Evidence-Based Intervention Sigmund Freud extensively studied the minds of combat soldiers during the World War I (WWI) era and was one of the first to describe symptoms associated with combat stress. Psychoanalysis had its beginnings in trauma theory and has been intimately associated with the concept of psychological trauma ever since. Psychoanalytic theory advanced military psychiatry’s understanding of post-deployment mental health problems beyond the broken brain conceptualization of “shell shock.” In turn, the successful application of psychodynamics in World War II (WWII) military psychiatry inspired a dramatic shift toward psychoanalysis and spurred the growth of departments of psychiatry across America (Kudler, 2007). PTSD could possibly be treated with a combination of treatments that consist of pharmaco-therapy, psychotherapy, or a combination of the two. In addition, PTSD can be treated with various psychotropic medications that helps reduce the symptoms. The researchers identified the most effective evidence-based treatment are classified as trauma-focused treatments. Examples of trauma-focused treatments consist of prolonged exposure (PE) therapy, and cognitive processing therapy (CPT) ( (Mcintyre-Smith, St Cyr, & Roth, 2013, p. 197). Therefore, prolonged exposure (PE) belongs to the family of exposure therapy (ET). Prolonged exposure therapy is an intervention that is a guidance for the patient to help overcome the traumatic experience
This paper explores post-traumatic stress and how it is seen as a disorder. Post-traumatic stress can manifest into post-traumatic stress disorder. The evaluation and review books and articles seem to reveal a relation to these symptoms and military member, either active or non-active veterans. These symptoms do not manifest strictly into the full-extent of the disorder in all cases of military, however, things such as depression and other physical symptoms are discussed through the readings. The end result is that we discovered that through the readings PTSD will in fact lead to suicide if left untreated.
PTSD is not easily treated. Sometimes people can not only suffer mentally but have physical impairments from the event as well. This can make it hard for them to obtain the treatment they need. A combination of medications and psychotherapy is usually recommended and is the most effect form of treatment for PTSD. The earlier a person seeks treatment for this disorder the better the outcome will be. The medications are used to help people cope with their emotions while the psychotherapy will help
We have all seen or read about the political and social upheavals caused by war. Some may have even experienced it first-hand. Throughout history war has had negative psychological implications on those effected. However, there is no greater negative impact of war than the psychological and emotional turmoil that it causes individual soldiers.
The first method of treatment is trauma-focused cognitive-behavioural therapy. In this method, a patient is gradually but carefully exposed to feelings, thoughts, and situations that trigger memories of the trauma. By identifying the thoughts that make the patient remember the traumatic event, thoughts that had been irrational or distorted are replaced with a balanced picture. Another productive method is family therapy since the family of the patient is also affected by PTSD. Family therapy is aimed at helping those close to the patient understand what he/she is going through. This understanding will help in the establishment of appropriate communication and ways of curbing problems resulting from the symptoms (Smith & Segal, 2011).
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
In today 's society, there is a great deal of research and practice about evidence based practice. Most of this is highly sought upon in the field of psychology, where evidence and decision making is key to accomplishing new ideas of treatments for people who retain psychiatric problems. The meaning of evidence-based practice in psychology is that it involves making very educated and supported decisions based on punctilious, unambiguous, and astute evidence (Rousseau & Gunia, 2016). With evidence-based practice, it assists in raising and deriving the issue of what evidence really is, the strength of the evidence, and how practitioners can improve the quality of their evidence (Rousseau & Gunia, 2016). Evidence is a major factor because it may either enhance or hinder the practitioner 's ability to make decisions and construct their practices on patients (Rousseau & Gunia, 2016). Evidence-based practice began in the 1980 's with the goal to combine the practices of scientific evidence with physician education and clinical practice. The issue with this was that medical schools did not have the ability to teach their own specific approaches to clinical problems (Rousseau & Gunia, 2016). As an effect to this cause, three main issues quickly arose about the effectiveness and quality of evidence-based practice. First, since other fields were advancing growth in
The first type of Treatment is called Cognitive behavioral therapy or CBT. Research says that this is the best type of treatment and counseling for anyone diagnosed with PTSD. Cognitive behavioral therapy is used to help the veteran think differently about their thoughts or feelings from the past. The main goal by the therapist is to help the veteran find out what past events or flashbacks correlate with the veteran’s thoughts that make the symptoms of PTSD occur. Many times, the veterans will blame themselves for a decision they made but the therapist will walk them through on how it was not their fault. Cognitive Behavioral therapy can last for three to six months. Although to some people it may seem that CBT might be the best type of treatment, it does not always work. One reason why it might not work is because the therapist may like the experience and education. The therapist may be qualified but sometimes, the therapist may fail at connecting with patient. The connection that is missed by some therapists and patients can simply occur by the therapist not having all the knowledge about all the situations soldiers face when they go to war. Soldiers struggle with their therapy if they feel that the therapist who is helping them does not have the knowledge about the battlefield or the difficulties of war itself. The relationship of the therapist and veteran can also play a major role on the effectiveness of the therapy. Some soldiers may struggle with feeling comfortable with their therapist because they are sensitive and emotional. Sometimes veterans struggle with this therapy if they cannot develop a relationship with their therapist. Another factor that can affect the effectiveness of CBT is the timing. Sometimes three to six months is not enough to show long term effectiveness of the therapy. Another treatment option is exposure therapy.
“Treatment for PTSD is usually based on a combination of therapy and medication to manage symptoms”(SocialChoice). Some veterans may be embarrassed to get help. Group therapy is a good option for these people. During “group therapy members of the service talk about the trauma they have been through. They also learn skills to cope or manage their symptoms of PTSD”(military.com). Family and couples therapy is also an
During World War I, thousands of British soldiers were diagnosed with “shell shock,” a condition which was thought to encompass both physical and psychological symptoms. The discovery of shell shock is typically considered to be an important catalyst in the gradual recognition of mental illnesses caused by combat. However, the characterizations of shell shock as an early discovery of post-traumatic stress disorder made by many historians are false. Shell shock should not be thought of as a credible wartime medical advancement, but as a false and primitive identification of war-trauma.
Prolonged exposure (PE) is a specific exposure therapy program that derives from Emotional Processing Theory (EPT). The idea of emotional processing is to interpret realistic information and accommodate that information into a fear structure which in turn diminishes the fear (Foa, 2011). Foa (2011) acknowledges that the idea of failing to process trauma is
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
Includes in-vivo, imaginal, or narrative (oral and/or written) exposures to traumatic memories, situations, or stimuli. These therapies also generally include elements of cognitive restructuring (e.g., evaluating the accuracy of beliefs about danger) as well as relaxation techniques.
(McElhiney, Moody, Steif, Prudic, Devanand, Sackheim, (1995) Studies show psychotherapy is one of the most used therapies for PTSD, but it’s not as effective as other therapies might be.
Currently available treatment for PTSD other than Prolonged Exposure (PE) include, Cognitive Processing Therapy (CPT) and Eye-Movement Desensitization and Reprocessing (EMDR). CPT is a type of cognitive behavioral therapy that was originally developed in 1992 for women to treat PTSD resulting from sexual assault and is based on the information processing theory of PTSD (Resick et al. 2002). The theory simply suggests that the probability of PTSD occurring arises from a person’s ability to process information, or more specifically the traumatic event (Buckley et al., 2000; Shapiro 2007). CPT consists of cognitive therapy and exposure, and is a treatment that reduces symptoms of PTSD by teaching patients to face and change harmful beliefs relating
Trauma theory represents a multi-faceted organic phenomenon, its evolution branching to and from many different individual and socio-cultural perspectives. The seminal works of Jean-Martin Charcot, Pierre Janet, and Sigmund Freud during the latter part of the 19th-century and throughout the first half of the 20th-century produced a proliferation of thoughts and ideologies that have significantly influenced the development of contemporary thought regarding the complex relationship between trauma and mental health. Observations of the mental and psychological aftermath of war by Sandor Ferenczi, Abram Kardiner, and Herbert Spiegel began to shed light on the concept of physioneurosis, a term used to explain the extreme states of physiological