Cognitive Behavioral Therapy Assignment PDF

Running head: COGNITIVE BEHAVIORAL THERAPY
1
Effective Cognitive Behavioral Therapy for Posttraumatic Stress Disorders
Name
Institution
Date

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Schnurr, P. P., Friedman, M. J., Engel, C. C., Foa, E. B., Shea, M. T., Chow, B. K., ... & Turner,
C. (2007). Cognitive behavioral therapy for posttraumatic stress disorder in women: A
randomized controlled trial. Jama, 297(8), 820-830.
Title
The article for critique gives a detail discussion on how military women are prone to
posttraumatic stress disorder.The authors suggest that the cognitive behavioral therapy will treat
the disorder. The therapy involves changing a person’s behavior and thought that is brought by
certain traumatic event (Frost, Laska and Wampold, 2014). The title of the article is informative.
However, the authors have generalized the title to women. In the research, they categorically
dealt with military women. According to Schnurr et al (2007), posttraumatic stress is prevalent
in women who serve in the military. The title does not distinguish whether the research is on the
active-duty women or women of any occupation. Perhaps the title could be cognitive behavioral
therapy for posttraumatic stress disorder in active-duty women. However, the title
clearlyindicates the population of study which is women, posttraumatic stress disorder as the
independent variable and the cognitive behavioral therapy as the dependent variable.
Aim and the hypothesis of the study
According to the researchers, their focus was on women. studies had been previously
done on men. They indicated there is high lifetime prevalence of posttraumatic stress disorder in
women in theUS than in menserving in the military (Harvey, Bryant and Tarrer, 2003).This
indicate it is necessary for this research to be conducted. Since the study was on active-duty
women, it is expected that the ability to perform their duties is reduced. As according to Foa and
Rothbaum (2001), when the posttraumatic symptoms goes untreated they lead to depression and

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changes a person’s way of life. The major causes of this disorder being events that cause anxiety
behavior such as attack, war, assault, rape and accident, the authors focused on military women
as the population under consideration. However, these traumatic events seem to be highly
experienced by refugees, orphans and slaves (Hoge and Chard, 2018). Therefore, more research
studies should be done in women who have been exposed to these traumatic events to avoid
biasness in the results. The aim of the study was to test treatments for posttraumatic stress
disorder. According to the researchers’ cognitive behavioral therapy and medications were used
in treatment of this disorder, therefore, it was not necessary to point that the study was to test
treatment. The aim of the study is not relevant since already there is treatment for the disorder.
Perhaps the aim could be to determine the effective treatment of the posttraumatic stress
disorder. The study hypothesized that prolonged exposure therapy would be more effective than
present-centered therapy. This hypothesisis drawn from the fact that re-experiencing the trauma
through memories helps the anxiety and emotions related to the traumatic event to die off (Power
et al, 2010). the justification for the study is that, present-centered therapy, a supportive
intervention was seen to reduce the posttraumatic stress disorder but do not remove depression as
compared to cognitive process therapy (Resick et al, 2015). Normally in the cognitive therapy,
the therapist and the client are usually the main participants. As stated by Roth, Eng and
Heimberg (2002), the therapist normally does not have the answers to the client problems, but
they work together to overcome the disorder. The level of cooperation from the client highly
determine the effectiveness of the treatment (kar, 2011).
Theoretical framework
The theoretical framework of the research was not clearly identified. The authors do not
explain why military women act as the focus of the study while the title generalizes on women.

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The concept on prolonged exposure as treatment for posttraumatic stress disorder was clearly
identified by reference to other single researches where the treatment was successful. However,
the researchers do not identify why the suggested treatments were chosen over other cognitive
behavioral therapy techniques. The literature review did not cover on the effectiveness of other
cognitive behavioral therapy techniques on the treatment of PSTD. The basis of development of
the hypothesis was clearly defined by the use of the present centered theory, present centered
therapy was seen as not effective on treatment on PSTD.
Methodology
In this research, the experimental design was used. Two hundred and eighty-four
participants were enrolled.The sampling of the veterans’ location was not well elaborated.
Theresearchersdetermined the criterion of inclusion. A participant should have symptoms
severity of forty-five or higher. This severity was determined by qualified clinicians. The
participants should have been exposed to the traumatic event three months or more before the
study. The criteria of setting the duration that one should have been exposed to the traumatic
event before the study was conducted, was not indicated in the study. The criteria of inclusion
coincide with the objective for the study, to test treatments for posttraumatic stress disorders. one
hundred and forty-one were randomly exposed to the prolonged exposure therapy and one
hundred and forty-three to the present-centered therapy.Here the experimenters do not have the
right to allocate participants into groups.This provide no room of experimenter manipulation. In
the prolonged exposure therapy, the patients were educated or taught on common reactions to
trauma and they were made to remember the events they had passed through more frequently. In
the present -centered therapy the patients were told to focus on the current life problems or
difficulties and think of the problem that brings more of the trauma symptom (McDonagh,

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Friedman, McHugo, Ford, Sengupta, Mueser, Descamps, 2005). the participants were later
followed up biweekly through telephone calls. The assessment was also done on three and six
months interval. The follow up of participant during the study was an efficient method of
identifying effects of the treatment and the adverse events. However, the client may give false
information especially in phone calls (Tuerk, Yoder, Grubaugh, Myrick, Hamner&Acierno,
2011). This may compromise on the results. The design allows tighter control of the participants
and therefore making it easier to identify the causes of the anxiety behavior and the effects of the
same on the participants. Comorbid symptoms and direct exposure data were collected through
questionnaires and life checklists respectively. This ensures standardization of the questions and
help to avoid biasness. However, this method of data collection lack details and perhaps video
recording could be used to collect data during the treatment sessions. They used a seven-point
scale to rate the treatment satisfaction.
Ethical consideration
The researchers observed the research ethics. The participants were well informed about
the study and their consent to participate in the study was put into consideration. They also had a
right to leave the study at their own will. The participant treatment conditions were handled with
confidentiality and the research focused on not harming the participants but rather helping them
to overcome the anxiety behaviors.
Data analysis and Results reporting
In this study, the quantitative data from the questionnaires and checklist were analyzed by
the biostatisticians. However, the analysis methods were not clearly explained it was a mere

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description of the tools used. the researcher could provide a statement describing how reliable
and valid the results are. his may make the results unreliable. In the analysis the primary analysis
was done using all randomized participants and the secondary analysis using data from all those
who completed the study. The quantitative result indicated that averagely the participants had
been exposed to ten types of trauma. Sexual trauma being the worst trauma ever experience,
physical assault and war zone exposure following respectively. as asserted by Suris and Lind
(2008), the risk factors that exposed military women to sexual harassments included age, enlisted
rank and negative home life. Tables were well and accurately used to indicate the type of trauma
they were exposed to. In the table presentation, data appeared vague. Perhaps bar chats could be
used instead to clearly depict the differences in severity. From the result the researchers found
that there is an increased number in treatment drop out in the prolonged exposure therapy. Also,
in the prolonged exposure the participants had a tendency of losing their diagnosis than those in
the present centered therapy. However, the researcher also identifies some adverse events that
occurred to the participant. The research results however cannot be extrapolated to the other
women who don’t serve in the military. This is because of variation in environments and
frequency of exposure to these traumatic events.
Discussion
The studies indicated factors that led to the high drop out from treatment in the prolonged
exposure. However, this was not covered extensively. Lack of reference from other researchers
in their discussion makes the work to lack credibility. The drop out could have been attributed to
other factors other than fear of the participants to contain their traumatic memories (Bennett and
Nelson, 2006),which was not well covered by the researchers. The loss of diagnosis in the
prolonged exposure that was attributed to the adaptation to the anxiety behaviors through re-

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experiencing the events was not well elaborated. The inclusion of qualified clinicians in the
study could affect the results of the study. the participants lacked a supportive environment that
could be achieved by having people who they could interact with well. The researchers achieved
their hypothesis by finding that the prolonged exposure therapy was an effective method of
treating posttraumatic stress disorder. However, further research should be done to determine
whether the results applies in other women exposed to the traumatic events frequently for
instance the refugees.
Conclusion
In conclusion, the articles procedures and methodology were well elaborated and
chronologically arranged. It was easy to follow and understand. The research found that there
were significant improvements in the prolonged exposure therapy. Therefore, recommended the
adoption of the results in the military department to prevents detrimental effects of the
posttraumatic stress disorder on the active-duty women. However, the article based their
arguments more on the prolonged- exposure therapy. The study focused on its own agenda of
proving that cognitive behavioral therapy was the right treatment of posttraumatic stress
disorder. It did not give the reader room to determine which of the treatment was effective. The
study therefore may not be considered credible. Further research should be done to find whether
the prolonged exposure therapy could be effective for other disorder other than those caused by
trauma events. For instance, bulimia, management of chronic pain, coping with grief and loss,
managing anger, drug addiction and overcoming sleep disorders.

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References
Bennett, R., & Nelson, D. (2006). Cognitive behavioral therapy for fibromyalgia. Nature
Reviews Rheumatology, 2(8), 416
Foa, E. B., &Rothbaum, B. O. (2001). Treating the trauma of rape: Cognitive-behavioral
therapy for PTSD. Guilford Press.
Frost, N. D., Laska, K. M., &Wampold, B. E. (2014). The evidence for present‐centered therapy
as a treatment for posttraumatic stress disorder. Journal of Traumatic Stress, 27(1), 1-8.
Harvey, A. G., Bryant, R. A., & Tarrier, N. (2003). Cognitive behaviour therapy for
posttraumatic stress disorder. Clinical psychology review, 23(3), 501-522.
Hoge, C. W., & Chard, K. M. (2018). A Window Into the Evolution of Trauma-Focused
Psychotherapies for Posttraumatic Stress Disorder. Jama, 319(4), 343-345
Kar, N. (2011). Cognitive behavioral therapy for the treatment of post-traumatic stress disorder:
a review. Neuropsychiatric Disease and Treatment, 7, 167.
McDonagh, A., Friedman, M., McHugo, G., Ford, J., Sengupta, A., Mueser, K., ... & Descamps,
M. (2005). Randomized trial of cognitive-behavioral therapy for chronic posttraumatic
stress disorder in adult female survivors of childhood sexual abuse. Journal of consulting
and clinical psychology, 73(3), 515.
Powers, M. B., Halpern, J. M., Ferenschak, M. P., Gillihan, S. J., &Foa, E. B. (2010). A meta-
analytic review of prolonged exposure for posttraumatic stress disorder. Clinical
psychology review, 30(6), 635-641.

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Resick, P. A., Wachen, J. S., Mintz, J., Young-McCaughan, S., Roache, J. D., Borah, A. M., ... &
Peterson, A. L. (2015). A randomized clinical trial of group cognitive processing therapy
compared with group present-centered therapy for PTSD among active duty military
personnel. Journal of Consulting and Clinical Psychology, 83(6), 1058.
Roth, D. A., Eng, W., &Heimberg, R. G. (2002). Cognitive behavior therapy. Encyclopedia of
psychotherapy, 1, 451-458.
Surís, A., & Lind, L. (2008). Military sexual trauma: A review of prevalence and associated
health consequences in veterans. Trauma, Violence, & Abuse, 9(4), 250-269.
Tuerk, P. W., Yoder, M., Grubaugh, A., Myrick, H., Hamner, M., &Acierno, R. (2011).
Prolonged exposure therapy for combat-related posttraumatic stress disorder: An
examination of treatment effectiveness for veterans of the wars in Afghanistan and
Iraq. Journal of anxiety disorders, 25(3), 397-403.