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The Effectiveness of Cognitive Behavioral Therapy With Posttraumatic Stress Disorder, Research Paper Example

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Research Paper

Cognitive behavioral therapy has been used in various forms to address a multitude of mental health problems presented at agencies, hospitals, and other psychiatric settings. It has been used to treat patients suffering from many different conditions, including posttraumatic stress syndrome, with varying degrees of success. This paper will examine two articles that discuss the use of cognitive behavioral therapy in the treatment of PTSD, describing the apparent strengths and weaknesses of this treatment approach when applied to this disorder.

In the article “Cognitive Therapy for Posttraumatic Stress Disorder,” Patricia Resik concludes that cognitive therapy is indeed an effective treatment for posttraumatic stress syndrome. Nevertheless, she acknowledges that the many studies that she describes do not necessarily support the idea that this therapy approach is effective when treating every trauma population, or whether it is a successful treatment method when used alone or in combination with exposure to the stressor (Resik, 2001.) The first study she describes, conducted by Foa and colleagues, describes the way cognitive behavioral therapy was applied to victims of female rape and assault, and found that when the treatment was applied successfully, it decreased the symptoms of PTSD as well as depression at a rate that exceeded what would normally be expected to occur naturally, i.e., typically within a period of three months. Indeed, all of the studies discussed in the Resik article described significant and tremendous decline in symptoms that existed before therapy started and following its termination (Ibid.)

The treatment implemented in Resik’s results was comprised of four, two-hour treatment sessions that provided education to the patients about what would constitute a “normal” reaction to the experienced trauma, imagined or actual exposure to the traumatic event or events, and cognitive therapy that was designed to examine and correct distorted impressions about the incident. The patients who received this therapy intervention had strikingly less intense symptoms of posttraumatic stress syndrome two months after the attack then the patients who did not receive the treatment, and only 10% of the individuals treated with CBT continued to meet the criteria for the disorder as opposed to 70% of the population who were untreated, or treated by different means.

Another study described in the Resik article considered the preventative quality of applying CBT, when patients with Acute Stress Disorder, a predictor of who will develop posttraumatic stress disorder, were given either cognitive behavioral therapy or supportive counseling shortly after a traumatic incident. The goal was to assess whether utilizing CBT at an early point would prevent the development of PTSD; when the treatment was over, incredibly, only 8% of the patients who had received cognitive behavioral therapy went on to develop posttraumatic stress syndrome, as compared with 83% of the individuals who had experienced supportive therapy only. The methods used in both treatments were quite different: cognitive behavioral therapy provided included relaxation training, cognitive reframing, and imagined or actual exposure to the traumatic elements, while the supportive therapy included instruction about the aftereffects of trauma, generic problem-solving skills, and social support (Resik, 2001.) The contrast in the results between both population groups was striking, providing significant indications regarding the effectiveness of CBT in preventing patients with acute stress disorder from developing the longer-lasting, debilitating condition known as posttraumatic stress syndrome.

The second article selected, “Trauma-Focused Cognitive Behavioural Therapy for Abused Children with Posttraumatic Stress Disorder: A Pilot Study.”, was based on a study of four children in New Zealand who had suffered from extensive abuse prior to being diagnosed with PTSD. The authors, Feather and Ronan, focused on the symptoms that abused children manifest that are similar to, as well as different from, those demonstrated by traumatized adults. Like adults, children typically demonstrate the symptoms of re-experience, avoidance and increased arousal (Ronan, 2007.) However, the point is made that children may display different symptoms at different ages, with interpersonal and separation problems being frequent, as well as irritability and anger directed at family members and peers, and self-blame for the trauma.

These symptoms may often be accompanied by depression, anxiety, and oppositional behavior. Since posttraumatic stress syndrome is considered to be an anxiety disorder, cognitive behavioral therapy for children with anxiety is considered to be ideal (Ronan, 2007.) CBT treatment in this situation is aimed at helping children develop skills to manage their symptoms, and to be able to comprehend their trauma as a past event that is time-limited, so that it can be successfully mastered by the child and his or her family. When working with children with PTSD and using CBT methods, a primary aspect of the approach is that it will be necessary to implement gradual exposure to the stressor in order to reduce symptoms; for children, the CBT approach can be quite effective by utilizing creative instruments to develop a trauma narrative as well as desensitizing the children to the original trauma, utilizing the creation of a safe therapeutic environment.

One of the strengths of this approach when working with a population of abused children is that the program initially helps them to build and solidify their relationships with caretakers, and since these children are often removed from their parents’  homes, cognitive behavioral therapy helps them to form new relationships with their current caretakers. It also provides them with practical educational information about abuse, remaining safe, and the need for processing emotions such as guilt, anger, separation, and loss (Ibid.). As in other therapeutic approaches, CBT necessitates the development of a positive relationship between the therapist and the client. One strength of CBT is the degree of control that the therapist has over the establishment of such a relationship; however, CBT’s reliance on the therapeutic alliance makes it vulnerable to ineffectiveness if the client is seriously impaired when it comes to developing object relations. Abused children, for example, have had negative experiences with the adults in their lives, which may make it difficult if not impossible to establish a therapeutic connection. In such cases, more traditional therapy methods such as play therapy or group therapy with peers might conceivably be more realistic and successful.

Overall, cognitive behavioral therapy can be extremely effective because it provides concrete, practical information and feedback to clients who may be in great need of such resources, and which will be delivered in a safe environment by a consistent, caring practitioner. It is an ideal therapeutic method for a variety of populations, although not for every population: certain clients, due to their age, background, and issues regarding authority and control, may find a more abstract, less concrete interaction with a therapist to be more valuable. For example, the traditional psychotherapeutic method of “starting where the client is” and allowing that person to either free associate or to, at the very least, direct the sessions’ agenda, might be more appropriate for adults and children who have never been permitted the ability to direct what is being discussed, when, and how those subjects will be addressed.

 

 

Bibliography:

Resik, P. (2001). Cognitive Behavioral Therapy for Posttraumatic Stress Disorder. Journal of Cognitive Psychotherapy , 321+.

Ronan, J. S. (2007). Trauma-Focused Cognitive Behavioural Therapy for Abused Children with Posttraumatic Stress Disorder: A Pilot Study. Thesis Submitted at Massey University, New Zealand .

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