Martins Case Analysis and Treatment Plan

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Nov 24, 2024

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Martin’s Case Analysis and Treatment Plan Introduction Suicide is a distressing phenomenon with adverse effects on individuals, families, friends, and communities. According to the World Health Organization (2021), over 700,000 people die yearly due to suicide, and for every, which has long-lasting effects on the victims people left behind. Hence the need to urgently understand and prevent suicide. Therefore, this paper provides a case assessment of Martin, a person at risk of committing suicide, to understand his problem and prevent him from committing suicide. The paper provides Martin’s risk and protective factors, trauma screening and relevant symptoms, relationship assessment, and family therapy interventions appropriate for this case. Risk and Protective Factors Risk and protective factors play a crucial role in preventing suicide. Identifying these factors provides information that can be used to assess and manage suicide risk in individuals by giving direction about what to promote or change. Therefore, this section provides Martin’s risk factors, protective factors, and identifies and explains how the protective factors can be used to develop effective safety measures. Risk Factors 1. Expressing a wish to die Martin feels guilty about his best friend’s death, and he has repeatedly told his family that he does not deserve to live since his friend was better than him and that he is the one who should have survived the attack. These feelings of survivor guilt and grief often lead to a high number of suicide behavior, attempts, and deaths. 2. Hopelessness

Martin is in low spirits from the loss of hope of returning to his combat duties due to the injuries he sustained in his leg that make it impossible for him to participate in active combat. This hopelessness has been found by various scholars, including Scott et al. (2016), to be a stronger predictor of suicide ideation compared to other factors such as depression. 3. Traumatic flashbacks of the enemy attack Martin is often depressed, and he sometimes experiences flashbacks of the traumatic attack by the enemy that resulted in him being severely injured and losing his best friend and other people he was working with. 4. Debilitating physical illness The enemy’s attack on Martin’s troop was bad and left him with severe leg injuries. The leg wounds Martin got while in active combat are severe that they will take months to heal, and he will still not be in the required physical state to go back to active combat. 5. Lack of meaning and purpose in life Martin expresses that his life has lost meaning since he cannot go back to work and has no purpose of continuing living. He wishes that he did not survive the enemy attack. Protective Factors 1. Strong connections to family Martin has a strong connection to his wife, teenage daughter, and son. He politely opens up to his family about how he feels, including feeling guilty for his friend’s death. Survivors of traumatic attacks such as the one Martin experienced are often aggressive and impulsive. Still, none of these behaviors has been reported by Martin, implying that he has a strong connection with his family that he cannot lose control when talking with them. 2. Availability of mental and physical health care

Martin’s employer, the military, provides the required mental and physical care to the nation's service men injured in active service. Therefore, this mental and physical care is available for Martin to use and be better. 3. Easy access to a variety of clinical interventions and support for seeking help 4. Excellent coping skills Despite being depressed, grieving, and facing many challenges in adjusting, Martin has established healthy boundaries and asked for support. 5. Contacts with caregivers Safety Measures 1. Martin’s guns or weapons should be stored in a locked safe. 2. Keep all medications in a locked box. 3. Monitor Martin’s movements. Trauma Screening and Relevant Symptoms In screening for trauma and the severity of the traumatic attack that Martin experienced that led to his current risk of being suicidal, I will use the Combat Exposure Scale (CES) to measure the severity of his trauma. Various assessment instruments are used to measure the type of trauma a person was exposed to and the severity of the traumatic event they experienced. Therefore, the Combat Exposure Scale is appropriate for Martin’s case because his trauma is combat-related. According to the U.S Department of Veterans Affairs (n.d.), the CES is a 7-item self-report measure that assesses combatants’ wartime stressors. The 7 items used in this instrument are rated on a 5- point frequency (1 = "no" or "never" to 5 = "26+ times" or "51+ times"), 5-point duration (1 = "never" to 5 = "7+ months"), or 45-point degree of loss (1 = "none" to 45 = "76% or more") scale. The combatants are asked to reply based on their exposure to

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active combat situations like stepping on a landmine, firing bullets at the enemy, and being caught in crossfires. According to Keane et al. (1989), the total exposure to combat score can be categorized from light (0-8) to light-moderate (9-16) to moderate (17-24) to moderate-heavy (25- 32) to heavy (33-41). Therefore, the severity of the combatant's (in this case Martin) trauma symptoms can be assessed based on the above score, where 0-8 will show low severity of the symptoms, while 33-41 will show extreme severity of the symptoms. Several possible symptoms may emerge as an indicator of trauma arousal after the assessment. The first symptom is flashbacks, where an individual relives a traumatic experience and feels like it is happening currently (National Center for PTSD, 2021). Flashbacks apply to Martin because he experiences repeated flashbacks of the enemy attack that killed his troop and injured him. In addition, having distressing thoughts is a possible symptom that may emerge as an indicator of trauma arousal. This symptom applies to Martin since he often has distressing thoughts that make him wish he was dead. Lastly, physical signs of stress are possible symptoms that may emerge as an indicator of trauma arousal, where one may experience aches and pains, exhaustion, and trouble sleeping (National Center for PTSD, 2021). Physical signs of stress may apply to Martin since he has an injured leg, which might be painful due to the severe wounds. Relationships Assessments Relationships assessments help clinicians understand a family’s strengths, priorities, goals. It also helps in identifying a family’s resources and needs to tailor interventions that can be used to address the identified needs. Description of Instrument In Martin’s case, a genogram is the family relationship assessment tool that will be used to provide insights into the quality of relationships in Martin’s family. Piasecka et al. (2018) state

that a genogram determines the relationships within a family and can visualize family patterns, psychological factors, and behavioral patterns. The rationale for the Instrument’s Use Genograms are used because they help clinicians understand the key people and relationships and people in their client’s life, making it easier to determine patterns or behaviors that affect the client. How Genograms Information Inform Treatment The information from the genogram can inform Martin’s treatment by uncovering the root cause of his change in behavior, including problems not known to the family, initiating behavior change, and making it easier for the patient to talk about his problems. Family Therapy Interventions In Martin’s case, I would suggest using Attachment-Based Family Therapy. Diamond and Levy (2015) state that attachment-based family therapy helps families create meaningful relationships and is more effective in treating and preventing depression and suicide. Therefore, this family therapy is appropriate for Martin’s family since it will help Martin overcome depression suicide and create meaningful relationships with his family. Martin has trauma and grief issues that can also be addressed using this family therapy because a mental health professional will help Martin overcome his grid and still honor his friend’s memory and help him develop more meaningful and strong relationships with his family. Diamond and Levy (2015) state that this family therapy incorporates components from other therapies used as interventions to help treat Martin’s problem. Therefore, I will integrate Martin’s trauma and grief issues and other interventions in Attachment-Based Family Therapy to target Martin’s trauma symptoms.

References Diamond, G., & Levy, S. (2015). Attachment-Based Family Therapy (ABFT) Webinar. Philadelphia, PA. Retrieved from https://www.youtube.com/watch?v=KcwHznzq-S4 Keane, T., Fairbank, J., Caddell, J., Zimering, R., Taylor, K., & Mora, C. (1989). Combat exposure scale (CES). Retrieved from . https://www.ptsd.va.gov/professional/assessment/documents/CES.pdf National Center for PTSD. (2021, January 29). Post-traumatic Checklist for DSM-5 (PCL-5). U.S. Department of Veterans Affairs. https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp#obtain Piasecka, K., Slusarska, B., & Drop, B. (2018). Genograms in Nursing Education and Practice a Sensitive but Very Effective Technique: A Systematic Review. J Community Med Health Educ , 8 (640), 2161-0711. https://pdfs.semanticscholar.org/74c6/bb8e10632ba5538435beef04d575d319f15a.pdf Scott, S., et al. (2016). Attachment-Based Family Therapy for suicidal adolescents: A case study. Australian & New Zealand Journal of Family Therapy 37(2): 154-176. Retrieved from Ebscohost multisearch U.S Department of Veterans Affairs. (n.d.). Combat Exposure Scale (CES). Retrieved on January 24, 2022, https://www.ptsd.va.gov/professional/assessment/te-measures/ces.asp World Health Organization. (2021, June 17). Suicide. Retrieved on January 24, 2022, from https://www.who.int/news-room/fact-sheets/detail/suicide

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