Supporting Martin’s Mental Health: Assessments and Interventions.Martin is a 38-year-old Mexican-American man who is a sergeant in the United States Army. He recently returned from Iraq with a purple heart for leg wounds sustained during an enemy attack. Some of his patrol were killed.
QUESTION
Martin is a 38-year-old Mexican-American man who is a sergeant in the United States Army. He recently returned from Iraq with a purple heart for leg wounds sustained during an enemy attack. Some of his patrol were killed. He is despondent over the prognosis that his injuries will prevent him from continuing with combat duties. Rehabilitation to regain normal use of his leg will take many months. He feels survivor’s guilt and grief at the loss of his best friend during the enemy attack. His wife of 18 years and teenage son and daughter are relieved to have him alive and home, but are confused as to how to help him. He repeatedly states that he “shouldn’t be here. Isaac was a much better soldier than me. I don’t deserve to live.” No matter what they do, he continues to be depressed and have flashbacks.
Questions:
1. Would you complete a suicide assessment with Martin? Why? Why not? What are the risk and protective factors that might have a bearing on this assessment. What safety measures might be needed?
2. Would you perform a trauma screening? Why or why not? What are some possible symptoms that might emerge as indicators of trauma arousal?
3. What relationship assessments might provide insight into the quality of his family relationships?
4. What family therapy interventions would you suggest for this case? How would you integrate these with trauma and grief issues?
The case assignment should be 5 – 8 pages double spaced, with headings for each of these questions and a reference list.
ANSWER
Supporting Martin’s Mental Health: Assessments and Interventions
Introduction
In this case analysis, we will examine the situation of Martin, a Mexican-American sergeant in the United States Army who is experiencing emotional distress following his return from Iraq. Martin’s injuries, survivor’s guilt, and grief have led to symptoms of depression, flashbacks, and a belief that he does not deserve to live. We will address important considerations in assessing his risk for suicide, the potential for trauma, the dynamics of his family relationships, and appropriate family therapy interventions to support his healing process.
Suicide Assessment
Given Martin’s statements about not deserving to live and his depressive symptoms, it is crucial to complete a suicide assessment. Risk factors for suicide in this case include Martin’s sense of guilt, the loss of his best friend, and his despondency over his prognosis. Protective factors may include the support of his family and their relief at his return. Safety measures should be implemented, such as ensuring that Martin does not have access to firearms or other lethal means, and establishing a crisis plan with emergency contact information.
Trauma Screening
Performing a trauma screening is essential in this case, as Martin has experienced a significant traumatic event during his military service. Symptoms that might emerge as indicators of trauma arousal include flashbacks, intrusive memories, nightmares, hyperarousal, and avoidance of trauma-related stimuli. A trauma screening will help identify the extent to which Martin may be experiencing post-traumatic stress symptoms and inform the treatment approach.
Relationship Assessments
Several relationship assessments can provide insight into the quality of Martin’s family relationships. The therapist may consider utilizing the Family Assessment Device (FAD) or the Family Adaptability and Cohesion Evaluation Scale (FACES). These assessments can provide a comprehensive understanding of communication patterns, adaptability, cohesion, and overall functioning within the family system. Assessing the family dynamics will help identify areas that may require attention and inform appropriate interventions.
Family Therapy Interventions
In addressing Martin’s trauma and grief issues within the context of family therapy, several interventions may be suggested:
Psychoeducation: Providing information about trauma, grief, and the impact of military experiences can help Martin and his family understand his symptoms and normalize their responses. This can reduce blame and enhance empathy.
Communication Skills Training: Teaching effective communication skills within the family can foster open dialogue, understanding, and emotional support. This can help family members express their concerns, validate Martin’s experiences, and promote healing.
Trauma-Focused Therapy: Integrating trauma-focused interventions, such as Cognitive-Behavioral Therapy (CBT) or Eye Movement Desensitization and Reprocessing (EMDR), can help Martin process and reframe his traumatic experiences, manage distressing symptoms, and develop coping strategies.
Grief Counseling: Incorporating grief counseling techniques, such as creating a safe space for sharing memories and emotions, exploring the impact of loss on family dynamics, and facilitating the grieving process, can support Martin and his family in their journey towards healing.
Conclusion
Assessing and addressing Martin’s mental health requires a comprehensive approach that considers suicide risk, trauma symptoms, family dynamics, and appropriate interventions. Completing a suicide assessment, trauma screening, and relationship assessments will inform the treatment plan. Family therapy interventions that integrate trauma and grief issues can help Martin and his family navigate their challenges, foster healing, and promote resilience. By providing a supportive and empathetic environment, the therapeutic process can aid Martin in reclaiming his sense of self-worth and rebuilding his life post-deployment.
