Reflective Practice Journal : Seeking Safety

Post-traumatic Stress Disorder is “a mental condition that can affect a person who has had a very shocking or difficult experience and that is usually characterized by depression, anxiety, etc.” (Merriam-Webster’s, n.d.) Post-traumatic stress disorder can occur after seeing a dangerous event such as war, hurricanes, car accidents, death of a loved one, and violent crimes. It can affect a victim mind, body, and the people around them. While some mental disorders are genetic, this disorder come from the things that people encounter in life. This paper will discuss the risk factor involved with post-traumatic stress disorder as well as treatments that will help overcome it and future research and approaches to treat this psychiatric illness.

As a support worker, it is necessary that organisation would need to have a foundational understanding of how to identify trauma associated responses. Similarly, there needs to be understanding when initiating treatment interventions for trauma-related symptoms, it is aimed to be conducive and empowering to the individual (Trauma-Informed Care: A Sociocultural Perspective, 2014). Also, all support workers should be skilled in identifying the symptoms of trauma, as well as not disregarding the probability of substance abuse and co-occurring disorders (Trauma-Informed Care: A Sociocultural Perspective, 2014). Hence, when creating an individual treatment plan, all likelihoods of self-medicating and individualised coping mechanisms should be reflected

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%,

Cook, Walser, Kane, and Woody (2006) did a study that had a goal of getting clinicians to accept Seeking Safety and evaluate its efficacy when treating veterans, in hopes of bridging the gap of parallel services at the VA to treat comorbid SUD-PTSD. This study reinforced the old ways of "cannot teach an old dog new tricks" because of how difficult it is to influence clinician behavior in routine medical care. A more passive approach was taken via a daylong interactive staff training in Seeking Safety, where clinicians were informally surveyed on their willingness to co-lead groups with the study. Four therapists volunteered. And thus, four Seeking Safety groups were formed with 25 veteran volunteers whom had comorbid SUD-PTSD. Of those, 18

An interesting form of treatment for PTSD is exposure therapy, this treatment is for people with PTSD as well as substance abuse disorder (Coffey). There were 126 subjects all from an unlocked 6-week community residential SUD treatment facility. The idea behind the study was to add prolonged exposure to a 12-step program for those with PTSD-SUD. It was found that as with other cases prolonged exposure is helpful to those with PTSD and if it is early on in the substance abuse issue then it is helpful with

Treatment for co-ocurring disorders fall under the outpatient spectrum for addiction rehabilitation, however, it is an essential and successful form of treatment specifically for veterans. For many civilians who have not been to combat it is difficult to comprehend the toxic combination of pride, anger, duty, anguish and anxiety many veterans feel after their time in the service. Consequently, adjusting back to civilian life is a difficult task to accomplish; while some veterans sustain only minor physical and psychological wounds from combat, others aren’t as lucky. As mentioned above, for veterans, PTSD is considered a mental health condition caused by the traumatic events experienced in wartime. Thus often causing veterans to drugs or alcohol to self-medicate. If left unaddressed, PTSD and substance abuse in veterans can be

Practice: This article first identifies the scope of the problem, followed by the effect of dual diagnosis on treatment outcome, followed by how individual PTSD treatments work and how they view substance abuse, followed by addressing the problems with sequential treatment of PTSD/SUD, lastly addressing the integrated treatment approaches. These implications are supported by empirical data collected from various studies.

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.

Post-traumatic stress disorder is considered as a psychiatric disorder that creates impairments in occupational, interpersonal, and social functioning. Although there are several treatment processes for veterans suffering from this condition, some intervention may fail to generate desired results. Veterans who fail to show appropriate recovery should be supported with an alternative treatment plan (Aurora et al., 2010). Veterans develop the condition because of exposure to traumatizing

Based on my experiences working with individuals involved in the criminal justice system, those suffering from co-occurring disorders is common. With the current opiate epidemic we are facing, I have come across a majority of individuals who are both opiate depended, as well as having a psychiatric diagnosis consisting of either, or both, depression and anxiety. When trying to provide services for these individuals, both their substance abuse and psychiatric issues need to be addressed. To be most effective, they need to be treated at the same time through integrated treatment. Based on the concept of “No wrong door”, the client will be provided with services to make sure they receive the appropriate treatment. After the client is assessed

The fast paced, often demanding world of life in the military, and the experiences of combat and death, create situations in which many veterans experience psychological stress. These stressful situations are typically complicated further by the self-medication of substance use, and other psychological disorders that may be present. There is a large number of military personnel that are facing stressful issues such as homelessness, suicide, and substance abuse, which could lead to them getting involved with the criminal justice system. There is approximately 18.5% of service members returning from Iraq or Afghanistan that suffer from post-traumatic stress disorder or depression, and about 19.5% of military personnel report experiencing a traumatic brain injury during their deployment in the middle east (Veterans and Military Families, 2014).

This literature review briefly examines the scholarly journal articles and research cited above. The aim of these articles were to identify the effective intervention methods used for the treatment of co-occurring posttraumatic stress disorder (PTSD) and substance use disorders (SUD). Although there is much evidence to support the high rate of individuals who experience symptoms of or are diagnosed with both PTSD and a SUD, there is little known about the comorbidity of these two disorders. There is also little research focused on specific populations, such as veterans, who experience a high rate of SUD diagnoses generally associated with combat PTSD. The literature also describes possible rationale for the high rate of

The evidence based intervention used at the Family First Program is called Seeking Safety. This intervention is used with clients with a history of trauma and/or substance abuse and teaches the clients coping skills ("SAMHSA," n. d.). Seeking Safety has five key elements: safety is the goal in relationships, thinking and emotions, it’s an integrated treatment that works on both PTSD and substance abuse, coping skills to deal with substance abuse and PTSD, there are four different content areas pertaining to cognitive, behavioral, interpersonal and case management, and helps clinicians with self-care and countertransference ("SAMHSA," n. d.).

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.

Post-Traumatic stress disorder (PTSD) affects many different people in different ways. Along with post-traumatic stress disorder often comes a co-morbid aspect that patients see as coping mechanisms for the post-traumatic stress disorder that they know little about. Post-traumatic stress and alcohol/substance abuse addiction often find themselves closely related due to the vast amount of individuals who use alcohol or other substances to treat the symptoms of PTSD. When a patient takes on substance abuse, they no longer have one disorder to deal with, they have two. Patients and counselors