By Day 5
Respond to two colleagues who selected a case study different from yours:
Compare and contrast the article you selected with your colleague’s article in terms of how they might inform appropriateness for use with the identified client.
Explain how reviewing the different studies presented in this Discussion influenced your decision about whether you would use the therapy, given various evidence for the different treatment modalities.
My Case Study for Paula Cortez is attached.
Please respond to these two peers.
RE: Discussion – Week 6
Article: Investigating the usefulness of trauma-focused cognitive behavioral therapy in adolescent residential care
This study used secondary analysis of adolescents from a residential treatment facility in Mississippi who were considered trauma cases. The facility’s primary intervention was trauma-focused cognitive behavior therapy (TF-CBT). The data was collected from January 1st, 2013 to December 31st, 2016. The final study used 55 female cases and 77 male cases, 132 adolescents in total. TF-CBT was presented in 16-20 1 hour’s session’s once per week for adolescents with trauma symptoms using 7 modules; psychoeducation, relaxation, affect modulation, cognitive coping, trauma narrative, cognitive processing, and safety planning (Joiner & Buttell, 2018. A pretest and posttest were conducted using the UCLA posttraumatic stress disorder reaction index (PTSD-RI). The results showed a significant difference in pretest and posttest scores as a result of TF-CBT intervention (Joiner & Buttell, 2018).
Tiffany is a 16-year-old female being court-ordered to a residential treatment facility. She has experienced multiple levels of trauma over the years including sexual abuse, sex trafficking, prostitution, and domestic violence (Plummer, Makris, & Brocksen, 2014). Using the PTSD-RI on Tiffani during her initial assessment and prior to discharge would be extremely helpful in determining if TF-CBT was a successful intervention choice. This treatment method was designed to help adolescents overcome trauma (Joiner & Buttell, 2018). Tiffani has shown signs of depression and PTSD symptoms due to trauma exposer. TF-CBT intervention would be helpful for Tiffani as studies have shown that many states who have implemented trauma-informed care have verified clinically significant improvements (Joiner & Buttell, 2018). The study provided was designed in a treatment facility using an age range Tiffani would fall into, along with adolescents who have experienced comparable trauma.
RE: Discussion – Week 6
ACT Therapy with Family Caregivers
Action and commitment therapy is a mindfulness-based intervention that focuses on overcoming negative thoughts and feelings attached to situations that arise throughout life (Serani, 2011). ACT has shown promising results on decreasing depression in primary caregivers to a family member. A quantitative study comparing ACT to CBT therapies, using 135 caregivers rating as having high levels of depressive symptomatology, found that ACT is an effective intervention for family members providing care for individuals with dementia (Losada, Marquez-Gonzalez, Romero-Moreno, Mausbach, Lopez, Fernandez-Fernandez & Nogales-Gonzalez, 2015). Utilizing a variety of assessment tools, before and after the intervention, to gauge the level of depressive symptomatology, anxiety, leisure, dysfunctional thoughts, and experiential avoidance, researchers found that there is no significant difference in ACT compared to CBT. That ACT is a viable form of intervention in this population (Losada et al., 2015).
Utilizing Act Therapy with Helen Petrakis
Helen Petrakis is a 52-year-old Caucasian female of Greek descent. She is a mother, wife, community member, and primary caregiver to her mother-in-law (Plummer, Makris Brocksen, 2014). Juggling so many roles has Helen experiencing depressive symptoms, and she finds herself avoiding any leisurely activity due to lack of time (Plummer et al., 2014). Helen’s Greek culture makes asking for help difficult (Plummer et al., 2014).
ACT therapy for caregivers focuses on “a) identification of personal patterns of experiential avoidance; (b) analysis of the trap of control of aversive inner events; (c) acknowledging the cost of the avoidant behaviors (creative hopelessness); and (d) learning the alternative to control (i.e., acceptance), using metaphors, cognitive defusion, and mindfulness techniques, in order to reduce depressive symptoms and increase leisure activity” (Losada, 2015).
The research supporting ACT therapies as a form of intervention for mental illness is well documented. Therefore, the interventions would also be well suited for those caregivers experiencing depressive symptomology. The National Association of Social Work Code of Ethics (2017) states that we must be culturally competent and sensitive. Therefore, utilizing this intervention with Helen is appropriate, especially as it relates to cultural sensitivity, as it focuses on her values.
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