UBC Jake Veteran Post Traumatic Stress Disorder & CPT Case Study Response Discussion

Respond to at least two colleagues by doing all of the following:

• Identify strengths of your colleagues’ analyses and areas inwhich the analyses could be improved. Address his or her evaluation ofthe efficacy and applicability of the evidence-based practice, his orher identification of factors that could support or hinder theimplementation of the evidence-based practice, and his or her solutionfor mitigating those factors.
• Offer additional insight to your colleagues by eitheridentifying additional factors that may support or limit implementationof the evidence-based practice or an alternative solution for mitigatingone of the limitations that your colleagues identified.

1-2 paragraphs with references for each post – posts are below

Student one

Please respond to the following

In the given case, Jake is a 31-year-old veteran who is married with children. Jake suffers from depression, Post-traumatic Stress Disorder (PTSD), and alcohol abuse resulting from traumatic events in combat (Plummer, Makris & Brocksen, 2013). Based on Jake’s condition, it would be beneficial to implement Cognitive Processing Therapy (CPT) exclusively that it has proven to work for those suffering from depression and PTSD. CPT is a specific type of cognitive-behavioral therapy that helps clients learn how to modify and challenge unhelpful beliefs related to trauma. In this case, military personnel frequently avoid reliving their trauma experience; thus, CPT would allow Jake to process his feelings and trauma experience in a professional and safe environment (SAMHSA, n.d.; Resick & Schnicke, 1992). For example, CPT involves extensive education on the root cause of PTSD and how negatively impacts the individual and his/her surroundings. It also provides clients with the appropriate skills to redirect negative thoughts with positive (Monson et al., 2006).

CPT is relatively short, commonly delivered in 12 meetings ordinarily guided by certified professionals. The sessions run between 60-90 minutes each individual or group session; as aforementioned, it helps clients to identify their challenge and modify unhelpful beliefs related to their experience. Consequently, the clients can understand and conceptualize the trauma incidents to help reduce any ongoing negative impacts on their daily lives. CPT is strongly recommended for the treatment of Jake (SAMHSA, n.d.). I addition to the in-person sessions, work-outside these meetings are encouraged. This is because literature indicates that those who do some homework besides attending the sessions, such as noting changes or triggers in a journal, report higher success in reducing symptoms. The measure would be conducted each week, identifying any changes that have occurred during the week. Another well-known program recommended in Jake’s treatment is the 12 Steps of Alcoholics Anonymous (AA) program. The program involves weekly meetings with a peer support group. Since Jake struggles with alcohol consumption, this program is ideal for helping him sober (SAMHSA, n.d.).

From a clinical standpoint, CPT is a suitable intervention for the client to treat his PTSD and alcohol consumption. As previously mentioned, this program has been proven to work with veterans who suffered from trauma. Hopefully, the supervisor would be open to its implementation because of its positive results and evidence-based intervention. To have a successful outcome of the EBP, the organization must have done extensive research on the desire EPB, and management and staff must be on board to implement the desired intervention as its success would depend on the hard work and commitment of those involved implementing it. The factors that may hinder its implementation are the lack of skills and office setting. It would be hard to implement the program if there is a lack of knowledge thereof. If the work environment is not set up where the therapist may feel uncomfortable, it would ultimately be not easy to deliver quality service to clients.

References

Baltimore, MD: Laureate International Universities Publishing

Monson, C.M., Schnurr, P. P., Rescik, P. A., Friedman, M. J., Young-Xu, Y., & Steven, S. P.,

(2006). Cognitive processing therapy for veterans with military-related stress disorder. Journal of Consulting and Clinical Psychology, 74, 898-907

Plummer, S.-B., Makris, S., & Brocksen, S. (Eds.). (2013). Sessions case histories.

Resick, P. A., & Schnicke, M. K. (1992). Cognitive processing therapy for sexual assault

victims. Journal of consulting and clinical psychology, 60(5), 748.

Substance Abuse and Mental Health Services Administration. (n.d.). NREPP: SAMSHA’s

national registry of evidence-based practices and programs.

Student 2

Please respond to the following

Jake is a thirty-one Caucasian, married male with children military veteran. Since Jake’s return home, he has been possibly experiencing military-related Post Traumatic Disorder (PTSD). Although PTSD is commonly associated with veterans who have gone to combat and witness horrific events, other civilians often have PTSD, as well. PTSD is a mental health condition that’s triggered by a terrifying event as an eyewitness or direct experience. PTSD is treatable; however, it has claimed the lives of many. Jake is using alcohol to cope with the stress that serving in the military has caused him.

Cognitive Processing Therapy

When choosing appropriate interventions for Jake Levy, the social worker needs to obtain pertinent information to understand the needs of the client, which includes considering what the client is ready to do in the early stages of treatment. CPT is one of the first-line treatments of PTSD and standard cognitive-behavioral treatment. In a safe space, veterans can focus on the impact of the trauma by identifying negative thoughts related to the event, understanding the cause of the stress, replacing thoughts, and how to cope with the uncomfortable feelings(Reisman, 2016). CPT can be delivered both individually and in structured group sessions. Regardless of modality, patients will have out-of-session practice assignments(Cognitive Processing Therapy, 2017).

Support

CPT is a specific type of cognitive-behavioral therapy that has been effective in reducing symptoms of PTSD that have developed after experiencing a variety of traumatic events, including child abuse, combat, rape, and natural disasters(Cognitive processing Therapy, 2017). According to Kehle-Forbes et al., 2020, CPT is a widely used treatment of PTSD in veterans engaged by the U.S. Department of Veteran Affairs (VA). Over 10,000 mental health professionals have been training to apply CPT to ensure that veterans have access to CPT. CPT involves 12 weeks of 60 to 90-minute individual sessions or group sessions and would include homework to continue practice beyond the session by a trained professional certified in CPT (SAMHSA, n.d.). A qualitative study to determine the effectiveness of applying CPT in veterans who met the criteria for PTSD reveals that participants report strengths of CPT. Nearly all veterans viewed CPT effectiveness as their greatest strength. It was the main factor associated with veterans’ willingness to engage in the treatment, and instilled hope that improvement and change were possible(Kehle-Forbes, 2020).

Appropriate Intervention

CPT is evidenced based and is highly recommended specifically for veterans who are having difficulty with their thoughts following combat. CPT is an appropriate intervention for Jake because he will learn how to challenge and modify unhelpful beliefs related to the trauma. In so doing, the patient creates a new understanding and conceptualization of the traumatic event so that it reduces its ongoing adverse effects on current life. As a result, Jake can live a more productive life as a husband and a father. Additionally, when Jake addresses the trauma, alcohol use can be addressed. Furthermore, loss of PTSD diagnosis has been associated with the achievement of good end state in nearly all domains of functioning following treatment, increasing interest in it as a patient-centered outcome Schnarr & Lunney (2016 as cited in Kehle-Forbes, 2020).

Issues Related to CPT

One issue that may prevent implementation is that Jake may not agree to participate with CPT. According to Kehle-Forbes, 2020, there is little prior work regarding how to best market CPT to patients to encourage clients to join in trauma-focused therapies such as CPT. Furthermore, applying the intervention in an appropriate environment serves a potential issue, which means the social worker would need to ensure that she has all of the materials necessary to apply CPT successfully. If the intervention is adapted to fit the needs of Jake, the results may vary. According to SAMHSA(2012), adaptations yield undesired results or unintended outcomes. Adapting the program will require additional resources and planning, which will delay the helping process.

Successful Implementation

The appropriate training and materials are pertinent to the successful implementation of CPT and willing participants. If the proper materials and training is not a priority prior to applying CPT, more harm can occur. Furthermore, the client will not meet his goals or gain anything from the treatment without the funding. According to Kehle-Forbes et al. (2020), more participants could improve effectiveness and decrease limitations. An implementation team is critical to successful implantation. The implementation team will be to guide and manage the change process and help mitigate fear and resistance(SAMHSA, 2012).

References

Cognitive Processing Therapy. (2018). https://www.apa.org/ptsd-guideline/treatments/cognitive-processing-therapy.

Kehle-Forbes, S. M., Gerould, H., Polusny, M. A., Sayer, N. A., & Partin, M. R. (2020). “It leaves me very skeptical” messaging in marketing prolonged exposure and cognitive processing therapy to veterans with PTSD. Psychological Trauma: Theory, Research, Practice, and Policy. https://doi-org.ezp.waldenulibrary.org/10.1037/tra… (Supplemental)

Reisman, M. (2016). PTSD Treatment for Veterans: What’s Working, What’s New, and What’s Next. P & T: a peer-reviewed journal for formulary management, 41(10), 623–634.

Substance Abuse and Mental Health Services Administration. (2012). A road map to implementing evidence-based programs. http://web.archive.org/web/20151010063916/http://www.nrepp.samhsa.gov/Courses/Implementations/resources/imp_course.pdf

Substance Abuse and Mental Health Services Administration. (n.d.). NREPP: SAMHSA’s national registry of evidence-based practices and programs.