, Gros & Acierno (2010), prolonged exposure therapy is a form of therapy treatment applied in posttraumatic stress disorders. Prolonged exposure treatment based on behavioral and cognitive levels of therapy, is a method used in treatment of trauma where the victim remembers the triggers of trauma rather than letting go, as it has been the case. Trained Social workers, psychologists and psychiatrist offer treatment to these conditions. What causes post traumatic stress disorders is not clearly known, but a mix of one's personality, inherited mental functionality risks, the way the brain releases chemicals in dealing with stress, and one's life experiences can be used to draw some insights (Powers, Halpern, Ferenschak, Gillihan & Foa, 2010).
To effectively treat Post Traumatic Stress Disorder, PTSD in combat Veterans and service members, therapists use different techniques, which are preceded by addressing any underlying pain associated with the disorder. In their research, Chard et al. (2011) reported significant modifications to the CPT protocol for use with patients in a TBI-PTSD residential treatment facility, including increasing the number of sessions per week, combining group and individual therapy, and augmenting the treatment with cognitive rehabilitation. However, their research was marred with the use of few participants which provides doubts regarding the outcome of the proposed treatment procedures. Moreover, the researchers do not state with certainty as to the
The Diagnostic and Statistical Manual of Mental Disorders describes posttraumatic stress disorder (PTSD) as an acute stress disorder (2013). Individuals that experience this disorder are exposed to or have had an experience of near death or bodily harm (American Psychiatric Association. 2013). Evidence based therapy that has shown positive outcomes in cognitive behavioral therapy (CBT) which is based on changing behavior. The use of client-centered therapy can also be beneficial with this type of client if applied in addition to CBT. Joseph stated that a client-centered approach to PTSD could result in Post-traumatic growth (2004). Post-traumatic growth does not try to bring the client back to the original state before the trauma but bring the client beyond their previous level of functioning (Joseph, 2004). When a person experiences a trauma, they can have a myriad of emotions, it is the therapist responsibility to help the client make better sense of the issue and continue functioning in a normal manner. Not all traumas are alike and not all clients can be treated equally. The most significant aspect of treatment in helping this type of client is the approach the therapist takes which should include the temperament of the client and the goals the client seeks. Included here is an examination of a fictitious client that has experienced a trauma and the therapist care plan. The therapist
People with PTSD also have to get a treatment called Exposure Therapy. The main goal of this exposure therapy is to lessen the fear of a person's memories of a traumatic event. The idea is used to help people who have to learn not to fear their thoughts and feelings that remind them of their past (“Treatment of PTSD”). A person that talks about their experience repeatedly with their therapist will give them the ability to control the thoughts and feelings about the trauma they have experienced. Being afraid of their memories won’t have any affect on them after they have been through this therapy (DeAngelis). It seems unusual to think about the stressful situations on purpose and this treatment seems like a hard task at first, but eventually
Research evidenced that CBT is effective helping clients with anxiety related disorders like PTSD. As part of CBT, exposure therapy, cognitive restructuring, and stress inoculation training (SIT) forms part of the techniques to be used in the treatment of PTSD (National Institute of Mental Health, 2009).
The therapists that were used were a nurse therapist and a clinical psychologist. In sessions 1 through 5 of Exposure Therapy subjects were asked to imagine their previous trauma memories. Patients were asked to talk in first person tense about what they experienced, and then were asked to imagine and describe critical aspects of the trauma and "rewind and hold"
For example, you may hear a car backfire and relive combat experiences. Or you may see a report on the news about a sexual assault and feel overcome by memories of your own assault. But to those who PTSD should not feel like there is no way out with plenty of treatment those with the disorder can/will live healthy normal lives. The first treatment is Cognitive Therapy this type of talk therapy helps you recognize the ways of thinking that are keeping you trapped. for example, negative or inaccurate ways of perceiving normal situations, For PTSD, cognitive therapy is sometimes used with exposure therapy. Exposure Therapy is a behavioral therapy that helps you safely face what you find scary so that you can learn to deal with it effectively. One approach to exposure therapy is virtual reality which allow you to re-enter the setting in which you experienced trauma. And the last form of treatment is a combination of both exposure therapy and a series of guided eye movement that helps process traumatic memories and change how you react to traumatic memories and this is called Eye movement desensitization and reprocessing. But to those who don 't like therapy-style treatment there are different types of anti-depressants that can help with some of the symptoms. Like for depression or anxiety a person would take Paxil or Zoloft. And if you don 't have depression but a severe case of anxiety you would look more in taking
If veterans do struggle with PTSD after they return from combat the Department of Veterans Affairs, a governmental agency that helps struggling veterans recover, offers two treatments. Studies have been done to see if one of the therapies is more effective than the other. There is not yet evidence that one therapy is better than the other. Cognitive processing therapy, CPT, helps by giving the vet a new way to deal with the maladaptive thoughts that come with PTSD. It also comforts them in gaining a new understanding of the traumatic events that happened to them. One of the other benefits of CPT is that it assists the person in learning how these disturbing events change the way they look at everything in life and helps them cope with that (“PTSD: National”). The second newer option of the two is prolonged exposure therapy, which is repeated exposure to these thoughts, feelings, and situations (“Most PTSD”). This type of therapy is now a central piece in the VA’s war on PTSD. “The problem with prolonged exposure is that it also has made a number of veterans violent, suicidal, and depressed, and it has a dropout rate that some researchers put at more than 50 percent, the highest dropout rate of any PTSD therapy that has been widely studied so far,”(“Trauma Post”). Both of the therapies are proven to reduce the symptoms but both have extremely high drop out rates and low follow through. It
CPT is based on the social cognitive theory of PTSD. This theory focuses on how the traumatic event is understood and how it is being coped with by the client who is struggling to regain control over his or her life. CPT also refers to the emotional processing theory of PTSD which is an extension of information processing theory by Foa, Steketee, and Rothbaum (Mullen, Holliday, Morris, Raja, and Surís 2014). This theory states PTSD emerges from the development of fear in one’s memory that creates avoidance behavior and provokes one to escape these memories. Mental fear builds stimuli, responses, and meaning elements (Mullen, Holliday, Morris, Raja, and Surís 2014). Therefore anything that is associated with the trauma may provoke fear that leads to the concept of escaping and avoidance behavior. In individuals with PTSD, the fear is known to be easily accessible. When the fear is activated by the reminders of one’s trauma, one builds intrusive symptoms due to the information trying to process and enter one’s consciousness. In order for an individual to avoid these feelings and thoughts, one tries to avoid it which leads to the avoidance symptoms of PTSD which include yet are not limited to depression, alienation (Mullen, Holliday, Morris, Raja, and Surís 2014). Emotional Processing Theory states the repetitive exposure of trauma in a safe environment such as a therapeutic setting, helps reduce PTSD symptoms by calming and addressing one’s fear (Mullen, Holliday, Morris,
The first method of treatment is trauma-focused cognitive-behavioural therapy. In this method, a patient is gradually but carefully exposed to feelings, thoughts, and situations that trigger memories of the trauma. By identifying the thoughts that make the patient remember the traumatic event, thoughts that had been irrational or distorted are replaced with a balanced picture. Another productive method is family therapy since the family of the patient is also affected by PTSD. Family therapy is aimed at helping those close to the patient understand what he/she is going through. This understanding will help in the establishment of appropriate communication and ways of curbing problems resulting from the symptoms (Smith & Segal, 2011).