Trauma-Informed Care for a Survivor of Childhood Sexual Assault

Case Scenario:

A woman is admitted to the adult inpatient behavioral health unit after experiencing flashbacks to her rape that occurred when she was a 12-year-old girl while at her babysitter’s. She was raped by the babysitter’s 15-year-old son and three of his friends. Upon admission, the client is quiet, curled on her side in the fetal position on the bed, and rejecting of others who enter her room, shrinking to the far side of the bed whenever any person opens her door. Her sister, who accompanied her to the hospital, tells you that the client has been like this since a news story appeared last week about a young girl being abducted from a mall and beaten and raped by several teenage boys. The client has not eaten, slept, or gone to work since hearing the news account.

a.  What trauma/stress-related disorder is this client experiencing?

b. What risk factors does she exhibit?

c.  List at least two treatment interventions that are viable options to assist the client at this time.

Instructions

Read Thoroughly: Familiarize yourself with the case, noting key elements like symptoms, medical history, and social factors affecting the patient.

Research: Conduct scholarly research to better understand the condition presented in the case study. Use at least five peer-reviewed articles to support your analysis.

Ethical Considerations: Examine any ethical considerations associated with the case. For example, consider patient consent, confidentiality, and duty of care.

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a. Trauma/Stress-Related Disorder: The client is experiencing symptoms consistent with Post-Traumatic Stress Disorder (PTSD). PTSD is characterized by intrusive memories, avoidance of trauma-related stimuli, negative alterations in mood and cognition, and arousal/reactivity symptoms following exposure to a traumatic event (American Psychiatric Association, 2013). In this case, the client’s flashbacks to her childhood rape, triggered by a news story about a similar incident, along with her avoidance behaviors and significant distress, align with the diagnostic criteria for PTSD.

b. Risk Factors: Several risk factors contribute to the client’s vulnerability to PTSD:

• Childhood sexual assault: The traumatic experience of being raped at a young age by multiple perpetrators, including the babysitter’s son and his friends, increases the likelihood of developing PTSD.
• Recent triggering event: The news story about a young girl being abducted and raped triggers memories of the client’s own trauma, exacerbating her symptoms and causing significant distress.
• Lack of coping mechanisms: The client’s withdrawal from daily activities, such as eating, sleeping, and working, suggests a deficit in coping skills to manage stressors effectively, which can further exacerbate PTSD symptoms.

c. Treatment Interventions: Two viable treatment interventions to assist the client at this time include:

1. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): TF-CBT is an evidence-based psychotherapy approach specifically designed to address trauma-related symptoms, particularly in children and adolescents (Cohen et al., 2017). This therapy involves several components, including psychoeducation, relaxation techniques, cognitive restructuring, and exposure therapy. Through TF-CBT, the client can learn coping skills to manage distressing thoughts and emotions, process traumatic memories in a safe and structured manner, and develop strategies to regain a sense of control over her life.
2. Eye Movement Desensitization and Reprocessing (EMDR): EMDR is another evidence-based therapy for PTSD that focuses on facilitating the processing of traumatic memories and reducing associated distress (Shapiro, 2018). During EMDR sessions, the therapist guides the client in bilateral stimulation, such as eye movements or tapping, while recalling traumatic memories. This process helps desensitize the client to the traumatic material and facilitates adaptive processing and integration of the memories. EMDR has shown effectiveness in reducing PTSD symptoms and improving overall psychological well-being.

Ethical Considerations: In providing care to the client, ethical considerations include obtaining informed consent for treatment, ensuring confidentiality of sensitive information, and upholding the duty of care to provide competent and compassionate care. Given the sensitive nature of the client’s trauma history, maintaining a safe and supportive therapeutic environment is paramount to promoting healing and recovery.

In conclusion, a trauma-informed approach to care is essential for supporting survivors of childhood sexual assault with PTSD. Through evidence-based interventions such as TF-CBT and EMDR, clinicians can help clients process their traumatic experiences, develop coping skills, and work towards healing and recovery in a safe and supportive therapeutic environment. Ethical considerations must guide all aspects of care to ensure the client’s autonomy, privacy, and well-being are respected throughout the treatment process.

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