Review the Levy Family video Episodes 1 through 5.

Review this week’s Learning Resources and consider the insights they provide.
Review the Levy Family video Episodes 1 through 5.
The Assignment
In a 2- to 3-page paper, address the following:

After watching Episode 1, describe:
What is Mr. Levy’s perception of the problem?
What is Mrs. Levy’s perception of the problem?
What can be some of the implications of the problem on the family as a whole?
After watching Episode 2, describe:
What did you think of Mr. Levy’s social worker’s ideas?
What were your thoughts of her supervisor’s questions about her suggested therapies and his advice to Mr. Levy’s supervisor?
After watching Episode 3, discuss the following:
What were your thoughts about the way Mr. Levy’s therapist responded to what Mr. Levy had to say?
What were your impressions of how the therapist worked with Mr. Levy? What did you think about the therapy session as a whole?
Informed by your knowledge of pathophysiology, explain the physiology of deep breathing (a common technique that we use in helping clients to manage anxiety). Explain how changing breathing mechanics can alter blood chemistry.
Describe the therapeutic approach his therapist selected. Would you use exposure therapy with Mr. Levy? Why or why not? What evidence exists to support the use of exposure therapy (or the therapeutic approach you would consider if you disagree with exposure therapy)?
In Episode 4, Mr. Levy tells a very difficult story about Kurt, his platoon officer.
Discuss how you would have responded to this revelation.
Describe how this information would inform your therapeutic approach. What would you say/do next?
In Episode 5, Mr. Levy’s therapist is having issues with his story.
Imagine that you were providing supervision to this therapist, how would you respond to her concerns?

MODEL ANSWER

Episode 1

I believe Mr. Levy is aware that he has a problem, but chooses not to accept it as he does not want to face what he has seen while serving in Iraq.  He is self-medicating with alcohol to blunt his emotions, feelings, guilt, and depression.

Mr. Levy considers going to Iraq as the cause of all the problems. He suggests that he cannot recover wholly when he points out that “that way is dead.” On the other hand, Mrs. Levy’s perception of the problem is that her husband suffers from depression, which is as a result of constant drinking. She thinks her husband has a hangover because he drinks every night. The problem might have implications, including Mr. Levy losing his job. Should he lose his job, the family might suffer financially. His habit may also make her wife divorce him, which means the family will be torn apart.  

Episode 2

Mr. Levy’s social worker’s ideas are more of trial and error. She has not examined the patient to know what he is suffering from. Her arguments are based on her perceptions of what he thinks Mr. Levy’s might be suffering from. She goes ahead to recommend that the patient be taken through newer treatment options, including art therapy, meditation, and yoga. In my own considered opinion, she should strive to meet the patient first and give recommendations for the treatment upon examination (Mott, Stanley, Street, Grady & Teng, 2014). Conversely, I think Mr. Levy’s supervisor is right with his suggestions for consideration of the client’s need. He thinks that it will be a good idea first to meet the client and listen to his side of the story before arriving at conclusions on the treatment options. 

Episode 3

The response by Mr. Levy’s therapist to issues raised by her client showed a high level of professionalism she has in the field of therapy. She seems to be well acquainted with what is affecting Mr. Levy, which makes her proceed to provide a treatment option that would see him recover.  I think the breathing exercises were great, but I have to wonder if this was the first therapy session.  I felt as if the therapist was pressuring him to do what she wanted without letting him express his thoughts and feelings.

In her response to her client’s issues, I think Mr. Levy’s therapist provided the perfect solution on how Mr. Levi should go about the whole problem. First, he listened to the events that Mr. Levi went through while in Iraq, which might have led to trauma, anxiety and Posttraumatic stress disorder (PTSD). She then consoled her client by first acknowledging the fact that she understood what he was going through and after that suggested exposure therapy as the first mode of treatment. It is often very difficult to know exactly how to help the client stabilize (Zoellner et al., 2012).

When initiating exposure therapy, educating the patient as the foundation to therapy on what to expect is imperative, as education will teach the client how to recognize symptoms, anticipate them, what they mean, and how to manage them (Sloan, Marx, Lee, & Resick, 2018). Education also decreases the patient’s shame, confusion, and a sense of being “crazy.”

Exposure therapy is the therapeutic approach that the therapist used.  I would use this therapy as it is one of the most effective therapies used in PTSD.  It is a collaborative process aiming at improving the quality of life and symptoms of the client (Zoellner et al., 2012).

Episode 4

Every experience with every soldier is different in how they process the experiences they’ve encountered. In this situation, I would allow him to tell his experience. No one can understand any traumatic experience unless they have lived it.  One thing a therapist can do is listening without trying to voice understanding or sympathy or make facial expressions, because the client may negatively perceive this.

When a client is disclosing a traumatic experience, the therapist should avoid reacting with disbelief. Positive responses are helpful because they are non-judgmental, compassionate, and can reduce shame. Offering words of comfort can enhance ego-strengthening and empowerment. However, it is equally essential to allow silence from the therapist (Cavanagh & Batista, 2015).

I would ask whether he would like to continue or take a break.  The information disclosed is a lot to release in one session, and it can be emotionally exhausting for both the client and the therapist. Deep breathing exercises and education are essential within any therapy, let alone exposure therapy.

In therapy, the focus should be mainly on the patient by assisting them manage their emotions. The therapist should be dynamically checking behaviors of the client, including the level of distress, paying attention to verbal and non-verbal cues, and attempting to identify underlying issues (Sloan, Marx, Lee, & Resick, 2018).

Episode 5

My first suggestion would be that the emotions and experiences of Mr. Levy should not be intertwined by the therapist since it might pose dire consequences on his therapy. Therapists themselves are likely to undergo a higher level of emotional distress when they hear or experience events considered traumatic. The difficulty therefore lies within the discovery of the necessary level of involvement in every session, targeting in-session covert avoidance, handling client distress during treatment, and assisting the client in shifting from being trauma focused to being more present and futuristic (Zoellner et al., 2012).

Clients and therapists can present their unique dispositions to the therapy room, and upon the establishment of a robust therapeutic relationship, it can be applied as a useful therapeutic tool. Zoellner et al. (2012) explains that this help client by giving them a chance to face their traumatic encounter in a safe therapeutic atmosphere.

References

Cavanagh, A., & Batista, E. W. (2015). Countertransference in Trauma Therapy. Journal of Traumatic Stress Disorders & Treatment, 04(04). doi:10.4172/2324-8947.1000149

Kim, S. H., Schneider, S. M., Kravitz, L., Mermier, C., & Burge, M. R. (2013). Mind-body Practices for Posttraumatic Stress Disorder. Journal of Investigative Medicine : The Official Publication of the American Federation for Clinical Research, 61(5), 827–834. http://doi.org/10.231/JIM.0b013e3182906862

Mott, J. M., Stanley, M. A., Street, R. L., Grady, R. H., & Teng, E. J. (2014). Increasing Engagement in Evidence-Based PTSD Treatment Through Shared Decision-Making: A Pilot Study. Military Medicine, 179(2), 143-149. doi:10.7205/milmed-d-13-00363

Sloan, D. M., Marx, B. P., Lee, D. J., & Resick, P. A. (2018). A Brief Exposure-Based Treatment vs Cognitive Processing Therapy for Posttraumatic Stress Disorder: A Randomized Noninferiority Clinical Trial. JAMA Psychiatry, 75(3), 233. doi:10.1001/jamapsychiatry.2017.4249

Zoellner, L. A., Feeny, N. C., Bittinger, J. N., Bedard-Gilligan, M. A., Slagle, D. M., Post, L. M., & Chen, J. A. (2012). Teaching trauma-focused exposure therapy for PTSD: Critical clinical lessons for novice exposure therapists. Psychological Trauma: Theory, Research, Practice, and Policy,3(3), 300-308. doi:10.1037/a0024642