Stabilizing Breathing Skills

Kayla shared with the QP, “I supposed to come in and have free play time” then QP informed Kayla, she is supposed to listen, follow directions, complete her work, and engaging in positive peer interactions instead of getting in trouble for any of doing things.

Sean listened as the QP shared he needs to learn relaxation skills to help reduce stressors.

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,

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

QP examined with Shonquasia, when she should seek help for her depression. QP asked Shonquasia to list the things she can do to keep mentally physical. QP examined with Shonquasia, how she respond and relate to depression. QP discussed with Shonquasia, how depression affects a person. QP provided Shonquasia with observational skills to avoid depression. QP discussed with Shonquasia identify and find healing from worries that cause depression. QP explained to Shonquasia, how negative thinking can increase depression mood. QP asked Shonquasia to list some negative thinking that keeps her in a depress mood. QP provided Shonquasia and her mom information on summer camp and summer activities. QP discussed with mom and Shonquasia the approaching of the end of IIH services. QP discussed with mom and Shonquasia the transition process of IIH services. QP ended the session by reminding Shonquasia and mom of the next scheduled

QP provided the purpose of this session which was to assist Justice and his mother with completing paperwork for school.

QP provided Maunica with a skill building activity geared towards medication management. QP explained to Maunica that the activity will provide her with information to take control of her medications and educate her on the side effect and important of take her medications as prescribed. QP asked Maunica, when was the last time she has seen her doctor. QP asked Maunica if she is taking any new medications. QP asked Maunica if she is taking her medications as prescribed. QP asked Maunica to list some of the side effect of her medications. QP discussed with Maunica the health goals of her medications. QP asked Maunica, what her personal health goals is. QP educated Maunica on medication management. QP explained to Maunica that she can talk to

Avoidance and numbing represent a flight response to stimuli associated with the traumatic event(s). In fact, avoiding people,

Decreases in blood volume:A decrease in blood volume can also cause blood pressure to drop. A significant loss of blood from major trauma, dehydration or severe internal bleeding reduces blood volume, leading to a severe drop in blood pressure, and Allergic reaction (anaphylaxis).When you get scarred a signal is triggered and is sent to the brain.The signal travels to the amygdala. The amygdala fires a brain chemical called glutamate out into two other regions of the brain. The first region makes us freeze or involuntarily jump. These reactions are so automatic because the signal is sent deep into the base of the brain to an area that we have little control over.The second signal is sent to the hypothalamus and triggers our autonomic nervous system — the system responsible for the fight or flight instinct. It elevates our heart rate and blood pressure and pumps adrenaline throughout our bodies.

QP gave the purpose of this session which was to address medication, Lizzie’s mother decision to stop smoking, and contacting the school.

Utilizing this activity was a quick and easy way to assess where the client’s thought process was during our session. I was able to gather more data about his family life and later connect it to his PTSD diagnosis. I consider this activity a success because I was able to obtain more and better data about the client’s life and his current thoughts and emotions regarding his

QP met with Dontrell and his mom for the first time. QP explained to then the services that will be provided. QP discussed the goals that Dontrell will be working towards. QP explained the rules and guidelines needed to be followed in order to participated in IIH Services. QP asked Dontrell these questions to in order to identify some of his problem areas, how often do he feel angry or frustrated, how does he express his anger, what frustrates him most, how does he express his anger at home, what do your family do when he gets angry at home, and on a scale of 1-10 how does he rate his anger. QP asked Dontrell about his relationship with his mom. QP asked Dontrell about his grades at school, QP asked Dontrell, what he would like to do in the future. QP asked Dontrell to list some

It is a normal response of the mind to “rationalize overwhelming emotions.” It works as a defense mechanism that blocks off the immediate shock, and a temporary response that carries us through the “first wave of pain” (Psych Central). This is congruent with the beginning of the story, when the protagonist tries to convince herself that “[her] case is not serious…” as her husband repeatedly tells her, that “Of course it is only nervousness” (The Yellow Wallpaper,

Consequently, there are numerous benefits of Neurally Adjusted Ventilation Assist (NAVA) for patients meeting the qualifications to both the patient and the medical team. First of all, the EdiCatheter can be used as an assessment tool for the patient. If you were to drop the catheter down a patient’s esophagus you could assess the diaphragm’s muscle strength which would determine if there was a possible neuromuscular problem occurring. (Kylie- KC Children’s) A patient placed on NAVA will also require less sedation to maintain comfortability, as a result this will let the patient’s respiratory muscles work while still being supported. NAVA will also help the nurses and doctors determine the appropriate level of sedation based upon the ventilator

Overall, the entire session went well. The therapist was able to get the client to confine in her regarding the traumatic event that had occurred. The client was able to manage his anxiety by using the breathing technique as well. “Shallow breathing limits the diaphragm's range of motion. The lowest part of the lungs doesn't get a full share of oxygenated air. That can make you feel short of breath and anxious. Deep abdominal breathing encourages full oxygen exchange that is, the beneficial trade of incoming oxygen for outgoing carbon dioxide. Not surprisingly, it can slow the heartbeat and lower or stabilize blood pressure” Harvard Medical School (2015). Yes, I would definitely use the exposure therapy on the patient. The benefits of using exposure therapy is that it is a trauma focused therapy that is effective in counseling clients diagnosed with PTSD. “Practice guidelines have identified that trauma-focused psychotherapies have the most evidence for treating PTSD. PE teaches you to gradually approach trauma-related memories, feelings, and situations that you have been avoiding since your trauma. By confronting these challenges, you can decrease your PTSD symptoms” National Center for PTSD (2017).