Cognitive Behavioral Therapy in Treating PTSD

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Evidence-based treatments have become particularly important in the past few decades due to the increased demand for mental health services. The development of the scientific method provided researchers with an opportunity to compare the effectiveness of various treatments based on objective data obtained from large samples of participants. However, some non-evidence-based treatments, such as animal-assisted therapy, remain popular with patients and mental health professionals.

Animal-assisted therapy developed as a result of the increased understanding and appreciation of people’s attachment to pets. It dates back to the late 18th century when farm animals, including chicken and rabbits, were first used to assist mentally ill patients in improving self-control (Kim, Hong, Lee, Chung, & Lee, 2015). Humanism was an emerging philosophical school of the time, and thus people’s connection to pets and other animals was seen as a fulfillment of their needs for love and care. This view also correlated with the contemporary humanistic theory of pathophysiology, which stipulates that mental disorders occur when a person’s needs are not fulfilled adequately.

Animal-assisted therapy is used as a standalone treatment or as a component of a comprehensive treatment plan for persons with posttraumatic stress disorder, anxiety, autism, and other conditions requiring psychotherapy. However, the treatment remains non-evidence-based, since there are few high-quality studies confirming its effectiveness (Jones, Rice, & Cotton, 2019). To transform animal-assisted therapy into an evidence-based treatment, scholars should review its methods and establish their compatibility with the humanistic psychological theory. Also, it would be necessary to conduct high-quality controlled studies with large sample sizes to gather enough evidence in support or against this approach.

The chosen case is the case of Ivan S., who is a war veteran who suffers from a variety of psychological symptoms that affect his relationships with his family and loved ones. First of all, Ivan experiences anger management issues and aggression, which cause domestic violence since he reported that he beats his wife. Secondly, Ivan shows evidence of substance abuse, and he uses drinking as a coping mechanism to relieve the symptoms. Thirdly, Ivan suffers from nightmares and night sweats, which impact his sleep quality and contribute to stress.

Based on the information provided in the case, posttraumatic stress disorder is the main provisional diagnosis. Ivan fits the DSM-5 diagnostic criteria for PTSD, such as evidence of past trauma, symptoms of stress, and negative coping mechanisms (Levin, Kleinman, & Adler, 2014). PTSD is a rather common mental health issue in war veterans, and it requires treatment to relieve symptoms and promote well-being.

One possible treatment option for Ivan is cognitive behavioral therapy, which involves addressing thinking patterns, emotional responses, and behaviors during one-on-one or group counseling sessions. There is substantial research evidence supporting the use of this method in treating PTSD in war veterans. For example, Ehlers et al. (2014) found that standard weekly CBT in groups helped 77% of war veterans to recover from PTSD symptoms after three months.

Another option is intensive CBT, which had a success rate of 73% after one week (Ehlers et al., 2014). The effectiveness of cognitive behavioral methods was also confirmed by multiple randomized controlled trials, which are considered to provide a higher quality of evidence than most other studies. Talbot et al. (2014) found that weekly individual CBT helped patients with insomnia and posttraumatic stress disorder to achieve a substantial improvement in symptoms after six months. Hence, based on research evidence, group or individual weekly CBT would be advised to treat PTSD in Ivan.

References

Ehlers, A., Hackmann, A., Grey, N., Wild, J., Liness, S., Albert, I.,… Clark, D. M. (2014). A randomized controlled trial of 7-day intensive and standard weekly cognitive therapy for PTSD and emotion-focused supportive therapy. American Journal of Psychiatry, 171(3), 294-304.

Jones, M. G., Rice, S. M., & Cotton, S. M. (2019). Incorporating animal-assisted therapy in mental health treatments for adolescents: A systematic review of canine assisted psychotherapy. PloS One, 14(1), 1-26.

Kim, O., Hong, S., Lee, H. A., Chung, Y. H., & Lee, S. J. (2015). Animal assisted intervention for rehabilitation therapy and psychotherapy. In M. Saad (Ed.), Complementary therapies for the body, mind and soul (pp. 147-161). London, UK: InTech.

Levin, A. P., Kleinman, S. B., & Adler, J. S. (2014). DSM-5 and posttraumatic stress disorder. Journal of the American Academy of Psychiatry and the Law, 42(2), 146-158.

Talbot, L. S., Maguen, S., Metzler, T. J., Schmitz, M., McCaslin, S. E., Richards, A.,… Varbel, J. (2014). Cognitive behavioral therapy for insomnia in posttraumatic stress disorder: A randomized controlled trial. Sleep, 37(2), 327-341.

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