Post Traumatic Stress Case Study

It will be important for the counselor to stress to Rosie that it took a great deal of strength to first report the abuse, and then to deal with the repercussions; events which even some adults do not have the courage to deal with (Davidson, 2014). The counselor should also encourage Rosie to use her time in counseling to discover other potential strengths, both within herself and in her relationships with other people (Davidson, 2014). Her mother could be a very important strength in Rosie’s recovery, if Rosie would allow her to be. The counselor should point out that while Rosie’s anger is justified, shutting her mother out of her recovery process is harmful to Rosie, and she might even find that the anger abates if she shares her feelings
with her mother.
Appropriate Assessment Tools in Counseling Rosie Probably the most widely used and researched screen for Post-Traumatic Stress Disorder (PTSD) in adults and adolescents is a self-report rating scale known as the PTSD Checklist (PCL) (Screening tools help in assessing trauma, 2011).
The PCL has good psychometric properties, including internal and test-retest reliability and convergent validity (Screening tools help in assessing trauma, 2011). The PCL contains 17 questions that map onto the three DSM-IV PTSD symptom clusters: re-experiencing, avoidance, and arousal (Screening tools help in assessing trauma, 2011). Respondents are asked to look at a list of "problems and complaints that people sometimes have in response to stressful life experiences," and then decide how much each problem has bothered them over the last three months. Psychometrics for the PCL in an adolescent population have not been published, but it is still used with an adolescent population (Screening tools help in assessing trauma, 2011). This tool will be helpful in assessing the level of distress Rosie is experiencing following her abuse and the also-traumatic events following it. It can be assumed that Rosie is experiencing some level of PTSD, so the counselor’s primary goal will be to determine to what extent she is affected. Following completion and scoring of the PCL, the counselor will be in a better position to know which symptoms of PTSD Rosie is experiencing, and to what extent they are affecting her daily life. They symptoms which are causing Rosie the most distress, are the symptoms which the counselor should address first in
counseling.
Advanced Skills Necessary for Treating Rosie Advanced skills which might be necessary when working with Rosie are immediacy, self-disclosure, and challenging. Immediacy is considered to be one of the most powerful tools in counseling, but is often difficult for non-experienced counselors to use effectively (Baker, 2006). It involves self-disclosure, in the sense that the counselor will use what is going on “in the moment” of counseling to express what she is feeling, and to state what she suspects that the counselee is experiencing, and then tie those feeling to the event that brought the counselee into counseling. In Rosie’s case, this would be the sexual abuse. Self-disclosure often feels counterintuitive to new counselors, who have learned in school to maintain a professional boundary when working with clients (Baker, 2006). However, in some cases, it is necessary for a counselor to disclose aspects of her own life which make her able to understand the issues the client is dealing with. This is especially true if the client shows a reluctance or inability to trust the counselor, or seems to believe that she is alone in her problems, and that nobody could possibly understand them. Challenging involves questioning beliefs which the client has, and pointing out how they may be either faulty or counterproductive to recovery (Baker, 2006). In Rosie’s case, her feelings of anger towards her mother are both misplaced, and likely to hold back her recovery by depriving her of a powerful ally in her treatment.
Treatment Plan for Rosie