Using CPT In Trauma Therapy: A Case Study

EMDR therapy, EMDR uses an eight-phase approach, referring to the past, present, and future aspects of the traumatic experience, and dysfunctional stress stored memories. The first Phase calls History and Treatment Planning. In this phase the therapist listens the patient's history and develops a treatment plan. In Phase II, the preparation, the therapist teaches the patient how to calm down him/herself with the help of relaxation techniques. The phase III is Assessment in which the therapist asks the patient to visualize the image of the disturbing event, then asks him/her to develop a positive cognition associating with that image. In Phase IV, Desensitization, the patient  focuses on the disturbing memories during short sessions of 15-30 seconds. At the same time, he/she also focuses on the alternative stimulation such as directed eye movements, slapping hands, or voices. This process repeats  many times until the patient's reaction to the target memory becomes less distressed. In Phase V, Installation, the therapist again with the use of bilateral stimulation asks the patient to remember the event about which the positive cognition is developed in the phase III, and makes sure that

This paper will examine, compare and contrast Eye Movement Desensitization Reprocessing (EMDR) and Cognitive Processing Therapy (CPT) in the case of Joe, a fictional client with post-traumatic stress disorder from two tours of combat duty as a Marine Corps sniper in the Middle East, without the use of psychotropic medications. EMDR uses side-to-side eye movements in a one-on-one session with a clinician while the client focuses on a distressing memory until he or she reports reduced symptomology or no psychological distress; the clinician then has the client think of positive thoughts while continuing the exercises. EMDR has been the target of debate over its effectiveness, with some scholars suggesting that it is the “rewiring” of the brain that is most beneficial. CPT is often used when other processes of recovery fail. Therapy, administered individually or in a group, initially focuses on misconstrued beliefs of denial and self-blame for the traumatic incident and then addresses beliefs the client has about himself and the world in general. CPT uses talk therapy and worksheets with the goal of the client learning to make sense of what happened and fit it in with the beliefs about themselves and others. Findings suggest that each therapy has its advantages and which is best depends on how responsive the client is to each mode and the therapeutic alliance between the client and therapist.

The goal of EMDR therapy is to process completely the experiences that are causing problems, and to include new ones that are needed for full health. EMDR focuses on desensitizing strong

A study was conducted by Monson et al. (2006) to assess the effects of (CPT) Cognitive Processing Therapy on military veterans who were suffering from PTSD. The study included sixty participants with prolonged combat-related PTSD who partook in a wait-listed controlled experiment of a CPT treatment. More than sixteen percent of the participants dropped out of the study from the original ninety-three participants who were authorized to receive treatment. Out of the sixty participants that remained the group was equally split into two groups of thirty clients (Wait Group vs. Immediate Group). The Wait Group waited for a period of ten weeks before receiving the CPT treatment, whereas the immediate group received treatment immediately. The treatment was provided twice a week and consisted of twelve CPT sessions. The results revealed overall that there were significant improvements in PTSD and comorbid symptoms in the Immediate Group in comparison to the Wait Group. The study not only revealed the importance of immediacy in treating veterans with PTSD but supports the use of cognitive–behavioral treatments in this population as well (Monson et al.,

For some patients with excessively traumatic experiences, the following preparation stage will last longer than the 1 to 4 sessions that most patients take. In the preparation phase, the therapist has to build a trustful relationship with the client in order to help establish appropriate expectations for the patient during the treatment. Since EMDR therapy does not require the patient to completely confide in the therapist her experiences, a therapeutic relationship between client and clinician is very important. Otherwise, the following sessions and treatments would be misdiagnosed since the patient’s statements to the therapist may not be completely true. After they establish a connection, the theory, procedures, and expectations of Eye Movement Desensitization and Reprocessing therapy is clarified by the clinician to the patient. Also explained to the patient is the concept of Bilateral Stimulation (BLS), oscillating eye movements, sounds, and sensations. BLS aids the left and

PE is built on the assumption that retelling an account of a traumatic experience repeatedly will allow the brain to fully process the memory of that experience, which makes it less painful and something that no longer dominates their life. Additionally, PE is based in Emotional Processing Theory, which posits that PTSD symptoms arise as a result of cognitive and behavioral avoidance of trauma-related thoughts, reminders, activities and situations. PE helps the client interrupt and reverse this process by blocking cognitive and behavioral avoidance, by introducing corrective information. Finally, PE facilitates in organizing and processing of the trauma memory and associated thoughts and

Developed by Edna Foa, prolonged exposure therapy exposes patients to their traumatic event over and over again while being in a safe place (Blankenship 277). Although prolonged exposure therapy is one treatment it has four main elements including education, breathing retraining, in vivo exposure, and imaginal exposure. Education consists of learning about the treatment, treatment symptoms, and goals of the treatment. Breathing retraining helps patients to relax and calm themselves when they become anxious. In vivo exposure allows patients with PTSD to be put in real-life situations that they are not comfortable with due to the trauma they have faced. Lastly, imaginal exposure allows the patients with post-traumatic stress disorder to talk through their traumatic event while it is recorded. After repeatedly talking through their event, the patient then listens to what they have said (Swan 28). Prolonged exposure therapy occurs over eight to fifteen sessions. Each session can range from 60 to 90 minutes depending on the patient and their specific needs (Blankenship 278). This treatment helps patients with post-traumatic stress disorder by allowing them to face their fears associated with the traumatic event and gain control over their emotions (Swan 28). Prolonged exposure therapy is proven to be a very effective therapy and is highly supported for the use of treating PTSD (Blankenship

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

As stated by the name of this particular EBP, the focus is on cognition in those with PTSD. Cognitive Processing Therapy (CPT) is a form of the well-known cognitive behavioral therapy. For this particular therapy, the clients taking part are older adolescents and adults (18-55+) who have a PTSD diagnosis (SAMHSA, 2014). The preliminary focus on CPT is to look at the distorted thoughts about the trauma experienced by the client. Beliefs such as self-blame and denial are initial conative focus, then therapy moves on to looking at the clients how the clients think themselves, others, and the world (Resick, Nishith, Weaver, Astin, & Feuer, 2002). Clients who are undergoing this therapy use of worksheets and what is known as “Socratic questioning” (Resick,

“The most basic definition of Post-traumatic stress disorder (PTSD) is a psychiatric sequel to a stressful event or situation of an exceptionally threatening or catastrophic in nature.” (Kassam-Adams, & Winston, 2004, p.409). In the event that a client suffers from PTSD an evidenced based therapeutic concept should be used, this concept is generally called Trauma-Focused Cognitive behavioral therapy (TF-CBT). TF-CBT has been used in the management of PTSD in both children and adolescents for many years as it has been proven over and over again to be the most effective in treating clients with PTSD with an emphasis on children. (Cohen, Mannarino, & Deblinger, 2012, p.3). Post-traumatic stress disorder (PTSD) can and usually is an extremely

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"

Prolonged exposure (PE) is a specific exposure therapy program that derives from Emotional Processing Theory (EPT). The idea of emotional processing is to interpret realistic information and accommodate that information into a fear structure which in turn diminishes the fear (Foa, 2011). Foa (2011) acknowledges that the idea of failing to process trauma is

Bottom-up. As mentioned at the beginning of the paper, the appropriate bottom-up intervention that has potential in treating trauma related symptoms is EMDR. Unlike other psychotherapies, EMDR therapy has continued to grow rapidly because it’s an efficient and effective treatment for PTSD (Leeds, 2016). EMDR appears to be effective in restructuring symptoms of both acute and chronic PTSD (Leeds, 2016). This type of psychotherapy employs techniques that may give the patient more control over the exposure experience and provides techniques to regulate anxiety in the apprehensive circumstance of exposure treatment (Rothbaum, Astin, & Marsteller, 2005).

Importantly such interventions may help to dissipate and address some of the long-standing symptoms of CPTSD that are hard to address in approaches largely relying on insight, understanding and creating a narrative of the past. It can help to reorganise the physiological responses connected to traumatic

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,