What evidence exists to support the use of exposure therapy (or the therapeutic approach you would consider if you disagree with exposure therapy)?
FEMALE SPEAKER: It was such an intense story. I just kept seeing things the way he did, you know. The weird green of his night-vision goggles, his sergeant screaming for Jake to kill him. I just keep seeing it all in my head. [MUSIC PLAYING]MALE SPEAKER: Why do you think you keep thinking about this story, this particular case?FEMALE SPEAKER: I don’t know, maybe because it’s so vivid. You know, I went home last night, turned on the TV to try to get my mind off it. And a commercial for the Marines came on, and there was all over again– the explosion, the screams, the man dying. Such a nightmare to live with, and he’s got a baby on they way.FEMALE SPEAKER: Maybe. That’s interesting you say that. I mean, the other vets I work with are older, and they have grown kids. But Jake is different. I just keep picturing him with a newborn. And I guess it scares me. I wonder if he’ll be able to deal with it
The last video above is like 23 minutes and I think is the summary or so
Sample
Levy Family: Assessing Client With Addictive Disorder
An addictive disorder can be defined as a chronic disease which has no cure but can be managed. It deals with a complex meshing of the physical, spiritual and psychological, therefore it can be surmised that an addictive disorder can be synonymous with a chronic disease which is best controlled rather than cured (Rizeanu, 2015). Alcohol is one of the most commonly abused substances. The rate of alcohol use disorder ranged from 4% to 92% (Stasiewicz et al, 2007). It is important for the healthcare provider to be knowledgeable about diagnosing and treating individuals with alcohol abuse. The purpose of this paper is to assess and recommend a treatment approach for Mr. Levy.
Episode 1
My perception of Mr. Levy in the beginning, is someone in denial of having drinking issues. This is seen when he told his wife that he is sick when his wife asked him to get dressed for work and he stated “I am not going to work, I am sick”. Also, I feel like Mr. Levy is depressed and might be suffering from PTSD from Trauma due to what he went through in Iraq and as such he is using alcohol to numb his feelings. Mrs. Levy knew something is wrong with her but she doesn’t know how to help him, she seems fed up with his nightly drinking and worries about their relationship. Mr. Levy, on the other hand seems to have given up on himself and their relationship when he stated “That way is dead. It died when I went to Iraq”. Some of the implications of this is an imminent divorce which is evidenced by Mrs Levy stating “My vows don’t cover this. You were never like this before. You’ve changed”. My levy might also lose his job if he continues down this path.
Episode 2:
I think the social worker was so excited about this case, and therefore has already mapped out a treatment plan even before meeting with the Client. She formulated the plan based on her experience with previous clients with PTSD. I think the first step would have been for her to research different therapies/treatments and also meet with Mr. Levy first before concluding which therapy will be best for him. It is important for a therapist to work with his/her patient and formulate a treatment plan together. Get to know your patients first before jumping to conclusions.
Episode 3:
My thoughts about this video today reviewed about Mr. Levy‘s therapist and how she responded I would say that my impression is that the therapist answered Mr. Levy‘s questions and guided him through a relaxation exercise. They exhibited empathy. She walked him through multiple symptoms some of which were hyperventilation uneasiness increased heart rate and fear as these are typically experiences of people who suffer trauma we’re going through some type of anxiety attack. She mentioned that proper breathing techniques would be very helpful for these types of symptoms. The suggestion of exposure therapy by the therapist was well received by Mr. Levy. Exposure therapy has been proven effective in the treatment of patients with PTSD (Coffey et al, 2016).
Episode 4:
The therapeutic approach of deep breathing exercises worked with the client’s signs and symptoms of fear, doom, and hyperventilation. The therapist was successful and exhibiting empathy, reasons were gathered that led the clients distractive behavior which was drinking and other associated symptoms of PTSD including insomnia, ruminating thought, and mood swings. The exposure therapy technique was successful as it was coupled with deep breathing exercises. This enabled the patient to verbalize his experience and how he faced, without actively reliving the particular trauma. This technique provides for the therapist to obtain subjective and object of information and see the holistic view of the patient to write a more descriptive and individualized treatment plan. I would consider utilizing similar therapy as well. Empathy is the understanding of a particular experience that the person has gone through, and working to see situations from another person‘s perspective, and encouraging ways to deal with the problem in a healthy aspect. I would consider working with the client to devise an individualized treatment plan which would include cognitive reconstruction therapy (CRT). CRT such as Cognitive Behavioral Therapy (CBT) is used to correct alterations in
thinking and behavioral patterns (Ellis, 2003). A randomized study on the effect of CBT on PTSD patients showed that CBT Clients improved significantly post treatment assessment (Mueser, 2008). This technique can change Mr Levy‘s thanking from and his irrational state to a rational state.
Episode 5: If I were providing supervision to this therapist I felt that her concern was valid however; I think there is a possibility of counter-transference on the part of therapist. I will encourage the therapist to be confidence and show her support. According to Hayes et al (2011), self insight, integration, anxiety management, empathy and conceptualizing ability are qualities of good therapist. Summary There are many different ways to cope with family, one common way to cope is with substance abuse. As a therapist to thoroughly assess the problem can you guide successfully to an individualized treatment plan. The plan should be patient centered and patient focused. The healthcare provider that implements to plan should take time to research the treatment plan of choice and give evidence-based treatment that has been successful in the past. The very first patient encounter could precipitate the appropriate treatment options. Treatment should be patient focused individualized and holistic. Being aware of counter transference on the part of the healthcare provider can make the treatment more patients focused and effective.
References:
Stasiewicz, P. R., Nochajski, T. H., & Homish, D. L. (2007). Assessment of alcohol use
disorders among court-mandated DWI offenders. Journal Of Addictions & Offender
Counseling, (2), 102
Hayes, J. A., Gelso, C. J., & Hummel, A. M. (2011).Managing
countertransference. Psychotherapy, 48(1), 88-97. doi:10.1037/a0022182
Rizeanu, S. (2015). Psychotherapy for addictive disorders.
Romanian Journal Of Cognitive-Behavioral Therapy & Hypnosis, 2(4), 42-46
Mueser, K. T., Rosenberg, S. D., Jankowski, M. K., Bolton, E. E., Lu, W., Hamblen, J. L., &
McHugo, G. J. (2008). A randomized controlled trial of cognitive-behavioral treatment
For posttraumatic stress disorder in severe mental illness. Journal Of Consulting And
Clinical Psychology, 76(2), 259-27
Ellis, A. (2003). Similarities and differences between rational emotive behavior therapy and
cognitive therapy. Journal of Cognitive Psychotherapy, 17(3), 225-240. doi:
https://doi.org/10.1891/jcop.17.3.225.52535
Coffey, S. F., Schumacher, J. A., Nosen, E., Littlefield, A. K., Henslee, A. M., Lappen, A., &
Stasiewicz, P. R. (2016). Trauma-focused exposure therapy for chronic
posttraumaticstress disorder in alcohol and drug dependent patients: A randomized
controlled trial. Psychology Of Addictive Behaviors, 30(7), 778-790.
doi:10.1037/adb0000201
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