Case Analysis and Strategies of Intervention Plan

Part A- Case Analysis

War is a serious and disastrous event which takes place due to differences and conflicts arising from political interests, human rights issues or abuse of power etc. These events are sudden or preannounced affecting different sections of the country. It often leads to loss of human lives and depletes the finances of the country.

According to Khamis (2015), the demographics of the war are majorly the youth of the country. The war takes places with the help of military forces, which comprises of the youth of the country because they are sent to the war field to fight with the opponents, the stronger the forces are, the greater the power resides. The families of the country irrespective of their choice are often forced to send their sons to fight for the country with no hope of getting them back. Youths are the upcoming future of the country, but the war in the country takes away all of them which causes trauma in their minds of losing their loved ones, their children and families ultimately leading to psychological distress. The trauma not only spreads to the youth but to their family members as well as hindering their daily lives. It has negative effects on their mental health, their emotions and their behavioral pattern.

This kind of trauma is complex in nature because it has multiple effects such as sexual assault, a continuous pattern of stress in the minds of the youth and its families which often leads to depression, anxiety and panic attacks, a ruckus in the country. These wars take away their children irrespective of the gender are used to kill and commit acts of violence. The effects of the war are long term in nature and often hard hitting to the families, their children and the upcoming generations.

The groups affected are also the families of the soldiers who majorly are youths as they are more energetic compared to other sections of the society thereafter it takes their families and their children which continues from generations to generations. The trauma of losing the loved one’s spreads over years which is usually more than it is expected hampering the physical and the mental health of the society. As per the author LeBoutillier, McMillan, Thibodeau & Asmundson (2015), the war trauma leads to Post Traumatic Stress Disorder (PTSD) which is a kind of a mental disorder when the people living in the war zone region gets effected due to the war for a long period of time. The effects of such trauma give birth to many other corrupt and illegal activities such as Stealing which is due to loss of proper food and shelter which arises due to distress in the country, murder or rape because they young minds fail to understand what is right and what is wrong, they suffer emotionally and mentally which in turn leads to depression.

According to Al-Borno (2019), the effects of war leads to chains of other illogical behavior and crimes in the young minds, which affects other human minds in the long run? The effects lead to suicidal thoughts declining the population which further increases the death rate, as youth are more prone to suicidal thoughts. 

According to Carta, Moro& Bass, (2015)Other effects of war is the physical health of the individual which leads to a malnutrition in the children of the country, because supply of essential goods are completely cut off as seen in Yemen and South Sudan. Further outspread of other diseases like typhoid, diarrhea etc. due to irregular supply of potable and contaminated water systems. In chemical blasts in Middle East countries, had degraded the quality of air, water and environment, which became the main cause of widespread diseases. As per Hutchison, & Bleiker, (2015), Serious of emotional traumatic stress place in all the sections of the society, the women, children and the youth which in long run hinders the overall development of the society and the economy.

As per Åhäll, & Gregory (2015), war benefits the political leaders who take decisions and outbreak  the war not realizing it effects affecting the whole population irrespective of the age groups hampering the social and economic activities, hinders the businesses and trade, hurting the sentiments of young minds which is also one of the reasons of trauma caused due to war.

According to the author Shpigelman & Gelkopf (2019) the impact of the war leads to terror in the individual groups, many disabilities they become physically disable remain unemployed and family treats them as burden as they are unable to support the mouths of the family which also leads to trauma and distress in the minds of the individuals of the country. The most affected community is the children as per Meiqari, Hoetjes, Baxter, & Lenglet (2018), during the war there is no proper  facilities, no proper medication, lack of nutrition due to unrest in the country, they lose parental support and attention, outbreak of diseases leads to psychological trauma  for the women of the community as a whole because they become helpless in such situations as men are on the war land in different countries, many indulge in illogical activities to meet the basic requirements of the family. These situations lead the children to go on the wrong way as there is no one around to take care of them who are going to be the youth icons of the country. War has more of negative impact in the country than one can fathom disrupting the peace and causing distress to the whole nation affecting countries, the youth and the children at large.

Part 2- Strategies of Intervention Plan

Several psychological therapies are available for people suffering from traumatic events due to exposure to war which includes both trauma-based and non-trauma-based interventions. Trauma-focused therapies specifically address traumatic event or thinking memories and emotions and feeling connected to a traumatic experience. The treatments which are focused on trauma, for instance, involve PE or Prolonged Exposure and CPT or cognitive processing therapy (Watkins, Sprang & Rothbaum, 2018). Non-trauma-focused therapies are aimed at reducing symptoms of traumatic events but are not targeted specifically at traumatic feelings, recollections and emotions. Instances of non-traumatic therapies include SIT, interpersonal therapy, and relaxation (Watkins, Sprang & Rothbaum, 2018). According to the American Psychological Association, most effective and strongly recommended treatments for this type of scenarios are Cognitive Processing Therapy and Cognitive Behavioral Therapy (American Psychological Association, 2019).

Cognitive Processing Therapy or CPT is a certain kind of cognitive behavioral treatment that enables patients to learn how to adjust and to fight unconstructive trauma-related beliefs. Cognitive Processing Therapy assumes that survivors try to understand what happened after a traumatic event. This often leads to skewed awareness about themselves and people and the environment around them (Watkins, Sprang & Rothbaum, 2018). Cognitive Processing Therapy takes place generally through 12 meetings and allows patients to question and change unconstructive trauma beliefs. This introduces a new conception and comprehension of the traumatic experience such that the continuing adverse effects on present life are reduced (Campbell et al., 2016). As an effective treatment for PTSD (Posttraumatic stress disorder), CPT has been widely supported. While CPT has been designed to treat rape survivors, this therapy has been implemented effectively across different trauma types and demographics (Chard et al., 2012). Findings of the recent studies suggest that the effectiveness of CPT treatment of PTSD among the veterans of Vietnam, Iraq and Afghanistan war (Chard et al., 2011). The effectiveness of treating PTSD, anxiety, and depression in veteran populations were found to be clinically significant.

Cognitive behavioral therapy or CBT focuses on the relations between thinking, behavior, and feeling. It focuses on current issues and symptoms and on modifying behavioral patterns, thoughts, and senses which leads to operational difficulties. CBT or Cognitive behavioral therapy records how alterations in one area can enhance the way others work. Changing a person’s ineffective thinking, for instance, can lead to improved behaviors and regulation of emotions (Watkins, Sprang & Rothbaum, 2018). It is generally provided in individual or group format in 12 to 16 sessions. Research supports the efficacy of the trauma-focused Cognitive Behavioral Therapy for PTSD which is reliable with the recommendations of the strategy. It was shown that Cognitive Behavioral Therapy was better than a waitlist, self-help book and support therapy. The researchers compare various components of Cognitive Behavioral Therapy (such as in vivo exposure, imaginary exposure, and cognitive restructuring) with certain combined results (Ung et al., 2015). In a study, it has been reported that 61 to 82.4 percent of Cognitive Behavioral Therapy patients lost their PTSD diagnosis which is 26 percent more PTSD diagnosis loss in comparison with waitlists or supportive counseling (Jonas et al., 2013).

There are three phases of recovery for the patients receiving treatments. Phase one is ‘Safety and Stabilization’. Trauma affects people generally feel unsafe in their body and their interactions with others. It might take days or even weeks for people who have suffered trauma, or months to years with people who have suffered continuous or chronic abuse to gain a sense of safety. It would be helpful for them to understand what areas of life must be stabilized and how this is to be done (Bosmans et al., 2015). The second phase of recovery is ‘Remembrance and Mourning’. This objective translates into the treatment, emotion, and understanding of the trauma. This is generally done in a group or other individual therapy with a consultant or therapist. And, the last phase is ‘Reconnection and Integration’.  A new sense of identity and a new phase must be created in this phase. This final challenge requires the patients to redefine themselves in constructive relations (Boyle et al., 2014).

One of the most common barriers of trauma-focused therapy is discontinuation or dropout and this dropout rates in prolonged exposure, Cognitive Processing Therapy, and trauma-focused Cognitive Behavioral Therapy appear to be similar. A great number of people leave treatment with PTSD (Imel et al., 2013). A meta-analysis of therapy drop-outs in PTSD was performed by Imel et al. (2013). However, there was a large variability across trials in the cumulative percentage of drop out of all active therapies at 18.28 percent. The dropout rate varies among active PTSD interventions in studies, however, the disparities were mainly driven by study results.

References:

Åhäll, L., & Gregory, T. (Eds.). (2015). Emotions, politics and war. Routledge.

Al-Borno, Y., Shaqqoura, S., Skaik, N., Giil, L. M., & Gilbert, M. (2019). Pain, Psychological Distress and Deteriorated Family Economy Follow Traumatic Amputation Among War Casualties in Gaza.

American Psychological Association. (2019). Treatments for PTSD. Retrieved from https://www.apa.org/ptsd-guideline/treatments

Bosmans, M. W., Hofland, H. W., De Jong, A. E., & Van Loey, N. E. (2015). Coping with burns: the role of coping self-efficacy in the recovery from traumatic stress following burn injuries. Journal of behavioral medicine38(4), 642-651.

Boyle, E., Cancelliere, C., Hartvigsen, J., Carroll, L. J., Holm, L. W., & Cassidy, J. D. (2014). Systematic review of prognosis after mild traumatic brain injury in the military: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Archives of physical medicine and rehabilitation95(3), S230-S237.

Campbell, M., Decker, K. P., Kruk, K., & Deaver, S. P. (2016). Art therapy and cognitive processing therapy for combat-related PTSD: A randomized controlled trial. Art Therapy33(4), 169-177.

Carta, M. G., Moro, M. F., & Bass, J. (2015). War traumas in the Mediterranean area. International journal of social psychiatry61(1), 33-38.

Chard, K. M., Schumm, J. A., McIlvain, S. M., Bailey, G. W., & Parkinson, R. B. (2011). Exploring the efficacy of a residential treatment program incorporating cognitive processing therapy‐cognitive for veterans with PTSD and traumatic brain injury. Journal of traumatic stress24(3), 347-351.

Hutchison, E., &Bleiker, R. (2015). 16 Grief and the transformation of emotions after war. Emotions, Politics and War, 210.

Imel, Z. E., Laska, K., Jakupcak, M., & Simpson, T. L. (2013). Meta-analysis of dropout in treatments for posttraumatic stress disorder. Journal of consulting and clinical psychology81(3), 394.

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