Posttraumatic Stress Disorder - Essay Example

Posttraumatic Stress Disorder PTSD (posttraumatic stress disorder) is an anxiety, disorder which is normally severe and develops dueto exposure to conditions which may lead to psychological trauma. These conditions may involve a death, threat to an individual’s self, someone else or to an individual’s sexual, physical or psychological integrity, which may surpass the ability of an individual to cope. The symptoms of PTSD that can be diagnosed include the re-experiencing of the real trauma through nightmares, flashbacks, increasing the arousal, and staying away from the stimuli that is linked to the trauma (Burgress, & Holmstrom, 2009). A diagnostic criterion that is formal, demands that the symptoms, and effects last for a period longer than a month (Boeschen, Sales, & Koss, 2008). This means that there would be a significant disability in the occupation, social, and other vital functioning areas. This paper explores a case study in abnormal psychology. The paper explains the case overview, case conceptualization, and the treatment plan of a client. Part one. This is a situation that occurred to a woman that I know, slightly. Less than three months in his marriage to a Chinese woman (Maya), the husband was accused by his wife of rape. The two lived in a flat that was shared. In the evening of the attack that was alleged, and after the same attack, Maya sat happily with their house mates and her husband, talking up to bed time. Together with her husband, Maya went to bed despite the fact that her husband had raped her earlier. She also prepared him breakfast the following morning, while having constant interactions with her housemates happily. Maya then disappeared since it looked like she was heading to the police station to give a complaint. Approximately a week prior to the that she was making the complaint, Maya found out that her permanent residence application could easily be spotted once she was believed to be a domestic abuse victim. Her marriage had been tracked easily since she had some visa challenges and she wanted it to remain in that country. In this regard, when the police finished interviewing each person, they were convinced that the woman had secret motive in making an allegation that is false. The police was not convinced that Maya waited for 12 hours before reporting the incidence and that in the whole situation she stayed with the alleged attacker and the other housemates without saying a word. The police was also surprised with the fact that she was laughing and happy, and he slept with the attacker the period after the main incidence, and she also ate two meals with her husband despite the attacks. In this case, the police argued out that there was no evidence of rape that was physical. Nevertheless, Maya’s husband was charged with rape. Her husband then withdrew his support towards Maya’s current application of visa. Maya called her husband, and told him that it was only a mistake, that she did not mean it, that she regretted the act of speaking to the police, and that she would withdraw the complaint. Maya’s husband recorded the calls from his wife. Maya followed her husband everywhere, visited him in his house, slept with the husband in many occasions, and promised to have the complaint withdrawn. All this were Maya initiatives. After this, the police obtained the information concerning everything that happened. The procession of the court decided to continue with the case, hence Maya’s husband had to enter the plea and attend the court. When Maya withdrew the complaint, the case was withdrawn. In real sense, if the offence that was alleged, was another thing apart from rape, there would not be any charges (Bohner, Jarvis, Eyssel, & Siebler, 2005). In this case, since Maya’s husband had to appear in court, it served as a prosecution that was failed. Part two. Even though, the medical and legal definitions may vary, rape is identified as an anal, vaginal or oral penetration involving force or threats towards a person who is unwilling. The penetration in this case, is known as statutory rape whenever the victims are younger than the consent age. In the case of Maya, she was assault sexually by the husband. A sexual assault is any sexual contact that comes from coercion, being grabbed, touched, shown genitals, or kissed (Boeschen, Sales, & Koss, P. 2008). On the other hand, rape is a feeling of anger, aggression, need for power, and psychological torture. It is normally extremely violent compared to sexual assault and it leads to injuries to the genitals. In the case study, Maya went through a rape instance. In this case, she experienced extragenital injuries, psychological torture, and genital injury. Apart from this, it could also have lead to sexual transmitted disease or unwanted pregnancy (Boeschen, Sales, & Koss, 2008). Maya as a rape victim, was referred to an emergency department of a hospital. The place was staffed with the practitioners who were trained to handle rape cases. During the evaluation, she went through a medial assessment, a prevention and treatment of STDS, injuries, and pregnancy; forensic evidence collection psychologic evaluation, and psychologic support. The clinical diagnosis of Maya involved a 5-axial, provisional diagnosis. This is a system that is used to classify different, disorders and illness. If they are considered together, the 5 levels provide the treatment giver a full diagnosis including the factors that influence the psychiatric conditions (Bohner, Jarvis, Eyssel, & Siebler, 2005). It is a useful tool, as it has a big role in the planning of an effective treatment. These levels are mostly referred to as axes. They include: Axis I: This is an axis that is normally reserved for developmental, learning and clinical disorders. In Maya’s case, the disorder that presented itself in this category is axial I: post traumatic stress. Maya experienced increased, anxiety levels, which she found hard to cope. She also experienced difficulties in sleeping (Ben-David, & Schneider, 2005). In many situations, she found it hard to stay asleep, and experienced nightmares, which is a symptom of PTSD symptom re-experiencing. This was a clear indication that she was going through the hyper arousal PTSD symptoms (Bohner, Jarvis, Eyssel, & Siebler, 2005). Axis II: This is an axis that deals with mental retardation or personality disorder. In this case, Maya was diagnosis with axis 1: dependent personality disorder. This is a condition, in which, a person may depend too much on another person in meeting their physical and emotional needs. The key symptom of this disorder is that, an affected person fails to trust her own ability in making decisions (Bohner, Jarvis, Eyssel, & Siebler, 2005). Such people may be annoyed through loss, and separation. Such people may suffer an abuse in a relationship, but remain in that relationship. In the case of Maya, she was abused with her husband but stayed 12 hours with him before making a complaint to the police. When her husband canceled her visa preparation, Maya was so upset to the extent that she withdrew the complaint. Axis III: This is an axis which covers the physical and medical disorders or conditions. In Maya’s case, there was no diagnosis in this category. Axis IV: This is level in which the factors affecting the psychiatric disorder and the outcome of the treatment are indicated. There are many factors that may affect the disorder faced by the client (Maya). Some of these factors include social issues, educational problems, work problems, legal problems, environmental and other psychosocial challenges, and the absence of enough support system (Ben-David & Schneider, 2005). Maya went through most of these effects especially when her husband did not support her after the incidence. The police also were not convinced with the physical evidences. Axis V: This diagnosis is for the global, assessment function (GAF). It involves 100-point scale in which the professional of mental health will use in describing the general patient’s performance level in the daily activities, occupational, social, interpersonal, and academic functioning (Ben-David & Schneider, 2005). Part three. Treatment plan. Recipient Information Provider information Medicaid Number: 87654321 Medicaid Number: 47829737 Name: Maya Scott Name: Brian Enrick DOB: 15-10-1982 Treatment plan date: 1-11-2010 Other involved Agencies: Plan to coordinate services: Charles Peters, M.D., Psychiatrist Contacts of phone done in the first treatment month, then as required, or at least once every 2 months. Medication(s) Dose: Frequency: Indication: Prozac 40mg 1 x day depression 1. Symptoms: sadness displayed depression, poor self esteem, suicidal ideation, low energy, and fear. Goal for the long term: The depression and psychological symptoms would be reduced hence no interference to Maya’s functioning. Measurements of this would be done using a t score having 60 on the YSR depressed/withdrawn scale during the discharge. The injuries to the genitals would be treated. The completion date that is anticipated is 4-2-2011 Short term Goals: 1. Maya and her husband will come up with a safety plan. 2. Maya will take part in a sport activity or extracurricular activity. 3. Maya will be giving a report concerning the suicidal ideation for duration of 3 weeks. 4. Maya will develop the skills of coping like emotional regulation, and problem solving. The skills would be measured by her maintaining her rapport with the husband and children. 5. Maya will learn the identification of negative, maladaptive thoughts and how these could be replaced with adaptive positive thoughts. The skills would be measured by her showing out the skills during sessions of therapy. Established date 1-11-2010 1-11-2010 1-11-2010 1-11-2010 1-11-2010 Completion date projected 1-11-2010 1-12-2010 4-1-2010 4-2-2010 4-3-2010 Date achieved 1-11-2010 Action/Intervention Persons Responsible Individual therapy of helping Maya implement and learn skills of copying and helping her to find out the process and feeling resolving. 1. Charles Peters, Ph.D. 2. Brian Rock Family therapy in developing safety plan, give psycho-education concerning depression so as to increase of parents towards Maya and their ability to encourage and support Maya in the utilization of the upcoming skills of coping. 1. Charles Peters, Ph.D. 2. Bryson and Rachel, Father and Mother. Medical Management John Homer, M.D. Review Date: Progress Review Date: Progress 2. Symptoms: Conflict in the family as displayed by poor communication between Maya and her husband. In order to come up with a baseline, Mr. peters was requested to record for two weeks: The number of occasions that he tried to talk to Maya concerning the concern and she withdrew or was evasive. Maya withdrew from her husband 16 times in the two weeks. Long term Goal: Reduction of the family conflict thus increasing the family interactions. Measurement would be done through the reduction of withdrawal interactions. The family was to report about two interactions for two consecutive weeks. Short term Goals: 1. Obtaining the baseline data on interactions that are withdrawn with her husband 2. Family form communication routine times in a week. Measurements would be done by family forming communication schedules. Date Established 1-11-2010 1-11-2010 Completion date projected 1-11-2010 24-11-2010 Achieved date 1-11-2010 Intervention: Therapy of the family to help and explore family dynamics, family problems, negative patterns, problems in the family, and helping Maya’s husband to be reclaimed from assault. Persons responsible: 1. Charles Peters 2. Brian Rock Therapy that is individual in exploring process, and resolving Maya’s feelings about the husband, structure and rules, and reinforcement of good communication, coping skills, and conflict resolution 1. Charles Peters 2. Brian Rock Review Date: Progress: Review Date: Progress: Involvement of Family: Husband will take part in the family therapy and go through the homework assignments so as to better the functioning of the family. Maya’s Husband will formally monitor the symptoms of Maya, progress and problems. Services beyond the organization scope that may be needed Management of Medication By Dr. Akatu Johnstone Estimated date of completion for the care level: 4-4-2011 Patient Signature: Provider Signature: Enricksbrian , Ph.D. Should be a real signature, No rubber stamped signatures, Electronic signatures are allowed. Date: Title of the provider: Brian Enrick, Ph.D., licensed psychologist. References Ben-David, S. & Schneider,O. (2005). Rape perceptions, gender roles attitudes, and victim-perpetrator acquaintance. Sex roles, 53, 385 -399. Boeschen, E., Sales, D., & Koss, P. (2008). Rape traumas in courtrooms. Psychological, Public Policies, and Laws, 4, 414-432. Bohner, G, Jarvis, C, Eyssel, F, & Siebler, F. (2005).The causal impact of rape myth acceptance on men’s rape proclivity: Comparing sexually coercive and non-coercive men. European Journal of Social Psychology, 35, 819-828. Burgress, W, & Holmstrom, L. (2009). Rape trauma syndrome. American Journal of sychiatry, 131, 981-986. Read More