A systematic review of cognitive behavioural therapy and psychodynamic approaches.
Respond to your colleagues by providing one alternative therapeutic approach. Explain why you suggest this alternative and support your suggestion with evidence-based literature and/or your own experiences with clients.
NOTE: I need a positive comment about the post bellow
PTSD is a debilitating disorder and should always be taken very seriously when a client presents with this disorder. Normally, it develops after experiencing or getting exposed to a traumatic event and it is always managed through both psychotherapies and pharmacotherapies (Lancaster, Teeters, Grs & Back, 2016). About 6.8 to 7.3 percent of Americans are affected by PTSD in their lifetime. Studies however show that African Americans have a higher rate of 8.7% in lifetime prevalence (Nguyen, Chatters, Taylor, Levine & Himle, 2016). This is a very significant statistics for the purpose of this discussion because William the client is an African American with high risk factor of having PTSD because he served in the army and was deployed to Iraq during the war.
In his narration, William seems not to concentrate especially in regard to his surroundings. He also points out that his family, that is him and his wife have been going through a lot. Just recently, he lost his job and he was not able to effectively meet the deadlines for his mortgage. Because of this, he became homeless. He was then taken in by his brother who lives with his wife and children. William denies the fact that his brother is concerned about his condition. It is known that he has a problem with alcohol, and this could be a way of coping with his PTSD from the war. In fact, through an exploratory analysis, it was concluded that drinking with a view of coping with PTSD was common in war veterans. This coupled with the perception that they were stigmatized led to increased severity of PTSD and alcohol abuse as well as associated consequences (Miller, Pedersen & Marshall, 2017). William was directly experiencing traumatic occurrences in the war. There is a very high possibility therefore that he has PTSD leading to his drinking problem as a way of coping. This has affected his life in very different ways including losing his job, house and becoming homeless. William has been having flashbacks about the events in the war. He avoids things that may remind him of such events, and he does not have interest in doing different activities including his hobbies. He has a sense of self-blame and he is reckless as well as experiencing sleep disturbance. All these have been going on for a while. Long enough to cost him his job and house. The DSM-5 requires that these disturbances should not be due to drugs, alcohol or a different medical issue (American Psychiatric Association, 2013). William is going through all these issues because of the traumatic events at war and the alcohol use is just because he thinks this is a way of coping.
In the treatment and management of PTSD for William, psychodynamic therapy shall be implemented. Through a systematic review, psychodynamic therapy showed efficacy in reducing all measures that were associated with PTSD and at the end of the studies reviewed, more than half of participants did not present with requirements or symptoms that could meet the PTSD DSM criteria (Paintain & Cassidy, 2018). As such, for William, psychodynamic theory shall be used. SSRIs that are first line treatment for PTSD can be used as an additional therapy. If such fails to work, Trazodone shall be used as it has been effective in cases where SSRIs fail in this patient population (Shin &Saadabadi, 2019). Psychodynamic theory can be used alone in this case. However, a combined therapy will be more effective in helping to improve symptoms and allowing William to start functioning effectively. If drugs shall be used, he is supposed to be told that they may have some side effects. This will allow him to choose whether he want psychotherapy alone or a combination.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub
Lancaster, C. L., Teeters, J. B., Gros, D. F., & Back, S. E. (2016). Posttraumatic stress disorder: Overview of evidence-based assessment and treatment. Journal of clinical medicine, 5(11), 105
Miller, S. M., Pedersen, E. R., & Marshall, G. N. (2017). Combat experience and problem drinking in veterans: Exploring the roles of PTSD, coping motives, and perceived stigma. Addictive behaviors, 66, 90-95
Nguyen, A. W., Chatters, L. M., Taylor, R. J., Levine, D. S., & Himle, J. A. (2016). Family, friends, and 12-month PTSD among African Americans. Social psychiatry and psychiatric epidemiology, 51(8), 1149-1157.
Paintain, E., & Cassidy, S. (2018). First‐line therapy for post‐traumatic stress disorder: A systematic review of cognitive behavioural therapy and psychodynamic approaches. Counselling and psychotherapy research, 18(3), 237-250.
Shin, J. J., & Saadabadi, A. (2019). Trazodone, Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470560/