Psychotherapy in Treating PTSD

Psychotherapy in Treating PTSD

Introduction

Posttraumatic Stress Disorder (PTSD) is a severe, usually chronic and disabling disorder, which develops in particular people following exposure to a particularly traumatic event involving threatened or actual injury to themselves or others. PTSD is characterized by avoidance of trauma reminders, negative cognitions and moods, flashbacks, and nightmares of a past traumatic event, and intrusive thoughts (Sones et al., 2015). Effective PTSD treatment includes psychotherapy and medications. For the achievement of an effective response, the combination of treatment must achieve a satisfactory therapeutic response. This paper will determine the causes of PTSD, followed by the examination of the different procedures of psychotherapies.

Symptoms and Causes of PTSD

Symptoms of PTSD may begin one month after the cause of the traumatic event or take several years in other cases. The symptoms usually interfere with an individual’s work and social relationship. Symptoms are usually placed into four classifications, and they include emotional and physical reactions, adverse changes in thinking and mood, avoidance, and intrusive memories (Delgadillo & Gonzalez Salas Duhne, 2020). However, symptoms vary from individual to individual. Changes in emotional or physical reactions (arousal symptoms include; extreme shame or guilt, aggressive behavior, angry outbursts, insomnia, and fear of danger. Negative changes in mood and thinking include; emotional numbness, lack of interest in activities past enjoyed, feeling of detachment from friends and family, hopelessness about the future, and negative thoughts about yourself. Avoidance includes; avoidance of people, places, and events that remind about the traumatic event and avoiding thinking of the traumatic event. Intrusive memories include upsetting nightmares or dreams about the game, flashback where one relives the event as if they were happening again, unwanted distressing memories about the traumatic event.

Some of the recognized causes of PTSD include serious emotional, physical, or sexual abuse, sexual, physical assault, drug addiction, major illnesses or accidents, major human-made or natural disasters (Delgadillo & Gonzalez Salas Duhne, 2020). Moreover, children and adults may experience PTSD symptoms after mugging incidents of bullying by peers. The study reports that about twenty-five percent of children exposed to significant violence can experience an acute or delayed onset of PTSD.

Treatment of PTSD

There exist several psychological treatments of PTSD, which are categorized into trauma-focused and non-trauma focused interventions. Trauma-focused treatment approaches aim at directly addressing the memories, thoughts, and feelings of the traumatic event; they include; cognitive behavioral therapy. Non-trauma focused aims at reducing the symptoms of PTSD, but not direct targeting of the feelings, memories, and thoughts related to the traumatic event. Cognitive and behavioral therapy used to treat PTSD include cognitive therapy, exposure therapy, and several combinations of such approaches (Alcántara et al., 2016). Cognitive-behavioral therapy particularly focuses on the traumatic material Cognitive approaches assist patients in correcting wrong cognitions while behavioral approaches aim at decreasing the symptoms through exposures to reminders of the traumatic event.

Cognitive Therapy

In cognitive therapies, patients are helped in thinking about the traumatic event and themselves more realistically. Through the utilization of Socratic questioning, information is elicited from the patient while subsequently challenging their maladaptive beliefs. For instance, a woman who had been raped by a home intruder blamed herself. The woman was taken by a therapist through several questions regarding the event, establishing through her answers that her actions were reasonable, she was not to blame for the event befalling her, and that she could not have prevented the event. She was then asked that if daughter or sister behaved similarly, would she think they were to blame? Thus, by allowing the woman to generate information, then re-evaluating her views proved successful in transforming her self-blaming believes.

Interpersonal Psychotherapy

Interpersonal psychotherapy focuses on impairment and symptoms specific to the disorders within the context of the current interpersonal relationships that have demonstrated efficacy for PTSD in a clinical trial. It is time-limited psychotherapy used in treating depression. Interpersonal therapy focuses on improving interpersonal relationships that have proven problematic or situations that are related to the current episodes of depressions. Depressive symptoms and interpersonal relationships seem to affect each other reciprocally. It has been in use since its development in the 1970s that demonstrated success in several studies, which led to a user-friendly treatment for various kinds of patients.

Couples Therapy

Cognitive-behavioral conjoint therapy is a manual based system of intervention with elements of CBT and couples therapy for persons with PTSD and their partners. In a clinical trial, both heterosexual and homosexual couples were randomly designed to receive fifteen sessions of couples therapy. At the end of the investigation, participants who had engaged in couple’s therapy recorded a reduced amount in PTSD symptoms and increased relationship satisfaction between the couples compared to the control group. A three-month followership program ascertained that treatment was maintained.

Exposure Therapy

It aids patients in confronting their feared situations or memories therapeutically. The reencounter of the experience of the trauma allows the patient to process the encounter so that it becomes less painful emotionally. Through a consistent confrontation of their traumatic memories, individual experiences them until they become less emotionally arousing, allowing the patient to see that they are not dangerous. However, many PTSD patients mistakenly perceive the remembrance of such an event as dangerous because they are often distressing, and this leads to avoidance. Exposure allows the patients to disconfirm the mistaken beliefs; thus, it lets them have decreased levels of distress as they think of the traumatic event.

Limitations to Psychotherapeutic Treatment for PTSD

There is the absence of long-term maintenance of therapeutic gains. Maintain ace is crucial to the welfare of the patients. Across all PTSD therapy models, the knowledge of the effects is only limited to brief periods. Data is only available within the third, sixth, or the twelve months of the end of treatment (Coleman et al., 2018). Where fifty-four percent of patients were claimed to have improved, only thirty-two percent met the criteria for clinical improvement; this indicates a decay of the effects of therapy over time.

PTSD therapies can lead to negative side effects of the therapy process; this is referred to as iatrogenic effects. In cases of psychological and neurobiological susceptibilities of persons developing PTSD in its severe form, iatrogenic effects are often severe where trauma-focused techniques are applied. The techniques usually require participants to intensely relieve what they have spent a lot of energy avoiding traumatic memories.

Attrition refers to drop out rates reflects the tolerability or applicability of a particular type of therapy. A study discovered that there were high rates of dropouts in controlled studies on cognitive-behavioral therapies focusing on PTSD. The dropout rates were usually high and varied from study to study, but the average drop rate was eighteen percent. Drop outside effects are often familiar with procedures such as prolonged exposure (PE) and trauma-focused cognitive behavioral therapy (CBT).

Subject reactivity is a phenomenon where persons change their performance due to the knowledge that they are being observed. Depending on the situation, the change may either be positive or negative. This is a threat to internal validity for research. It is possible to observe participants acting in a way that will confirm the hypothesis of the study. Most patients are aware of the treatment procedure of a controlled trial of psychotherapeutic techniques.

Conclusion

Trauma-focused procedures such as cognitive therapy, interpersonal psychotherapy, and couples therapy have been highly recommended by the American Psychological Association (APA). There is evidence for the proof of treatment of these types of treatment. By being trauma-focused, they address issues relating to feelings, thoughts, and memories associated with the traumatic event. However, these treatment procedures are not perfect. They are subject to several limitations, such as negative side effects such as lack of maintenance of the effects of therapy, negative side effects, subject reactivity in the process of research.

References

Alcántara, C., Li, X., Wang, Y., Canino, G., & Alegría, M. (2016). Treatment moderators and effectiveness of Engagement and Counseling for Latinos intervention on worry reduction in a low-income primary care sample. Journal of consulting and clinical psychology, 84(11), 1016.

Coleman, J. A., Lynch, J. R., Ingram, K. M., Sheerin, C. M., Rappaport, L. M., & Trapp, S. K. (2018). Examination of racial differences in a posttraumatic stress disorder group therapy program for veterans. Group Dynamics: Theory, Research, and Practice, 22(3), 129.

Delgadillo, J., & Gonzalez Salas Duhne, P. (2020). Targeted prescription of cognitive-behavioral therapy versus person-centered counseling for depression using a machine learning approach. Journal of Consulting and Clinical Psychology,88(1), 14.

Sones, H. M., Madsen, J., Jakupcak, M., & Thorp, S. R. (2015). Evaluation of an educational group therapy program for female partners of veterans diagnosed with PTSD: A pilot study. Couple and Family Psychology: Research and Practice, 4(3), 150.

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