“Cognitive-behavioral therapy (CBT), specifically exposure therapy, has garnered a great deal of empirical support in the literature for the treatment of anxiety disorders” (Gerardi et al., 2010). Exposure therapy is an established PTSD treatment (Chambless & Ollendick, 2001) and so is a benchmark for comparing other therapies (Taylor et al, 2003). “Exposure therapy typically involves the patient repeatedly confronting the feared stimulus in a graded manner, either in imagination or in vivo. Emotional processing is an essential component of exposure therapy” (Gerardi et al., 2010). “Exposure therapy in the virtual environment allows the participant to experience a sense of presence in an immersive, computer-generated, three-dimensional, …show more content…
The patients used it this design were outpatients referred in 1992 through 1995 by professionals, Victim Support, police, ambulance, fire services, and even the subjects themselves. The criteria that had to be met in order for the subjects to be used in this study were as followed: PTSD for 6 or more months; age of 16 to 65 years; and absence of melancholia or suicidal intent, organic brain disease, past or present psychosis, antidepressant drug (unless the patient had been receiving a stable dose for 3 or more months); and diazepam in a dose of 10 mg/d or more or equivalent, ingestion of 30 or more alcohol units a week, and past exposure or cognitive therapy for PTSD (Marks et al., 1998). The therapist used a procedure manual and 4 treatment manuals which covered each session in each treatment condition. The sessions were audiotaped and each individual session lasted either 90 minutes or 105 minutes in Exposure Combined with Cognitive Restructuring (EC) therapy. 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"
In this scenario, the independent variable is the type of treatment and the values are the treatment groups. The dependent variables are the patient’s measurable PTSD symptoms, including frequency of dissociative reactions, recurrent distressing dreams, negative alterations in cognitions and mood, and marked alterations in arousal and reactivity (American Psychiatric Association, 2013). The demographic variables in this study are age and ethnicity. The control variables are gender, geographic location, and PTSD.
Foa and her colleagues (2011) created prolonged Exposure (PE) for clients trying to overcome with PTSD that is based on the emotional processing therapy (Foa, 2011). PE treatment plan includes collecting of information associated to both the traumatic experience and the trauma survivor's responses to it, the teaching of breathing retraining techniques, education, the re-experiencing of the trauma in imagination, and in vivo exposure (Foa, 2011). When compared with CPT, PE is a 10-session treatment (60-90 minutes) that is centered on both in-vivo and imaginal exposure to the trauma memory and ensuing adaptation. PE reports that repetitive stimulation of the trauma memory allows the clients to integrate new, counteractive information about themself and their world. Additionally, homework assignments in PE allow the client to face safe situations, which were formerly resolute to be threatening based upon inaccurate post-traumatic beliefs (Foa,
The fear of heights can sometimes leave people frozen in terror. There is large amount of evidence suggesting that virtual reality therapy has successfully helped alleviate conditions similar to PTSD. This is accomplished by slowly increasing the amount of stressors, as to not overload the patient with irrational fear. For example, with fear of heights, researchers can gradually increase the difficulty of the simulation, so that the height of the platform increases after every session. In a similar case study, 49 patients had volunteered to participate in a virtual reality treatment for their fear of flying. Results showed, “By the 6-month follow-up, 90% of treated participants had flown since completing treatment” (Anderson 2001). Effectiveness also hugely depends on plausibility and affordability. We need to consider if this treatment is convenient for
The symptoms that are being treated through this individualized treatment plan related to post traumatic stress disorder are: dissociative reactions, irritable and aggressive behavior, concentration problems, and trauma-related external reminders. The first goal is in place to assist Precious in learning to eliminate intrusive memories, a “notable feature of memory in PTSD is the reliving experiences or “flashbacks” to the trauma” (Berwin, 2003, p. 340), and addressing causes of these memories through the intervention of prolonged exposure. In addition, the second goal that is being implemented, preventing and addressing distortions, is being addressed through prolonged exposure. This technique is “a general treatment strategy for reducing anxiety that involves confronting situations, activities, thoughts, and memories that are feared and avoided even though they are not inherently harmful.” (Foa, 1998, p. 65). The flashbacks and distortions that Precious experiences are being addressed through prolonged exposure, due the fact that it
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.
Although American service members have felt the lasting effects of combat throughout the history of the nation, it was not until 1980 that Post-Traumatic Stress Disorder was formally added to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. Once referred to as “irritable heart” or “shell-shock,” PTSD made its way into the national spotlight in the years following the wars in both Iraq and Afghanistan due to U.S. military members having difficulty reintegrating into civilian life. High rates of suicide, depression, and elevated levels of violent crime within the veteran community made the need to find an effective treatment of this disorder a top priority for the Veterans Health Administration. While it is widely accepted by medical professionals that there is no single, definitive cure for PTSD, many different methods have been cultivated within the past 15 years that make coping with it an easier process; some to a greater extent than others. While medications, namely antidepressants and benzodiazepines, usually find themselves at the forefront of any discussion regarding mental debilitation, they are not a one-size-fits-all solution to the problems that combat veterans face. As this particular disorder is attached to a certain memory or traumatic occurrence, alternative methods of rehabilitation such as Cognitive Behavioral Therapy (CBT) and Prolonged Exposure (PE) have also shown promise in
Developed by Edna Foa, prolonged exposure therapy exposes patients to their traumatic event over and over again while being in a safe place (Blankenship 277). Although prolonged exposure therapy is one treatment it has four main elements including education, breathing retraining, in vivo exposure, and imaginal exposure. Education consists of learning about the treatment, treatment symptoms, and goals of the treatment. Breathing retraining helps patients to relax and calm themselves when they become anxious. In vivo exposure allows patients with PTSD to be put in real-life situations that they are not comfortable with due to the trauma they have faced. Lastly, imaginal exposure allows the patients with post-traumatic stress disorder to talk through their traumatic event while it is recorded. After repeatedly talking through their event, the patient then listens to what they have said (Swan 28). Prolonged exposure therapy occurs over eight to fifteen sessions. Each session can range from 60 to 90 minutes depending on the patient and their specific needs (Blankenship 278). This treatment helps patients with post-traumatic stress disorder by allowing them to face their fears associated with the traumatic event and gain control over their emotions (Swan 28). Prolonged exposure therapy is proven to be a very effective therapy and is highly supported for the use of treating PTSD (Blankenship
To conclude, Kristen Walter neither confirmed nor denied if one treatment program was better than the other. She stated that both outpatient and residential programs can be beneficial to veterans with PTSD, but the treatment program that works best may depend on the severity of their symptoms. In the article “Cognitive Processing Therapy for Veterans with Posttraumatic Stress Disorder: A Comparison Between Outpatient and Residential Treatment”, Kristen Walter evaluates the treatment success in outpatient and inpatient programs for veterans with
PE is built on the assumption that retelling an account of a traumatic experience repeatedly will allow the brain to fully process the memory of that experience, which makes it less painful and something that no longer dominates their life. Additionally, PE is based in Emotional Processing Theory, which posits that PTSD symptoms arise as a result of cognitive and behavioral avoidance of trauma-related thoughts, reminders, activities and situations. PE helps the client interrupt and reverse this process by blocking cognitive and behavioral avoidance, by introducing corrective information. Finally, PE facilitates in organizing and processing of the trauma memory and associated thoughts and
The patients were split into two groups; the waiting list comparison group (n=64) and brief CBT (n=79) with a duration of 4 weekly sessions with assessments initially and post-therapy. The measure used to articulate the severity of PTSD was an interview with a counselor and the secondary measures were depression and anxiety. The results demonstrated that initially after one week post-therapy, patients who went through the brief CBT had better scores on the PTSD measure and less anxiety and depression than the control group. However, 4 months after the intervention, the difference in care was no longer evident which shows that CBT may provide immediate relief from PTSD symptoms but may not be able to provide long-term results. One interesting note that should be mentioned is patients who were in the study 1 month after their traumatic experience and patients with a comorbid diagnosis of depression showed an enhanced efficacy in their
It has been proven to have a better response rate.The Institute of Medicine recognized exposure therapies as the only treatment approach with sufficient empirical data to be deemed effective for PTSD (Institute of Medicine, 2007).While pharmacotherapy with SSRI can reduce symptoms, the most effective treatments involve understanding and overcoming avoidance behaviors (Foa & Rothbaum, 1998) Exposure therapy is a behavioral treatment for PTSD that aims to reduce your fear, anxiety and avoidance behavior by having you fully face, or be exposed to, thoughts, feelings or situations that are feared. During exposure therapy, the patient will face varying stimuli that stimulate the PTSD. This will go on until the intensity of the stimuli is
The emergence of research dedicated to TF-CBT and its focus removes a significant amount of ambiguity from the prescription of treatment. Due to the overwhelming positive response in research, clinicians now can confidently recommend TF-CBT and prevent further suffering within patients. Also, completing additional research in this area could lead to even more efficient and helpful methods of treatment. For young people who experienced trauma, this interactive treatment method can bring about progressive changes in their behavior and their thoughts, which can help to eradicate PTSD over the course of treatment as well as the time that follows it.
Symptoms were assessed with self-report measures of PTSD (PTSD Checklist) and depression (Beck Depression Inventory-II) before and throughout therapy. Mixed linear models were utilized to determine the slope of reported symptoms throughout treatment, and the effects associated with fixed factors such as site, treatment setting (residential vs. outpatient), and TBI severity were
Clinician will use Cognitive Behavioral Therapy (CBT) and exposure therapy to attempt and reduce her symptoms. Both modalities will help to change her cognition and fear of leaving her house and being among others. The primary problem of the client is her thoughts that prevent her from leaving the house or interacting with others. These problems are affecting her daily life, she is afraid to leave her house because “they are following me”. The goals are (1) identify trigger thoughts (2) challenge paranoid thoughts (3) replace paranoid thoughts with realistic thoughts. The main distorted cognitions are “they are out there watching me” and “I fear people will hurt me.”
Foa approaches the understanding and treatment of mental disorders from a cognitive-behavior. The Therapy she developed is known as Prolonged Exposure or PE. All details to the trauma are important, including not only what happened but what the patient was feeling and thinking and what sensations they experienced. Patient’s recount their experience repeatedly throughout their therapy. Patients must not only talk about the experience they must engage in the story emotionally or the treatment won’t