Hours Ago: Almira Espinosa Week 5 Main Discussion

4 Hours Agoidalmis Espinosaweek 5 Main Discussioncollapsetop Of Formn

In this case study, the client is William Thompson, a 38-year-old veteran who served as a captain in the Iraq war. Despite achieving success in his career as a finance lawyer, William has become homeless and resides with his brother and his wife. The core concerns presented are post-traumatic stress disorder (PTSD) and alcohol abuse, which have resulted in the loss of his employment. This scenario reflects a common trajectory for many military veterans affected by war-related trauma.

William’s homelessness is directly linked to his struggles with PTSD and alcohol dependence. His military service exposed him to traumatic events, including the death of friends, severe injuries among comrades, and life-threatening situations involving firearms and bombings. These traumatic experiences are characteristic of war zones, especially in conflicts like Iraq, where the constant threat of death leads to profound psychological distress. Research indicates that such trauma significantly contributes to the development of PTSD among veterans (Reisman, 2016).

PTSD diagnosis relies on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). William exhibits several symptoms consistent with PTSD, including re-experiencing trauma through distress and avoidance of stimuli associated with war. He shows signs of distorted cognition, difficulty regulating emotions, increased irritability, and concentration problems—all characteristic of PTSD (American Psychiatric Association, 2013). Furthermore, William perceives himself as detached from reality, perceiving his symptoms as depersonalization, which is a subtype of PTSD. His statement about others falsely claiming he has PTSD reflects his externalized perception of his condition and emotional numbing.

William’s substance abuse compounds his psychological issues, fueling a cycle of reckless and self-destructive behavior, including irresponsible drinking, which further impairs his functioning both socially and professionally. His inability to concentrate and manage daily responsibilities led to his homelessness and job loss. These symptoms underscore the detrimental impact of untreated PTSD, especially when compounded by substance use disorder.

Evidence-based treatments endorsed by the American Psychological Association (APA), Veterans Health Administration, and Department of Defense recommend several psychotherapy modalities for PTSD. Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) are considered effective in addressing trauma-related symptoms by processing distressing memories, altering maladaptive thoughts, and reducing avoidance behaviors (Watkins, Sprang, & Rothbaum, 2018). These therapies target core aspects of PTSD, including emotional regulation and maladaptive cognition.

Recent research has explored pharmacological adjuncts to psychotherapy, notably intranasal oxytocin. A systematic review by Giovanna et al. (2020) suggests that intranasal oxytocin enhances emotional regulation, modulates cognitive responses, and activates reward centers in the brain of PTSD patients. When combined with psychotherapy, oxytocin may bolster treatment outcomes by amplifying emotional engagement and reducing fear responses. This promising approach warrants further clinical trials for validation but offers potential for improved therapeutic efficacy.

Applying these therapies to William’s case, an integrated treatment approach combining CPT or PE with intranasal oxytocin could substantially reduce his PTSD symptoms. Such interventions should focus on helping him process traumatic memories safely, reduce avoidance, and restore emotional stability. Alongside psychotherapy, addressing his alcohol dependence through motivational interviewing and cognitive-behavioral strategies would be crucial to prevent relapse and promote recovery. As William begins to experience symptom reduction, his capacity to re-engage with daily life and rebuild his social and professional functioning is anticipated to improve significantly.

In conclusion, PTSD among veterans like William necessitates a comprehensive, evidence-based treatment plan. Combining psychotherapeutic modalities such as CPT or PE with adjunct pharmacotherapy like oxytocin offers a promising pathway toward symptom alleviation and functional recovery. Tailoring interventions to suit individual needs and ensuring continuity of care are vital for achieving long-term recovery and improving quality of life for trauma-affected veterans.

References

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). American Psychiatric Publishing.
• Giovanna, G., Damiani, S., Fusar-Poli, L., Rocchetti, M., Brondino, N., de Cagna, F., & Politi, P. (2020). Intranasal oxytocin as a potential therapeutic strategy in post-traumatic stress disorder: A systematic review. Psychoneuroendocrinology, 115, 104605.
• Reisman, M. (2016). PTSD treatment for veterans: What’s working, what’s new, and what’s next. Pharmacy and Therapeutics, 41(10), 623.
• Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258.
• Bisson, J. I., et al. (2013). Trauma-focused cognitive behavioral therapy for PTSD. Cochrane Database of Systematic Reviews, (12).
• Foa, E. B., et al. (2018). Prolonged Exposure Therapy for PTSD: An Overview. Journal of Anxiety Disorders, 54, 39-44.
• Lee, C. W., & Resick, P. A. (2016). Evidence-based psychotherapies for PTSD in veterans. Annals of Internal Medicine, 164(4), 282-283.
• Bradley, R., et al. (2005). A Multidimensional Approach to PTSD Treatment in Veterans. Journal of Clinical Psychology, 61(4), 497-519.
• Monson, C. M., et al. (2012). Cognitive processing therapy for veterans with PTSD. Journal of Traumatic Stress, 25(3), 297-304.
• Resick, P. A., et al. (2017). Trauma-focused cognitive-behavioral therapy for military trauma. Clinical Psychology Review, 52, 110-123.