Case Study Development and Theoretical Explanation - Term Paper Example

? Case Study Development and Theoretical Explanation Case John Carter is a 45 year old man who was referred to psychological help or treatment after a long period of alienation and leave from work. More than two months ago John’s son was hit by a car while he was running from a man who was trying to assault him, and died on the spot. A week later, John’s brother, the only family member he had left, committed suicide and died. In addition to these traumatic events in John’s life, he has a history of child neglect. John’s father was absent from their lives and they never knew him because his mother was a single parent having separated with the husband when the boys were still very young. John’s father never looked for them while the mother was a drunkard, perhaps due to social pressures and problems of a single parent. As a result, John and his brother suffered from child neglect due to lack of effective parental attention, love and care. Over the past days following the recent traumatic deaths, he has been having several psychological or mental problems. For instance, John is haunted by the images of his deceased son and brother whereby he keeps seeing their images. The images of how the deceased appeared just before the funeral keep on flashing on his head. No matter how much he tries to suppress the images, they keep on appearing and getting worse and worse. In addition, John also experiences symptoms such as intrusive memories and thoughts, feelings of intense distress, nightmares, avoiding of situations that are similar to the traumatic situations, insomnia, fear, emotional numbness and detachment (O'Donohue & Lilienfeld, 2013). Furthermore, John has also lost interest in both present and future activities such as work and social functions. John also experiences restlessness, irritability, headaches, fatigue, mind blanks and hot flashes. Looking at the symptoms and the background issue, it is evident that John is suffering from Post-Traumatic Stress Disorder. This results from traumatic events experiences, which leads to intrusive thoughts (Ball, 2012). This conclusion was draw with respect to the DSM criteria for diagnosing PTSD. For instance, John was exposed to traumatic events that resulted in injury, and eventually death of a loved one, and thus, he responded with fear and helplessness. In addition, he continues to re-experience the traumatic events through intrusive thoughts, images, nightmares and psychological distress. He also tries to avoid stimuli associated with the trauma, activities and places that mimic the trauma, feelings of detachment and diminished interest in significant activities (American Psychiatric Association, 1994). Furthermore, he also experiences symptoms of amplified arousal that are persistent, which are insomnia, irritability and difficulty in concentrating. He has experienced the psychological disturbances or symptoms for a period of more than 30 days, and finally, these disturbances results in clinically significant impairment in occupational, social and other key areas of functioning. Intervention The treatment approach that I have chosen for this case is Cognitive Behavioral Therapy (CBT). These are a set of treatments that incorporate mechanisms of stress management to achieve understanding or insight of the case and administer intervention. This follows a skills training mechanism whereby the individual masters specific behavioral techniques first, which are known to amend response to anxiety, and then coached on how to utilize these skills in managing the PTSD-type symptoms (Keane & Kaloupek, 1996). Some of the skills taught are interpersonal skills training, anger management, relaxation training, thought stopping and guided dialogue among others. These are specifically designed interventions to deal with a specific trauma symptomatology (Keane & Kaloupek, 1996). The goal of cognitive behavioral therapy is to help the patient understand and consequently, change their way of thinking about the trauma and its aftermath. Thus, the patient is aided to understand how certain thoughts about the trauma results in feelings of stress and make other symptoms worse. This intervention guides the patient to identify those thoughts about themselves and the environments that make them feel upset or afraid (Ball, 2012). Then, they learn to replace these traumatic thoughts with less distressing and more accurate thoughts. As a result, the patient learns how to cope with feelings of guilt, fear and anger. People tend to blame themselves for the events that occur during traumatic situations or experiences, and this is the main issue in PTSD (Ball, 2012). Evidently, John feels guilty about the two subsequent deaths that resulted in a traumatic experience for him. He thinks that he could have done something to prevent the events from occurring. For instance, he believes that if he had given his brother extra attention, then he would have opened up to things that were disturbing him that eventually drove him to commit suicide. Similarly, he believes that he is the protector of his son, and thus, he should have been there to protect his son from the abuser, and so, the accident would have not happened. Perhaps, he had lost meaning in life following the childhood experience of neglect, and all these recent events only stirred up the underlying emotions and made them worse. The aim of this cognitive-behavioral therapy is to make John believe that all these traumatic events that he experienced were not his fault, and thus, understand the need to manage his thoughts and emotions (Taylor, 2009). Using cognitive therapy evaluation, it is apparent that John mixed up his emotional feelings from childhood with the traumatic events that happened to him recently, that is, death of his son and brother. People with PTSD such as John develop worries of reminders of their traumatic experiences, which maybe in the form of environment such as smell, pictures sounds that remind them of the events (Taylor, 2009). These bring about feelings and thoughts connected with the traumatic experiences or events. For the case of John, the reminders are in the form of nightmares, memories or intrusive thoughts, which brings significant distress whereby a person fears them and tries to avoid them. Exposure therapy is a type of cognitive therapy that focuses on reducing the level of fear and anxiety connected with the reminders such as nightmares, intrusive thoughts or memories. This in turn helps in reducing avoidance. The idea behind this technique is to expose the patient to the reminders that he worries about without trying to avoid them. This maybe be done by physically or actively exposing a person to the reminders, for example, through imagination or by displaying a picture that reminds him of the traumatic event (Taylor, 2009). Therefore, by encouraging John to deal with fear and anxiety, he learns that fear and anxiety will reduce on its own, and eventually lessening the extent with which the traumatic events are perceived as fearful and threatening. This therapy is effective when paired with teaching client relaxation skills, which enable the patient to manage his fear and anxiety better when it occurs. As such, a therapist would encourage John to talk about his trauma repeatedly in order for him to understand and learn to be in control of his feelings and thoughts about the traumatic events. Though it may be hard at first, this intervention will help John to understand that he does not have to be scared of his memories. Thus, thinking about the stressful things or traumatic events overtime will help him to become less overwhelmed with the thoughts. References American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, DC: American Psychiatric Association. Ball, D. E. (2012). Issues in Clinical Psychology, Psychiatry, and Counseling: 2011 Edition. ScholarlyEditions. Keane, T. M., & Kaloupek, D. G. (1996). Cognitive behavior therapy in the treatment of posttraumatic stress disorder. The Clinical Psychologist, 7-8. O'Donohue, W., & Lilienfeld, S. O. (2013). Case Studies in Clinical Psychological Science: Bridging the Gap from Science to Practice. Oxford: Oxford University Press. Taylor, S. (2009). Clinician's Guide to PTSD: A Cognitive-Behavioral Approach. The Guilford Press. Read More