Psychotherapy With Individuals
Psychotherapy With Individuals
Idalmis Espinosa
Week8- Main Discussion
COLLAPSE
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NURS 6640: Psychotherapy With Individuals
Initial Post
A client that shall be discussed in this case is a young man that has been experiencing PTSD. Ideally, this is a mental health issue that is prevalent especially in war veterans like the young man who was in the army. PTSD is known to cause significant psychiatric morbidity (Sareen, 2014). According to the Diagnostic Statistical Manual 5th Edition, PTSD is associated with a number of symptoms including recurrent memories, flashbacks and nightmares about the event. It is also associated with self-blame and constant avoidance of the stimuli associated with the traumatic event among other symptoms (APA, 2013). These symptoms have been mentioned in this paper because they are the symptoms that the patient presented with. The client complained of nightmares and flashbacks. He also had a problem seeing or meeting members in uniformed forces because the uniforms reminded him of the events during the war. The client was started on exposure therapy. This is an approach that is commonly used especially in war veterans that have PTSD and it has been associated with positive outcomes. In fact, this is considered a first-line treatment for PTSD in war veterans (Reisman, 2016). However, in this case, after weeks of therapy, the client said that he is able to meet colleagues with uniform without a problem but he still has nightmares and flashbacks. These memories prevent him from living a normal life.
It was expected that through the use of exposure therapy, the client would be able to understand the disturbances and perceive them as normal especially after a traumatic event. It was expected that after using exposure therapy. His perception of the event that caused PTSD would change and the flashbacks as well as recurrent dreams would stop. However, there is a barrier to this progress and it might be because the client still blames himself for what happened in the war. He feels if he was more vigilant and keener, maybe he would be able to foresee an ambush and prevent the injuries and death of some of his colleagues. He is also guilty because he left only with bruises and a broken arm. This client therefore, continues to have disturbed thoughts and memories.
Its shall be very difficult for this client to get better if he continues to blame himself. The exposure therapy may work for some symptoms such as responding to stimuli but if he does not deal with the negative thoughts and self-blame, the disturbances shall persist and affect his life in a negative manner. The client denies having suicidal ideation like he used to have and this is a positive outcome. However, the goals of the treatment have not been realized and there is need to change the approach. In this matter, there is need to add cognitive behavioral therapy which shall be used to focus on the negative thoughts including self-blame. CBT is known to be very effective in dealing with negative thinking especially thoughts that are repetitive as the case of the client mentioned here (Spinhoven et al., 2018). Therefore, this should be the next step in dealing with this client in order to make sure that the goals of the treatment are completely realized. It should be noted that there might be a possibility of using drugs in the future but this is just an option if the client continues to have the same thoughts and disturbance. However. Cognitive behavioral therapy is known to be very effective and this might be the last intervention needed before the client feels better and starts to live his life as a normal person. Discussing the options with the client is very important also because his preferences and values must be considered all the time.
