Consider a couple/family where one member has a severe and persistent mental illness. (Note: This may be a fictitious case or a case from your professional experience). Think about how you would conceptualize the couple’s/family’s problems using the lens of your chosen theoretical orientation. Locate two evidence-based journal articles that support interventions for the present issue.
The Assignment (2–3 pages)
• Identify the pervasive mental illness or health concern present in the couple/family.
• Conceptualize the couple’s/family’s problem through your chosen theoretical orientation.
• Design a treatment plan including short- and long-term goals.
• Explain two evidence-based interventions you would use to address the couple’s/family’s issues and how you would use them. (Note: The interventions may not emerge from your chosen theoretical orientation.)
• Justify the intervention you selected with two evidence-based research articles.
Pervasive Mental Illness: Posttraumatic Stress Disorder (PTSD)
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Pervasive Mental Illness: Posttraumatic Stress Disorder (PTSD)
Jim and Rose, a couple, requested help because of severe post-trauma symptoms experienced by Jim. Jim served in the military and was discharged after he sustained a spine injury. Although Jim has been home for the past four years, he suffers from severe and persistent posttraumatic stress disorder (PTSD) caused by witnessing the death of his colleagues and he blames himself for not saving them. His main symptoms include hyper alertness, insomnia, irritability, constant anger outbursts, flashbacks, and nightmares. He rarely visits his therapist because he feels that the therapist does not understand him. In addition, he relies on marijuana and alcohol to sleep. His wife says she wants him to get more help since the situation has become unbearable.
Conceptualizing the Problem
Jim’s problem can be explained and defined using the emotional processing theory (EPT). According to Alpert et al. (2021), EPT is based on the idea that the psychopathology of traumatic stress and anxiety begins with exposure to stimuli and response elements including physiological, emotional, behavioral, and cognitive responses. Fear activation is a major component of EPT associated with emotional engagement that occurs when people remember traumatic events. In the case study, Jim’s symptoms can be attributed to fear activation caused by remembering what happened to his colleagues and this triggers excessive emotional and psychological reactions.
Treatment plan and Evidence-Based Interventions
The treatment plan for Jim’s case should focus on helping him find healthy ways of alleviating PTSD symptoms. The short-term goals include helping Jim address current symptoms and correcting irrational thinking patterns that lead to PTSD. Long-term goals include maintaining good emotional, physical, cognitive, and psychological health. The main treatment interventions that will be used to address Jim’s symptoms include cognitive processing therapy (CPT) and Prolonged Exposure (PE). Jim will attend weekly CPT sessions for 12 weeks and will also attend weekly PE therapy sessions that will continue for eight weeks. Each session will go for 60-90 minutes.
Rationale
As per Watkins et al. (2018), CPT is an intervention based on the assumption that after traumatic events, people try to make sense of the event which results in distorted cognitions about themselves, other people, and the world. Survivors either attempt to accommodate, assimilate or over-accommodate. Assimilation and over-accommodation are linked to negative symptoms such as self-blame and negative beliefs about others. CPT focuses on helping patients accommodate the traumatic event through healthy coping strategies. Rutt et al. (2017) conducted a study about the effectiveness of CPT use among veterans with PTSD and determined that CPT helps to reduce PTSD symptoms associated with negative cognitions and to improve the quality of life of the survivors.
PE is about changing fear structures through exposure to stimuli that remind one of the traumatic events. PE sessions include psychoeducation on PTSD including the effects of trauma. As per Ragsdale and Horrell, (2016), exposure to stimuli helps patients recount the traumatic event and find effective ways of processing the emotions associated with the event. PE helps survivors to change negative reactions they may have towards the memories of the traumatic event.
Conclusion
The case study is about a military veteran with severe and persistent PTSD. The main interventions for the patient include CPT and PE which will help him deal with fear associated with the memory of the traumatic event and the distorted cognitions he has about himself, others, and the world.
References
Alpert, E., Hayes, A., Yasinski, C., Webb, C., & Deblinger, E. (2021). Processes of Change in Trauma-Focused Cognitive Behavioral Therapy for Youths: An Approach Informed by Emotional Processing Theory. Clinical Psychological Science, 9(2), 270-283. https://doi.org/10.1177/2167702620957315
Ragsdale, K., & Voss Horrell, S. (2016). Effectiveness of Prolonged Exposure and Cognitive Processing Therapy for U.S. Veterans with a History of Traumatic Brain Injury. Journal of Traumatic Stress, 29(5), 474-477. https://doi.org/10.1002/jts.22130
Rutt, B., Oehlert, M., Krieshok, T., & Lichtenberg, J. (2017). Effectiveness of Cognitive Processing Therapy and Prolonged Exposure in the Department of Veterans Affairs. Psychological Reports, 121(2), 282-302. https://doi.org/10.1177/0033294117727746
Watkins, L., Sprang, K., & Rothbaum, B. (2018). Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions. Frontiers in Behavioral Neuroscience, 12. https://doi.org/10.3389/fnbeh.2018.00258