Logic Model

Introduction
I work for the same organization where I am completing my field practicum. It is described as an “employment-based practicum” (EBP). First Step Recovery Centers are rehab centers created to help people of all ages and cultural backgrounds recover from addiction (AOD) as well as identify and treat mental health disorders (such as anxiety disorders, major depressive disorder, bipolar disorder, schizophrenia, conduct disorders, and personality disorders) using a combination of spiritual, social-cultural, and psychological therapies. I answer to First Step Recover Center’s Clinical Director, Thomas Gogolin (LPCC-S), for all matters about my employment. Both my field supervisor Danielle Ruben and task instructor Shaun Tilton are directly in charge of overseeing my practicum work.
The problem being addressed is determining whether the results of the data collected are as accurate as possible to allow for a better understanding of the individual care we are providing. This evaluation will thoroughly analyze a patient’s symptoms and other information (Brown et al., 2019). At the beginning, middle, and end of the program is when this evaluation will be conducted. A Beck Depression Inventory and a Beck Anxiety Inventory will be given to each client to gather more precise data. In the Psych/mental Health ward, we will also speak with a nurse practitioner, whose observations and comments will be documented following the consultation. Compliance notes and test outcomes are taken to pinpoint each patient’s symptoms. To draw a valid conclusion about the outcomes of each intervention, a comparison is conducted to see how effective it has been for each patient.
What I will be completing is a case-level evaluation. A case-level evaluation involves examining a specific case to understand what happened and why. This evaluation is often used to explore a particular program or intervention’s effectiveness. The project’s primary goal is to examine what interventions can be put in place to ensure that data presented on patients is as accurate as possible (Held et al., 2018). This falls under a case-level evaluation type. When conducting case-level evaluation, it is essential to consider several factors, including the client’s goals, progress made over time, and any challenges encountered. Additionally, it can be helpful to compare the progress of individual clients to the improvement of other clients who are receiving similar treatment. By considering all these factors, case-level evaluation can provide valuable insights into the effectiveness of a treatment plan.
Literature Review
The 3M method and Cognitive Processing Therapy (CPT) are the current intervention programs. A cognitive-behavioral therapy called cognitive processing therapy (CPT) is used to treat post-traumatic stress disorder (PTSD). The 3M method encourages the collaboration of clinical and mental health treatments, or “whole person care.” The effectiveness of this intervention, which was developed in the 1980s, has been demonstrated in a variety of populations, including those with PTSD or PTSD symptoms, such as military veterans, sexual violence survivors, emergency service personnel, victims of child abuse, and others (Held et al., 2018). CPT normally entails a twelve-session therapeutic intervention with fifty-minute sessions. It may be applied in group therapy, individual treatment, or both. The CPT and 3M approach is based on social cognitive theory, which aims to correct the unfavorable memories and ideas resulting from the trauma that led to PTSD (Held et al., 2018). The CPT and 3M approaches are evidence-based therapies that address cognitive biases, including those brought on by past traumas, and challenge those related to those experiences. The International Society for Traumatic Stress Studies, the Department of Veterans Affairs, and CPT/3M methods all strongly support CPT/3M as a first-line treatment for PTSD (Held et al., 2018). However, more investigation is still required to assess patients with co-occurring illnesses, such as substance addiction problems, which may impede them from participating fully in the therapeutic process, such as completing their assignments. Cognitive processing treatment begins with an educational phase in which patients are informed about PTSD and the feelings and ideas that result from their experience. The trauma’s formal evaluation is the second stage’s main emphasis. In this stage, the therapist frequently employs Socratic questioning to delve into complex topics and help the client to reconsider their experience in light of their judgments and viewpoints (Lewis et al., 2020). By doing this, the therapist can assist the client in focusing on altering their self-blame-related beliefs. The final stage concentrates on solidifying the fresh ideas from the previous stage and strengthens the concepts of security, trust, authority and control, esteem, and intimacy.
The information processing theory by P. J. Lang, and the concept of social cognition of PTSD, served as the foundation for CPT, a cognitive behavioral therapy. According to Lang’s information processing hypothesis, memories of a traumatic event trigger feelings of fear, which in turn encourage people to engage in evasive and avoidant behaviors. In other words, when stimuli that trigger thoughts of a traumatic experience are experienced, a fear network in the memory is engaged (Lewis et al., 2020). The person then tries to suppress or eliminate this anxiety, but this action usually has the unintended consequence of sustaining the fear. In order to accept this anxiety and afterward be able to view it as less potent, this theory proposes that prolonged exposure to the traumatic experience in a secure, therapeutic context is a crucial step (Lewis et al., 2020). The social cognitive model of PTSD is more comprehensive than Lang’s theory since it explains how fear networks form and other pertinent emotional reactions happen. In order to restore a feeling of control over their lives after a traumatic incident, people may have different capacities for seeing and coping with it. This theory concentrates on how individuals do this. To this view, primary emotions are the ones that arise immediately after a traumatic experience. However, secondary emotions may arise due to how the individual interprets the traumatic event (Liddell et al., 2021). For instance, the basic emotions of fear and wrath may first be felt by someone person has attacked. However, someone who feels slightly at fault for the attack could also feel secondary guilt and humiliation. People may feel less secondary feelings and negative thinking well about trauma as a consequence when they can successfully challenge inaccurate perceptions like these.
Evidence-based psychotherapies (EBPs) like mental processing therapy (CPT) and the 3M method for post-traumatic stress disorder can significantly improve health and wellbeing, healthcare use, and quality of life when they are widely implemented. Though several mental health systems (MHS) have substantially invested in initiatives to adopt EBPs, few qualified patients receive EBPs in regular care settings because clinicians do not seem to be providing many of their patients with the full treatment protocol (Liddell et al., 2021). Recent research indicates that clinical results suffer when CPT and other EBPs are applied with little fidelity. Therefore, developing plans to enhance and maintain the transmission of CPT and other EBPs is essential. Two competing approaches to promoting sustainability have been suggested in the literature. One stresses fidelity to the therapeutic regimen through increased interaction and fidelity monitoring. The other emphasizes using an information, continuous quality improvement method to enhance the fit and performance of these treatments by making the necessary adjustments to the therapy or the clinical setting (Neumeister et al., 2017). Both have not been assessed in terms of their effects on long-term implementation. Outcome metrics show that CPT generates significant clinical benefits for PTSD comparable to those seen in randomized controlled experiments when provided as part of standard clinical practice.
Several studies have shown that the CPT and 3M methods successfully treat PTSD. Although CPT was created to help rape survivors, it has been studied and successfully used in various trauma types and demographics. According to research, CPT is a successful treatment for PTSD in adult males with concomitant TBI and PTSD, veterans who participated in Vietnam, Iraq, or Afghanistan, and survivors of sexual assault. With results still holding at the 5- and 10-year post-treatment follow-up, the interventions have demonstrated clinically significant reductions in PTSD, sadness, and anxiousness in sexual harassment and Veteran populations (Resick et al., 2017). According to meta-analyses, the therapies are successful in PTSD symptoms being reduced significantly. The number of people who no longer fulfill the requirement for PTSD after therapies varies across research, much like the findings for PE. Compared to waiting, self-help book, and treatment as usual control groups, 51% more people are treated with CPT, and the 3M method eliminated PTSD diagnosis. The rates of individuals who no longer satisfy PTSD requirements ranged between 30% and 97%.
Description of the Intervention/Program under Evaluation
CPT emphasizes how the trauma has affected your cognition and instructs you to examine your thoughts to advance your recovery. Veterans, victims of sexual harassment, refugees, and other groups are among the demographics for which CPT is useful in treating PTSD. It can be provided in an individual or group style and normally comprises 12 weekly sessions. When offered individually, programs last roughly 50 to 60 minutes, but when done in a group, programs last 90 minutes. The treatment is suitable for people with a PTSD diagnosis (Resick et al., 2017). The objectives of CPT are to: first, reflect; second, gain a better understanding of PTSD; third, consider how the trauma has affected your ideas and feelings; and fourth, lessen avoidance and issues with feeling happy. Second, redefine; develop critical thinking abilities; and consider different perspectives on the trauma, oneself, and the wider environment. The final steps are to recover, ease trauma-related discomfort, lessen anxiety, anger, guilt, and shame, and improve day-to-day functioning.
CPT helps persons receiving treatment address and alter uncomfortable ideas brought on by trauma. It consists of 12 sessions and normally lasts three months. This strategy comprises four elements (Riedel et al., 2021). The first discussion will involve the client and therapist discussing their specific PTSD symptoms. The psychologist will then provide knowledge and training about this symptomatology, other PTSD symptoms, how people react to trauma, the fundamentals of cognitivism, how allows the implementation of CPT might continue, and other topics related to PTSD well as PTSD diagnoses in general. Patients can next ask questions and compose an adverse inference, a brief essay describing how their encounters may have affected their perceptions of themselves, others, such as their spouses or family, and the wider world (Riedel et al., 2021). After treatment starts, patients seek to comprehend their assumptions about how to feel after a traumatic occurrence, often growing more conscious of their sensations and thoughts in the process. Therapists assist persons receiving treatment in sharing a thorough narrative of the traumatic experience to accomplish this goal. A therapist might begin confronting self-blame beliefs and other perceptions that have led to feelings of being “locked” or “trapped” through Socratic inquiry. People receiving treatment frequently succeed in learning how to confront and examine their thoughts as therapy sessions go on (Riedel et al., 2021). Worksheets or other work samples that assist the development of particular skills for identifying harmful thought patterns and confronting one’s ideas are frequently given as homework by therapists. Therapists assist clients in understanding how ideologies can alter due to trauma throughout the later phases of CPT, which typically last from sessions 8 to 12. They do this by examining and emphasizing ideas about safety, ego, interpersonal partners, power, authority, and trust.
Many different populations, notably veterans, survivors of sexual assault, and refugees, respond well to CPT when treating PTSD. It is frequently presented in a 12-week schedule and available individually and in groups (Sloan et al., 2018). Sessions are provided individually for 50 to 60 minutes and in groups for 90 minutes. The treatment is suitable for those who have been diagnosed with PTSD.
Logic Model & Hypotheses
Increased utilization of CPT for PTSD inside the MHS and an increase in the number of trauma specialists with CPT training inside MHS clinics are the intermediate goals. The long-term objective is to increase the MHS’s utilization of evidence-based methods and to improve patient outcomes.
CPT is a successful treatment choice for those with depression symptoms brought on by physical and sexual violence as well as interpersonal victimization, to put it simply. Additionally, it is employed in treating post-traumatic stress disorder (PTSD), a condition typically brought on by exposure to stressful events like accidents, violent acts, and other incidents (Sloan et al., 2018). This intervention emphasizes the relationships between bodily sensory experiences, feelings, opinions, and emotions; as a result, it has undergone testing and is effective in easing the trauma caused by domestic violence. Recognizing how stressful events affect thoughts and attitudes is crucial to the intervention.

 
References
Brown, C., Stoffel, V. C., & Munoz, J. (2019). Occupational therapy in mental health: A vision for participation. FA Davis.
Held, P., Klassen, B. J., Brennan, M. B., & Zalta, A. K. (2018). Using prolonged exposure and cognitive processing therapy to treat veterans with moral injury-based PTSD: Two case examples. Cognitive and behavioral practice, 25(3), 377-390.
Lewis, C., Roberts, N. P., Andrew, M., Starling, E., & Bisson, J. I. (2020). Psychological therapies for post-traumatic stress disorder in adults: Systematic review and meta-analysis. European journal of psychotraumatology, 11(1), 1729633.
Liddell, B. J., Malhi, G. S., Felmingham, K. L., Den, M. L., Das, P., Outhred, T., … & Bryant, R. A. (2021). Activating the attachment system modulates neural responses to threats in refugees with PTSD. Social cognitive and affective neuroscience, 16(12), 1244–1255.
Neumeister, P., Feldker, K., Heitmann, C. Y., Helmich, R., Gathmann, B., Becker, M. P., & Straube, T. (2017). Interpersonal violence in posttraumatic women: brain networks triggered by trauma-related pictures. Social cognitive and affective neuroscience, 12(4), 555-568.
Resick, P. A., Wachen, J. S., Dondanville, K. A., Pruiksma, K. E., Yarvis, J. S., Peterson, A. L., … & STRONG STAR Consortium. (2017). Effect of group vs. individual cognitive processing therapy in active-duty military seeking treatment for posttraumatic stress disorder: A randomized clinical trial. JAMA psychiatry, 74(1), 28-36.
Riedel, B., Horen, S. R., Reynolds, A., & Hamidian Jahromi, A. (2021). Mental health disorders in nurses during the COVID-19 Pandemic: implications and coping strategies. Frontiers in public health, 1597.
Sloan, D. M., Marx, B. P., Lee, D. J., & Resick, P. A. (2018). A brief exposure-based treatment vs. cognitive processing therapy for posttraumatic stress disorder: A randomized noninferiority clinical trial. JAMA psychiatry, 75(3), 233-239.