Free «Post Traumatic Stress Disorder and Its Effective Treatment Approaches» Essay
Table of Contents
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- The Effective Treatment of PTSD
- Design Considerations
- Psychological Treatment
- Family and Social Treatments
- Family and Couple Therapy
- Interpersonal Psychotherapy
- Behavioral Treatments
- Behavior Activation
- Trauma Management Therapy
- Imagery-Based Treatment
- Imagery Rescripting
The post-traumatic disorder is identified to be caused by an anxiety over an event. The disorder has been categorized depending on the impact and its level into two types: the chronic and acute PTSD. The disorder is acute when there is persistence of symptoms for a consistent period of less than three months. It is considered chronic if symptoms extend the mentioned period. The occurrence of PTSD arises once an individual happens to be exposed to or might have undergone through traumatic situations and events. The disorder is among the most serious psychiatric disorders in the United States, according to Lombardo & Gray (2005). The obvious and common events that lead to the post-traumatic disorder are natural disasters or events. These phenomena happen to strike the environment surrounding an individual resulting in major massive destructions and catastrophes. These events include tornadoes, hurricanes, and earthquakes among others that cannot be controlled by human ability.
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An event that is considered traumatic could be a psychological, emotional or physical experience, and is related to disestablishing safety of a person in society. The event is described as the one that causes a feeling of being overwhelmed, hopeless and alone once a person undergoes through the experience. In the process of traumatic event, an individual tends to undergo various emotional changes, which include the feeling of numbing, loss of consciousness, and an appropriate response towards events (Weissman, Markowitz, & Klerman, 2007). With subsequent experiences in later times, an individual has the possibility of relieving those feelings of anger, fear, horror, and, perhaps, helplessness based on the memory of the event that caused the trauma.
The Effective Treatment of PTSD
The initial guidelines for practice on PTSD had to be published by International Society for Traumatic Stress Studies in the year 2000 (Martell, Dimidjian, & Herman-Dunn, 2010). Further steps to treatment were enhanced by guidelines that were later produced by the Department of Veterans Affairs in the United States and American Psychiatric Association. To augment the steps taken, Australia and the United Kingdom had to establish their own guidelines on the approach towards PTSD that were identified to be in tandem with other guidelines that had been provided initially by other relevant stakeholders. The guidelines in this approach derive their solutions from psychotherapy figures on the treatments established from cognitive behavioral therapy (CBT).
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A wide spectrum of research evidence has been brought up since the initial introduction of guidelines in 2000. Several researches have led the ISTSS in constantly updating the guidelines each time a substantial discovery is made, and an example is the guideline update in 2008 (Martell, Dimidjian & Herman-Dunn, 2010).
According to Goodman, Gilman, & Brunton (2005), contrary to medication trials, psychotherapy studies, which include interventions in non-pharmacological specifically fail to utilize controlled placebo designs internationally referred to as the gold standard of intervention evaluation. In their place, researchers have to utilize diverse methodologies, which are necessary for the skills and knowledge of a certain type of treatment. Diverse research on the disorder treatment initially makes application of waitlist designs whereby the intended study participants often may receive treatment intended for cure or undertake studies that are specialized for a given period (Martell, Dimidjian, & Herman-Dunn, 2010). In those studies, when treatment is made random, the waitlist makes a powerful control tool on threats of validity in the study by allowing inferences on the possibility of treatment being responsible for observed changes.
However, according to these studies, the recommended treatments that arise from these studies have been termed ineffective since the waitlist does not provide a clear avenue for identifying the best treatment over the others. These waitlists have also been used in studies for comparing treatments and giving results that are easily interpretable, especially when treatments that are to be offered do not differ significantly from one another (Lombardo, & Gray, 2005). However, a group of scholars has come to a conclusion that psychological treatment remains the cornerstone to treating PTSD and PTSD-related disorder outcomes.
The bigger number of psychotherapy treatment on PTSD treatment confirms eye movement desensitization and response (EMDR) and cognitive-behavioral treatments (CBT) as the most efficient treatment approaches. According to the report of the Institute of Medicine (2007), sufficient evidence could be obtained from the treatment based on exposure. However, sufficient evidence on approaches to cognitive therapy arises from cognitive treatments that include cognitive processing therapy and exposure (Weissman, Markowitz, & Klerman, 2007).
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Psychological therapy that a researcher identifies to be relevant and appropriate to treating PTSD includes having family and social-based treatments (family therapy, couples therapy, and interpersonal therapy), behavioral treatment (behavioral activation and trauma management therapy) and treatments based on imagery (imagery rescripting).
Family and Social Treatments
Family and Couple Therapy
Relationship and marital difficulties have been known to be associated with PTSD, especially with aggression towards children, emotional distancing, and sexual dysfunction (Taylor et al., 2003). Several veterans have reported marital issues leading to studies that are aimed at family treatment. The first approach studied does focus on PTSD symptoms and trauma stemming from family issues. This approach is the best since it tackles PTSD from the root cause as it targets reparation of family’s dynamism and reducing stress in the family by borrowing concepts of PTSD marginalized treatment and family treatment on itself. Another approach concentrates on personal PTSD and derives support from the family partner aiding in the recovery of the person.
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These treatments involve the critical action theory that is relevant to curb family-related PTSD and emotionally focused therapies (Weissman, Markowitz, & Klerman, 2007). These studies were evaluated on their efficacy through the study techniques that have been carried by other psychological scientists since they combine integrative behavioral couple therapy as it has been used in veteran treatments. The approach enables the family to approach the event that caused the trauma positively in an effort to ensuring complete recovery and courage to face future similar events.
Despite the lack of sufficient empirical data on family treatments, the theoretical basis for PTSD family treatment has been strong in military family population. Engaging the partner has been the central area of focus when intervening on PTSD as it enhances belongingness and acceptance of the problem.
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PTSD is associated with the loss of interest in social relationships that extends to the failed social and occupational networking processes. Therapy focused on interpersonal psychotherapy concentrates on social behaviors that are related to improving of PTSD symptoms. According to the pilot study performed on 14 individuals, they were identified to be having chronic PTSD arising from various traumas on interpersonal level, realized that a 14 consecutive week treatment based on interpersonal treatment is effective. The treatment enhanced social relationships and proved effective in minimizing PTSD. 70% of the treated participants had a positive reduction in PTSD, hence expressing no longer desire to attend further treatments (Mufson, Dorta, Moreau, & Weissman, 2011).
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These studies are in tandem with the opinion presented by the researcher that psychological intervention stands the best approach to PTSD treatment. Treating PTSD arising from interpersonal violence and accidents finds this therapy efficient.
Psychological intervention related to behavioral interaction enhancement by introducing activities that attract attention by developing homework events. The approach has been efficient to persons that have PTSD leading to social isolation and avoidance of people to be prominent. A study done on a behavioral activation of a police officer that underwent 11 sessions of the program and gave reports that he no longer needed to have the criteria of MDD and PTSD (Martell, Dimidjian, & Herman-Dunn, 2010). In addition, sufficient reductions were observed at an increasing rate.
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The above results combine with other randomized pilot studies on traumatic injury have resulted in significant changes in PTSD noted in the group that underwent behavior activation. Behavior therapy, therefore, is sufficient in addressing several PTSD symptoms and the picture at large.
Trauma Management Therapy
The treatment was developed in the year 1996 in an effort to addressing serious social PTSD impacts that involve withdrawing, anger expression, numbing, and interpersonal inefficiencies. A study carried during a 17 weeks course by using 29 sessions in the original protocol observed the psychoeducational program for trauma management therapy (Averbuch et al., 2012). After individuals were exposed to the program through controlled exposures, social and emotional rehabilitation was introduced, which guided approximately 3-6 individuals in establishing social interactions. The social skill presented in the program helped people to maintain the relationship created through training on communications and anger management.
TMT has proved worth in establishing best-maintained relationships that have been maintained for a long period. It reduces anxiety, nightmares, heart rate reactivity, flashbacks, and social functioning in general. Despite being lengthy in treatment, its outcomes are long-lasting.
Imagery rescripting is another type of psychological intervention that is proposed to be effective in treating PTSD. DSM-V identified PTSD in its category through introducing sexual abuse a serious event that leads to trauma (Grunert, Weis, Smucker, & Christianson, 2007). The treatment has been used for treatment enhancement on chronic exposure on survivors of sexual abuse. The process entails information expansion through the model processing and by having the key goal of this therapy in facilitating cognitive change in pathogenic schemes and events related to the event. The theory focuses on imagery as having a powerful influence on establishing positive emotions as compared to verbal interventions.
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An individual is asked to engage in an imagined exposure and then rescripting followed. In the process of rescripting, the client is directed to have imaginary thoughts on trauma experiences while establishing mastery of the images through imagining himself or herself as an adult coming to protect and save the kid’s vulnerability. The process has to take four sessions accompanied with audio tapes and homework for rescripting. The process has been effective for sexually abused individuals and those who have undergone PTSD trauma (Long et al., 2011).
The recent increased PTSD treatment approaches indicate that researchers are identifying the need to develop and address evaluated alternatives on the current treatment options available. Since there are diverse treatments coming up, little or any have enough evidence that helps draw conclusions on their efficiency (Taylor et al., 2003). Despite technological treatments having scientific evidence, psychological interventions still stand out. Psychological approaches improve behavior of patients through developed communication that ensures that the social interaction is maintained. Therefore, enhanced exposure therapy seems to be the promising approach when it comes to populations of multiple traumas arising from PTSD.