Cognitive Behavior Therapy (CBT)

The fourth case study Jared is a 37-year-old divorced African-American father of two teenage children, aged 13 and 15, as well as a girlfriend. He is a retired Marine Corps medic who served on active service for four years. According to his partner, the client has a short temper and is irritable, claiming that he yells at her and loses his cool with his children. After being divorced after returning from deployment, he is separated and destitute. He acknowledges that he has had erroneous beliefs and misinterpreted information. He’s contemplated contemplating himself by locking himself in his room and murdering himself. He displays emotional dysregulation by openly crying while narrating the atrocities he witnessed. He is afraid of being labeled a weakling or a phony if he goes to counseling. The client acknowledges that he is experiencing awful unwanted memories that are interfering with his normal functioning and interpersonal interactions. He is terrified of losing his sanity as well as his family. The client claims to have developed a coping mechanism of drinking beer and smoking marijuana to block out terrible memories, indicating that he or she has developed a substance use disorder.

The goal of this study is to see if Cognitive Behavior Therapy (CBT) and Trauma-Focused CBT can help veterans with PTSD with anger issues, emotional dysregulation, suicide ideation, and intrusive memories.

An investigational question

 

Is psychotherapy effective in treating PTSD veterans who struggle with rage, substance misuse, suicide ideation, intrusive memories, or emotion dysregulation?

 

Action plan for your search

 

Psychotherapy’s efficacy as well as veterans’ experiences

 

The effectiveness of CBT and veterans’ experiences

 

Veteran-focused and trauma-informed CBT

 

Annotations

 

The First Article

Capone (2018). Is integrated CBT effective in reducing PTSD symptoms and substance abuse among Iraq and Afghanistan war veterans? The results of a randomized clinical trial. 735-746 in Cognitive Therapy and Research. https://doi.org/10.1007/s10608-018-9931-8

 

For soldiers who served in Afghanistan and Iraq, PTSD and its ramifications are becoming a growing concern. Serious symptoms like wrath, emotional dysregulation, and poor psychosocial functioning are connected to comorbid PTSD and drug use disorder, all of which can lead to suicidal ideation. The study’s goal is to see how effective integrated CBT and VA treatment as usual (TAU) is in reducing PTSD symptoms and substance use disorder among veterans compared to TAU. There is currently no gold standard treatment for individuals with mental health issues, but cognitive behavior therapy has been shown to be effective in civilians. It’s a randomized controlled trial to investigate if the combination of CBT and TAU has a higher influence on the research than TAU alone. The study recruited 44 participants through convenience sampling, who were randomly assigned to the control and experimental groups. The participants’ consents, as well as the permission of the affiliated facility review board, were used to get legal and ethical approval. The data was analyzed using SPSS version 22 and the chi-square and t-test with a 95% confidence level. Covariance patterns were determined using a general linear model. When compared to TAU, combining integrated CBT and TAU resulted in a significant reduction in PTSD symptoms among veterans. The goal of the trial was to see if a CBT hybrid intervention could treat veterans with PTSD. A high attrition rate, gender bias, and a limited sample population impeded the study, making generalization difficult. In a group setting, the treatment was personalized to the individual, which had an impact on the outcome.

 

The Second Article

 

10. K. Dobscha, M. W. Lu, J. M. Plagge, M. C. Marsiglio, and M. W. Lu (2016). Documentation of trauma-focused evidence-based psychotherapies received in a VA PTSD clinic. Vol. 43, no. 1, pp. 71-87 in Behavioral health services and research. https://doi.org/10.1007/s11414-013-9372-9

 

Trauma-focused psychotherapy is centered on recognizing and emphasizing the negative impact of traumatic experiences on a person’s mental and psychosocial well-being. Evidence-based psychotherapy such as cognitive behavior therapy and prolonged exposure therapy are regarded first-line therapies for veterans with PTSD. Soldiers are unwilling to begin or receive PTSD psychiatric therapy, according to studies. The increasing evidence of TF-favorable EBP’s impacts on veterans in clinical research warrants an investigation of veterans’ remarkable resistance to the mental health care intervention. The study focuses on the utilization of trauma-focused evidence-based psychotherapy interventions and clinician-reported reasons for non-receptivity. Following ethical and legal permissions, a total of 63 persons were sampled. It’s a qualitative longitudinal study aiming at figuring out what elements impact TF-EBP uptake and identifying potential hurdles to research topic non-acceptance. To interpret text data, it used qualitative content analysis and inductive category construction. The data was analyzed using SPSS, which includes chi-square and regression analysis. The results show that some respondents utilized TF-EBP on a regular basis, while others cited embarrassment, a lack of support, an active substance disorder, referrals, and redeployment as explanations. At the completion of the trial, eight participants joined the TF-EBP because of its established benefits. The small sample size and gender bias in the study limit its generalizability. Reports from single clinics are skewed as well, ignoring regional differences as well as veteran preferences and needs. TF-CBT was found to be effective in the treatment of PTSD in the study, according to clinical evaluations.

 

Article No. 3

 

26. Barish, E. B. Elbogen, H. Aralis, C. F. Cassiello-Robbins, P. Lester, W. Saltzman, E. B. Elbogen, H. Aralis, C. F. Cassiello-Robbins, P. Lester, W. Saltzman, and E. B. Elbogen (2021). In PTSD veterans with PTSD, a pilot study integrating mobile technology and social support with cognitive behavioral treatment for rage was conducted. Behavioral health in the military, vol. 9, no. 1, pp. 17-26. https://doi.org/10.1080/21635781.2020.1768972

 

 

 

Emotion dysregulation, which is common among veterans, manifests itself in rage outbursts, unjustifiable weeping, and unpredictable emotional reactions. It’s a PTSD symptom with a slew of concerns that need to be addressed right away to avoid physical and emotional harm, as well as strained interpersonal connections. Anger has been related to a higher risk of suicide, and it is more prevalent among veterans than civilians. Because there is no single best way to deal with anger, a combination of tactics must be employed to effectively manage the problem and improve health. The researchers want to create an effective fury treatment for war veterans with PTSD by integrating mobile technology and social support with CBT. For legal and ethical clearances, relevant review boards and participants were consulted. The randomized control pilot study enlisted the participation of 26 participants. A relaxation, cognition, and communication plan aimed at lowering anger was delivered to the experimental group. The sessions were recorded, and the outcomes were published. The study’s purpose was to see if employing a mobile phone and a support system in an anger management intervention was feasible and acceptable, as well as the consequences of combining the three approaches.

 

At a 95 percent confidence level, the data was analyzed using SAS version 9.4 with descriptive statistics such as frequencies and percentages, as well as inferential statistics such as chi-square and fisher exact test. In terms of anger management, the findings demonstrate that the smartphone app is acceptable to vets and their families. Participants in the control group exhibited an improvement in employing CBT skills when compared to the experimental group. The study’s strength is in its capacity to create an in-vivo data collection portal that is free of client recollection bias. The small sample size limited the study’s statistical power and applicability. A single point data collection makes it impossible to estimate treatment trajectories.

 

The reason for the treatment

 

To establish a treatment psychotherapy plan for Jared, who has been diagnosed with PTSD, that incorporates CBT and TF-CBT for coping with anger issues, emotional dysregulation, substance abuse, suicidal thoughts, and intrusive memories in order to improve his health and quality of life.

References

 

26. Barish, E. B. Elbogen, H. Aralis, C. F. Cassiello-Robbins, P. Lester, W. Saltzman, E. B. Elbogen, H. Aralis, C. F. Cassiello-Robbins, P. Lester, W. Saltzman, and E. B. Elbogen (2021). In PTSD veterans with PTSD, a pilot study integrating mobile technology and social support with cognitive behavioral treatment for rage was conducted. Behavioral health in the military, vol. 9, no. 1, pp. 17-26. https://doi.org/10.1080/21635781.2020.1768972

 

10. K. Dobscha, M. W. Lu, J. M. Plagge, M. C. Marsiglio, and M. W. Lu (2016). Documentation of trauma-focused evidence-based psychotherapies received in a VA PTSD clinic. Vol. 43, no. 1, pp. 71-87 in Behavioral health services and research. https://doi.org/10.1007/s11414-013-9372-9