Educating Partners of Military Personnel with PTSD - Research Paper Example

?RUNNING HEADER: Educating Spouses/Partners of Military Personnel with PTSD RESEARCH PROPOSAL: Educating Spouses/Partners of Military Personnel with PTSD BY YOU YOUR SCHOOL INFO HERE DATE HERE Educating Spouses/Partners of Military Personnel with PTSD Introduction Post-Traumatic Stress Disorder (PTSD) is a psychological condition, a severe type of anxiety disorder, that develops after an individual has been exposed to traumatic events such as threat to one’s life, combat scenarios involving the destruction of trusted and valued comrades, or the experience of traumatic medical complications that all leave a lasting psychological impact. An individual suffering from PTSD experiences recurring flashbacks of these events, nightmares, sleeping difficulties, increased anger response and hyper-stimulation to external stimuli in which a non-mentally disturbed individual would find no discomfort or anxiety. Some victims of this disorder become emotionally numb, eventually reaching a stage where one is unable to feel any important emotions, thus rejecting participation in many lifestyle activities and socialization that can erode spousal tolerance and empathy (Olszewski & Varrasse, 2005). Military personnel exposed to traumatic events often find significant difficulty in communicating their feelings about their own difficult anxiety responses and flashbacks, and for those who lack high levels of emotional intelligence and effective coping skills prior to the event will often lash out at others unexpectedly with increased aggression or hostility. Others suffering from this disorder will take an opposite approach and become withdrawn and unresponsive to family members. Whatever the outcome of the individual case of PTSD, the military personnel member can create considerable division, conflict and stress with spouses and other family members. Spouses of those suffering from PTSD must first understand the dynamics of experiential learning, a cyclical learning process that requires hands-on intervention rather than just comprehension of auditory or visual learning instruction. It is a tactile form of learning in which the student must be actively engaged in the learning experience, must discern technical problem-solving skills effectively, and be able to evaluate their own performance in learning (Merriam, Caffarella & Baumgartner, 2007). Experiential learning makes the individual an active participant in the learning process to facilitate greater comprehension and the ability to analyze their performance and comprehension levels. Experiential learning must be goal-oriented, developed with emotional intelligence principles of self-exploration and awareness of others’ emotional states, and also maintain conscientiousness to facilitate motivation in the interactive portion of learning (Jackson, 2008). Thus, group-oriented learning should be a focus of assisting spouses of military members suffering from PTSD in order to maximize comprehension and training in cognitive behavioral therapy concepts and practice. There are significant gaps in literature illustrating how spouses and partners of those suffering from PTSD can be effectively trained to facilitate treatment. This project maintains the ability to provide significant knowledge to the research community regarding the development of PTSD-related curriculum to improve household interventions with those suffering with this mental illness. It will, theoretically, provide a new template for learning to assist psychologists and sociologists to develop educational programs for better household counseling and interventions with military members maintaining PTSD. Purpose Statement This research proposal is designed to help spouses of military personnel with PTSD to understand the complex dimensions of post-traumatic stress disorder so assist in finding empathy for their spouses or serve as counseling agents. Most military spouses lack the formal education associated with cognitive processes and psychological defense mechanisms to develop a communications strategy that would be effective in curbing anger responses and to help their military loved ones learn to cope with these horrific memories. The proposal outlines a program of teaching methods to assist spouses and partners of military personnel suffering from PTSD to: (1) understand the disease and (2) also act as competent facilitators of treatment. The study proposes assisting spouses and partners of those with PTSD in learning positive cognitive behavioral therapy knowledge in order to facilitate more effective discussions with the military family member and enact psychological reprogramming. These stages include relaxation therapy constructs, learning to change maladaptive behaviors and thinking, the minimization of self-defeating thoughts and concepts, and development of motivational self-talk to improve ambition and reintegration back into normal lifestyle characteristics (Hofmann, Sawyer & Fang, 2010). Once the spouse understands more than just the symptoms, but is equipped to facilitate change and improvement in the condition, they will be better equipped to reestablish harmony in the household and assist in counseling their spouses or partners about taking a more effective, self-managed viewpoint about coping and healing from PTSD anxieties. Research Questions and Hypotheses The proposed study has two specific research questions: 1. Does a spouse or partner understand the principles of cognitive behavioral therapy and general knowledge of PTSD symptoms and outcomes? 2. How effective is an educational program in cognitive behavior therapy targeted towards spouses/partners of military members diagnosed with PTSD in improving their coping skills in accord with their spouses/partner’s level of PTSD? The following hypotheses can be generated from the research questions: H1: A spouse or partner of those with PTSD will maintain favorable attitudes and comprehension of CBT and PTSD education and thus work with dedication to achieve positive CBT outcomes in their partner H2: The elements of experiential learning, which involve tactile learning outside of auditory and visual learning aids, will have the highest level of comprehension. Hypothesis 1 takes into consideration attitudes and behaviors of the participant group, which will be measured by post-survey responses associated with individual handling of PTSD episodes. Hypothesis 2 tactile learning will be measured by role play observation to identify comprehension and behavioral attitudes. Study Design and Methods It will be necessary to recruit a simple random sample of ten different spouses. The sampling method will recruit 10 spouses of military members suffering from PTSD through newspaper advertisements indicating participation required in a study program to assist non-trained individuals to become effective facilitators of cognitive behavioral therapy. Interested parties will respond directly to the researcher where they will be pre-screened to understand current participant knowledge of PTSD. The pre-screening consists of a brief questionnaire requiring acknowledgement of a degree or lack thereof in psychology. Once recruited, this sample will receive a pre-interview session to describe the specific characteristics of their spouse suffering from PTSD and to determine previous strategies of intervention used prior to recruitment in the program. The study will maintain qualitative and quantitative design due to the complexities of psychological and performance management in learning. The quantitative design will consist of post-testing surveys to determine whether values, attitudes and comprehension of PTSD and its complexities exist or have occurred through teaching outcomes. The qualitative approach consists of pre-interview assessment, pre-test questionnaire, and descriptive questioning associated with the post-testing survey instrument described in the next section. During the course of the program, which will be held once weekly over the duration of this twelve week study, students will be given traditional lecture-based instruction in the fundamentals of PTSD and cognitive behavioral therapy. The researcher will develop scenario case studies of PTSD interventions in the household with unique lifestyle situations associated with PTSD interventions between spouse and military partner. At this time, the post-test survey responses will be evaluated for knowledge, comprehension and the ability to intervene. Six weeks into the program, the researcher will begin experiential learning practices, including role playing, to measure whether learning is taking place. “Integrating experiential learning activities in the classroom increases interest in the subject matter and understanding of course content” (Poorman, 2002, p.32). Role playing is a trusted and respected teaching methodology that ensures development of social empathy, conflict management skills and conflict negotiation in a real-life, practiced environment through the application of theory in different social and household scenarios. Role playing exercises will provide the researcher with the ability to observe interactions in hypothetical PTSD-related situations with both rational and irrational responses to determine how the spouse might react in various situations with the military personnel family member. At the end of the program, the counselor will distribute another set of hypothetical situations requiring a written response from each participant. This will determine whether interactive learning has provided the best substantial comprehension of the course material and whether or not the participant will be able to effectively utilize concepts of CBT in a real-life family environment. As part of long-term follow-up, the participants will be given an exit interview to discuss concerns related to the program and their role as counselors or behavioral change facilitators to their suffering spouse. Concerns related to comprehension, the program design, counseling techniques and effective coping for spousal self-exploration will be the topic of the interview template. Interview Guide The pre-screening interview will consist of a background session to determine the level of pre-existing knowledge available to the participants as it relates to psychology and PTSD symptoms and causes. 1. What is your formal background in psychology? 2. Tell me your knowledge of PTSD? What causes it and what are its symptoms? 3. What behaviors are typical of PTSD episodes? 4. How do you usually handle these episodes when they occur, individually? 5. Emotional intelligence is the process of understanding one’s emotional capacity and recognizing various emotional states in others. Please describe what you believe is your current emotional intelligence and by what principles do you support it? 6. Are you prepared, by the end of this study, to provide counseling and advanced-level psychological support to your spouse? How do you suppose you will go about the process of aiding using psychological theories? 7. Please describe what you believe is causing your spouse to act in the way he/she does related to their PTSD and why? The results of this particular pre-interview template will not only assist in screening random samples viable for the study, but also determine whether the individual genuinely maintains pre-existing knowledge of psychology and the nature of the disorder and its symptoms/outcomes. Post-test surveys will determine whether learning has changed through the course curriculum. The post-test survey and brief open-ended interview consists of questions related to the program and comprehension, concerns about viability of providing counseling and cognitive behavioral therapy concepts, and to assess their self-evaluations of learning. This is structured as part of long-term follow-up. 1. On a scale of 1-10, how would you rate the lecture-based learnings associated with the course? Why? 2. On a scale of 1-10, how would you rate the effectiveness of the interactive role playing exercises to your learning of the material or confidence in providing psychological support to your spouse? Why? 3. Has your partner exhibited more PTSD-related episodes in the last four weeks? If so, how were they handled? Analysis Plan Qualitative methodology is subjective, meaning open to interpretation which requires further research. The researcher will examine various case studies of CBT treatment plans used in real-world application to correlate learning effectiveness, learning outcomes, and whether or not behavior of the PTSD sufferer have changed as a result of these interventions or counseling sessions as part of long-term follow-up. This will assist in evaluating the post-interview results, post-test survey results, and observational notes taken throughout the duration of the course to determine the viability of the sample group in performing complex psychological interventions with their partners or spouses. Throughout the course, the instructor will be developing a balanced scorecard system with set criteria for comprehension and learning that will be used throughout each weekly session to highlight individual capabilities or group comprehension skills development. This scorecard will be compared to the two scenario assessment tools used in Week 6 and Week 12 to determine the level of comprehension occurring as a product of lecture and print distribution as compared to experiential-based role play exercises and scenario planning. If there are any recognizable correlations in post-interview responses stemming from multiple individuals, it will be charted categorically to illustrate these connections, looking at them comparatively based on the principles of lecturing versus experiential knowledge sharing and knowledge development. This will illustrate whether there are more successes or failures associated with tactile versus non-tactile learning programs in the course. Analysis Tools Software such as Microsoft Powerpoint, Excel and Office will be utilized for database storage and notations that will be referred to by the researcher throughout the course. Emails received from the participants throughout the course will be saved in digital format for analysis and review to show evolutionary patterns in critical thinking and course concept comprehension to assist in the qualitative analysis process of the study. Biases / Threats to Reliability Self-selection bias could occur in this study, since the spouses and partners are volunteers with their own pre-conceived attitudes about PTSD and spousal interventions. The researcher maintains no biases associated with course content and delivery or with the nature of post-traumatic stress disorder. The researcher understands that with each participant, it is probable that symptoms and episodes associated with partner PTSD will differ and be unique according to household lifestyle. The researcher holds no predispositions about the validity of certain PTSD-related concepts or symptoms over others and therefore the curriculum will be developed with a balanced and equitable system for review, teaching and evaluation of performance in learning. The study maintains some risk associated with reliability as the measurement tools have been designed to be tested and again retested with the sample. The pre- and post-testing instruments differ in that pre-testing measures the dependent variable of pre-existing formal education in psychology while the post-testing instruments recognize change through learning in CBT. Ethical Considerations The only ethical concerns in this study are related to the duration of the program in attempting to create qualified counselors and assessors of PTSD treatment. The participants will be given an informed consent form to engage in the study and also to practice the fundamental concepts of cognitive behavioral therapy in the household at their own risk and without post-course support from the researcher or the delivering school. This removes liability from the researcher and the school where the course is being developed and delivered in the event that advanced counseling and psychological learning fails to meet its intended objectives in the household. The consent form will indicate these principles and guidelines prior to selecting the participants. The participants must understand that though the learning is based on solid academic, medical and psychological theories, they have not been practiced to fit a specific household profile or those of specific PTSD characteristics and thus are considered risk conditions which the participant must be willing to accept. The factors and other liability-related concerns will be easily understood on the consent documentation requiring participant signature for acknowledgement. References Hofmann, S., Sawyer, A. T., & Fang, A. (2010). The Empirical Status of the New Wave of Cognitive Behavioral Therapy. Psychiatry Clinic North America, 33(3), 701-710. Jackson, C. J. (2008). Measurement Issues Concerning a Personality Model Spanning Temperament, Character and Experience. In Boyle, G., Matthews, G., & Saklofske, D. Handbook of Personality and Testing. Sage Publications, pp. 73-93. Merriam, S. B., Caffarella, R. S., & Baumgartner, L. M. (2007). Learning in Adulthood: A Comprehensive Guide. San Francisco: John Wiley & Sons, Inc. Olszewski, T., & Varrasse, J. F. (2005). The Neurobiology of PTSD. Journal of Psychosocial Nursing, 43(6), 40. Poorman, P. B. (2002). Biography and Role-Playing: Fostering Empathy in Abnormal Psychology. Teaching of Psychology, 29(1), 32-36. Read More