Senior seminar of Psychology
Fairleigh Dickinson University
The main point of this paper is to discuss how Cognitive behavioral therapy can be an effective treatment for Posttraumatic stress Disorder. In today’s world we are able to see how this topic is can be relevant to our lives. Not everybody has the misfortunate of having to go through such a tough disorder. But we never know if there will be a time where it might just hit us or significant others. Therefore having knowledge of this disorder is very important especially for those people that are frequently going through tough times in their lives.
Posttraumatic stress disorder occurs when we face a certain situation where we feel like their lives is being threatened. The fear that a person faces during a threatened situation is what actually causes their mental health condition to be in danger .The reason why people get the disorder is because of what they go through during that certain situation. Some people are not used to being exposed to dangerous situation and everybody’s reaction is different .A lot of people can go through situations where they almost die but they don’t necessarily develop PTSD from that because they instantly recover from it.
There are many different factors that can cause posttraumatic stress disorder. One of them is traumatic accident, where the person faces a horrible situation that they might have never even faced before. A terrorist attack can also lead to PTSD because it is something that threatens us and can leave us feeling insecure about our lives. Another factor that can cause a person to develop PTSD would be a soldier who went to war and had to experience horrific scenes and was able to actually see people getting killed which can result to that person getting traumatized by it .As I mentioned before going through hard events in our lives does not necessarily affect the person who goes through it. There have been a lot of people who get PTSD by simply witnessing the scene.
A lot of the people who have to deal with PTSD go through a devastating procedure in which they might end up feeling hopeless for their future .It is due to the lack of motivation to move on with their lives .It is actually common for a person to feel stuck up after facing a traumatic situation. Most of the people that go through PTSD are also less likely to keep in touch with reality, it is very hard for them because facing their reality would mean leaving the past behind which is something they have to get accustomed to. Some people are used to their daily living life routine but those who go through the process of PTDS usually try to do things differently because they fear that the same traumatic event might happen again.
Since is it hard for people who suffer from PTSD to accustomed to their actual life, try really hard not to think about their past because for them it will feel like reliving the moment all over again. Due to this disorder It has been proven that one of the treatment for post traumatic stress disorder that would be one of the most effective one is CBT .CBT or cognitive behavioral therapy s a therapy based on psychotherapy, which means a therapy through talk that helps the patients to release all the negative thinking due to the traumatic episode that marked his or her life, to start view challenging situations in a different way and to respond in a successful manner.
CBT consisted of therapy sections, more as problem solving therapy that engage the patient to overcome his or her fears, and to go beyond the difficulties, changing their behaviors and the way they thinking. Therefore, cognitive behavioral therapy works for a lot mental problems, such as depression, anxiety; sleep problems, posttraumatic stress disorders and more. The fact a person is under CBT, it does not mean the patient has to suffer of any mental problem, but rather a health condition. The process of CBT is through a conversation with the patient, so he or she focuses on his or her thoughts, to any images or beliefs and at the same time, they are able to deal with any emotional problem, if so.
In addition, CBT has proven a fast recovery on people who actually go through the treatment. Therefore this treatment is very effective because it actually helps the patient deal with their fears. This treatment also has positive impact on the patient’s behaviors. One of the hardest things is dealing with our minds since most of the times we cant really control our own thoughts. It is also important to have a positive mindset in order to overcome the fear of another traumatic event happening again. With this being said, Cognitive Behavioral Therapy actually change our life to a better one, and to have the capacity to manage any situations or difficulties that comes along the way.
Furthermore, most individuals do not know what to do to help one to overcome the overwhelming condition. Therefore, it is important to educate not only physicians but also the individuals or patients who turn up with the PTSD issues. This way it would enable one to prevent or control the symptoms of PTSD. In most cases it has been witnessed that the physicians do not share the full details of one’s medical or mental health issue with the patient. This practice hampers the confidence of patients, which further demoralizes them . Therefore, it is important that the doctors should share the full details about one’s health. This would not only help the physicians in gaining the patient confidence but also will enable the physicians to share knowledge about the available treatments such as counseling therapy, Cognitive Behavioural Therapy and anti- depressants or other drugs. Today, the use of medicines/ drugs are common in PTSD cases. This is probably because of its fast recovery and are readily available . However, these anti- depressants have their own side- effects and discontinuation of the medications can also lead to serious events . Medications and drugs only help the doctors to suppress the depression or the symptoms in their patients. Therefore, the root- cause of the disorder still remains untreated. Therefore, it further becomes important for the physicians to find out ways in which the patient’s main problem can be treated.
In 2006, Rauch proved that reducing the thought of incompetence or uselessness or the feelings such as the world is dangerous in patients can greatly reduce the symptoms of PTSD. The evidence provided by them in their study was directly supported by the Emotional Process Theory, which states that a PTSD patient can be appropriately treated only when the physicians targets the fear structure activation in patients. This process helps the therapist to reach the bottom of the issue and accordingly find a solution, which in turn helps them to re- activate the fear in the patient and thereby help them overcome the fear, which is the root cause of the disorder. In 2004, McRae showed that PTSD in patients was effectively dealt with the aid of the psychotherapeutic and pharmacotherapeutic treatments. In 2010, the study conducted by Foy revealed that when cognitive behavioral therapy was used to treat patients with PTSD could effectively reduce the symptoms in their patients. Additionally, they also proved that CBT sessions conducted via telemedicine or live video chat were as effective as the face- to face- CBT sessions. However, the major limitation of this therapy was that it is time- consuming and most people (40%) who suffer from these disorders are from the rural areas, where the mental health care services are limited. Evidence- based practice has also repeatedly reported that when CBT was combined with prolonged imagery and psycho- education, the speed of recovery had significantly increased in the subjects with PTSD. It also helped in preventing or minimizing the relapses after the intervention .
Researchers in the past have taken initiatives to compare the effectiveness of Cognitive Behavioural Therapy with other available pharmacotherapies. However, except for one study, all other studies reported that CBT is not only effective but is also useful for the long- term management of the disorder as compared to the pharmacotherapy. It was only in a study conducted by Frommberger (2004) that negated these findings as they found relapse in their patient with PTSD within 6 months of the CBT sessions. Similarly, another study conducted by Kolk (2007) reported that relapse post- six months of the CBT sessions occurred in 58% of the asymptomatic patients. However, no conclusion can be made based on these evidence. This is because these studies had its own limitations and also were conducted for a shorter period. Long- term studies on the effectiveness of the CBT is yet to be conducted. The effectiveness of CBT in treating mild to severe forms of PTSD is still controversial as there are many studies that report that CBT is non- responsive in 50 % of the patients with PTSD. The probable reason behind it could be either the nature of the studies or the comorbid condition the patient is in. CBT has also been rendered to be non- responsive in patients who are into drugs, alcohol, etc. Levitt (2007) demonstrated in their study that 12- 25 CBT sessions when conducted for the PTSD patient from the World Trade Center attack could significantly reduce the depression levels and other symptoms in the patients. Similarly, research studies conducted by Brewin (2005) and Gillespie (2002) reported that CBT techniques not only significantly reduced the PTSD in patients but also helped in maintaining the health progress even after 1 year of the therapy. Otis (2009) conducted a study in which they conducted an intervention that included 12- sessions of the components of the CBT to manage chronic pain in veterans with PTSD. They concluded from their results that CBT was not only feasible but also had clinical benefit. Similar results were reported by researchers who assessed the efficacy of the CBT in treating motor vehicle accident patients with PTSD .
A number of studies that compared CBT with other psychotherapies recommended the use of CBT as it had better remission rates than supportive therapies or EMDR. CBT was also suggested to be equally effective and compliant as the exposure therapy and cognitive therapy are (Mendes, 2008). Evidence obtained from the existing literature on CBT and PTSD reveals that the exact efficacy of CBT use is still to be validated. However, considering the amount of literature available that favors the usage of CBT for treating PTSD patients highlights the need for conducting long- term research studies to validate the effectiveness of CBT in treating PSD patients. Additionally, it has been witnessed that most doctors do not prefer to use CBT for treating PTSD and its related problems such as suicidal tendencies, anxiety, depression, etc. This is probably because it is a time- consuming process and in most cases doctors need to put extra efforts to force patient to stick to their treatment regimen. Additionally, despite the existing evidence on the efficacy of this therapy, there is a probability that 50 % of the patients are non- responsive to CBT. Therefore, based on the existing literature that sheds limelight on the effectiveness of the CBT, this research proposal aims to prove the hypothesis.
References
Bhagar, H. &. (2007). Pharmacotherapy of combat-related post traumatic stress disorder. RX Primer.
Breggin, P. R. (2010). Antidepressant-induced suicide, violence and mania: Risks for military personnel. The International Journal of Risk and Safety in Medicine, 149- 157.
Brewin CR, F. N. (2010). Outreach and screening following the 2005 London bombings: Usage and outcomes. Psychol Med, 2049- 2057.
Foy, D. R. (2010). Telemedicine for anger managementtherapy in a rural population of combat veterans with posttraumatic stress disorder: Arandomized noninferiority trial. J Clin Psychiatry, 855- 863.
Frommberger U, S. R.-F. (2004). Comparison between paroxetine and behaviour therapy in patients with posttraumatic stress disorder (PTSD): A pilot study. Int J Psychiatry Clin Pract, 19- 23.
Garske, G. G. (2011). Military-related PTSD: A Focus on the Symptomatology andTreatment Approaches. Journal of Rehabilitation, 77 (4).
Gillespie K, D. M. (2002). Community based cognitive therapy in the treatment of posttraumatic stress disorder following the Omagh bomb. Behav Res Ther, 345- 357.
Levitt JT, M. L. (2007). The flexible application of a manualized treatment for PTSD symptoms and functional impairment related to the 9/11 World Trade Center attack. Behav Res Ther, 1419- 1433.
McRae, A. L. (2014). Comparison of nefazodone and sertraline for the treatment of posttraumatic stress disorder. Depression and anxiety, 190- 196.
Mendes DD, M. M. (2008). A systematic review on the effectiveness of cognitive behavioral therapy for posttraumatic stress disorder. . Int J Psychiatry Med, 241- 259.
Otis JD, K. T. (2009). The development of an integrated treatment for veterans with comorbid chronic pain and posttraumatic stress disorder. Pain Med, 1300- 1311.
Ponniah K, H. S. (2009). Empirically supported psychological treatments for adult acute stress disorder and posttraumatic stress disorder: A review. . Depress Anxiety., 1086- 1109.
Rauch, S. &. (2006). Emotional processing theory (EPT) and exposure therapy for PTSD. Journal of Contemporary Psychotherapy, 61- 65.
Russell, M. C. (2009). Training, Treatment Access, and Research on TraumaIntervention in the Armed Services. Journal of EMDR Practice and Research, 24- 31.
Van der Kolk BA, S. J. (2007). A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: treatment effects and long-term maintenance. J Clin Psychiatry, 37- 46.
Zoellner T, R. S. (2010). Post-traumatic growth as outcome of a cognitive-behavioural therapy trial for motor vehicle accident survivors with PTSD. . Psychol Psychother.
References
In-Depth: Cognitive Behavioral Therapy. (n.d.). Retrieved April 11, 2016, from http://psychcentral.com/lib/in-depth-cognitive-behavioral-therapy/
