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INTE R V E NT I ON

WESTLEY WU
VIGNETTE

MARK
21 YEAR OLD
CAUCASIAN
VETERAN
MARRIED AND HAS ONE DAUGHTER
SYMPTOMOLOGY

EXPERIENCING NIGHTMARES AND FLASHBACK


INSOMNIA
FIGHTS WITH HIS WIFE
TURNED TO ALCOHOL AND DRUGS IN ORDER TO COPE
DIAGNOSIS

DUAL DIAGNOSIS/CO-OCCURRING DISORDER


ALCOHOL AND SUBSTANCE ABUSE
POST TRAUMATIC STRESS DISORDER
STATISTICS

2 IN 10 VETERANS WILL SUFFER FROM PTSD


1 IN 5 VETERAN WHO HAVE PTSD ALSO HAVE A SUBSTANCE ABUSE DISORDER
1 IN 3 VETERAN SEEKING TREATMENT FOR SUBSTANCE ABUSE DISORDER ALSO HAVE PTSD
POST TRAUMATIC STRESS DISORDER
DSM-V
CRITERIA A: STRESSOR
DIRECT EXPOSURE
REPEATED AND EXTREME IN DIRECT EXPOSURE
CRITERIA B: INTRUSIVE SYMPTOMS
INVOLUNTARY AND INTRUSIVE MEMORIES
TRAUMATIC MEMORIES
DISSOCIATE REACTIONS (FLASHBACKS)
INTENSE OR PROLONGED DISTRESS AFTER EXPOSURE TO TRAUMATIC REMINDERS
POST TRAUMATIC STRESS DISORDER CONT.

CRITERIA E: ALTERATIONS IN AROUSAL AND REACTIVITY


IRRITABLE OR AGGRESSIVE BEHAVIOR
SLEEP DISTURBANCE
CRITERIA F: DURATION
PERSISTED OVER 1 MONTH
SUBSTANCE ABUSE DISORDERS
ALCOHOL USE DISORDER (AUD)
BINGE DRINKINGSAMHSA (SUBSTANCE ABUSE MENTAL HEALTH SERVICES ADMINISTRATION) DEFINES BINGE
DRINKING AS DRINKING 5 OR MORE ALCOHOLIC DRINKS ON THE SAME OCCASION ON AT LEAST 1 DAY IN THE
PAST 30 DAYS
CRITERIA A- IMPAIRED CONTROL
USING MORE THAN THE INTENDED AMOUNT
WANTING TO REDUCE BUT UNABLE TO DO SO
SPENDING EXCESSIVE TIME USING OR PROCURING SUBSTANCE
SUBSTANCE ABUSE DISORDER CONT.

CRITERIA B- SOCIAL IMPAIRMENT


NEGLECT CHILD AND MARRIAGE
GETTING INTO HEATED ARGUMENTS ABOUT USE
PATHOPHYSIOLOGY

REPTILIAN BRAIN TAKES OVER


BODY RELEASE ADRENALINE
FLIGHT, FLIGHT, OR FREEZE
OVERSTIMULATED AMYGDALA
UNDERACTIVE HIPPOCAMPUS
INTERVENTION
EXPOSURE THERAPY
8-15 WEEKS LONG
IMAGINAL EXPOSURE
REVISITING TRAUMATIC MEMORY AND RECOUNTING IT OUT LOUD
IN VIVO EXPOSURE
REPEATED CONFRONTATION OF INNOCUOUS SITUATIONS AND OBJECT THAT RECOUNT THE MEMORY OR CAUSES
DISTRESS
INTERVENTIONS CONT.

MINDFULNESS- CBT
TYPICALLY 8 WEEKS LONG
BRINGING THE CLIENT BACK TO THE PRESENT
SIGHT, TASTE, SMELL, TASTE, TOUCH
BE AWARE BY NOTICING AND WITNESSING, BUT NOT JUDGE IT
ADDITIONAL SUPPORT

REFER CLIENT TO PSYCHIATRIST


REFER CLIENT TO GROUP THERAPY
CULTURAL CONSIDERATIONS

MILITARY
RACIAL DYNAMIC BETWEEN THERAPIST AND CLIENT
REFERENCES
HTTPS://WWW.PTSD.VA.GOV/PROFESSIONAL/TREATMENT/OVERVIEW/MINDFUL-PTSD.ASP
BAER, R. A., SMITH, G. T., HOPKINS, J., KRIETEMEYER, J., & TONEY, L. (2006). USING SELF-REPORT ASSESSMENT METHODS
TO EXPLORE FACETS OF MINDFULNESS.ASSESSMENT, 13, 27-45.

BISHOP, S. R., LAU, M. A., SHAPIRO, S., CARLSON, L., ANDERSON, N. D., CARMODY, J., ET AL. (2004). MINDFULNESS: A
PROPOSED OPERATIONAL DEFINITION.CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, 11, 230-241.

BLOCK-LERNER, J., SALTERS-PEDNEAULT, K., TULL, M. T., ORSILLO, S. M., & ROEMER, L. (2005). ASSESSING MINDFULNESS
AND EXPERIENTIAL ACCEPTANCE: ATTEMPTS TO CAPTURE INHERENTLY ELUSIVE PHENOMENA. ACCEPTANCE AND
MINDFULNESS-BASED APPROACHES TO ANXIETY: CONCEPTUALIZATION AND TREATMENT (PP. 71-99). NEW YORK:
SPRINGER SCIENCE + BUSINESS MEDIA.