Traumatic events can shape a persons life and cause untold stress and pain for long periods of time. Natural disasters occur and can affect a persons life in terms of losing their home, causing long-term injuries, and creating a sense of instability. Betty has experienced a powerful tornado that ravaged her home and led to her husband breaking his leg. This essay will focus on post traumatic stress disorder (PTSD) assessment and treatment options for someone like Betty to enable her stabilize herself and find ways to positively cope with such trauma. 1.

The first thing to understand is the difference between screening and assessment. Screening involves a typical yes or no answer and evaluation for possible existence of a specific problem. An assessment on the other hand is a process used to define the nature of an issue, determination of diagnosis, and development of specific treatment recommendations to help address diagnosis/issue. Because Betty experienced a traumatic event that result in long-term consequences like losing a home and her husbands surgery and physical therapy, the first two questions should focus on identifying whether she may display symptoms of PTSD.

The key reason for PTSD as a possible diagnosis is her re-experiencing of symptoms. Betty stated she relives what happens to her frequently. While she did not say, she has night terrors, or unwanted daytime memories, it seems her reliving the events points to this. Reliving events that are often accompanied by guilt, grief, or other intense emotions can signal PTSD. PTSD is also diagnosed typically following a crisis. Both Panic Disorder and PTSD are two subtypes within Anxiety Disorders that often are associated with crises (Cavaiola & Colford, 2011, p. 132).

Therefore, the first question would be: Do you experience nightmares, flashbacks, or daydreams? If so, what feelings are invoked when you they occur? This two-part question would be used to confirm what has already been stated by Betty. It will demonstrate she is reliving the trauma in forms that potentially signal PTSD. The answers will also serve as the basis for the PTSD diagnosis.

The next question will center on avoidance symptoms because traumatized individuals try and avoid situations, people, or events that could harken back the trauma experienced. Betty stated her husband needs to have surgery and therapy. She also stated she experiences guilt because she feels she caused her husbands injury. The question would then be: What are you trying to avoid, if at all, concerning the night of the tornado? If she answers her husband, this can help determine the source of her guilt and anxiety and hopefully will be a means of providing treatment recommendations.

The next question would center around arousal symptoms. While Betty has not stated any substance abuse, she may be experiencing some arousal symptoms like feeling easily startled, jumpy, reacting to loud noises, insomnia, and diminished cognitive ability. The 3rd question would then be: What kinds of behaviors have you exhibited after the tornado? If Betty needed clarification, some of the arousal symptoms may be provided as examples. This way, she can understand and communicate what has happened to her lately. One important clue of her having arousal symptoms is her inability to sleep due to reliving the traumas.

The fourth question will focus on depression. This is because she has experienced something that has destroyed much of her everyday life. She has nowhere to live, her husband is injured, and she cannot function in the way she could before. The fourth question would then be: Do you feel hopeless, and if so, why? People often with PTSD experience depression. Some also experience anxiety disorders and substance abuse. The assessment questions must...

The question would be: Have you had thoughts of hurting yourself or trouble concentrating on things? What are you having trouble concentrating on? This two-part question will allow the assessment to help navigate what Betty is having trouble with and enable development of a treatment plan/recommendation that will allow her to get back some of the autonomy and independence she had before the tornado. Because Betty was such a prominent figure prior to the tornado, she needs to incorporate some of her former self and former actions into the rebuilding of herself and her life.
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The diagnosis code that would be used to diagnose Betty would be (PTSD) DSM-5 309.81 (F43.10). Because Betty experienced symptoms after a traumatic event (the tornado), her symptoms fall under PTSD. While the assessment questions included a potential additional diagnosis of depression, research suggests depression in those that suffer from PTSD may come after the individual experiences a state of emotional numbing. Emotional numbing symptom cluster was more strongly related to depression (P < .001) and worse mental health-related functioning (P < .001) than other symptom clusters, while the externalizing behavior symptom cluster was more strongly related to hostility (P < .001) (Tsai et al., 2015, p. 546). Betty does not appear to display emotional numbing. She feels guilty, she is worried. Therefore, she most likely is not depressed yet.

Now that the diagnosis is PTSD, assessment of her issues and her subsequent needs will be able to allow for a suitable recommendation for treatment for Betty. The two main issues Betty is dealing with are her husbands surgery and physical therapy and her search for a new home. She feels guilty because her actions (shoving her husband into the basement), led to his leg breaking and then requiring surgery. She needs help in the form of an in-home physical therapy or personal care attendant to facilitate her husbands recovery.

In relation to finding a new home, because of the tornado, she feels displaced and lacking any foundation from which to recover from her ordeal. Help for her in the form of cognitive behavioral therapy may help her create positive coping mechanisms in order to effectively deal with the stress of her condition and prepare to find a new home and establish herself after the tornado.

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The kinds of multidisciplinary referrals needed would be for two things, the first is helping Betty cope with her new life post tornado by establishing healthy coping mechanisms for the stress she must endure to stabilize herself and find a new home. Many that have experienced a traumatic event turn to cognitive behavioral therapy as a treatment option. Cognitive-behavioral therapy for postdisaster distress (CBT-PD) is a transdiagnostic intervention that has been used following major disasters such as the 9/11 terrorist attacks and Hurricane Katrina (Hamblen, Norris, Symon, & Bow, 2016, p. 1). The second would be for a social worker so she can be provided options to help deal with her husbands current state of health. He needs someone there long-term to help him with physical therapy. Betty may have to apply for additional health insurance to cover the costs or see if there is a less expensive alternative to the physical therapy. Physical therapy may cost less if it is done in the home rather than in a medical office.

Research has proven cognitive behavioral therapy (CBT), to be helpful for sufferers of PTSD. Participants who received intervention early (i.e., 10 to 15 months after Sandy) had the same improvement as those who received it…