PTSD and Traumatic Stress Paper
PTSD and Traumatic Stress Paper
Investigate the factors that influence patients with co-morbid chronic illnesses across the lifespan and across transitions of care and health. GEL-1.03: Demonstrate college-level communications through the oral delivery of original materials in Standard English. Approximately one third of all veterans returning from service in the Middle East have received a mental health diagnosis (Ganzer, 2016). The most common diagnoses differ between male and female veterans. Female veterans are at greater risk for post-traumatic stress disorder, military sexual trauma, and suicide (Ganzer, 2016) while male veterans are at greatest risk for post-traumatic stress disorder, depression, and traumatic brain injury (National Alliance for Mental Illness, 2017). The need for mental health services to our newest veterans has never been greater. References Ganzer, C. A. (2016). Veteran women: Mental health-related consequences of military service. American Journal of Nursing, 116(11), 32-39. doi: 10.1097/01.NAJ.0000505583.09590.d4 National Alliance for Mental Illness. (2017). Veterans & active duty. Retrieved from https://www.nami.org/Find-Support/Veterans-and-Active-Duty For this Assignment, you will determine the adequacy mental health services available to veterans in your community. Assess the community and/or state sponsored services that are available to veterans with co-morbid chronic mental illness. For example, what services are available to a veteran who suffers from post-traumatic stress disorder and alcohol abuse? In a 10-12 slide informative PowerPoint presentation (title slide and reference slides are in addition to the 10-12 slide requirement), Include the following: What factors (outside of military service) influence the veterans need for mental health services? (Use evidence to support your rationale.) How is the veteran evaluated to determine eligibility for services? What is the cost of these services to those veterans receiving it? Are the available services in your community adequate for the population served?PTSD and Traumatic Stress Paper Explain your answer. What recommendations do you have for improving the available services? (Are more services needed? Are different services needed? How would additional funding help?) Your presentation should establish a clear viewpoint and purpose. A minimum of three references should be included, and placed in a reference slide at the end of your presentation. The presentation should include speaker notes, which will assist in the audio portion below. You will also need to add audio to your presentation. The audio should present the information, not just read from the presentation slides. Use your speaker notes to assist with the audio narration. Please keep your audio narration to a maximum of 20 minutes. How to record on PowerPoint: Prepare to record the narration. Open the presentation and Click the Slide Show tab on the menu bar. Click the Record Slide Show button and select Start Recording From Beginning from the pull-down menu. The Record Slide Show dialog box will open. Place a check in the Narrations And Laser Pointer check box and click Start Recording. The Slide Show preview window will open. Record the narration. Click the right-pointing arrow in the left corner of the preview window to begin the narration. Record the presentation in a quiet environment and in a professional manner reflective of a presentation given in your workplace. Pause the narration at any time by clicking the pause button on the Recording shortcut menu, located in the upper-left corner of the screen. Assignment Requirements Before finalizing your work, you should: be sure to read the Assignment description carefully (as displayed above) consult the Grading Rubric to make sure you have included everything necessary; utilize spelling and grammar check to minimize errors; and include a minimum of three references Your writing Assignment should: follow the conventions of Standard English (correct grammar, punctuation, etc.); be well ordered, logical, and unified, as well as original and insightful; display superior content, organization, style, and mechanics; and use APA 7th edition formatting and citation style as found in the Writing Center’s Citation Guidelines. I will record my voice on power point and if you type power point on regular separate sheet from notes,I can make my power point. I ned 2 page reading for power point and 2 page for making my power points.
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Factors Influencing Patients with Comorbid Chronic Illnesses
Chronic physical diseases are heterogeneous conditions that have persistent lifelong impacts on quality of life and subjective wellbeing. Chronic illnesses are continually increasing across the world, raising the multifactorial causes of this phenomenon. For example, psychiatric disorders are acknowledged as comorbid conditions that influence the course of chronic diseases with several sequelae and complications. Physical activity and coping resources are factors influencing patients with comorbid conditions across the lifespan and transition of care.
Physical activity is a contributing factor to the increase in mortality from any chronic illness.
Evidence from literature shows that inadequate daily physical activity is one of the main causes of chronic diseases, and physical activity is the rehabilitative intervention for inactivity-based dysfunctions (Di Benedetto et al., 2014). Reduced physical activity reduces the lifespan of people by making them more susceptible to lifestyle diseases, such type 2 diabetes and cardiovascular disease. Type 2 diabetes diagnosis at the age of twenty is linked with 17.2 years of life lost in males and 17.9 in females (Booth et al., 2012). In addition to this, inactivity further increases susceptibility to psychological illness, including depression (Di Benedetto et al., 2014). Therefore, it is essential to consider the bidirectional relationship between physical exercise and chronic diseases to understand how the former affects chronic diseases’ onset and progression.PTSD and Traumatic Stress Paper
Availability of coping resources also influences exacerbation of comorbid depression and chronic illnesses. Di Benedetto et al. (2014) found that higher depressive symptoms in patients with cardiac conditions are linked with lower coping resources. When dealing with stress, coping resources ranging from cognitive coping involving positive appraisal from others and oneself, social coping, and emotional coping serve as factors for managing it. The stress-diathesis model explains the relationship between mental affliction and coping among cardiac populations (Di Benedetto et al., 2014). Considering their nature of work, veterans have lower cognitive coping resources. As a result, they become predisposed to mental health problems which consequently increase the risk of certain diseases, including depression. Coping is thus a critical factor influencing the need for mental health services of veterans that should be taken into consideration at state and local levels.
The Department of Veterans Affairs (VA) enforces minimum duty requirements for eligibility to healthcare service access. Veterans serving in the combat or those discharged from active duty are eligible for comprehensive VA health care services for up to five years after discharge (National Academies of Sciences, Engineering, and Medicine, 2018). Such persons whose mental health status, wellbeing, or suicide risk are evaluated for eligibility before enrolment into a mental health program. Concerning cost of care, veterans get free VA healthcare for any disease or injury determined to be related to service-connected. They receive additional services for free including readjustment counselling and mental health services, care for problems arising from military sexual trauma (MST) (National Academies of Sciences, Engineering, and Medicine, 2018). As an individual, a veteran does not incur expenses for their care, test or medication for treatment of conditions related to the service.
The services available in my community are adequate for the population served. The Department of Defense provides various programs and services for veterans with post-traumatic stress disorder (PTSD). The Air Force Behavioral Health Optimization Program incorporates mental health and primary health care to manage stigma and improve psychological wellbeing of veterans (Richie, 2014). There are military units in my community providing intensive outpatient services for treatment of psychological conditions, including evidence-based psychotherapy and pharmacotherapy, endorsed by the VA/DoD Clinical Practice Guidelines to manage post-traumatic stress (Richie, 2014). The Army Warrior Resilience Center (WRC) is an example of an intensive outpatient PTSD program at Fort Bliss, Texas (Richie, 2014). The four-week program provides soldiers with complementary and alternative therapy sessions, family and partner support groups while monitoring patient outcomes. The programs help veterans overcome stress, thus promoting mental health and reducing comorbid diseases.
There are various recommendations for improving access to mental health care. One is promoting measurement-based care for enhancing the quality of care provided and treatment outcomes. To achieve this, health plans can provide action plans requiring providers to use standardized measurement-based tools such as PHQ-9 or GAD-7 for guiding decision making (APA, n.d.). Requiring them to issue aggregate-level outcomes data veterans or other populations receiving treatment for mental health conditions could also improve care provision and promote positive health outcomes. Another recommended solution is expanding telepsychiatry in health plans and behavioral health organizations (APA, n.d). At community level, providers and plan enrollees can receive education concerning telepsychiatry and have health plans ensure training is available for in-network providers on metrics of delivering telepsychiatry. These approaches would greatly enhance standards of mental health care thus boosting mental health status and general wellness of veterans and other patient groups.
In conclusion, increasing physical exercise and coping mechanisms and resources is key to reducing PTSD and promoting physical and mental health status. Among veterans, coping can be enhanced by providing mental health services such as medications, peer support, and therapy sessions. Implementation of evidence-based interventions for this group and the general population can improve mental wellbeing and lower the onset and progression of chronic diseases. As a recommendation, identification of barriers to care expansion through tele psychiatry and action plans to take to overcome the barriers would help improve access to care and improve the quality of mental health services.PTSD and Traumatic Stress Paper
References
American Psychiatric Association. (n.d.). Workplace Mental Health. https://workplacementalhealth.org/getmedia/b8723772-c65a-4942-8ee4-c5706c5c4dee/CWMH-Recommendations-for-Improving-Access-to-Care
Booth, F. W., Roberts, C. K., & Laye, M. J. (2012). Lack of exercise is a major cause of chronic diseases. Comprehensive Physiology, 2(2), 1143-1211.
Di Benedetto, M., Lindner, H., Aucote, H., Churcher, J., McKenzie, S., Croning, N., & Jenkins, E. (2014). Comorbid depression and chronic illness related to coping and physical and mental health status. Psychology, health & medicine, 19(3), 253-262.
National Academies of Sciences, Engineering, and Medicine. (2018). Evaluation of the Department of Veterans Affairs mental health services.
Ritchie, E. C. (2014). Treatment for Posttraumatic Stress Disorder in Military and Veterans Populations Final Assessment, Institute of Medicine, 2014 (Doctoral dissertation, Department of Behavioral Health Clinical Professor of Psychiatry, Georgetown University).
We are the world’s leading research and educational center of excellence on PTSD and traumatic stress.
PTSD is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault. It’s normal to have upsetting memories, feel on edge, or have trouble sleeping after this type of event. If symptoms last more than a few months, it may be PTSD. The good news is that there are effective treatments.
What is PTSD?
PTSD Basics
It’s normal to have upsetting memories, feel on edge, or have trouble sleeping after a traumatic event. At first, it may be hard to do normal daily activities, like go to work, go to school, or spend time with people you care about. But most people start to feel better after a few weeks or months.
- PTSD Basics
If it’s been longer than a few months and you’re still having symptoms, you may have PTSD. For some people, PTSD symptoms may start later on, or they may come and go over time.
More PTSD Topics
- Avoidance
Avoidance is a common reaction to trauma. It is natural to want to avoid thinking about or feeling emotions about a stressful event. But when avoidance is extreme, or when it’s the main way you cope, it can interfere with your emotional recovery and healing.PTSD and Traumatic Stress Paper - Trauma Reminders: Anniversaries
On the anniversary of a traumatic event, some survivors have an increase in distress. These “anniversary reactions” can range from feeling mildly upset for a day or two to a more extreme reaction with more severe mental health or medical symptoms. - Trauma Reminders: Triggers
People respond to traumatic events in a number of ways, such as feelings of concern, anger, fear, or helplessness. Research shows that people who have been through trauma, loss, or hardship in the past may be even more likely than others to be affected by new, potentially traumatic events. - Aging Veterans and Posttraumatic Stress Symptoms
For many Veterans, memories of their wartime experiences can still be upsetting long after they served in combat. Even if they served many years ago, military experience can still affect the lives of Veterans today. - Very Young Trauma Survivors
Trauma and abuse can have grave impact on the very young. The attachment or bond between a child and parent matters as a young child grows. This bond can make a difference in how a child responds to trauma. - PTSD in Children and Teens
Trauma affects school-aged children and teenagers differently than adults. If diagnosed with PTSD, the symptoms in children and teens can also look different. For many children, PTSD symptoms go away on their own after a few months. Yet some children show symptoms for years if they do not get treatment. There are many treatment options available including talk and play therapy. - History of PTSD in Veterans: Civil War to DSM-5
PTSD became a diagnosis with influence from a number of social movements, such as Veteran, feminist, and Holocaust survivor advocacy groups. Research about Veterans returning from combat was a critical piece to the creation of the diagnosis. So, the history of what is now known as PTSD often references combat history.PTSD and Traumatic Stress Paper
PTSD Treatment Basics
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PTSD can be treated. With treatment trauma survivors can feel safe in the world and live happy and productive lives. Effective treatments for PTSD include different types of psychotherapy (talk therapy) or medication.
Recommended Treatments: Treatments with the Most Research Support
Trauma-focused Psychotherapies
Trauma-focused Psychotherapies are the most highly recommended type of treatment for PTSD. “Trauma-focused” means that the treatment focuses on the memory of the traumatic event or its meaning. These treatments use different techniques to help you process your traumatic experience. Some involve visualizing, talking, or thinking about the traumatic memory. Others focus on changing unhelpful beliefs about the trauma. They usually last about 8-16 sessions.
The trauma-focused psychotherapies with the strongest evidence are:
- Prolonged Exposure (PE)
Teaches you how to gain control by facing your negative feelings. It involves talking about your trauma with a provider and doing some of the things you have avoided since the trauma.
What Type of Treatment Is This?
Prolonged Exposure (PE) is a psychotherapy for PTSD. It is one specific type of Cognitive Behavioral Therapy. PE teaches you to gradually approach trauma-related memories, feelings, and situations that you have been avoiding since your trauma. By confronting these challenges, you can actually decrease your PTSD symptoms.
- Cognitive Processing Therapy (CPT)
Teaches you to reframe negative thoughts about the trauma. It involves talking with your provider about your negative thoughts and doing short writing assignments.
What Type of Treatment Is This?
Cognitive Processing Therapy (CPT) is one specific type of Cognitive Behavioral Therapy. It is a 12-session psychotherapy for PTSD. CPT teaches you how to evaluate and change the upsetting thoughts you have had since your trauma. By changing your thoughts, you can change how you feel.
How Does It Work?
Trauma can change the way you think about yourself and the world. You may believe you are to blame for what happened or that the world is a dangerous place. These kinds of thoughts keep you stuck in your PTSD and cause you to miss out on things you used to enjoy. CPT teaches you a new way to handle these upsetting thoughts. In CPT, you will learn skills that can help you decide whether there are more helpful ways to think about your trauma. You will learn how to examine whether the facts support your thought or do not support your thought. And ultimately, you can decide whether or not it makes sense to take a new perspective.
Helps you process and make sense of your trauma. It involves calling the trauma to mind while paying attention to a back-and-forth movement or sound (like a finger waving side to side, a light, or a tone).PTSD and Traumatic Stress Paper
What Type of Treatment Is This?
EMDR is a psychotherapy for PTSD. EMDR can help you process upsetting memories, thoughts, and feelings related to the trauma. By processing these experiences, you can get relief from PTSD symptoms.
How Does It Work?
After trauma, people with PTSD often have trouble making sense of what happened to them. EMDR helps you process the trauma, which can allow you to start to heal. In EMDR, you will pay attention to a back-and-forth movement or sound while you call to mind the upsetting memory until shifts occur in the way that you experience that memory and more information from the past is processed. Although EMDR is an effective treatment for PTSD, there is disagreement about how it works. Some research shows that the back and forth movement is an important part of treatment, but other research shows the opposite.
During the first stage, you will learn about physical and emotional reactions to trauma. You and your provider will discuss how ready you are to focus on your trauma memories in therapy. To prepare, you will learn some new coping skills. Next, you will identify the “target”, or the upsetting memory you want to focus on–including any negative thoughts, feelings and bodily sensations related to the memory. You will hold the memory in your mind while also paying attention to a back-and-forth movement or sound (like your provider’s moving finger, a flashing light, or a tone that beeps in one ear at a time) until your distress goes down. This will last for about 30 seconds at a time, and then you will talk about what the exercise was like for you. Eventually, you will focus on a positive belief and feeling while you hold the memory in your mind. Towards the end of treatment, your provider will re-assess your symptoms to see if you need to process other targets.
Is It Effective?
Yes, trauma-focused psychotherapy (including Eye Movement Desensitization and Reprocessing) is one of the most effective types of treatment for PTSD.
What Are the Risks?
You may feel uncomfortable when focusing on trauma-related memories or beliefs. These feelings are usually brief and people tend to feel better as they keep doing EMDR. Most people who complete EMDR find that the benefits outweigh any initial discomfort.
Group or Individual?
EMDR is an individual therapy. You will meet one-to-one with your provider for each session.
Will I Talk in Detail about My Trauma?
No, in most cases you will not be asked to talk about the details of your trauma out loud. But you will be asked to think about your trauma in session.PTSD and Traumatic Stress Paper
Will I Have Homework?
No, EMDR does not require you to complete homework or practice assignments between sessions.
How Long Does Treatment Last?
About 1-3 months of weekly 50-90 minute sessions. But, many people start to notice improvement after a few sessions. And the benefits of EMDR can last long after your final session with your provider.
How Available Is This in VA?
Low. This treatment is not common in VA. It is more widely available outside VA.
Does VA Have an App for That?
No, currently the VA has not developed an app for EMDR.
Choosing the Best Treatment for You
Trying to figure out which PTSD treatment is best for you? For more videos about Eye Movement Desensitization and Reprocessing and other treatments that work, get started with the PTSD Treatment Decision Aid.
Reference
PTSD and Traumatic Stress Paper
