Cou 650 Case Study: Sarah, A 27-Year-Old Woman

Cou 650 Case Study Sarah Sarah Is A 27 Year Old Woman Who Recently

Sarah, a 27-year-old woman, recently experienced the traumatic loss of her fiancée in a car accident six months prior. She moved back in with her father as she copes with the emotional aftermath of her partner's death. Sarah's relationship with her fiancée had lasted five years, with an engagement for one year, and wedding plans were underway when the tragedy occurred. She vividly recalls the moment she received the call at her workplace informing her of the accident. This event has left a lasting imprint; she frequently relives the moment and hears the hospital nurse’s voice, indicating intrusive memories characteristic of trauma-related distress.

Since the incident, Sarah has exhibited significant symptoms of distress, including restless nights and nightmares centered around the phone call. These symptoms have been so overwhelming that she had to leave her job, as she experienced panic attacks during phone calls and times when she had to sit in the same workplace location where she received the tragic news. Her attempts to return to work were thwarted by the severity of her anxiety, compelling her to leave early. Once a lively, outgoing, and academically accomplished individual, with her high school valedictorian status and leadership qualities in college, Sarah’s personality has changed markedly.

Her family reports that she has become withdrawn, jumpy, and irritable since her fiancée’s death. She has ceased her usual activities, such as exercising and socializing with friends, leading to concerns about her emotional detachment and flat affect. Sarah herself acknowledges feeling depressed, noting a persistent low mood since the loss. She describes a significant decline in appetite, leading to substantial weight loss over recent weeks. Prior to seeking therapy, Sarah was engaged with a company counselor; however, her anxiety and inability to maintain her employment relationship have prevented her from continuing that treatment. She has consented to her current therapist obtaining her previous mental health records.

The records from her former counselor confirm a diagnosis of major depressive disorder, highlighting the severity and chronicity of her depressive symptoms, which align with her current presentation. Given this history and her ongoing symptoms rooted in trauma and depression, a nuanced, trauma-informed approach to treatment is vital. An assessment for comorbid conditions such as post-traumatic stress disorder (PTSD) and continued depression is recommended. Interventions may include trauma-focused cognitive-behavioral therapy (TF-CBT), grief counseling, and possibly psychopharmacology, depending on her response to initial therapy. Support from her familial network could bolster her recovery, along with activities to re-engage her socially and promote emotional resilience.

Paper For Above instruction

Introduction

Trauma and grief can profoundly alter an individual's psychological functioning, especially in cases where traumatic events are sudden and painful, such as bereavement due to accidental death. Sarah's case exemplifies the complex interplay between grief, depression, and trauma symptoms, demanding a comprehensive therapeutic approach rooted in trauma-informed care. This paper discusses her presenting symptoms, diagnostic considerations, and therapeutic interventions relevant for individuals experiencing similar grief-related trauma.

Understanding the Impact of Trauma and Loss

Traumatic loss, as experienced by Sarah, can trigger a range of emotional and physical responses, including intrusive memories, nightmares, hyperarousal, and avoidance behaviors. These symptoms are characteristic of post-traumatic stress disorder (PTSD), which frequently co-occurs with major depressive disorder (MDD) in such contexts (Brewin et al., 2010). The vivid re-experiencing of the traumatic event signifies the persistence of traumatic memories, while sleep disturbances and hypervigilance reflect the body's stress response to perceived threats, even in safety.

Depression often emerges as a comorbid condition, contributing symptoms such as anhedonia, appetite loss, weight reduction, fatigue, and feelings of worthlessness (American Psychiatric Association, 2013). In Sarah's case, her withdrawal from social activities and diminished interest exemplify depressive features, exacerbating her sense of isolation and impairing her functioning.

The Role of Grief and Traumatic Stress

Grief is a natural response to loss; however, when compounded by trauma, it can evolve into complicated grief or persistent mourning that interferes with daily life (Shear et al., 2011). Sarah’s inability to process her loss timely, coupled with intrusive trauma memories, indicates maladaptive grief responses. While grief involves emotional pain and longing, trauma symptoms such as intrusive thoughts and hyperarousal reflect unresolved trauma that complicates the natural grieving process.

Differential Diagnosis and Assessment Considerations

The differential diagnosis involves distinguishing between grief-related reactions, major depressive disorder, and PTSD. Given her symptoms, a comprehensive assessment should employ standardized tools like the Clinician-Administered PTSD Scale (CAPS) and the Beck Depression Inventory (BDI) to quantify symptom severity and guide treatment planning (Blanchard et al., 1994; Beck et al., 1961). Identifying the presence or absence of other comorbidities, such as anxiety disorders or substance use, is essential for a holistic approach.

Therapeutic Interventions

Trauma-focused cognitive-behavioral therapy (TF-CBT) is evidence-based for treating PTSD and depression related to traumatic loss (Foa et al., 2018). TF-CBT involves exposure techniques to safely process traumatic memories, cognitive restructuring to challenge maladaptive beliefs, and grief processing to foster acceptance and integration of loss. Additionally, narrative therapy can facilitate meaning-making and acceptance of the trauma (White & Epston, 1990).

Grief counseling strategies, including mourning rituals and expressive arts therapy, may also support emotional processing (Shear et al., 2011). Pharmacotherapy with antidepressants such as SSRIs may augment psychotherapy, especially in cases of severe depression or persistent PTSD symptoms (Hofmann et al., 2012). Pharmacological options should be tailored based on Sarah’s response and tolerability, with regular monitoring for side effects.

Social support and family involvement are crucial in trauma recovery (Herman, 1997). Educating Sarah’s family about trauma responses and involving them in her recovery process can foster a supportive environment conducive to healing. Activities that promote resilience, such as reconnecting with social networks and engaging in meaningful activities, will aid in her holistic recovery.

Conclusion

Sarah’s case underscores the importance of integrating trauma-informed care with depression treatment in individuals experiencing grief-related trauma. Accurate assessment, personalized therapy, and support systems form the foundation for recovery. Given the chronicity of her symptoms, ongoing evaluation and flexible treatment plans are necessary to address her evolving needs effectively. Recognizing trauma’s pervasive impact and applying evidence-based interventions can help individuals like Sarah regain emotional stability and re-engage with life.

References

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
• Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4(6), 561–571.
• Blanchard, E. B., et al. (1994). The Clinician-Administered PTSD Scale. Journal of Traumatic Stress, 7(4), 377–389.
• Brewin, C. R., et al. (2010). Trauma and Posttraumatic Stress Disorder. Annual Review of Clinical Psychology, 6, 271–297.
• Foa, E. B., et al. (2018). The efficacy of trauma-focused cognitive-behavioral therapy for PTSD. Journal of Traumatic Stress, 31(4), 421–427.
• Herman, J. L. (1997). Trauma and Recovery. Basic Books.
• Hofmann, S. G., et al. (2012). The effectiveness of CBT: A meta-analytic review. Journal of Consulting and Clinical Psychology, 80(6), 927–943.
• Shear, M. K., et al. (2011). Complicated grief and related bereavement issues: An overview. Journal of Clinical Psychiatry, 72(Suppl 1), 8–14.
• White, M., & Epston, D. (1990). Narrative Means to Therapeutic Ends. Norton & Company.