Identify strengths of your colleagues’ analyses and areas in which the analyses could be improved

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Respond to at least two Bridget & Shelby colleagues by doing all of the following:
Identify strengths of your colleagues’ analyses and areas in which the analyses could be improved. Address his or her evaluation of the efficacy and applicability of the evidence-based practice, his or her identification of factors that could support or hinder the implementation of the evidence-based practice, and his or her solution for mitigating those factors.
Offer additional insight to your colleagues by either identifying additional factors that may support or limit implementation of the evidence-based practice or an alternative solution for mitigating one of the limitations that your colleagues identified.
Bridget Laney
RE: Discussion – Week 2
Generating Support for Evidence-Based Practices
The Case of Jake
In the case of Jake Levy, he would benefit from engaging in Eye Movement Desensitization and Reprocessing (EMDR) therapy. Jake is a 31-year-old veteran who has been diagnosed with Posttraumatic Stress Disorder (PTSD). Hurley (2018) found that in 18-20 sessions with veterans diagnosed with PTSD and have symptoms of disassociation and moral injury issues. In 1998 Carlson et al. found that within 12 EMDR sessions, veterans had 76% fewer symptoms of PTSD (Hurley, 2018). EMDR therapy allows the client to engage in bilateral stimulation to process their trauma.
Implementation Issues
Although Macklin et al. (2000) found that ten sessions of EMDR therapy were not enough to decrease trauma symptoms, ten sessions of any type of therapy are not enough to decrease trauma symptoms. When treating trauma, time and commitment are made with both the client and therapist. To effectively treat PTSD symptoms, ongoing routine sessions must occur as well as a follow-up session to ensure the overall wellbeing of the client. EMDR would be an appropriate treatment for Jake due to his severity of trauma and the effectiveness this intervention has on clients with severe PTSD symptoms. War veterans should not be subjected to selected sessions to overcome the severity of trauma endured. Instead, clients should be provided with support and encouragement to continue ongoing sessions to decrease overall symptomology.
Necessary Factors and Potential Barriers
Routine follow-ups should be implemented with all clients diagnosed with PTSD. Ongoing sessions ensure that the client continues to work and heal through their trauma, instead of being discharged after select sessions. Additionally, comfortability of the client should be considered. EMDR therapy has been effective in treating clients diagnosed with PTSD.
Russell (2008) studied the effectiveness of EMDR therapy with war-related trauma diagnosis. The study found that some combat veterans were resistant to this type of therapy intervention (Russell, 2008, p. 1736). Resistance and hesitance to try EMDR therapy could be a potential barrier, especially for older combat veterans. However, Jake is 31-years-old and might be open to the idea. Due to EMDR being relatively new to therapists, there is limited research on EMDR and its effectiveness on combat veterans. For obvious reasons, this should be examined and researched further with a broader range of sessions provided to the client.
Conclusion
If EMDR was implemented correctly and routinely, Jake Levy would benefit from this type of intervention modality. Several interventions work for various individuals and diagnoses. However, if treatment is not routine and the intervention is not implemented correctly, effects may vary. If presented and explained thoroughly, Jake could benefit from EMDR therapy. I believe Jake would be less resistant to EMDR therapy than older combat veterans. Additionally, I would remind Jake that if he did not feel comfortable with this intervention, at any time, then an alternative intervention would be utilized. As his therapist, I would not want to force an intervention if the client is uncomfortable.
References
Hurley, E. C. (2018). Effective treatment of veterans with PTSD: Comparison between intensive daily and weekly EMDR approaches. Frontiers in psychology, 1458.
Macklin, M. L., Metzger, L. J., Lasko, N. B., Berry, N. J., Orr, S. P., & Pitman, R. K. (2000). Five-year follow-up study of eye movement desensitization and reprocessing therapy for combat-related posttraumatic stress disorder. Comprehensive psychiatry, 41(1), 24-27.
Russell, M. C. (2008). Scientific resistance to research, training, and utilization of eye movement desensitization and reprocessing (EMDR) therapy in treating post-war disorders. Social Science & Medicine, 67(11), 1737-1746.
Walden University, LLC. (Producer). (2013c). Levy family episode 2 [Video file]. Retrieved from https://class.waldenu.edu
Shelby Baker
RE: Discussion – Week 2
Post an evaluation of the evidence-based practice that you selected for Jake. Describe the practice and the evidence supporting it. Explain why you think this intervention is appropriate for Jake.
In this case, Jake is a 31-year-old married veteran who has witnessed a traumatic event when he was deployed to Iraq. He is currently on medication for post traumatic stress disorder (PTSD), has a hard time sleeping, moodiness, and heart palpitations. Jake has been drinking alcohol a lot, that was he is avoiding dealing with his symptoms. His drinking has affective negatively against his marriage, children, and job (Plummer, Makris, & Brockson, 2014). An evidence-based intervention that I would select for Jake would be Cognitive Processing Therapy (CPT). CPT effective in reducing symptoms of PTSD and is 12 sessions long which helps clients learn to challenge beliefs related to trauma (American Psychological Association, 2021). This intervention will help Jake with his distorted beliefs about trauma that he experiences like denial and self-blame. The goal of CPT is that clients learn to make sense of their own trauma. This treatment can be conducted by psychologists, social workers, and other mental health therapists.
Then provide an explanation for the supervisor regarding issues related to implementation.
An explanation for the supervisor regarding issues related to implementation of cognitive processing therapy would be to educate my supervisor and co-workers about this therapy. Educating my supervisor about how this therapy has been around since the 1980’s and that research has confirmed that it is effective. This therapy would have one or two sessions a week for an hour long (SAMHSA, n.d). There are also a lot of information that we do not know about Jake and more issues could come from knowing more information about Jake.
Identify two factors that you believe are necessary for successful implementation of the evidence-based practice and explain why.
A factor that I believe is necessary for successful implementation of CPT is that Jake believes that this therapy will work. If he thinks that it will not be effective, then we will not get the results that we both want. This therapy will help Jake gain a better deeper understanding of how traumatic experiences can influence the way they think about themselves. Another factor would be that I would have to hold myself and Jake accountable to attend sessions and be prepared for the next sessions.
Then, identify two factors that you believe may hinder implementation and explain how you might mitigate these factors.
A factor that might impede implementation of CPT would be that he would have a hard time cooperating with me. Another factor would be making sure that he attends sessions. During the first session with Jake, I would stress the importance of this therapy and why compliance with the therapy will create effectiveness. I would also discuss with Jake about the adverse effects related to CPT and how symptoms may increase. According to research, clients do not report a worsening of symptoms after using CBT (SAMHSA, n.d).
References,
American Psychological Association. (2021). Cognitive processing therapy (CPT). American Psychological Association. Retrieved from https://www.apa.org/ptsd-guideline/treatments/cognitive-processing-therapy
Plummer S.B, Makris S.., & Brockson S.M. (2014) Sessions: Case Histories. “The Levy Family”. Laureate International Universities Publishing, Inc.
Substance Abuse and Mental Health Services Administration (n.d.) NREPP: SAMHSA’s registry of evidence-based practices and programs. Retrieved June 5, 2018, from https://www.nrepp.samhsa.gov

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