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On the whole, it should be stressed that SSgt Rodriquez is apparently suffering from the post-traumatic stress disorder (PTSD), which may occur after an individual has been exposed to a traumatic event (such as witnessing a death or injury during the war as a civilian or a soldier), and includes symptoms such as disturbing thoughts, dreams or feelings pertaining to the traumatic situation, changes in the thinking style, increased magnitude of the fight-or-flight response, and so on (American Psychiatric Association, 2013).
Clinical and Counseling Goals for Patient
Because SSgt Rodriquez is suffering from the PTSD, it is possible to set the following as the clinical goals for him:
- Understand the elements of the memories of the traumatic experiences that cause distress and anxiety in SSgt Rodriquez;
- Help the patient to avoid using the common coping strategies that only exacerbate the problem;
- Subject the experiences to additional reflection so as to reduce the capability of the memories to induce pathological behaviors in the patient.
The counseling goals will include:
- Helping the patient cope with the fact that others may display irrational behaviors in stressful situations;
- Helping SSgt Rodriquez to restore his relationships with his colleagues and his friends, which have been harmed by his anger management issues resulting from the PTSD.
In addition, SSgt Rodriquez should visit a physician for his headaches, which may be the result of some yet unidentified health condition caused by his concussion.
According to such authors as Ehlers et al. (2014), cognitive therapy may be highly effective for patients suffering from PTSD. It should be stressed that cognitive therapy is usually provided for the patient over the course of several months, but the study by Ehlers et al. (2014) provides evidence that intensive cognitive therapy over seven days (with daily sessions lasting 90-120 minutes) may be as effective as the standard therapy lasting several months. Because its effectiveness was demonstrated in studies (Ehlers et al., 2014), cognitive therapy will be selected for SSgt Rodriquez.
To reach the goals outlined above, it is needed to implement the following steps (Ehlers et al., 2014):
- Identify and change the overly adverse assessments of the traumatic experiences present in the patient (Ehlers et al., 2014). For instance, SSgt Rodriquez complained that his colleagues did not react adequately when a soldier’s leg was torn off. It is possible to elaborate that the colleagues were shocked and that such shock can also be understood as trauma; therefore, colleagues did not react adequately not because they were malicious or incompetent, but because they also were traumatized.
- Elaborate the whole memory pertaining to the traumatic event, and find out what exactly triggers SSgt Rodriquez to recollect and re-experience the whole event (Ehlers et al., 2014). For instance, it is possible that seeing his colleagues behave in a certain manner, or seeing them wearing a uniform, etc., may cause SSgt Rodriquez to re-experience the memory. If this is so, this problem needs to be addressed; the nature of the bond between the trigger and the memory needs to be disentangled and elaborated.
- Limit the utilization of cognitive methods that serve to sustain the existence of the issue (for instance, rumination or thought suppression; Ehlers et al., 2014). Such behaviors only cause the patient to e.g. re-experience the event, instead of dealing with the causes of it being so traumatic.
American Psychiatric Association. (2013). DSM-5: Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publishing.
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.