Reason for Seeking Treatment
The client entered the treatment after being referred to by their brother, who has been observing the worrying behavior of his sister for several weeks.
Background Information
The client is a young Caucasian woman named Helen Right from the United States of America. Helen is not married and studying accounting and finance at a university. Two months ago, Helen was involved in a serious car accident that led to the death of both of her parents. After getting her driver’s license, Helen drove the car and showed her skills to her parents. Helen was not at fault because her car was hit by another driver. As a result of the event, Helen began to suffer from depressive symptoms and decided to avoid any social contact. Her brother is the only person she talks to, yet their communication is limited because Helen spends most of her time locked in her room.
History of the presenting complaint
There are several notable symptoms suffered by the client; the main one is that Helen has recurrent memories of the tragic event, which make her upset. As reported by Helen, she remembers every detail of the moment when another driver hit her car. Moreover, sometimes she experiences such memories simply when she sees or hears cars driving outside her house. Additionally, Helen gets occasional nightmares which are often related to the accident and in which she sees her happy parents sitting in the backseat. Essentially, the sight of cars outside her window causes her distress to rise, and she begins crying. During such moments, she does not want to talk to anyone, including her brother, and prefers to stay completely alone. Nevertheless, there are certain days when she manages not to think of the accident.
Although she cannot completely avoid remembering the accident in detail, Helen intentionally refuses to interact with cars in any way. As a result, her brother cannot drive her to the hospital because it becomes particularly stressful for Helen when she finds herself in a vehicle. Helene prefers not to talk extensively about her feelings, but according to her brother, she still blames herself for the death of her parents. At some point, Helen’s brother tried to explain to her that it was not her fault, and it seemed that she understood, yet the next day she continued to blame herself. Helen lost interest in all activities, including her education, and generally cannot experience any positive feelings. Helen reports having problems with her sleep and needs to take insomnia medication to help herself fall asleep.
She also needs to have light in her room since she has become afraid of the dark, especially at night. Helen has been having the aforementioned symptoms for more than one month. According to her brother, Helen became depressed after hearing the news about the death of her parents. The current state prevents her from engaging in any type of academic or occupational activity because she fails to do basic tasks requiring concentration.
Other pertinent information
As mentioned above, Helen was involved in a car accident, yet, unlike her parents, the young woman only suffered a mild concussion. Before the tragic event, Helen was a positive person who had many friends and a good relationship with her parents. Helen never had any problems with substance abuse and always tried to adhere to a healthy lifestyle. The only medication Helen takes is sleeping pills, and its dose is standard, one pill every time Helen has a problem falling asleep.
Diagnosis
Based on the symptoms of Helen, reported by herself and her brother, Helen meets the DSM-5 (American Psychiatric Association, 2013) criteria for Post-Traumatic Stress Disorder (PTSD). In order to be diagnosed with the condition, the patient needs to have a traumatic experience which, in the case of Helen, was the car accident and the death of her parents (Nevid et al., 2021). Additionally, the patient needs to have recurring memory episodes of the traumatic event, which is also relevant for Helen since she often remembers the accident’s details and the moment prior to it. Moreover, Helen also has nightmares which are based on her experience of the accident. Another criterion of PTSD is avoidance which is also present in Helen’s case since she refuses to drive in a car (American Psychiatric Association, 2013). The blame on oneself is the next major criterion of PTSD, and it is visible in Helen’s behavior because she believes that it was her fault that her parents died. The fact that the symptoms have been affecting Helen for more than one month also proves the diagnosis.
Recommendations for Treatment
Since Helen’s case is clear, it is possible to develop a treatment plan which will address the condition of PTSD. Although there are several effective treatment options, Helen will be offered two options: cognitive-behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR). The study by Khan et al. (2018) demonstrated that both interventions were equally effective in reducing the symptoms of PTSD, including anxiety and depression. Thus, CBT and EMDR will be the primary treatment methods for Helen.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.) Arlington, VA: American Psychiatric Publishing.
Khan, A. M., Dar, S., Ahmed, R., Bachu, R., Adnan, M., & Kotapati, V. P. (2018). Cognitive behavioral therapy versus eye movement desensitization and reprocessing in patients with post-traumatic stress disorder: Systematic review and meta-analysis of randomized clinical trials. Cureus, 10(9), 1–17.
Nevid, J., Rathus, S., & Greene, B. (2021). Abnormal psychology in a changing world (11th ed.). Pearson.
