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CT-PTSD following a COVID-19 ICU admission in the context of unresolved grief, delirium and incurable cancer: a single case design with an older adult client

Published online by Cambridge University Press:  05 September 2023

Charlotte Peters Open the ORCID record for Charlotte Peters [Opens in a new window] ,
Kate Jenkins  and
Rachel Paskell
Charlotte Peters*
Affiliation:
Department of Psychology, University of Bath, Bath, UK
Kate Jenkins
Affiliation:
Salisbury NHS Foundation Trust, Salisbury, UK
Rachel Paskell
Affiliation:
Department of Psychology, University of Bath, Bath, UK
*
Corresponding author: Charlotte Peters; Email: cp2079@bath.ac.uk
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Abstract

This case study recounts an application of Ehlers and Clark’s (2000) cognitive model of post-traumatic stress disorder (PTSD) to post-intensive care unit (post-ICU) PTSD. An AB single case design was implemented. The referred patient, Rosalind (pseudonym), completed several psychometric measures prior to the commencement of therapy (establishing a baseline), as well as during and at the end of therapy. Idiosyncratic measures were also implemented to capture changes during specific phases of treatment. The importance of the therapeutic alliance, particularly in engendering a sense of safety, was highlighted. Findings support the use of cognitive therapy for PTSD (CT-PTSD) with an older adult, in the context of a coronavirus infectious disease (COVID-19)-related ICU admission. This case is also illustrative of the effectiveness of implementing CT-PTSD in the context of co–morbid difficulties and diagnoses of delirium, depression, and complicated grief.

Key learning aims

  1. (1) To recognise the therapeutic value of CT-PTSD in addressing PTSD following a COVID-19 admission, in the context of complicated grief and delirium.

  2. (2) To consider the importance of a strong therapeutic alliance when undertaking CT–PTSD.

  3. (3) To understand the intersection of complicated grief and delirium in the context of ICU trauma.

  4. (4) To consider the challenges in working with PTSD, whereby the target trauma (COVID–19 ICU admission) is linked with ongoing uncertainty and continuing indeterminate threat.

Keywords

CBTCOVID-19Critical careGriefHallucinationsPTSD
Type
Case Study
Information
the Cognitive Behaviour Therapist , Volume 16 , 2023 , e21
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of British Association for Behavioural and Cognitive Psychotherapies

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References

Further reading

Murray, H., & El-Leithy, S. (2022). Working with Complexity in PTSD: A Cognitive Therapy Approach. Taylor & Francis.CrossRefGoogle Scholar

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