Case Vignette: Treatment Plan for Recovery
Identified Problem # 1: Veronica is experiencing symptoms of PTSD that are interfering with her daily functioning.
Behavioral Definition: Post traumatic stress disorder is caused as a result of traumatic events that affect the mental health of an individual. The traumatic event is either manifested on the individual or such events are witnessed by the individual. The symptoms include anxiety, depression, nightmares, flashbacks of events, among others (Www.nimh.nih.gov, 2017). The patient Veronica had also been subjected to a traumatic event in the past. Her behavioral definition statement is as follows.
Had been subjected to a traumatic event like rape at a young age. Had been raped and assaulted repeatedly. Was verbally threatened but there were no signs of physical injuries. During the assaults, she felt detached, embarrassed, guilty and numb. Had an extramarital affair and showed signs of depression following the end of the 5 week extramarital affair. Having flashbacks of the traumatic events that had occurred 10 years ago. Experienced distressing images of the traumatic events. After the assaults, she led a troubled life. She had withdrawn from high school and started socializing with troubled children. She also subjected herself to drinking, fighting with her mother and lied frequently. She also had a car accident. She was very rarely connected to the reality and these in turn affected her choices in life. She even got pregnant and had to undergo an abortion. Apart from destructive behaviors like drinking, she smoked marijuana and was defensive about the use of this drug and also did not show any efforts on quitting the harmful drug.
- Long term goals involve the provision of a supportive and trauma free environment providing holistic healing therapies for women who are subjected to extremely traumatic events that involved physical violence, abuse, struggle, among others. Doctors, psychiatrists, coaches involved in teaching life skills and holistic healers, can provide counseling either individually or in groups. Such counseling helps to reduce the symptoms of the post traumatic stress disorder and helps the individual to lead a normal constructive life. It also helps to stop the destructive behaviors like drinking, smoking drugs, among others that is associated with denial and escape from such activities and in turn garners responsible functioning among the individual (Cusack et al., 2016).
- Various healing modalities can be used to provide an overall benefit to the body particularly mental and physical health. The healing modalities also helps in the healing of the depressive symptoms that results due to the post traumatic stress disorder. These modalities are eye movement desensitization and reprocessing (EMDR) technique, talk therapy, acupuncture, group therapy, somatic work and bodywork. Such modalities helps to teach self care and life skills. Moreover, exercises and meditation is also beneficial (Church & Feinstein, 2017).
- Psychological testing to determine the symptoms of the post traumatic stress disorder and creating a complete list of the symptoms that is responsible for the patient’s distress. It is necessary to explain the traumatic events and describe the feelings associated with such an event.
- Determination of the use of mood altering drugs like marijuana that can have a negative impact on life. Exploration of patient history regarding chemical use or bio-psychosocial history.
- Raising awareness of the ill effects of posttraumatic stress disorder on individual and the family members. Promotion of practicing relaxation techniques and exercises or meditation that helps to cope with feelings of tension, anger, grief, anxiety, among others (Patki et al., 2014).
- Reliving the biological stimuli triggered as a result of the past traumatic incidents and explaining how to stay calm by promotion of positive self talk, therapy sessions and application of relaxation techniques. Encouraging the use of proposed medications (Nathan & Gorman, 2015).
- Psychological debriefing helps to educate the victim about the traumas and the reactions associated with it, which are normal. The victim is encouraged to share the experiences and the emotional turmoil faced by them.
- Psychological first aid or PFA is a set of actions that helps to reduce the distress associated with post traumatic stress disorder and provides support for both long and short term adaptive functioning. PFA consists of 8 actions. These are engagement and contact, comfort and safety, practical assistance, information gathering, stabilization, coping skills, providing social support and linking with the collaborative services (Everly et al., 2016).
- Coping skills therapy includes stress inoculation therapy, relaxation training helps to reduce anxiety and increase coping skills (Barlow, Allen & Choate, 2016).
- Pharmacological interventions involve the use of serotonin reuptake inhibitors (paroxetine), beta blockers (propranolol), narcotic medications (morphine), among others (Amos, Stein & Ipser, 2014).
Amos, T., Stein, D. J., & Ipser, J. C. (2014). Pharmacological interventions for preventing post?traumatic stress disorder (PTSD). The Cochrane Library.
Barlow, D. H., Allen, L. B., & Choate, M. L. (2016). Toward a Unified Treatment for Emotional Disorders–Republished Article. Behavior therapy, 47(6), 838-853.
Church, D., & Feinstein, D. (2017). The Manual Stimulation of Acupuncture Points in the Treatment of Post-Traumatic Stress Disorder: A Review of Clinical Emotional Freedom Techniques. Medical acupuncture, 29(4), 194-205.
Cusack, K., Jonas, D. E., Forneris, C. A., Wines, C., Sonis, J., Middleton, J. C., ... & Weil, A. (2016). Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clinical psychology review, 43, 128-141.
Everly Jr, G. S., Lating, J. M., Sherman, M. F., & Goncher, I. (2016). The Potential Efficacy of Psychological First Aid on Self-Reported Anxiety and Mood: A Pilot Study. The Journal of nervous and mental disease, 204(3), 233-235.
Nathan, P. E., & Gorman, J. M. (Eds.). (2015). A guide to treatments that work. Oxford University Press.
Patki, G., Li, L., Allam, F., Solanki, N., Dao, A. T., Alkadhi, K., & Salim, S. (2014). Moderate treadmill exercise rescues anxiety and depression-like behavior as well as memory impairment in a rat model of posttraumatic stress disorder. Physiology & behavior, 130, 47-53.
Www.nimh.nih.gov. (2017). NIMH » Post-Traumatic Stress Disorder. Nimh.nih.gov. Retrieved 12 December 2017, from https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml