Reference no: EM133299768

Case: About this ExampleThe first case example about Terry documents the treatment of PTSD using Prolonged Exposure. The second is an example of in-session imaginal exposure with a different client. Prolonged Exposure is strongly recommended by the APA Clinical Practice Guideline for the Treatment of PTSD. Download case study (PDF, 107KB).Terry's Story

Terry, a 42-year-old earthquake survivor, had been experiencing PTSD symptoms for more than eight years. Terry consistently avoided thoughts and images related to witnessing the injuries and deaths of others during the earthquake. Throughout the years, he began spending an increasing amount of time at work and filling his days with hobbies and activities.

By the time he sought treatment, Terry had managed to fill his entire week with various obligations in order to keep his mind occupied and to minimize the possibility that he would think about the traumatic event. He also worked hard to convince others that the earthquake had not affected him. He did this by avoiding people that knew he had gone through this experience and by quickly changing the topic when it came up. However, he found that whenever he had free time, he would have unwanted intrusive thoughts and images about the earthquake. In addition, he was having increasingly distressing nightmares that were causing him to lose several hours of sleep each night. His repeated violent awakenings throughout the night had also disturbed his wife's sleep, resulting in them no longer sharing a bedroom. Terry found that the harder he worked to avoid these thoughts, the more frequent they would become, and that they were getting stronger each day. He feared that if he thought about the memory he would lose control of his emotions and would not be able to cope. He was concerned that the fear and panic that occurred when he was reminded of the trauma would last forever. By avoiding thoughts about the memory, he never allowed himself to test out his predictions. Furthermore, through his repeated avoidance of the trauma memory, his fear continued to grow.

Terry eventually sought treatment because his symptoms were significantly impairing his work and family life. After receiving a thorough assessment of his PTSD and comorbid symptoms, psychoeducation about PTSD symptoms, and a rationale for using imaginal exposures, Terry received a number of sessions of imaginal exposure. With encouragement from his therapist, he engaged with the trauma memory in session by providing a detailed account of what he witnessed during the earthquake. The therapist prompted him to begin the account at the point at which he initially was aware that the earthquake was happening. She prompted him to describe in detail where he was at the time, who he was with, what he saw, how it ended, the sensations he had, and importantly, what he was thinking and feeling at the time. With each recounting, the therapist asked Terry to provide even more sensory and emotional details about the experience to facilitate habituation to the memory and to increase his mastery of his anxiety related to facing it. These retellings were recorded so that Terry could listen to the account outside of session for homework.

By engaging with the memory in a systematic manner and not allowing himself to escape or avoid it, he recognized that his fear and anxiety subsided as the exposures went on. Furthermore, he was able to test some of the predictions he had made about what would happen if he allowed himself to think about the trauma. He recognized that he could fully maintain control of his emotions and that, although he felt fear and anxiety throughout the exposure, these feelings quickly passed. Through the use of repeated imaginal exposures, Terry slowly began to feel more comfortable with discussing the trauma and telling people about his experience. He no longer feared the memory and was able to recognize that the memory itself was not dangerous.

Question 1: Briefly summarize the event that led to PTSD.
Question 2: Explain the type of treatment received and the outcome.
Question 3: Discuss why you believe the therapy worked or did not work and if you think other treatment plans/types may have been effective and why.
Question 4: write a brief scenario where an employee suffers from PTSD and then explain the treatment plan that was used to help the employee. You can write an example of the right plan being used that works well for the employee or you can go the other way with the wrong plan for the situation. Explain why it does or does not work.