Discussion: Posttraumatic Stress Disorder

Respond to your colleagues by providing one alternative therapeutic approach. Explain why you suggest this alternative and support your suggestion with evidence-based literature and/or your own experiences with clients.

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Discussion: Posttraumatic Stress Disorder (PTSD)

Posttraumatic Stress Disorder (PTSD) is known as a mental health condition or a psychiatric disorder that occurs in people who witnessed or experienced a traumatic event in which physical harm occurred or was threatened (Bisson, Cosgrove, Lewis, & Roberts, 2015). According to Lancaster et al. (2016), PTSD creates long-lasting consequences of traumatic ordeals that creates intense fear, feeling of guilt, helplessness, persistent sadness due to sudden death of loved one, natural disaster, major accident, war or combat, physical assault, rape, terrorist attacks. According to Pai et al. (2017), DSM-5 diagnostic criteria related to PSTD includes flashbacks of the trauma, nightmares, intense distress, panicking, lack of sleep or self-disturbance, self-destructive behavior, aggressive behavior, reduce interest, avoidance or avoiding distress memories, emotionally numb and increase the use of alcohol and drugs. In the case study of Thomson Family, William Thompson is a 38 years old African American who is the younger brother of henry. William is a military person and was involved in an Iraq war veteran who recently starts living with her brother in Pasadena, California (Laureate Education, 2012a). Both his brother and wife argue that William is suffering from PTSD but William does not accept this thing and show the symptoms of avoidance when someone tries to talk to him about that. William starts living with his brother when he was unable to pay his mortgage and now working on jeopardy due to his PTSD and alcoholic concerns. The behavior of William that aligns with the DSM-5 diagnostic criteria of PTSD includes avoidance, war veteran, alcoholic concerns, concentration issues on working due to which he was unable to pay the mortgage due to joblessness, working in jeopardy due to PTSD concerns and his brother also admits that William is suffering from PTSD.

Psychotropic MedicatioSelective serotonin reuptake inhibitors (SSRIs) are the only FDA-approved drugs that are used in the treatment of PTSD (Ipser & Stein, 2012). In PTSD treatment sertraline antidepressants such as Zoloft, Pfizer and Paroxetine antidepressant HCl such as Paxil are recommended in the medication process. SSRIs work by helping to create a balance between certain chemicals such as neurotransmitter serotonin levels in the brain (Feduccia, et al., 2019). This chemical balance in the brain helps in regulating mood, improving sleep disturbance, improving appetite and decreasing other symptoms. According to Alexander (2012), the first-line treatment method for PTSD includes the use of Fluoxetine (Prozac) which helps in improving the energy level, restoring daily interest, decrease fear, unwanted thought, improve concentration and reduce panic attacks.

In the case of PTSD along with first-line treatment process different therapeutic approaches are also adopted for the patient which includes the use of cognitive-behavioral therapy (CBT). According to Paintain and Cassidy (2018), CBT is considered the most effective type of psychotherapy and first-line therapy which is used in both short term and long term treatment of PTSD. The main focus of CBT therapy is the traumatic event that are creating problems in the behavior of the patient. CBT helps in identifying, determine, understanding and focuses upon changing the thinking pattern and behavioral pattern of individuals involved in the treatment process (Watkins, Sprang, & Rothbaum, 2018).

Expected Outcomes

With the help of the recommended medication process and therapies, it becomes easy for the patient to overcome the symptoms of PTSD. The expected outcomes from the recommended therapy are to return a sense of control in patients along with self-confidence, reduce symptoms of escaping and avoidance behavior (Syros, 2017). CBT will target current problems and symptoms of the patient and focuses on changing pattern behaviors, feelings, thoughts that are creating difficulties in functioning (Shubina, 2015).

References

Alexander, W. (2012). Pharmacotherapy for post-traumatic stress disorder in combat veterans: Focus on antidepressants and atypical antipsychotic agents. Pharmacy and Therapeutics, 37(1), 32-38. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278188/

Bisson, J. I., Cosgrove, S., Lewis, C., & Roberts, N. P. (2015). Post-traumatic stress disorder. British Medical Journal, 1(2), 351-366. doi:10.1136/bmj.h6161

Feduccia, A. A., Jerome, L., Klosinski, B., Emerson, A., Mithoefer, M. C., & Doblin, R. (2019). Breakthrough for trauma treatment: Safety and efficacy of MDMA-Assisted psychotherapy compared to paroxetine and sertraline. Frontiers in Psychiatry, 10(1), 650-678. Retrieved from https://www.frontiersin.org/articles/10.3389/fpsyt.2019.00650/full

Ipser, J. C., & Stein, D. J. (2012). Evidence-based pharmacotherapy of post-traumatic stress disorder (PTSD). International Journal of Neuropsychopharmacology, 15(6), 825-840. doi:10.1017/S1461145711001209

Lancaster, C. L., Teeters, J. B., Gros, D. F., & Back, S. E. (2016). Posttraumatic stress disorder: Overview of evidence-based assessment and treatment. Journal of Clinical Medicine, 5(11), 105-110. doi:10.3390/jcm5110105

Laureate Education. (2012a). Academic year in residence: Thompson family case study . Baltimore, MD: Author .

Pai, A., Suris, A. M., & North, C. S. (2017). Posttraumatic stress disorder in the DSM-5: controversy, change, and conceptual considerations. Behavioral Sciences, 7(1), 7-21. doi:10.3390/bs7010007

Paintain, E., & Cassidy, S. (2018). First‐line therapy for post‐traumatic stress disorder: A systematic review of cognitive behavioural therapy and psychodynamic approaches. Counselling and Psychotherapy Research, 18(3), 237-250. doi:10.1002/capr.12174

Shubina, I. (2015). Cognitive-behavioral therapy of patients with ptsd: literature review. Procedia-Social and Behavioral Sciences, 165(1), 208-216. doi:10.1016/j.sbspro.2014.12.624

Syros, I. (2017). Cognitive behavioral therapy for the treatment of PTSD. European Journal of Psychotraumatology, 8(4), 1-14. doi:10.1080/20008198.2017.1351219

Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12(1), 258-277. doi:10.3389/fnbeh.2018.00258

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