CBT and IPT EBP Interventions: Description
To address the needs of crisis survivors, one will have to consider not only the events that led to the development of PTSD but also the factors that trigger the immediate recollection of the traumatizing situation and the following aggravation of the patient’s state. Thus, the opportunities for building the patient’s confidence and allowing them to overcome the effects of the specified factors by developing the strategy that will help them disregard the stimuli in the future (Paradise & Kirby, 2005).
Because of the variety of scenarios and the possible routes of PTSD development in military patients, an Evidence-Based-Practice (EBP) approach will have to be considered as the foundation for managing the needs of PTSD patients accordingly. The use of the Cognitive Behavior Therapy framework, in its turn, will contribute to the conscious development of coping skills. The incorporation of an Intensive Treatment Program (ITP), in its turn, will serve as the foundation for helping the patient adapt to the environment in which they will have to use the appropriate coping strategies (Gerber & Basham, 1999). To manage the needs of military people with PTSD, one may have to consider the EB TF CBT-related programs as the available options.
Among the reasons for choosing EB TF CBT as the framework for addressing the needs of military trauma survivors, one will have to consider the fact that it helps the victim of PTSD to learn more about their disorder and how to address it. In other words, the tool invites the target population to acquire the relevant knowledge and skills in an active and efficient manner: “There are three phases to treatment that involve education about the procedure, trauma processing, and learning how to disrupt the flow of negative feedback individuals generate for themselves” (James & Gilliland, 2017, p. 173).
As a result, an in-depth understanding of the problem and the subsequent acquisition of new skills and habits can be expected. In other words, the patients become engaged in the process of treatment and are capable of directing it in the way that they consider the most comfortable. One must also give credit to the specified framework for allowing the patient to confront the guilt that dominates their choice of coping strategies and, therefore, reinvent their perception of the situation that caused PTSD.
Apart from the identified framework, one should consider the adoption of the Virtual Reality (VR) strategy. Though admittedly costly, the identified method is bound to help the target population re-experience the scenarios that led to the development of PTSD. As a result, the patients will be able to confront their fears instead of escaping them. By creating the environment in which the patients are able to control the situation, a therapist will promote the development of healthy coping mechanisms and a deeper, more detailed understanding of the problem by the target population (James & Gilliland, 2017).
As far as the choice of the ITP-based framework is concerned, one should view the use of therapy sessions involving extinguishing intrusive images (EIS) as a possible solution since it will help prevent the recollection of the traumatizing images (James & Gilliland, 2017). It is expected that the identified tools will help the victim of PTSD manage the factors that trigger painful memories. Additionally, the use of support groups can be suggested as the means of recognizing the problem and, therefore, developing the coping mechanism that will allow addressing the issue. By providing the patients with an opportunity to share their experiences, one will be able to help them develop a new approach toward confronting their fears (James & Gilliland, 2017).
PTSD Before the Trauma: Changes
Although PTSD is typically viewed as the consequence of trauma experienced in the past, the phenomenon may occur before the trauma, thus, complicating the process of recognizing the needs of the patient and managing them successfully. In the identified scenario, the patients are even more vulnerable to the array of stressors that they may face in the modern environment. To handle the specified issue, a therapist must consider two situations that led to the development of the emotional issues, i.e., the initial set of negative factors that triggered PTSD (e.g., depression, a disease, etc.), as well as the trauma that ensued. Consequently, the frameworks will have to be altered slightly to address both of the problems and allow the target population to reconcile with their past (Marotta, 2000).
The first and most obvious, a therapist will have to determine the factors that caused the initial PTSD. As stressed above, these may vary from depression and related disorders to health issues, relationship-related problems, drug abuse, etc. (Taylor & Baker, 2007). The residual effects of PTSD, however, linger and, thus, affect the patient’s well-being, as well as their resistance to the recent trauma. To allow the patient to recall the required part of their life and consider the events that led to the development of PTSD, a therapist may need to adopt the CBT-based strategy first. In other words, a patient must develop a conscious understanding of the issues that triggered PTSD.
Particularly, the application of the Stress Inoculation (SI) approach strategy instead of EB TF CBT should be viewed as a necessity. Seeing that the framework allows for patient education, it is bound to help the target population recognize the necessity to face their issues and cooperate with the therapist to reconcile with their traumatizing past. In addition, it is crucial that family support should be provided to the target population. Family support is an essential factor contributing to a faster recovery and the development of healthy behaviors that allow for producing efficient coping mechanisms.
Military Personnel: Changes
When considering the choice of an appropriate CBT framework for managing the needs of military people, one should make use of the Cognitive Processing Therapy (CPT) and the approach involving extinguishing intrusive images (EIS). The identified frameworks serve as the foundation for determining the factors that trigger negative reactions and painful memories through the active use of imagery. For instance, in case the patient suffers from intrusive thoughts, such as the negative ideas about a possible military attack, the isolation of the specified imagery and the further acknowledgment of fear will serve as the foundation for building the strategy allowing the patient to prevent their brain from producing the images in question.
It should be noted, though, that one of the strategies mentioned above is bound to work for military personnel much faster and more efficiently than with civilians. Particularly, the VR framework, which provides an opportunity to relieve the PTSD experience and, therefore, cope with the stress that it has produced, can be deemed as the approach that meets the needs of military people in an impeccable manner.
As James and Gilliland (2017) explain, the strategy based on the use of VR creates prerequisites for a better understanding between the patients and the therapist: “A VR system designed to assist clinicians doing prolonged exposure not only impacts therapeutic practice, but cultural conceptions of therapy as well due to its gamelike quality in destigmatizing therapy among young male ‘digital generation’ soldiers” (James & Gilliland, 2017, p. 174).
Therefore, it is strongly recommended that the identified approach should be used as one of the essential components of the PTSD therapy for military patients. It should be kept in mind, though, that the VR framework is only a part of the Prolonged Exposure (PE) therapy and, therefore, should be used in combination with an appropriate ITP framework so that the needs of the patients could be addressed properly. For instance, if a patient was exposed to a series of violent scenes involving military actions, the use of VR techniques as the means of helping the patient recognize the traumatic effects of the past and reconcile with it can be considered legitimate.
Creating the environment in which people suffering from PTSD will recover is a challenging task, mainly because of the uniqueness of each case and the need to develop a comprehensive approach that allows embracing every possible factor triggering the disorder. However, if a combination of CBT- and ITP-based approaches are used, the premises for a successful intervention and the further eradication of the disorder can be created. Consequently, the recovery process will occur at a faster pace and lead to much more impressive and satisfying results.
Gerber, S. & Basham, A. (1999). Responsive therapy and motivational interviewing: Postmodernist paradigms. Journal of Counseling and Development, 77(4), 418–422.
James, R. K., & Gilliland, B. E. (2017). Crisis intervention strategies. Boston, MA: Cengage Learning.
Marotta, S. A. (2000). Best practices for counselors who treat posttraumatic stress disorder. Journal of Counseling and Development, 78(4), 492–495.
Paradise, L. V., & Kirby, P. C. (2005). The treatment and prevention of depression: Implications for counseling and counselor training. Journal of Counseling and Development, 83(1), 116–119.
Taylor, J. G., & Baker, S. B. (2007). Psychosocial and moral development of PTSD-diagnosed combat veterans. Journal of Counseling and Development, 85(3), 364–369.