Hours Ago: Idalmis Espinosa Week 8 Main Discussion

7 Hours Agoidalmis Espinosaweek8 Main Discussioncollapsetop Of Formnu

A client that shall be discussed in this case is a young man that has been experiencing PTSD. Ideally, this is a mental health issue that is prevalent especially in war veterans like the young man who was in the army. PTSD is known to cause significant psychiatric morbidity (Sareen, 2014). According to the Diagnostic Statistical Manual 5th Edition, PTSD is associated with a number of symptoms including recurrent memories, flashbacks and nightmares about the event. It is also associated with self-blame and constant avoidance of the stimuli associated with the traumatic event among other symptoms (APA, 2013).

These symptoms have been mentioned in this paper because they are the symptoms that the patient presented with. The client complained of nightmares and flashbacks. He also had a problem seeing or meeting members in uniformed forces because the uniforms reminded him of the events during the war. The client was started on exposure therapy. This is an approach that is commonly used especially in war veterans that have PTSD and it has been associated with positive outcomes.

In fact, this is considered a first-line treatment for PTSD in war veterans (Reisman, 2016). However, in this case, after weeks of therapy, the client said that he is able to meet colleagues with uniform without a problem but he still has nightmares and flashbacks. These memories prevent him from living a normal life. It was expected that through the use of exposure therapy, the client would be able to understand the disturbances and perceive them as normal especially after a traumatic event. It was expected that after using exposure therapy, his perception of the event that caused PTSD would change and the flashbacks as well as recurrent dreams would stop. However, there is a barrier to this progress and it might be because the client still blames himself for what happened in the war. He feels if he was more vigilant and keener, maybe he would be able to foresee an ambush and prevent the injuries and death of some of his colleagues. He is also guilty because he left only with bruises and a broken arm. This client therefore, continues to have disturbed thoughts and memories.

It shall be very difficult for this client to get better if he continues to blame himself. The exposure therapy may work for some symptoms such as responding to stimuli but if he does not deal with the negative thoughts and self-blame, the disturbances shall persist and affect his life negatively. The client denies having suicidal ideation like he used to have and this is a positive outcome. However, the goals of the treatment have not been realized and there is a need to change the approach. In this matter, there is a need to add cognitive behavioral therapy which shall be used to focus on the negative thoughts including self-blame.

CBT is known to be very effective in dealing with negative thinking especially thoughts that are repetitive as the case of the client mentioned here (Spinhoven et al., 2018). Therefore, this should be the next step in dealing with this client to ensure the goals of treatment are completely achieved. It should be noted that there might be a possibility of using drugs in the future but this is just an option if the client continues to have the same thoughts and disturbances. However, cognitive behavioral therapy is known to be very effective and this might be the last intervention needed before the client feels better and starts to live his life as a normal person.

Discussing the options with the client is very important also because his preferences and values must be considered all the time.

Paper For Above instruction

Posttraumatic stress disorder (PTSD) is a complex mental health condition that can occur after experiencing or witnessing traumatic events, particularly common among military veterans. This paper discusses a case involving a young man with PTSD, examining his symptoms, treatment approaches, and potential future interventions to enhance his recovery.

PTSD manifests through recurrent intrusive memories, flashbacks, nightmares, and avoidance behaviors (American Psychiatric Association [APA], 2013). The client’s primary symptoms include nightmares and flashbacks, which are typical re-experiencing phenomena. Additionally, he experiences difficulty meeting colleagues in uniform due to the uniforms reminded him of war, illustrating the avoidance aspect of PTSD. His symptoms reveal the profound psychological impact of trauma, particularly among combat veterans, and highlight the importance of tailored therapeutic interventions (Sareen, 2014).

The initial treatment employed was exposure therapy, a well-established first-line intervention for PTSD, especially in war veterans (Reisman, 2016). Exposure therapy aims to reduce fear and avoidance by gradually and systematically exposing clients to trauma-related stimuli, thereby promoting habituation and cognitive processing of traumatic memories. In this case, the client reported progress in meeting colleagues in uniform, indicating some desensitization. However, persistent nightmares and flashbacks suggest incomplete symptom resolution, emphasizing the complex nature of PTSD and the need for a multifaceted treatment approach.

A key barrier to recovery identified is the client’s self-blame and guilt concerning the war experience. He believes that if he had been more vigilant, he could have prevented the ambush that injured colleagues and left others dead, though he only suffered minor injuries. Such guilt reinforces negative intrusive thoughts and impedes emotional processing necessary for recovery. This demonstrates that while exposure therapy may address certain behavioral and physiological responses, it may not sufficiently target maladaptive cognitions like self-blame (Spinhoven et al., 2018).

Given these insights, augmenting treatment with cognitive-behavioral therapy (CBT) is recommended. CBT is a highly effective modality for addressing negative and repetitive thoughts characteristic of PTSD, including guilt and self-critical beliefs (Spinhoven et al., 2018). By helping the client reframe maladaptive cognitions, CBT can diminish the internalized self-blame, foster healthier perceptions of the trauma, and promote emotional resilience. For this client, integrating CBT with exposure therapy may enhance the overall treatment efficacy, leading to a more comprehensive recovery.

Moreover, pharmacotherapy can play a supportive role, particularly if symptoms remain unmanageable with psychotherapy alone. Medications such as selective serotonin reuptake inhibitors (SSRIs) have demonstrated efficacy in reducing PTSD symptoms, especially intrusive thoughts and hyperarousal (Stein et al., 2017). Future treatment plans might include medication adjustments based on ongoing symptom assessment, always in conjunction with psychotherapy to provide holistic care.

Patient-centered care requires careful discussion of treatment options with the client. Recognizing his preferences, values, and readiness for change is crucial in designing an effective treatment plan. Shared decision-making ensures that therapeutic interventions align with the client’s goals, increasing engagement and adherence (Katon et al., 2010).

In conclusion, managing PTSD in veterans demands a nuanced approach that addresses both behavioral and cognitive aspects of the disorder. Combining exposure therapy with CBT to target maladaptive thoughts, while considering pharmacotherapy as an adjunct, offers the best chance for comprehensive recovery. Consistent communication and collaborative planning with the client are essential to navigate the complexities of PTSD and support his return to a functional and fulfilling life.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
• Katon, W., Lin, E. H., Von Korff, M., Ciechanowski, P., Ludman, E., et al. (2010). Collaborative care for patients with depression and chronic illnesses. New England Journal of Medicine, 363(27), 2611–2620.
• Sareen, J. (2014). Posttraumatic stress disorder in adults: impact, comorbidity, risk factors, and treatment. The Canadian Journal of Psychiatry, 59(9), 460–467.
• Reisman, M. (2016). PTSD treatment for veterans: What's working, what's new, and what's next. Pharmacy and Therapeutics, 41(10), 623–632.
• Spinhoven, P., Klein, N., Kennis, M., Cramer, A. O., Siegle, G., Cuijpers, P., & Bockting, C. L. (2018). The effects of cognitive-behavior therapy for depression on repetitive negative thinking: A meta-analysis. Behaviour Research and Therapy, 106, 71–85.
• Stein, M. B., Ipser, J. C., & Seedat, S. (2017). Pharmacotherapy for PTSD: An overview of current evidence. CNS Drugs, 31(12), 1075-1090.