Counseling is essential for handling issues related to Post Traumatic Stress Disorder (PTSD). The condition has been ranked as one of the most expensive mental health disorders due to its complexity. Most of the time, people experience this disorder as a result of past experiences that were not pleasant, and the condition may drastically affect the day-to-day activities of its victims. In our current scenario, Theo, a 6-year-old African American male, is currently experiencing the same condition, and it is significantly interfering with his daily activities. Theo began having the disorder after a near head-on collision about six months ago. The condition has affected his usual behavior, which has raised significant concerns for his parents and teachers. The research paper thus seeks to analyze Theo’s condition, identify developmental and systemic issues, and offer possible treatment options for Theo. Moreover, the paper utilizes multicultural and psychological theories to explain Theo’s condition better.
Client Concerns
Some of the symptoms that indicate that Theo is experiencing PTSD include sleep disturbances, nightmares, avoidance behavior, hypervigilance, and startle response, as well as emotional and behavioral changes.
From the case study, Theo has been described to be experiencing trouble sleeping due to frequent nightmares that are related to near head-on collisions. The nightmares result in Theo waking up full of fear. Due to this fear, Theo has trouble going back to sleep. As a result, his sleep pattern has been dramatically affected, leading to fatigue and restlessness throughout the day.
Furthermore, Theo has been avoiding participating in activities he once enjoyed. His mother says she bought Theo a new video game he still needs to play. It is contrary to his previous behavior, as she would always shout at him to stop playing video games as his screen time was over. He also avoids attending gatherings and engaging other students despite being very social and engaging. This type of behavior is mainly seen in people who are experiencing PTSD.
Additionally, Theo has been very keen while driving on the highway. In the case study, Theo is described as sitting in the middle of the back seat to help his parents spot cars that are coming at them. He is vigilant, always looking for potential danger due to the fear of another tragic event. Moreover, he screams and covers his head with his hands even when the vehicle is in its lane. Such kind of behavior indicates that Theo is still in trouble with the events of the near head-on collision.
Lastly, there has been a lot of behavioral and emotional change in Theo. He plays aggressively with his toys, slamming them against each other and flipping them over. His teacher has cautioned him from playing aggressively as other students are backing away from him as if they do not want to get hit by a flying car. Moreover, his academic performance could have been better despite being an honor student during the first quarter of the first grade. The poor performance has been linked to Theo being distracted most of the time. It has resulted in Theo experiencing difficulty completing his spelling worksheets. Furthermore, he needs help with sitting quietly in class.
Assessment
Theo has been diagnosed with a traumatic disorder that is affecting his daily activities. To assess his situation further, counselors may utilize the RESPECTFUL model to gain more insights concerning handling the situation (Harrichand et al., 2020). Some significant aspects to be analyzed by the model concerning Theo include Religious and spiritual identity, economic background, sexual identity, psychological maturity, ethnic and racial identity, chronological challenges, trauma and threats to wellbeing, family background and history, unique physical characteristics and location of residence and language differences. Obtaining the data using the abovementioned model may help arrange how Theo can begin therapy and track the healing process effectively. Moreover, the model is comprehensive and thus would be very important in our current scenario.
Diagnostic Impression
Primary Diagnosis
Post-Traumatic Stress Disorder
Signs and Symptoms
| DSM-5 Diagnostic Criteria for PTSD | Client Signs/Reported Symptoms |
| Criterion A: Exposure to threatened death | She was screaming and holding hands over her head after seeing oncoming vehicles while driving on two-lane roads. |
| Criterion B: Recurrent dreams about the traumatic event | Theo was experiencing nightmares about the traumatic event and woke up immediately before the crash. |
| Criterion C: Persistent avoidance of activities that arouse distressing memories (Carmassi et al., 2020) | Theo was playing video games before the accident. He is afraid of playing video games again because he is worried that something terrible will happen if he plays the game. |
| Criterion D: Reduced interest and participation in significant activities | Theo’s performance has dramatically declined because he cannot sit quietly in class.
Most of the time, he is distracted in class and has difficulty completing his assignments. |
| Criterion E: Arousal and reactivity due to traumatic events | Theo was hypervigilant while driving on two-lane roads. He sat in the middle of the back seat to help his parents spot oncoming vehicles. |
Developmental Theories and Systemic Factors
Theo’s condition may be better understood through various developmental and systemic theories. At his current age, Theo is facing an “Initiative vs. guilt” psychological development (Orenstein & Lewis, 2022). The theory states that for initiative, children are more open to trying new things, and when they make mistakes, they do not consider it as their fault. As for guilt, children are afraid of trying new things because they are afraid of being judged.
In our scenario, Theo is currently feeling guilty for the occurrence of the accident. He feels this way because his mother was yelling at him to stop playing video games before the accident. It is likely that if Theo had not been playing the video games as instructed by his mother, the traumatic event would not have occurred. The guilt is evident as he stops being interested in video games despite his mother obtaining new games for Theo to play. Furthermore, the author states that at this phase, the child starts to try to control his environment. Trying to do this poses a risk of failure, which leads to guilt. Theo is seen trying to help his parents watch for any risk of oncoming vehicles by sitting in the middle of the back seat. He does this as he tries to control the risk of another traumatic event occurring because he feels guilty for the previous incident.
However, enrolling Theo in therapeutic interventions that handle such developmental issues may help generate coping strategies, which is possible through thoughtful analysis of the current systemic problems facilitating the developmental issue.
Multicultural And Social Justice Considerations
Some multicultural and social justice issues that may impact Theo’s treatment and recovery process are analyzed using the abovementioned RESPECTFUL model.
Theo’s family are Jehovah’s Witnesses, and their sense of religious belonging most likely affects how they make decisions. Identifying and respecting their views will thus be helpful in understanding how their beliefs impact Theo’s recovery process. Moreover, the financial capability of Theo’s parents directly impacts Theo’s treatment and recovery process. His parents’ financial constraints affect his access to resources and support services. In our scenario, Theo’s mother states that her husband’s insurance cover will cover six sessions of counseling. It is thus essential that the counselor is mindful of this financial constraint.
Furthermore, the counselor utilizes diverse sexual identities during the treatment process to ensure that all parties present do not feel offended. Another factor that ought to be considered is Theo’s age. He is current in his psychological development age, and thus, his emotional behavior should be highly considered while helping him overcome the traumatic events. Additionally, the fact that he is an African American male should be considered as it has a significant influence on how he views the world and perceives it. It is crucial that at this young age, the counseling is successful without hurting his racial and ethnic belonging.
The developmental challenges Theo is currently facing are also of great importance. The counselor must take a recovery approach that will enable him to take more initiative to boost his confidence. Moreover, it may help Theo overcome the death-threatening trauma of driving on the highway, which is a threat to his wellbeing. The recovery process may thus be accelerated by understanding his family background as he is an only child. The family may have a significant impact on his coping mechanism due to how he relates with his parents. It would be advisable to alert his parents and to use a friendly tone during his recovery process.
Lastly, Theo’s physical condition must be monitored closely despite not being injured in the accident. It is essential to keep track of his physical condition in order to note whether there are any signs of self-infliction during the recovery process. Furthermore, it is essential to ensure that Theo is in a friendly environment to accommodate his current condition. A friendly environment is essential as it will help Theo recover.
Treatment Recommendations
Key Issues for Treatment
- Impaired functioning at school
- Arousal reactivity
- Trauma-induced threatened death
- Experiencing nightmares
Recommendations For Individual Counselling
I recommend that Theo enroll in cognitive behavioral therapy (CBT) and exposure therapy.
- Cognitive Behavioral Therapy (CBT): This type of therapy is beneficial for a person diagnosed with PTSD. Cognitive behavioral therapy helps alter the patients’ thinking concerning the traumatic event (Scott et al., 2023). The therapy may help enlighten Theo about the toxic thoughts about the traumatic event that is currently worsening his condition. Furthermore, it may help him overcome the fear of another accident occurring while enabling him to overcome his guilt.
- Exposure Therapy: Exposure therapy has been deemed more effective than medication (McLean, 2022).This kind of therapy may help Theo gain control of his thoughts and feelings concerning the accident. It may help make him feel comfortable while traveling on two-lane roads. Gaining control of his thoughts and feelings may help him sleep better at night while reducing his arousal reactivity to oncoming vehicles.
Conclusion
Theo must visit a counselor with experience in treating PTSD. Counseling sessions may help Theo cope with his current condition and thus reduce the effects of this traumatic condition on his everyday life routines. Cognitive behavioral and exposure therapy can help in helping Theo with his recovery process. The therapy sessions may help him express his feelings as well as give his opinions concerning the traumatic events.
References
Carmassi, C., Bertelloni, C. A., Cordone, A., Cappelli, A., Massimetti, E., Dell’Oste, V., & Dell’Osso, L. (2020). Exploring mood symptoms overlap in PTSD diagnosis: ICD-11 and DSM-5 criteria compared in a sample of subjects with Bipolar Disorder. Journal of affective disorders, 276, 205-211.
Critical role of counseling for PTSD treatment: Wake Forest University. WFU Online Counseling. (2020a, July 17). https://counseling.online.wfu.edu/blog/the-critical-role-of-counseling-for-ptsd-treatment/
Harrichand, J. J., Kirk, K., & Mwendwa, J. M. (2020). Deepa’s discovery: Examining intersectionality when multiple identities collide—Managing family roles, doctoral work, and clashing Eurocentric worldviews.
McLean, C. P., Levy, H. C., Miller, M. L., & Tolin, D. F. (2022). Exposure therapy for PTSD: A meta-analysis. Clinical psychology review, 91, 102115.
Orenstein, G. A., & Lewis, L. (2022). Eriksons stages of psychosocial development. In StatPearls [Internet]. StatPearls Publishing.
Scott, A. J., Bisby, M. A., Heriseanu, A. I., Salameh, Y., Karin, E., Fogliati, R., … & Dear, B. F. (2023). Cognitive behavioral therapies for depression and anxiety in people with chronic disease: a systematic review and meta-analysis. Clinical Psychology Review, 102353.
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