1. It saddens me to hear of Christina’s experience of hospitalization as a child. She was sexually abused by her babysitter, confided in her parents, and then was punished at the hospital by being put in isolation, and by being medicated. No one took the time to listen to Christina’s experience. She wasn’t given the opportunity to have a voice. Listening to Christina speak about taking her recovery into her own hands was empowering. She shares that she started doing research online to learn about alternative options for treatment. Being medicated was not helping her to get better. She shares that her diagnosis and behaviors were viewed as a weakness and not a strength. She learned about the benefits of cognitive behavioral therapy, and started attending a group. She shares that peer support was helpful. Christina started going to school and got a job as a Medical Assistant. If I were working with Christina, I would utilize Strategy #7 encouraging participation in 12 step, peer support, and other mutual-help programs. (SAMHSA, 2014, p.121) I would also focus on person centered approach, and encourage Christina’s self-advocacy.
2. The Brief Trauma Questionnaire is a screening tool that I would use in my practice. In reviewing this tool, a positive would be that client’s, especially new clients would be able to share if they had experienced a traumatic event without verbalizing their experience. A negative may be that questionnaires can be triggering. It would be helpful to discuss the possibility for a reaction to the questions being asked. The PTSD Checklist is another screening tool that I would use. This would be a helpful tool in assessing my clients for PTSD symptoms. Many of the client’s that I meet with have previously been diagnosed with PTSD. This would be a tool that would allow my clients to assess the symptoms they are experiencing. The limitation with this tool is it applies to the last month of the client’s life. This would be a limiting factor in diagnosing, and with past trauma.
3. In my approach with Selena, I would focus on building trust, addressing sleep disturbances, and providing psychoeducation. Building trust will be vital for treatment with Selena. Her trust was violated when she was sexually assaulted by someone that she knew, and thought of as a big brother. Providing a safe and trusting environment will assist in building a strong therapeutic alliance. Selena’s sleep disturbance is severe. She has developed a fear of sleeping, and avoids sleeping until she is exhausted. Assisting Selena in increasing her sleep hygiene and creating a routine before bed, will assist in increasing restful sleep. Providing psychoeducation about PTSD symptoms would be beneficial. Selena appears to be experiencing severe sleep disturbances related to trauma. As she has predominantly been treated for depression, she may be confused about the emotions and symptoms that she is experiencing. Discussing treatment options, coping strategies, and types of therapy will be helpful in assisting Selena choose the right treatment option for her needs.