Cognitive-Behavioral Therapies for Posttraumatic Stress Disorder

This paper explores post-traumatic stress and how it is seen as a disorder. Post-traumatic stress can manifest into post-traumatic stress disorder. According to Sareen (2014), Post-traumatic stress disorder is defined in the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5 as having 4 core features that are as follows. First, the person must witness or experience a stressful event. Secondly, the person or persons would re-experience symptoms of the event that include nightmares and/or flashbacks. The person or persons would also have hyper arousal symptoms, such as concentrations problems, irritability, and sleep disturbance. The final core feature dictates

When humans undergo traumatic events that threaten their safety and wellbeing, they may become vulnerable to nightmares, fear, excessive anxiety, depression, and trembling. Post Traumatic Stress Disorder (PTSD) is a psychological illness that results from the occurrence of a “terribly frightening, life-threatening, or otherwise unsafe experience” (Posttraumatic Stress Disorder (PTSD), 2012). This condition often leads to unbearable stress and anxiety. PTSD is significantly prevalent as indicated by data from the National Co-morbidity Survey which shows that at a particular time in their lives, 7.8% of 5, 877 adults in America suffered from PTSD (Andrew & Bisson, 2009). In the general population, the lifetime prevalence is estimated at 8%,

Spitalnick, Josh. Difede, JoAnn. Rizzo, Albert. O. Rothbaum, Barbara. “Emerging treatments for PTSD” Clinical Psychology Review, Volume 29, Issue 8, December 2009, Pages 715-726, ISSN 0272-7358, Web. 21 April 2016

Posttraumatic stress disorder can occur after someone experiences a traumatic event. Once the mind hits the coping threshold, it is imperative to seek professional help. The VA offers evidence-based treatments, individual, group treatments, and medications. Coping mechanisms range from individual to individual, hence the need for a diverse PTSD program. Under the evidence-based treatment there are two sections: prolonged exposure therapy and cognitive processing therapy. Prolonged exposure therapy is when someone continues to talk about their fears/trauma to gain control of feelings associated with those fears. The cognitive processing therapy is to understand the feelings associated with trauma and finding a way to replace negative feelings with positive

As stated by the name of this particular EBP, the focus is on cognition in those with PTSD. Cognitive Processing Therapy (CPT) is a form of the well-known cognitive behavioral therapy. For this particular therapy, the clients taking part are older adolescents and adults (18-55+) who have a PTSD diagnosis (SAMHSA, 2014). The preliminary focus on CPT is to look at the distorted thoughts about the trauma experienced by the client. Beliefs such as self-blame and denial are initial conative focus, then therapy moves on to looking at the clients how the clients think themselves, others, and the world (Resick, Nishith, Weaver, Astin, & Feuer, 2002). Clients who are undergoing this therapy use of worksheets and what is known as “Socratic questioning” (Resick,

In the case of Conrad Jarrett I would envision utilizing two frontline treatment options in order to reduce the client’s symptoms of Posttraumatic Stress Disorder (PTSD). Bryant (2008) designed a treatment protocol that combines the use of cognitive restructuring and exposure therapy. Utilizing both of these therapies within structured individual sessions would allow a reduction in negative cognitions (e.g., feelings of guilt and shame) should these feelings intensify during exposure. My concern stems from the patient’s previous attempt at suicide and my desire to provide Conrad with some tools to combat his negative thoughts increasing the likelihood that he will remain unharmed and in therapy through the duration of treatment.

According to Tuerk, Yoder, Ruggiero, Gros & Acierno (2010), prolonged exposure therapy is a form of therapy treatment applied in posttraumatic stress disorders. Prolonged exposure treatment based on behavioral and cognitive levels of therapy, is a method used in treatment of trauma where the victim remembers the triggers of trauma rather than letting go, as it has been the case. Trained Social workers, psychologists and psychiatrist offer treatment to these conditions. What causes post traumatic stress disorders is not clearly known, but a mix of one's personality, inherited mental functionality risks, the way the brain releases chemicals in dealing with stress, and one's life experiences can be used to draw some insights (Powers, Halpern, Ferenschak, Gillihan & Foa, 2010).

Existing controlled examinations of intervention efficacy specific to only sexual assault and rape are presently minimal in comparison to intervention examinations of combination or other types of trauma (Regehr, Alaggia, Dennis, Pitts, & Saini, 2013). Psychotherapeutic interventions that fail to differentiate sexual assault and rape victims from other types of trauma victims may decrease the treatment effectiveness or inadvertently harm participants in this subgroup. Trauma associated from rape or sexual assault differs from other forms of trauma and treatment efficacy should be examined in this manner. Trauma from rape or sexual assault entail symptoms of PTSD, depression, suicidal ideations and sexual dysfunction. Individuals may also indicate feelings of vulnerability, loss of control, fear, shame, self-blame, societal blame and stigma (Russell & Davis, 2007; Regehr et al., 2013; Ullman &Peter-Hagene, 2014). This research proposal intends to explore the long term effectiveness of Prolonged Exposure Therapy (PE) at reducing distress and trauma explicitly for adult victims of sexual assault and rape.

If veterans do struggle with PTSD after they return from combat the Department of Veterans Affairs, a governmental agency that helps struggling veterans recover, offers two treatments. Studies have been done to see if one of the therapies is more effective than the other. There is not yet evidence that one therapy is better than the other. Cognitive processing therapy, CPT, helps by giving the vet a new way to deal with the maladaptive thoughts that come with PTSD. It also comforts them in gaining a new understanding of the traumatic events that happened to them. One of the other benefits of CPT is that it assists the person in learning how these disturbing events change the way they look at everything in life and helps them cope with that (“PTSD: National”). The second newer option of the two is prolonged exposure therapy, which is repeated exposure to these thoughts, feelings, and situations (“Most PTSD”). This type of therapy is now a central piece in the VA’s war on PTSD. “The problem with prolonged exposure is that it also has made a number of veterans violent, suicidal, and depressed, and it has a dropout rate that some researchers put at more than 50 percent, the highest dropout rate of any PTSD therapy that has been widely studied so far,”(“Trauma Post”). Both of the therapies are proven to reduce the symptoms but both have extremely high drop out rates and low follow through. It

Posttraumatic stress disorder (PTSD) is a widespread disorder that affects certain individuals psychologically, behaviorally, and emotionally following the experience of a traumatic event (Lee et al., 2005, p. 135). However, because of inconsistencies regarding the percentage of individuals who experience PTSD and the percentage of individuals who subsequently develop PTSD, researchers hypothesize that both biological and environmental factors contribute to the development of PTSD (Wolf et al. 2010, p. 328). In order gain a better understanding of this disorder and to discover contributing and predicative factors which contribute to the development of PTSD, this paper analyses the historical context and prevalence of PTSD, the

Chapter Seven, The Body Remembers, by Rothschild (2000) increased my understanding how somatic experiencing can be used to treat body memories, people who are stuck in flashbacks, panic attacks, and depression. Since trauma can express itself in many ways, trauma treatment has to be able to work on various symptoms. Rothschild’s (2000) explanation of different somatic experiences involves gathering all of the information we have about one’s trauma and put it into a respectable cohesive narrative. Before this can be done, we have to calm our client’s systems down so that their amygdala stops going off (Rothschild, 2000). Not all people can shake off the trauma or dysregulation that they may feel.

What do you do when you experience a life threatening, traumatic event, and months later you are still experiencing the same frightening responses? Individuals who experience trauma are often forced to face their problems long after the event has happened. The first step to dealing with this issue would be to seek professional help as soon as possible so that they may be properly diagnosed and receive accurate treatment to overcome the intrusive symptoms. An individual who is suffering from symptoms of post-traumatic stress disorder (PTSD) have experienced, witnessed, or was affected by a life

This treatment approach is based on cognitive and learning theories, tackling-misleading beliefs related to the traumatic events of acknowledgments related to the abuse and provides a supportive environment of which individuals are encouraged to talk about their traumatic experience. A numerous amount of research has been carried out to investigate into how effective CBT really can be for PTSD. (Resick et al, 2002) carried out an investigation comparing CBT with strong cognitive restructuring focus and CBT with a strong exposure focus and to a waiting-list control of rape survivors. Prior to this experiment approximately 80% of patients who completed either form of CBT no longer met the criteria for PTSD. Once this investigation was complete a follow up treatment took place of which it was noted 2% of the waiting list group had lost the PTSD diagnoses. Only a year after this investigation Bryant, Moulds, Guthrie, Dang & Nixon, (2003) restructured the experiment comparing exposure alone, exposure plus cognitive restructuring, and supportive counselling in civilians with PTSD resulting from various traumatic events. At this particular follow up 65-80% of participants who either completed either form of CBT were now clear of PTSD diagnosis, compared to less than 40% of those who completed supportive counselling.

The therapists that were used were a nurse therapist and a clinical psychologist. In sessions 1 through 5 of Exposure Therapy subjects were asked to imagine their previous trauma memories. Patients were asked to talk in first person tense about what they experienced, and then were asked to imagine and describe critical aspects of the trauma and "rewind and hold"

“The goal of CBT is to teach clients how to separate the evaluation of their behaviour from the evaluation of themselves and how to accept themselves in spite of imperfections” (Corey, 2009, p. 279). In CBT the clients are expected to change their current behaviour (normally full of automatic thoughts) to a more rational way of thinking. The clinician will challenge the client’s behaviour in order for the client to understand his or her behaviour and get alternatives to change his/her behaviour. When using CBT, the client’s behaviour changes when they are aware of the abnormal behaviour. This approach allows the client to focus on improving his/her wellbeing. This enhances the client’s awareness of an existing issue and that changes are necessary. The client will develop new coping skills to deal with the situation and develop a new way of thinking from negative (automatic thoughts) to positive (more realistic thoughts). Initially the client may not recognise that a problem exists, but through this process will get