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The purpose of this paper through looking at complementary or alternative therapies and ways in which people need to be educated about PTSD due to the fact that Post-Traumatic Stress Disorder (PTSD) is a vastly growing epidemic. Due to current wars it has only currently been brought to the front of discussion. Even though not directly mentioned it can be found in the Bible. The paper briefly defines what the "goal standard therapies" or go to therapies for PTSD are; which are Prolonged Exposure and Cognitive Processing Therapy or Cognitive Behavior Therapy.
Followed by how many times these therapies are not the best for some that are diagnosed with PSTD, leaving them looking for complementary or alternative therapies, such as therapeutic recreation therapy (high intensity sports or fly-fishing) mind/body therapy (pressure point, yoga, or mediation); out of the box therapies such as cannabis (if state legalized), art therapy, music therapy even smart phone application (coaching) therapy.
Additionally, people may need to be educated or reeducated based on knowledge of trauma and treatments along with such things that are associated with PTSD such as the "stigma paradox, and secondary PTSD".
This is followed by understanding what policy changes there are currently and what improvements may be required. Finally, discussing preventative measure and hoe to improve the quality of life for those living with or caring for those with PTSD.
The Ins and Outs of PSTD: Alternative Therapies and Education Among Military Communities
Post-Traumatic Stress Disorder (PTSD) is defined as a "psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event," (Parekh, 2017).
PTSD is "a personal, social, economic burden of human suffering, that many consider to be costly, in treatments, disability compensation and productivity loss," (Lake, 2015). "While some scholars believing that the responses to trauma is a single event but are products of social, institutional and technological environment that are exist and are understand," (Fisher, 2014).With approximately, "60% of men and 50% of women will experience some type of trauma, 78% of these people will develop PTSD," (Nolan, 2016). Symptoms of PTSD can include however, are not limited to "nightmares, difficulty sleeping, avoidance of loved ones, inability to fully relax, heightened awareness of the persons surroundings, and inability to enjoy or participate in activities they once enjoyed," (Bennett, Piatt, & Van Puymbroeck, 2017). Additionally, because of the symptoms associated with PTSD those with PTSD often struggle with other issues such as "martial and/or parenting issues, domestic violence, substance abuse, homelessness and are at a greater risk of suicide." (Church, 2014). "Some people may be at a greater risk for developing PTSD, those are women, racial or ethnic minorities or people with personal or family history of mental health issues, those that have been repeatedly exposed to trauma, and those that do not have strong social support after trauma," (Nolan, 2016).While "no one person understands how PTSD can affect some people while not effecting others there is still at greater debate on what is the best treatment for trauma," (Lake, 2015). Treatments are often therapy based and done within healthcare facilities, (Bennett, Piatt, & Van Puymbroeck, 2017).
Government agencies such as the Veteran's Administration (VA) as it will be referred to for the remainder of this paper are " the first health care systems to utilize evidence-based therapies such as Cognitive Processing also known as Cognitive Behavior therapies (CPT/CBT) or Prolonged Exposure (PE) therapy as the first line or gold standard of therapies." (Osei-Bonsu et al., 2016). Currently, "over 95% of VA medical facilities utilize one if not both of these therapies to treat patients for PTSD," (Osei-Bonsu et al., 2016). Unfortunately, of the "roughly 20.4 million US veterans" (Bialik, 2017); only "15% of veterans are utilizing or receiving any treatment for PTSD," (Osei-Bonsu et al., 2016). There are also a number of things to be considered when a person enters into treatment therapy for PTSD, those are "is the patient willing and ready to begin therapy, do they show that they have coping skills, and are there additional issues that need to be met prior to therapy such as addiction" (Osei-Bonsu et al., 2016). The biggest goals for the VA when helping veterans seeking treatment for PTSD are "for the patient to be an active participant through giving the patient knowledge and treatment options so that they can be part of the decision-making process and to help build a therapeutic relationship between the care team and the veteran, thus allowing for a positive action" (Osei-Bonsu et al., 2016). However, not all people fit into the criteria of traditional therapies, therefore "there is often debate over effectiveness and harmful side effects of traditional therapies, leaving many including the VA are looking at alternative or holistic treatments for PTSD," (Bennett, Piatt, & Van Puymbroeck, 2017). It is important to understand that "PTSD is an illness; however, it will not go away over time, and those that suffer with PTSD still show signs and symptoms years even decades after the initial trauma," (Church, 2014) Need 3465words
There are at least two examples in the Bible of men having symptoms of PTSD the first is King Saul who one could say was exposed to combat. In 1 Samuel 14:47 it states, "After Saul had assumed rule over Israel, he fought against their enemies on every side: Moab, the Ammonites, Edom, the kings of Zobah, and the Philistines. Wherever he turned, he inflicted punishment on them." Later in 1 Samuel 14:52 it states, "All the days of Saul there was bitter war with the Philistines, and whenever Saul saw a mighty or brave man, he took him into his service." As the wars progressed you can see in 1Samuel 16:14 how King Saul was tormented by is hallucinations, "Now the Spirit of the Lord had departed from Saul, and an evil spirit from the Lord tormented him". This is one noted symptom of PTSD. However, one could also say that he was being treated for PTSD through what we currently call a complementary or alternative therapy that being music 1 Samuel 16:23 shows "Whenever the spirit from God came on Saul, David would take up his lyre and play. Then relief would come to Saul; he would feel better, and the evil spirit would leave him." The relief was not enough and in 1 Samuel 31:4 "Saul said to his armor-bearer, 'Draw your sword and run me through, or these uncircumcised fellows will come and run me through and abuse me.' But his armor-bearer was terrified and would not do it; so, Saul took his own sword and fell on it." Even in the Bible PTSD lead to suicide as it still can potentially today, other issues that PTSD can cause include "Alcohol and drug abuse, reliving terror, heart attacks, depression, dementia, stroke and suicide," ("Has PTSD Become an Epidemic?" 2018).
Additionally, within in the Bible Job could have been classified as suffering from PTSD. Job encountered, the death of family, crops dying and everything taken away from him. In Job 3:25-26 it states, 25"What I feared has come upon me; what I dreaded has happened to me.
26 I have no peace, no quietness; I have no rest, but only turmoil." Whereas in Job 7:14-16 it shows what symptoms of PSTD Job has such as hallucinations, contemplating suicide and hopelessness 14 "even then you frighten me with dreams and terrify me with visions,15 so that I prefer strangling and death, rather than this body of mine.16 I despise my life; I would not live forever. Let me alone; my days have no meaning." However, as stated later in Job 13:15-28 Job remains faithful to God even though, Job further notes "that mans wastes away like something rotten," because they do not but faith in God above all else. Job showed that with mindfulness he understood that God was the greater power and oversaw all things, which allowed him to overcome his suffering. One could say that King Saul benefitted even in short term by the Complementary and Alternative therapy, known as music therapy. Of the "170 VA PTSD treatments 96% of these programs offered at least one Complementary and Alternative Medicine therapy which can include mindfulness, stress management/relaxation, yoga, guided imagery, spiritual practice theory and recreational therapy," (Lake, 2015).
The benefits of Complementary and Alternative medicine therapies to include therapeutic recreation therapy are "that they may reduce symptoms of PTSD, in a non-threatening setting, allowing for veterans to develop coping skills and positive support," (Bennett, Piatt, & Van Puymbroeck, 2017). Fly-fishing therapy can benefit PTSD suffers, while teaching "basic camping and fly-fishing techniques through providing the return of self-determination and motivation, while also provide a sense of "camaraderie and confidence," (Bennett, Piatt, & Van Puymbroeck, 2017). Additionally, fly-fishing can "increase leisure satisfaction which can increase leisure activity participate thus impacting and improving the veteran's overall well-being," (Bennett, Piatt, & Van Puymbroeck, 2017). Need 3336
Equine assisted therapy has the potential to "help treat PTSD symptoms as well as anxiety," (Earles, Vernon, & Yetz, 2015). Horses "are immensely responsive to human behavior, thus may provide instant feedback to nonverbal behavior, making one aware one's one behavior and emotions," (Earles, Vernon, & Yetz, 2015). During initial equine-assisted therapy clients/patients met the horses during which time they "work on developing no-critical self-awareness, while improving concentration and listening skills," (Earles, Vernon, & Yetz, 2015). Following the initial sessions, clients/patients "learn about the effects of actions, body language setting relationship boundaries, and creating safe places, while learning focusing techniques ", (Earles, Vernon, & Yetz, 2015). During the last sessions the clients/patients "review techniques in how to deal with challenges and stressful situations, learning coping skills while exploring inner mindfulness," (Earles, Vernon, & Yetz, 2015). Need 3226
During combat, service members often experience a euphoric high, due to the continued feeling of "fight or flight" because of this when veterans return home from combat zone they feel as if they are "invincible" (Rogers, Mallinson, & Peppers, 2014). To stay in this euphoria veterans "often become impulsive or 'adrenaline junkies' this can lead to risky behavior, which can include substance abuse," (Rogers, Mallinson, & Peppers, 2014). "High intensity sports therapies" such as snowboarding, rock climbing or surfing, etc. "can be more socially acceptable then risky behavior," (Rogers, Mallinson, & Peppers, 2014). Additionally, "high intensity sports can 'balance fear against skill and experience' through psychological and environmental pattern challenges that can provide a support system and a way to explore and learn how to deal with stress while in a stressful situations, this can lead to helping veterans make transitional life changes," (Rogers, Mallinson, & Peppers, 2014). During community-based ocean therapy veterans not only learn how to surf, but they also receive focus group processing and are able to so in a social setting (Rogers, Mallinson, & Peppers, 2014). At which time veterans are able to "explore PTSD issues such as loneliness, hyper vigilance in a supportive environment," (Rogers, Mallinson, & Peppers, 2014). There is a "73% completion rate among those that participate in ocean therapy who have PTSD," (Rogers, Mallinson, & Peppers, 2014). However, the biggest drawback to high intensity sport therapy is often location. Need 3024
Another type of therapy that could be effective in treating PTSD is Emotional Freedom Techniques (EFT). In EFT therapy, therapist use pressure point therapy, "this involves using tapping, rubbing or pressing on acupoints (which are channel points that lie within the body) while focusing on traumatic memories," (Church, 2014). Generally speaking EFT therapy is a therapy that is done in "two part, the first is split into six separate sessions and the second is a five-day intensive therapy," (Church, 2014). Studies have shown that of the "83% of veterans that participated and presented symptoms of PTSD prior to treatment therapy dropped to 28% still exhibited severe PTSD symptoms after therapy," (Church, 2014). Many of these participants "also self-reported that their pain that is associated with PTSD was reduced following treatment," (Church, 2014).
With the "increased interest in mind-body therapies especially in treatment for PTSD, people may utilize mindfulness-based stress therapy, relaxation, yoga and tai chi which require active involvement, minimal equipment and are often group related," (Niles et al., 2018). Mind-body therapies can also be individual and less active these can include "massage, acupuncture and meditation therapy which can greatly reduce PTSD symptoms," (Niles et al., 2018). During mindfulness therapy a patient/client uses "mantra repetition, which shows signs of reduction in those that have been clinical assessed with PTSD symptoms," (Niles et al., 2018). Both mindfulness-based stress reduction therapy which provided to be a greater asset in the reduction of PTSD symptoms over center group therapy, and relaxation therapy which provided to be greater reduction then eye movement therapy showed greater improvement of symptoms in long-term therapy, (Niles et al., 2018).Need 2778
Cognitive Behavior Therapy (CBT) "may not address the issues related to interpersonal trauma (IPT) therefore people are often looking for alternative or complimentary therapies such as Trauma-Sensitive Yoga (TSY) to address the mental and physical aspects of trauma," (Nolan, 2016). Trauma-Sensitive Yoga sessions generally last between 30 minutes to 1 hour and are "done in a welcoming environment to reduce the sense of vulnerability and sense of safety," (Nolan, 2016). The differences between TSY and traditional yoga is that "the instructor of TSY is prohibited from touching the students, there is also emphasis on gentle soothing language instead of directional language," (Nolan, 2016). Furthermore, TSY students "can choose whether or not to participate in an activity, at any given time they can also choose not to participate in the end of class closed eye relaxation exercise,"
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