This is a hypothetical case study for the diagnosis of posttraumatic stress disorder (PTSD). The client in question is 41 years old man. He has been serving as a soldier for more than twenty years. He has been involved in rescuing people from military attacks. The last attack was so horrible that it made him get under stress. It was a big blow to the family since he could no longer live normally. The stress he was going through ruined his relationships with the wife and siblings. However, he started to look for a therapist’s help because of his spouse. The study includes the effect of PSTD on the client’s relationships with the family members and the limitations of DSM-5 system used in this problem’s management. It also highlights some aspects of the code of ethics that guide the client and the counselor during the problem management. It covers the socio-economic factors influencing the diagnostic approach and the diagnostic labels’ impact on the client
Key Words: Posttraumatic disorder (PSTD), culture, traumatic event, psychiatric diagnosis.
Developing a Case Study (PTSD)
This research comprises of a hypothetical case study for the PTSD principal diagnosis. The paper highlights the client’s description and history. The research will review the symptoms of disease, the relationships that have been affected, and socio-cultural factors which influence the diagnostic process. The disorder is a critical psychological trauma that develops after a person suffers emotionally. It causes a severe impairment of the individual’s social functionality. A traumatic event is a confusion that is happening for a long time to person’s psyche. It also reveals the victim’s behavior (Ozer, Best, Lipsey, & Weiss 2003).
Client Description and Demographics
In this case study, the client is an adult. The man, aged 41, serves in military and is a husband and a father to three children (a boy and two young girls). He has served for 20 years as an infantry. The client was very self-confident. In his career, he had struggled as a soldier to gain to higher ranks. Currently, he is on MEC3 sick leave from ADF. He is of American origin and lives in Canada. His wife works as a senior manager in an international company.
History of the Client
The case study is a soldier who has served in the infantry for twenty years. He is 41 years old, currently on MEC3 sick leave. He has been an active soldier and was able to excel in all things. It is a justification for him being promoted to a warrant officer. He was senior to many soldiers whom he had guided and had been their model. He was expected to be strong at all times. In fact, he was able to achieve this. However, since last year, he has struggled to keep up his old form. As a soldier, he had repeatedly encountered horrible scenes of death. He managed to stay strong by trying to forget it and drinking alcohol. Nevertheless, last year’s incident was different. The militia swept a village clean by killing all the residents. As a soldier, he went later, and the scene he saw was horrifying. There were so much destruction. The houses were burnt down; people had terrible injuries as they screamed everywhere. The soldiers did their job well and managed to bring on board medics. In addition to this, they managed to track down some of the militia. After a couple of weeks, he still could not erase from his memory the scenes he had seen. Among all those images, he could not help remembering a child been badly mutilated and left alive. The soldier became short-tempered and very irritable. He refused to admit the problem but had to seek for help. By means of his wife, he got an appointment with the psychiatrist.
Symptoms, Issues, and Reasons for Seeking Counseling
The soldier could not forget the vivid images of the attack. He saw these images during the day and dreamt of them at night. It became hard for him to enjoy his peaceful life anymore. The patient was sad most of the time. He felt miserable and worthless. After he had a recurrence of such memories, he was desperate and helpless as he realized that he could not deliver himself from this bondage. He had also occasional foul mood and was falling into depression as he suffered from insomnia. He felt tired all the time. Other symptoms included low concentration, poor memory and decision making (Hathaway, Boals, & Banks, 2010). He confessed that he lost interest in sex and motivation in pursuing his hobbies.
When the veteran came back home, his life had been no longer normal. He had difficulties in falling asleep. He used to experience hallucinations and dreams at night. He tried to suppress all these problems with alcohol. However, he could not control it. Considering all these experiences, he became helpless and irritable. He could not realize that strong and able leader he used to be could give up due to such issues. This made him moody and miserable. The client became short-tempered and easily irritated. Most of the time, he found himself shouting at his wife for no apparent reason. His children began to fear him as he could no longer be good with them. He had been losing his temper with children. As this progressed, he failed to control himself and became very withdrawn. He had a problem but refused to acknowledge it.
Socio-cultural Factors that Influence the Diagnostic Process
The veteran has been in the military for almost twenty years. During this time, he managed to climb the promotion ladder to become a warrant officer. Because of the success and confidence he had, he failed to acknowledge when he had a problem that justified medical attention. He could not come to terms with the loss of control over his life. This inability was mainly associated with the losers and the powerless people in the society. Equally, his secretiveness of the problem could have occurred because males are known to be hardy and masculine; thus finding it hard to share their problems.
Influence of Personal Socio-cultural Background
Most of the war veterans succumb to stress-related diseases. This is because of all the challenges they face in serving their countries (Ozer, Best, Lipsey, & Weiss 2003). The majority of such men are likely to be victims because of their ego. The ego makes them believe that they are above some human challenges such as mental sickness. This presumption has been a problem to most of the patients due to the various achievements they have had in the course of their lives. As patients fail to seek for medical attention, the problem becomes worse. Most clients become addicted to alcohol as the means to normal life. Others have been very secluded because of the struggles they undergo. When the problem becomes too complicated, most people resort to suicide.
Limitations of using Current Diagnostic Systems
Current diagnostic systems comprise of the DSM-5. There are challenges in applying such systems in a multicultural society. DSM -5 is considered to miss empirical support. Many disorders experience low inter-rater reliability (Friedman et al, 2011b). Numerous sections have confusing information. This makes it difficult for clinicians to distinguish the problems since it is rather hard to accomplish without concrete evidence (Friedman et al, 2011a). Clinicians barely use this system in major treatments that include drug prescriptions and medical coverage. This system is not transparent enough (Friedman et al, 2011a). The entire process is done without the patient’s notification. The patients lack for the chance to challenge any procedure done on them. Therefore, there is a need for introducing more specific safeguards. The methodology employed is weak. The processes are secret and incomprehensibly closed. This is experienced beyond the task force and committee of the system. There are also confusing terms used under the DSM-5, for instance the difference between depression and grief is not clear. The confusion has made people to fail to respond properly to grief, which is usually regarded as a pathological disorder (American Psychiatric Association, 2013). Equally, the multiaxial diagnostic scheme has not been incorporated. It develops into no distinction between Axis I and Axis II disorders.
ACA’s Ethical Standards and other Ethical Codes as Applicable (AAMFT)
According to the ACA Code of ethics (2005), the counselor has the main responsibility to respect the patients’ dignity and to uphold their welfare. The clients, on the other hand, have the right to choose being in a counseling relationship or getting out of it. They must have proper information about the entire counseling process. In cases where clients do not agree to give their consent voluntarily, counselors can seek for it. The latter are also required to protect their clients, research assistants, and trainees against any harm. Counselors also supervise the clients’ welfare in order to fulfill their health obligations (Code of Ethics, 2005).
Impact of the Diagnostic Labels to the Client
Men find it hard to admit that they need help. Since treatment mainly involves the admission of drugs, men realize that they can overcome the emotional pain they have undergone as they continue to seek for help. Thus, there is optimism of living a normal life once again. Through these achievements, the relationship of the client with the medical assistant improves. This goes on to the point when they can freely visit a psychiatrist every week. As treatment goes on, the clients find their way back to the social life and improved their relationships with families (American Psychiatric Association, 2013). This helps them to talk in details over the needed events. Additionally, there is limited negative labeling once the patient is under treatment.
In conclusion, there is some level of trauma that is felt by adults who undergo posttraumatic disorder. Though most male clients are normally in denial by the time they are taken to psychiatrists (as it was discussed in this case study), there is need for them to accept their conditions and be helped. Like in this case, such clients’ relationship with their family was almost broken by the time he sought help. The study has also revealed some criticism of using DSM-5 as a diagnostic system. The approach is yet to be fully accepted into the society. The clinical officers, for example, experience difficulties while using this system on a patient, who is covered by an insurance company. The pharmacists are perceived to benefit a lot from this system as they prescribe drugs for problems that can be managed with the help of other means.