Best Practice Treatment in Mental Health: Evidence Based Treatments
Best practice treatment in mental health: what are the best evidence based treatments for PTSD, bipolar disorder, and borderline personality disorder?
Consider each disorder and describe what the best overall treatment approach for that disorder is and why; what is the evidence?
Consider why these best treatment approaches for different disorders are quite different. Why are the treatment approaches different for different disorders?
Consider as to how the best treatment approach for different disorders might also have some things in common.
Best Practice Treatment in Mental Health: Evidence Based Treatments
Mental health practitioners are focused on an accelerated application of both scientific and practical knowledge in helping individuals with mental health issues to recover. One of the best practice interventions for the treatment of mental health disorders is the use of evidence-based practice (EBP) interventions (Chiang et al., 2017). Notably, according to the National Alliance on Mental Illness, EBP refers to the interventions/treatments which have been not only researched academically and scientifically but also proven effective through replication in more than one study/investigation (Dotson et al., 2014). Various EBPs can be deployed in the treatment of mental health conditions. This paper provides a discussion of the EBP treatments for post-traumatic disorder, bipolar disorder, and borderline personality disorder. Additionally, the reasons for the differences and similarities in the EBP approaches will be discussed.
Post-Traumatic Stress Disorder (PTSD)
PTSD is a mental health disorder which arises from an individual either witnessing or experiencing a terrifying event. Some of the most common symptoms of this disorder include severe anxiety, nightmares, and even flashbacks. According to Rossouw et al. (2018), although PTSD can be treated through therapies such as cognitive behavioral therapy, exposure therapy, and eye movement desensitization and reprocessing (EMDR) as well as medications such as antidepressants and antianxiety medications, the best overall treatment approach for PTSD is cognitive behavioral therapy (CBT) and in specific, prolonged exposure. More specifically, prolonged exposure is pegged on the emotional processing theory which holds that there is no emotional processing of traumatic events at the happening of an event. Dozois (2013) argues that CBT is mostly the treatment of choice for PTSD. However, a case study of Elaine (case 2) presented by Gorenstein and Comer (2015) illustrates that exposure therapy should also be incorporated. Additionally, in a single-blind randomized clinical trial done by Rossouw (2018) to examine the effects and effectiveness of prolonged exposure therapy in the treatment of adolescents with PTSD, it was found that exposure therapy is an effective treatment. Similarly, an RCT done on 38 adolescents and adults by Gilboa-Schechtman et al. (2016) established that exposure therapy not only results in a greater reduction of PTSD, but also a greater increase in global functioning.
Formerly referred to as manic depression, bipolar disorder is a mental health condition characterized by the presence of extreme mood swings as well as emotional highs such as hypomania and downs such as depression. Some of the treatment options for bipolar disorder include medications such as mood stabilizers, antidepressants, and antipsychotics. However, psychotherapy options for bipolar disorder include cognitive behavioral therapy, family-focused therapy, and interpersonal and social rhythm therapy (IPSRT). The most effective treatment approach based on evidence for the treatment of bipolar disorder is CBT. In specific, case 6 discussed by Gorenstein and Comer (2015) demonstrates that medication for bipolar is not enough unless supplemented by CBT. in a meta-analysis done by Chiang et al. (2017) to evaluate the effectiveness of CBT on the treatment of patients with bipolar disorder, it was established that CBT is effective in decreasing the relapse rates as well as the improvement of depressive symptoms. Additionally, a metanalysis done by Napierała (2017) established that; when applied to adult patients of different ages, CBT is effective in the treatment of unipolar affective disorders. In specific, in this study, CBT was found to decrease the frequency of the disorder reoccurring and a reduction in the intensity of the manic and depressive symptoms.
Borderline Personality Disorder
A borderline personality is one of the mental health conditions which alters the manner in which an individual thinks and feels about himself/herself as well as others (Napierała, 2017). Such alterations of thoughts and feelings result in dysfunctions in everyday life. Some of the characteristics of the condition include unstable and intense relationships, extreme emotions, distorted self-image, and impulsiveness. Mental health practitioners have deployed a wide range of interventions to treat borderline personality disorder. Some of these include dialectical behavior therapy (DBT), schema-focused therapy, mentalization-based therapy (MBT), and transference-focused psychotherapy. However, the evidence-based treatment for the condition is dialectical behavior therapy (DBT). The evidence for the effectiveness of this approach was supported by Choi-Kain et al. (2017) in a study based on the analysis of various RCTs and meta-analyses. The findings were that evidence-based integration of DBT, as well as exposure therapy for BPD, was effective. Additionally, Linehan et al. (2015) conducted case studies to evaluate the effectiveness of DBT in the prevention of suicidal ideations for individuals with BPD. The findings of this study were that DBT was effective in not only treating BPD but also reducing the suicidal thoughts.
Differences in Best Treatment Approaches
An examination of the best treatment approaches for the three disorders has demonstrated that the interventions are different just as they are similar. For instance, despite the three being mental health disorders, the treatment of PTSD is different from the evidence-based practice interventions for the treatment of BPD. The reason for the difference is because evidence has demonstrated that one treatment cannot be used (unless scientifically proved to be effective) in all those disorders (Dotson et al., 2014). Various studies which have been done are applied in the determination of the best treatment approach. The determination of the best approach is not pegged on theory alone but rather on the various real-life cases which have been done on the disorders. As such, the best treatment approach for each of the disorders is based on the available evidence which proves the effectiveness or otherwise of an intervention for one disorder compared to its use in others.
Similarities in Best Treatment Approaches
Despite the differences in the approaches, the best treatment approach for both PTSD and bipolar disorder has been found to be cognitive behavior therapy. As such, some of the best approaches can be shared for different mental health conditions. Considering this similarity, the reason is that some of the mental health conditions present similar symptoms and are caused by similar issues. As such, some interventions cut across different disorders. Additionally, the similarity was based on the fact that evidence has demonstrated the effectiveness of the use of CBT in the treatment of the two mental health conditions (Chiang et al., 2017). As such, the similarities are pegged on the fact that EBPs obtained from various sources such as case studies and scholarly resources has demonstrated the effectiveness of the approach when applied in different mental health conditions.
In conclusion, evidence-based practice interventions for mental health disorders are those approaches which have been scientifically tested and proven to be effective in more than one study/investigation. The best treatment approach for the treatment of PTSD was found to be cognitive behavior therapy. Similarly, bipolar was found to be best treated via the use of CBT. However, in the case of BPD, the best treatment approach was found to be DBT. The differences in the interventions were pegged on the available evidence which has demonstrated that different interventions are effective in different mental health conditions. However, the similarities in the interventions arise from the fact that studies/investigations have proved that some interventions can be effectively used in treating more than one mental health condition.
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