The Long Term Effectiveness Of Prolonged Exposure Therapy

Victims of sexual assault suffer from a wide variety of mental and emotional issues throughout their lives as a result of the experience. Results can range from depression, anger, feelings of loneliness, and difficulty when trying to formulate relationships of trust (Hyde 45). Victims experience a wide variety of psychological issues as a result of sexual crimes, which they will have to carry with them throughout their entire lives. Also, “Psychological problems can start later in life with changes in behavior- vague fears, feeling unprotected and helpless, nightmares, bedwetting, sleeping problems, fear to loss parents approval/love, need to please others, poor self esteem, anger, depression, withdrawal from activities, daydreaming, difficulty concentrating, behavior problems” (Hyde 47).

The term “Psychological trauma” refers to damage wrought from a traumatic event, which that damages one’s ability to cope with stressors. “Trauma” is commonly defined as an exposure to a situation in which a person is confronted with an event that involves actual or threatened death or serious injury, or a threat to self or others’ physical well-being (American Psychiatric Association, 2000). Specific types of client trauma frequently encountered by which therapists and other mental health workers frequently encounter in a clinical setting include sexual abuse, physical , or sexual assault, natural disasters such as earthquakes or tsunamis, domestic violence, and school or/and work related violence (James & Gilliland, 2001). Traumatic

The incidence of intimate partner violence is quite common amongst individuals in the United States. As a result, PTSD and depressive disorder have been consequences associated with this issue, further adding to numerous public health issues that our society is facing. Intimate partner violence not only affects the victim, but the families and society as well. Therefore, efforts must be made to decrease the prevalence of IPV, as well as assisting those individuals who have been victimized in this issue. Past research has associated PTSD with individuals with sexual abuse, but not specific to IPV. One example in particular, included research done amongst women

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

(2012) conducted a follow-up assessment on women who survived at least one episode of sexual assault at least three months prior to receiving treatment; 86% of the sample had experienced at least one other traumatic event in addition to the index event. To be included and considered for treatment, the participants could have no current psychosis, substance dependency, or violent ideation.

In thinking about developing an exposure-based model working with veterans who experience PTSD, I plan to use prolonged exposure therapy (PE) because it has been shown to be effective with veterans and in treating anxiety and depression. I plan to use a 15-session model that has been adapted already for use within the Department of Veteran Affairs. This model will be implemented using small groups of six. Knowing that Veterans typically have a trust issue when it comes to personal problems, it will be important that I take the time to establish a trusting therapeutic relationship. Therefore, I will initially meet with each Veteran individually and explain the group atmosphere and the basis of PE, as well as building rapport,

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).

Sexual violence can cause a survivor to have psychological, emotional, and physical effects. These effects aren't easy to cope with or

Multicultural Considerations: Cultural differences may see exposure therapy as worse than the disorder (Prochaska & Norcross, 2005, p.252). Therapist should show empathy with clients instead of using terrifying visualization scenes for the client to deal with. In Exposure therapy the therapist 's empathy is used as a more freighting scene. Trauma victims in search of sensitivity, support, and empowerment are provided more, higher decibel pain. When there is no empathic and caring relationship between clinician and client, psychotherapy, is not worth doing (Prochaska & Norcross, 2005, p. 252). In these therapies the therapist focuses on the behavior or feared stimulus, rather than deal with feels as much. Feelings of anxiety will be talked about while the client is going through the process of visualization, and at the end of the visualization to rate where their anxiety is. Strengths include a collaborative relationship between therapist and client in working toward mutually agreed-upon goals, continual assessment to determine if the techniques are suited to clients ' unique situation, assisting clients in learning practical skills, an educational focus, and stress on self-management strategies (Corey. 2005, p.485). With the client and therapist on the same page about how to work through the anxiety they can determine together would be more productive and helpful for the client. The therapist also needs to help the client with consequences

Victims can exhibit all sorts of mental and emotional reactions to the unwanted violation of assault. Mentally, the most common effects are PTSD, depression, and dissociation, all of which are not remediable overnight and ordinarily require outside help (Effects of Sexual Assault and Rape, 2017). Outside help includes speaking with a psychiatrist. However, the healing process is lengthened unnecessarily because it takes at least a year for 75% of child victims to tell someone what happened (The Assessment Center, 2016). For all ages, this waiting time before attempting to receive help serves the prevention of the healing process, thus prolonging the span of time spent in pain.

Research in this area is extremely important because so many people are uneducated about sexual assault and rape. For the purpose of this paper, I conducted your research by utilizing news articles, empirical articles, the FBI’s Uniform Crime Reporting Program (UCR) and the United States’ Department of Justice and several websites who advocate against sexual assault and rape. In addition, I included an article and its methodology of the peer reviewed article entitled Trauma Exposure, Posttraumatic Stress Disorder and Problem Drinking in Sexual Assault Survivors.

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"

Prolonged Exposure therapy focuses on repeating exposure to the trauma. This method also focuses on the beliefs about the stimulus that don’t represent the world accurately. These meetings tend to occur for about ninety minutes, typically last between 9-15 sessions, and have four main sections. An example of this would be if you are scared of a spider you would continue to show your client a spider and eventually get them to hold the spider in their hand. This is called imaginal exposure. Prolonged exposure also has in vivo exposure, where the client confronts the stimuli in a safe setting. (from website) Usually the clients use escape and avoidance responses from harmeless stimuli. These responses begin to interfere with their behaviour. Quiet

This is a good and very difficult question. I would use CBT with this client if they would think that because they had a bad interaction with an Arab American then that means that they would have the same experience with all of them. I would explore those thoughts, rationale, and fears further. I agree with Sara on using exposure therapy because it allows the client to expose themselves to what is causes the trauma in order to reduce its negative effects. I would start small with the client by asking them to introduce themselves to an Arab American. Depending how well the client is doing then I would gradually add more. For example, The client would go to an Arab American