Refection Journal 1-Modality Choice- TRMA840

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REFLECTION JOURNAL: MODALITY CHOICE Reflection Journal Assignment 1: Modality Choice Janelka Williams School of Behavior Sciences, Liberty University

REFLECTION JOURNAL: MODALITY CHOICE Key Ideas Symptoms of Posttraumatic Stress Disorder (PTSD) are common right after traumatic events, but for most trauma survivors, these symptoms decrease over time through natural recovery. However, for some people, the PTSD symptoms continue after a 6-month (or more) delay, become chronic, and interfere with daily functioning. When this happens individuals should seek help and a more intensive treatment. Prolonged Exposure Therapy (PE) is helpful with those who have prolonged or delayed responses to traumatic events (Rothaum et al. 2019). Prolonged Exposure Therapy PE is a way to help trauma survivors to emotionally process their traumatic experiences. PE reduces PTSD and other trauma-related problems. According to FOA et al., (2019) the term “prolonged exposure” comes from the long tradition of exposure therapy for anxiety disorders. In exposure therapy, people are helped to confront safe but anxiety-arousing situations to decrease their excessive fear, anxiety, and distress. Often times clients say that they have tried and failed to face their trauma-related fears and other negative emotions, or that they did face them, but their distress did not diminish. Some just cannot picture themselves stopping their avoidance or being strong enough to visualize and describe traumatic memories. Others think that avoidance is an effective coping technique, and they need to be encouraged to try another technique (FOA et al., 2019). I find myself trying to explain to people all the time that some nonchalant characteristics may be a coping skill. Avoidance There are two ways that people avoid dealing with trauma reminders. One is trying to push away memories, thoughts, and feelings about the trauma. Another is escaping or avoiding situations, places, people, and objects that cause distress and fear because they are similar to the

REFLECTION JOURNAL: MODALITY CHOICE trauma or are reminders of the trauma. However, while the strategy of avoiding trauma-related thoughts and situations works in the short run, it actually prolongs the post trauma reactions and prevents you from getting over your trauma-related difficulties. In a video about PE provided by this course one of the professors noted that PE is enduring temporary pain for long-term relief (FOA et al., 2019). Components of PE FOA et al., 2019, was insightful in seeing how sessions should be conducted when administering PE. PE sessions consist of education about trauma, PTSD, and PE including “in vivo” exposure, “imaginal exposure” and retraining of breathing techniques. In vivo consists of repeated real-life exposure to situations, people or objects that are objectively safe or low risk. imaginal exposure is repeated trauma memories or resist visiting and recounting the trauma in the person's imagination. I used to believe that implementing these methods could potentially re-traumatize clients. Yet, research indicates that the more an individual confronts and revisits their trauma, the more desensitized they become. Regardless of the client or the symptoms they present, I firmly believe that breathing techniques are always beneficial. Deep breathing not only aids mental wellbeing but also promotes physical health. I recall a time when I suffered from a migraine, and with some deep breathing, I noticed it slowly decline. Technological Advances What I found interesting and immediately downloaded was the PE Coach that utilizes technology to keep up with one's PE treatment. PE coach can be used with Android or iPhone and helps the patient to progress through the whole PE protocol, including presentation of treatment rationale, support for monitoring the Subjective Unit of Discomfort Scale (SUDS), and

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REFLECTION JOURNAL: MODALITY CHOICE scheduling in vivo and other appointments (Rothaum et al. 2019). This technology is always useful, and you can go back, to reprocess or rethink every session. It's like an app that I used called “I am Sober” with my clients presenting eating disorders or addictions. It helped them to keep track of their relapse and to help them find alternatives, and positive distractions. Christian World View According to Tan (2022) basic psychological and spiritual needs include needs for security (love), significance (meaning/impact), and hope (forgiveness). When someone experiences a traumatic event, there is a loss of security, significance, and hope. In incorporating Christian counseling, I am happy to offer God's love, my clients meaning in this world and a reason to hope. The Holy Spirit Christian counseling or psychotherapy can be simply described as counseling conducted by a Christians who is Christ centered, biblically-based and spirit filled. The Holy Spirit is also described as the giver of life by the Nicene Creed, supported by Scripture in both the old and New Testament. His key role in Christian therapy as a counselor as well as the giver of life means that Christian therapist must acknowledge and depends on the Spirit's presence and healing power in every counseling situation, with the basic biblical understanding of the work in the ministry of the holy spirit (Tan, 2022). I work with clients who are Christians and those who are not. I make it my business not to be biased and I can apply therapeutic techniques without my Christian beliefs being incorporated if it's not warranted. However, I often ask my clients if they have a religious background during our intake and once, I know that they are Christians, I ask them if it's okay to incorporate Christian counseling. I pride myself in knowing when I'm incorporating Christian

REFLECTION JOURNAL: MODALITY CHOICE counseling that I have a prayer life and I am keen to allow the Holy Spirit to lead and guide me in counseling sessions, (even when I'm not administering Christian counseling). When receiving a breakthrough in counseling that I know the Holy Spirit led me to, I feel so grateful. I often tell my Christian clients you're blessed to have a person with book knowledge, life experience, a connection to our Lord and Savior Jesus Christ and His Holy Spirit. Incorporating Christian Counseling I am careful to ask if a person is a Christian if they would like to incorporate Christian counseling. I also try to make it clear that it's okay if they do not. After pastoring for many years, I know a lot of bitter Christians who have had bad experiences in church and may be triggered by incorporating Christian counseling. In this understanding some have had traumatic experiences in their Christian experience. Helping clients heal spiritually, is something that I desire because I've had my own negative experiences in church. One of my passions is to let people know leaders in ministry are not God and are prone to make mistakes. However, because leaders make mistakes, we should not project this on God, or our relationship with Him. Spiritual Triggers While the research cited in Sherman et al. (2015) primarily documents positive relationships between spirituality and indicators of mental health, spirituality is a complex construct. Some have been found to have negative relationships with various aspects of well- being. For example, spiritual struggles may have negative effects on mental health, such as anger or disappointment with one’s Higher Power or community of faith, difficulty resolving appropriate or inappropriate guilt, and loss of faith (Sherman et al., 2015). According to Sherman et al. (2015) spiritual struggles may have negative effects on mental health, such as anger or disappointment with one’s Higher Power or community of faith,

REFLECTION JOURNAL: MODALITY CHOICE difficulty resolving appropriate or inappropriate guilt, and loss of faith. This construct has been found to be related to higher levels of PTSD symptoms, poorer quality of life, poorer cognitive functioning, and poorer physical health. In my experience, this is reason I am careful to ask clients their wishes (Sherman et al., 2015). Conclusion Following a traumatic event, it is not uncommon for individuals to experience symptoms of PTSD. For some symptoms naturally diminish over time as they embark on their journey of recovery. Unfortunately, there are some individuals who continue to suffer from persistent PTSD symptoms even after a delay of six months or more, which can severely disrupt their daily lives. In such cases, it is crucial for these individuals to seek assistance and opt for a more intensive treatment approach. One empirically supported treatment is PE, specifically designed to address the prolonged or delayed responses to traumatic events experienced by individuals. If it is deemed necessary, it is the responsibility of a Christian counselor, who is providing guidance to a Christian individual, to assist them in rediscovering a sense of security, significance, and hope. I am grateful that irrespective of whether my client is a Christian or not, I rely on the Holy Spirit as my compass in every interaction with each client. With the help of the client and the Holy Spirit to leave me when a client feels triggered by Christian counseling. I firmly believe that everything works together for the benefit of those who love God and are called according to His purpose (Romans 8:28, NIV). Regardless of what unfolds during our sessions or in my client's life, which often brings fulfillment, I trust that everything is under God's control and that my path is guided by Him.

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REFLECTION JOURNAL: MODALITY CHOICE References Foa, E., Hembree, E., Rothbaum, B. O., & Rauch, S. (2019). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences: Therapist guide (2nd ed.). New York, NY: Oxford University Press. Rothbaum, B., Foa, E., Hembree, E. & Rauch, S. (2019). Reclaiming your life from a traumatic experience: A prolonged exposure treatment program (2nd ed.). New York, NY: Oxford University Press. Sherman, M. D., Harris, J. I., & Erbes, C. (2015). Clinical approaches to addressing spiritual struggle in veterans with PTSD. Professional Psychology: Research and Practice , 46 (4), 203–212. https://doi.org/10.1037/pro0000020 Tan, S.-Y. (2022). Counseling and psychotherapy: A Christian perspective . Baker Academic. The holy bible: New international version . (2011). Biblica.

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